How to Apply

"Ok, I'm ready to apply for coverage....what now?"

To begin the initial process of applying for your desired coverage, please open the attached file below. This form is a fillable PDF and only takes a few minutes to fill out. The majority of the questions included are "yes" and "no" questions that simply require a check mark. Some of these questions may not relate to your specific business model but are required to be answered during the underwriting process. Once the initial application is completed, we can refine your specific risk and work with you to complete the remaining documentation required to finish your proposal.

Prior to returning to us, please confirm all fields have been answered to the best of your ability. If you would like one on one assistance while you are filling in this form, please contact our offfice and one of our associates will be happy to schedule a time to assist you.

Initial New Business Fillable PDF Form

Please return all completed forms to:
This e-mail address is being protected from spambots. You need JavaScript enabled to view it.
-or-
Fax: (864) 751-6333

For individual health quotes in South Carolina:
Instant SC Individual health quoting site

Disclaimer: No coverage will be placed or afforded based on this application. This form will be used to help us better understand your business and to gather the initial requirements needed to apply for coverage.