Providers & Forms
We offer several helalth plans and product offerings for your specific business or personal needs. Below is an overview of the products and carriers that we underwrite.

We conveniently provide you with forms and applications that you can download and print. You can do this by right mouse clicking on the specific form below and select "Save Target As", then choose where on your computer that you want to save the file. After the download is complete, double click on the file and open in Acrobat Reader. Print and complete the form, then submit it to us via fax, email or mail.

National Benefits Group
Fast Quote Form
Group Application
Agent of Record Change Form
Medical Savings Plan
Medical Savings Plan
Dental, Eyewear, and Prescription Savings
http://www.medicalsavingsplan.com
Guaranteed savings on prescription drugs, accidental death, eyewear, hearing services, dental care, accident coverage, air medical transportation, and chiropractic. Easy to use benefits:
• NO Waiting Periods for Coverage
• NO Deductibles (except for Accident)
• Absolutely No Claim Forms to File (except for Accident)
• NO Exclusion of a Pre-Existing Condition
• NO Health Restrictions
• NO Dollar Limits
• NO Turn Downs/Everyone Issued.
Fidelity Security Life
Fidelity Security Life
Traditional Dental Coverage
http://www.medicalsavingsplan.com
This is not a discount plan but a real Dental Insurance Policy:
A rundown of benefits Include:
• There is no PPO Provider list use your current family dentist
• There is a onetime 35.00 deductible for the life of the policy then 100% Pay on Class A procedures
• Class A procedures (Cleanings, Fluoride treatments, & Exams have no waiting period
• Plan pays 80% on class b procedures after only a 6 month wait
• This plan offers the most competitive price with the best benefits in the Dental insurance industry
• Easy to read brochure and application
Brochures & Forms
Brochure
Application
American Community
American Community
Health Insurance for Individuals and Families
http://www.american-community.com - American Community Online Application
Designed with convenience and affordability in mind, the American Community Medalist plan is an economical Preferred Provider Organization (PPO) plan that features coverage that fits a variety of needs. You are able to choose from a Maternity option, Dental benefit option and Doctor Office Visit Copay. The sensible benefit structure is intended to minimize your out-of-pocket expenses while maximizing your coverage by utilizing the PPO network, use of generic drugs when available, and eliminating costly emergency room visits. You can design your health plan to meet your needs and fit your budget with five deductible choices, two benefit percentage selections, and three benefit options (as listed above). Please contact your agent today for more details about the Medalist plan. 
Brochures & Forms
Application - Missouri
Application - Illinois
Brochure - Medalist PPO
Application - Medalist PPO - Illinois
Brochure - Community Med HSA
Application - Community Med HSA - Illinois
UniCare
UniCare
Individual and Family Medical Plans
http://www.unicare.com - Uni-Care Online Application
If you’re ready for "A Healthy Dose of InnovationSM", then you’re ready to choose UniCare. Our vision for health benefits helps individuals move in control of their health and financial future. How? By providing affordable plans that offer products and services for all stages of life, not just for sickness. While everyone’s needs are different, everyone needs quality, affordable health insurance benefits. That’s what you can count on with UniCare. Whether you need health insurance for yourself, your family or your employees, UniCare is ready to help.
Brochures & Forms
Application - Illinois
30 Day Health History
Short Term
Assurant Health
Fortis/Assurant Health
Health Plans for Individuals and Families
http://www.assurantdirect.com - Assurant Online Application
Formerly Fortis , Now Assurant Health. A unique health insurance company that caters to individuals who choose to live life on their own terms. At Assurant Health, we celebrate independent spirits. And we've provided customized health coverage for them and for their families for more than 110 years. If you're out on your own and you need health insurance, call and let us put together a plan designed to work with yours.
Brochures & Forms
Application - Missouri
Application - Illinois
Application - HSA
Application - Preferred - Missouri
Application - Preferred - Tennessee
Blue Cross/Blue Shield
Blue Cross/Blue Shield - AllianceChoice
Individual Health Plan
http://www.bcbsmo.com/products/AllianceChoice.shtml - BC/BS Online Application
AllianceChoice is designed for people in the St. Louis metropolitan area who want the freedom to choose their health care provider but still want a higher level of benefits, including preventive care. When you use network physicians, you pay only a copay for each office visit. You will get higher benefits when you use network providers, but you still get substantial benefits if you use non-network physicians and hospitals.
Brochures & Forms
Application - Individual - Missouri
Application - Employer - Missouri
Application - Group - Missouri
Application - PPO Employee - Missouri
Mutual of Omaha
Mutual of Omaha Insurance Company
Critical Illness Insurance
http://www.mutualofomaha.com
Critical Illness Insurance helps you cover the indirect costs of suffering a serious illness like life-threatening cancer, stroke, heart attack or major organ transplant with money you can use for anything you need. Critical illness insurance provides money when you need it most, upon diagnosis (as defined by the policy). It can free you from worrying about finances, letting you focus on getting well.
Brochures & Forms
MED Sup Brochure (MO)
MED Sup Outline of coverage
Med Sup App. (MO)
Med. Sup. Replace Form
United Health Care
United Health Care
Insurance for Small Businesses
http://www.uhc.com
United Health Care offers a wide range of traditional plan designs paired with a spectrum of innovative, consumer-directed options. You'll find the right mix for your unique needs, consistent across all funding types and your geographic location.A simplified, comprehensive plan for you and your employees.
Golden Rule
Golden Rule
Health insurance available only to members of FACT
http://www.goldenrule.com - Golden Rule Online Application
Golden Rule offers individuals a choice of three types of health insurance plans: 1) Health Savings Account (HSA) Plans are an excellent choice for individuals and families who want to control their health insurance costs by combining a lower cost high deductible insurance plan with a tax advantaged savings account and network discounts. 2) High Deductible Plans may be ideal for those willing to take additional responsibility for routine health care expenses in exchange for lower premiums. 3) Copay Plans are designed for individuals and families who prefer the convenience of copay benefits for routine health care expenses.
Brochures & Forms
Brochure
Application - Missouri
Application - Illinois
GR HSA Insert
Essential Choice
Essential Choice
Health Insurance Benefits Solutions
No Website Listed
The Essential Choice plans offer selection and flexibility through easy to understand plans. Consumers may choose from a variety of options, customizing coverage for thier specific needs. Multiple networks to choose from. A variety of copay and deductable options. On the job protection.
World Insurance Company
World Insurance Company
Affordable, quality individual health insurance products and services
http://www.worldinsco.com
WorldCare Flex Advantage Major Medical
HDHP/HD Advantage
WorldCare Flex Advantage Limited
WorldCare Value Advantage
Short Term Major Medical
Individual Dental
Brochures & Forms
Application - Missouri
Brochure - Flex Advantage - Missouri
Application - Illinois
Brochure - Value Advantage
Brochure - Advantage Portfolio - Illinois