Online Group Benefits Quote for Small Businesses

Instant Online Quote!

Use the form below to generate an instant online quote for group benefits for your small business of 5 or less employees. Simply fill out the details below and your quote will be emailed to the address you’ve provided. Note: If you do not wish to use your employee’s real names, use their ID#’s or another identifier you’ll recognize instead.

Your Contact Information
Company Name*
Your Name*
Phone*
Email*
Enter Email Confirm Email
Province*
Number of Employees*
You can insure up to 5 employees with the 1two3 plan.
Employee #1
Employee Name or ID#*
Date of Birth*
Status*
* Choose waived if the employee is already covered by another benefit plan (e.g. through a spouse/etc.)
Annual Income*
Employee #2
Employee Name or ID#*
Date of Birth*
Status*
* Choose waived if the employee is already covered by another benefit plan (e.g. through a spouse/etc.)
Annual Income*
Employee #3
Employee Name or ID#*
Date of Birth*
Status*
* Choose waived if the employee is already covered by another benefit plan (e.g. through a spouse/etc.)
Annual Income*
Employee #4
Employee Name or ID#*
Date of Birth*
Status*
* Choose waived if the employee is already covered by another benefit plan (e.g. through a spouse/etc.)
Annual Income*
Employee #5
Employee Name or ID#*
Date of Birth*
Status*
* Choose waived if the employee is already covered by another benefit plan (e.g. through a spouse/etc.)
Annual Income*
Confirmation
Please check the box below to help us prevent spam submissions

Contact

Phone: 780-830-1130
Toll Free: 1-877-855-1130
Fax: 780-830-1133
Email Jim
Email Christy
Email Jeremy
Email Kevin

Address

Suite 111, 8716 – 108 Street
Grande Prairie, AB
T8V 4C7

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Hours of Operation

Mon–Fri: 8:30–12:00, 1:00–4:30
Saturday: By Appointment Only
Sunday: Closed

Instant Online Quote!

Your Contact Information

Employee #1

Employee #2

Employee #3

Employee #4

Employee #5

Confirmation

Contact

Address

Hours of Operation