Get Started with us!

For employers and benefit advisers exploring ArmadaCare solutions, this is the place to request a proposal. Share a few key details below, and our team will guide you through the next steps.

What you’ll need before submitting

Start your proposal request:

Please have your company information, census (DOB, gender, zip code and enrollment tier) as well as primary plan details and summary of benefits ready before submitting. This information is needed for any employees you want quoted on an ArmadaCare plan.

Not sure which ArmadaCare solution is the best fit? Our team can help guide you in the right direction.

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Comments

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Your basic Information

Name*

First Last

Email*

Business email addresses only

Phone number*

I am a….*

Company general information

Company name*

Address*

City*

State*

Zip Code*

Number of full-time employees*

Please enter a number greater than or equal to 0.

Number of employees to enroll*

Please enter a number greater than or equal to 0.

Website*

Industry

Company primary contact information

Name*

First Last

Title*

Email*

Phone

Company primary contact information

Fill this out only if you are not the primary contact.

Name

First Last

Title*

Email*

Phone

Broker contact information

Fill this out only if your company uses a broker.

Name

First Last

Email*

Phone

Agency

Desired new plan information

Primary renewal month*

Effective coverage date*

Deliver quote to

Current Plan Information

Underlying base plan carrier(s)*

Dental plan carrier(s)

Vision plan carrier(s)

Documents

Please upload primary medical plan summaries and census that includes DOB, gender, zip code and enrollment tier for any employees you want quoted for ArmadaCare plans. If you have multiple files to upload, please zip them first before uploading.

Note: If an employee has a Waiver or Medicare, please indicate W for Waiver Plan (Spouse’s Plan or Retiree Plan) or M for Medicare and a Supplement.

Waiver Plans: Coverage can be extended to employees waiving the policyholder’s primary medical plan(s) if they have alternate qualifying primary health coverage, as long as the number of waivers does not exceed 33% of the employees enrolled. Those employees (and their dependent tiers) should be included in the census and SBC for all waiver plan(s) provided. Employees who are only on Medicare will be required to provide evidence of enrollment in Medicare parts A, B and a supplemental plan with Part D.

Questions? Call 1.800.481.3380

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Max. file size: 300 MB.