Providing Insurance Quotes for Individuals, Families, and Businesses in Ohio
Home About Us
  The Statz and Associates Team
  Our Location
  Individual and Family Health Insurance Quotes for Ohio Residents
  Insurance Services We Offer for Individuals and Families
  Business Insurance Services
  Quoting Forms for A Medically Underwritten Quote
  Primary Insurance Carriers
  Free Information for Uninsurable Diabetics
  Featured Links
  Tell A Friend
  Agent Needed Documents
  Health Care Reform Information
Learning Center
  Articles
  Calculators
  Newsletters
  E-Seminars
  iMoney
  Glossary
  Tax Library
Market Watch
  Detailed Quote
  Symbol Lookup
  Multi Quote
  Markets at a Glance
  Charting
  Portfolio
Request A Quote
  Annuity
  Long-Term Care Insurance
  Group Health
  Life Insurance
  Individual Health
  Disability Insurance
  401(k) Information Request
  Information Request
Contact Us

Agent Needed Documents

 

 Statz and Associates Forms:

Individual Applications and Forms:

Individual Quote Request Fill-In Form

Individual Quote Request Paper Form

Group Forms: 

 Agent Change of Record Form Please have client fill in carrier, policy number, effective date, and have group controller or president sign the letter on Company Letterhead

Terminate Employee from Group Form

Terminate Dependent from Employee Policy Form

Terminate Group Policy

Terminate Individual Coverage Form

Small Group Quoting Checklist

Health Questionnaire for 2- 50 Lives

Small Group Submission Checklist

Large Group Quoting Checklist

Large Group Health Questionnaire

Employer Risk Assesment

Shock Claim Form

 

 

 

 

About Us

  • The Statz and Associates Team
  • Our Location
  • Individual and Family Health Insurance Quotes for Ohio Residents
  • Insurance Services We Offer for Individuals and Families
  • Business Insurance Services
  • Quoting Forms for A Medically Underwritten Quote
  • Primary Insurance Carriers
  • Free Information for Uninsurable Diabetics
  • Featured Links
  • Tell A Friend
  • Agent Needed Documents
  • Health Care Reform Information
Contact Us

Providing Insurance Quotes for Individuals, Families, and Businesses in Ohio

Please call to set up appointment at (440) 546-8330
Brecksville, OH 44141

Phone: (440) 546-8330; (800) 788-0440
Fax: (440) 546-8333

Saquotepage@msn.com
Map and Directions


Statz and Associates has always been committed to protecting the information you share with us and is required by law to maintain the privacy of your protected health information by HIPPA. Statz and Associates holds its employees and consultants to strict policies and procedures protecting your information.  All employees must sign confidentiality agreements.