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Wellpath Coventry One Wellpath Coventry One
There is a new plan in town from Wellpath called Coventry One. They have rates 15% - 25% lower as well as $15 Doctor Copayment choices.

UHC Golden Rule United HealthCare Golden Rule"
Have you been rated too high? We offer affordable quality health insurance for individuals and families including Low Copay plans for RX and Doctor visits.

term life insurance Most of our clients are able to buy $250,000 Term Life Insurance for only $7.09 per month! (example - male age 25; N/S, 10 Yr. Term)

  Look at these Rate Examples:

  • 34 year old Male, non-smoker. $250,000 coverage.     ONLY $9.41 per month!

     
  • Single Female, 49 year old; $500,000 coverage.     ONLY $33.25 per month!

     
  • 45 year old Male, non smoker. $500,000 coverage.     ONLY $26.25 per month!

    » GET YOUR QUOTE NOW!

    		•

    On-Line Personal Health & Other
    Insurance Quotation Form
    One Simple Form - takes only 2-3 Minutes!

    Your Personal Data

    Your Name:
    Street Address:
    City:
    State: (Must be North Carolina)
    Zip Code:
    E-Mail (REQUIRED):
    E-Mail again for accuracy:
    Phone (REQUIRED):
    Fax (optional):
     
    Marital Status:
    Single Married
    		Gender:
    Male Female
     
    Type of Health Insurance
    you have currently?
     
    Select ALL the Coverage
    Options You'd Like Us
    to Quote for you:
    		 Health Plan
    Dental
    HSA (Health Savings Account)
    Short Term Health Option
    Disability Income
    Critical Illness

    UNDERWRITING INFORMATION
     
    Insured Name: Birthdate:
    Insured Height: Insured Weight:
    Spouse's Name: Spouse's Birthdate:
    Spouse's Height: Spouse's Weight: (M/F):
     
    Include Spouse?: Yes No Include    
    Children?:    		 Yes No
     
    List children's names,
    (first & last), their
    relationship to you,
    and birthdates:
    (up to 6 children)    		 Name/Rel.:B-Date: M/F:
    Name/Rel.:B-Date: M/F:
    Name/Rel.:B-Date: M/F:
    Name/Rel.:B-Date: M/F:
    Name/Rel.:B-Date: M/F:
    Name/Rel.:B-Date: M/F:
     
    Be as specific as you can on the underwriting questions below so we may find the most competitive product for you!

    Does any family member living in the household use or has used any tobacco products? (if yes, give dates and details below).
    Yes   No

    Describe usage (cigarettes,cigar,
    pipe, chew, etc... and how long.)  

     
    Any Pre-existing Health Conditions?
    		 (If yes, descibe in detail, and to which of the insured persons they apply.)
     
    Any Covered Persons Currently Taking Medication of Any Kind?
    		 (If yes, descibe in detail, and to which of the insured persons they apply.)

    COVERAGE INFORMATION
     
    Are You Looking for Coverage for more than 6 months?
     
    What Deductible Are You Interested In?
    ($250, $500, $1000, $2000 etc.):
     
    Any special coverages needed?
    (Maternity, H.M.O., P.P.O., etc.)
     
    If you're looking to reduce premium cost, and want information on the NEW HSA (Health Savings Plans), check the HSA box here and we'll include information. Please Include HSA Information
     
    Tell Us What You Want MOST
    in your Health Plan, or any
    other plan selected; Or,
    list any other Remarks here:

    Please ENTER the captcha code on the right to prevent our forms from being spammed. Thank you!

    Send my quotation via: E-Mail Fax
    Regular Mail
    Call me by Phone!

    Thank you for filling out this form COMPLETELY!

    We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

    Yes, I Agree. Please Send Me My
    Health Insurance Quote NOW!



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    Legacy Planning & Insurance Services has made purchasing North Carolina individual health insurance and medical insurance EASY. We have developed a website where anyone can find, compare, then purchase Individual Health Insurance, Short-term Health Insurance, Health Savings Accounts (HSA's), Life Insurance Plans, Plans for the uninsurable, Maternity coverage , Disability coverage and other medical benefit plans for the state of North Carolina.

    We provide you access to the nations strongest health insurance carriers to find you the best value on health insurance, and allow you to save money on your individual health insurance through A Rated carriers and approved health insurance providers. Get a free quote on your health insurance today! Should you have any questions about our products or our website, contact us at: info@nchealthinsuranceplan.com.

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