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Upcoming Events: Seminar Schedule

Workers' Compensation & Safety Management Seminar- NORTH RIDGEVILLE
Thursday, June 12, 2025 - 11am-1:30pm
Ridgefield Recreation Center
Forklift Safety Training & Certification for Dealership Employees
Wednesday, May 28, 2025 - 9:00am-12:00pm
Spitzer Ford Cuyahoga Falls
SAFE: $0; GCADA Members: $50; Non-Member: $100
Workers' Compensation & Safety Management Seminar- CUYAHOGA FALLS
Tuesday, May 20, 2025 - 9am-11:30am
Sheraton Suites Cuyahoga Falls
Space is limited
Workers' Compensation & Safety Management Seminar - BOARDMAN
Thursday, May 15, 2025 - 11am-1:30pm
Holiday Inn Boardman
Space is limited
Workers' Compensation & Safety Management Seminar - INDEPENDENCE
Tuesday, May 13, 2025 - 9am-11:30am
Holiday Inn Indepenence
Space is limited

Group Insurance Quote Form

Please complete the following information and click the "submit" button.

Contact Information:
    Dealer Name
    Person
    Requesting
    Address
    City, ST, ZIP   
    Phone
    Fax
    E-mail Address

Indicate number of employees only, covered in each category:
    Single
    Employee & Spouse
    Employee & Children
    Family
    COBRA
    Total employees currently covered
 
    COBRA eligible, not yet covered
    Emplyees eligible,
    not currently covered
    Total emplyees eligible for coverage

Current Policy Information:
    Current Group Health Carrier
    Date policy expires
  Employee Emp & Sp Emp & Child/ren Family
    Current Rates:
    Renewal rates if available:

Prior Policy Information:
    Prior Group Health Carrier
    Date coverage expired
  Employee Emp & Sp Emp & Child/ren Family
    Prior Rates:

    Are you aware of any serious medical conditions, such as cancer, heart, circulatory
    conditions, etc.? If so, please describe below:
    

Current coverage information:


In-network
Out of network
    Deductibles
    Co-insurance
    Out of pocket maximums

Prescription co-pays:
    Generic   
    Name Brand   
    Non Preferred