Please send all quote requests to rbgjaxquote@rogersbenefit.com or fax to 904-346-0555.

  

   Employer: Name, Address, Industry/SIC code, Current carrier, Requested effective date, Total # of 

                     Employees, # of Eligible Employees, etc.

 

   Employee: Name (Preferred but not required), Date of birth (or Age), Gender, Zip code, Coverage   

                      Election*You must have at least 4 enrolling to obtain a quote

 

-Quote Request Medical / Dental 

-Quote Request Principal Non Meds 

 

 

For all Large Group quotes we must have a census in Microsoft Excel, along with information forms you may download by clicking the appropriate carrier:

   BCBS

   Aetna