SMA Services, Inc. - Quick Quote

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SMA Services, Inc. Subsidiary:
SOMED Financial, LLC

Insurance Products

Quick Quote

Please provide me a quick quote on the following types of coverages:

*Name:
*Address:
*City:
*State:
*Zip:
*Country:
*Birth Date:
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Office Fax:

Term Life
Physician coverage available in $50,000 increments from $50,000 to $1,000,000 then multiples of $250,000 up to $2,000,000. Spouse coverage is one-half member coverage with a maximum of $500,000 in increments of $25,000. Dependent coverage of $7,500 is available for children under age 20.
State Benefit Desired:	$ Member
	$ Spouse
	$ Child
Outsource Life
up to $5,000,000
State Benefit Desired:	$ Member
	$ Spouse
	$ Child
Impaired Risk
up to $5,000,000
State Benefit Desired:	$ Member
	$ Spouse
	$ Child
Accidental Death & Dismemberment
Physician coverage available in $50,000 increments from $50,000 to $1,000,000 then multiples of $250,000 up to $2,000,000. Spouse coverage is one-half member coverage with a maximum of $500,000 in increments of $25,000.>
State Benefit Desired:	$ Member
	$ Spouse
Long Term Disability
Available in $500 increments from $2,000 to $15,000
Total monthly income earned BEFORE taxes:	$
Waiting Periods:	30 days 60 days 90 days 180 days
State monthly benefit desired:	$
Short Term Disability
Available in $100 increments from $500
Total monthly income earned BEFORE taxes:	$
	Option 1 (15/15/75)
	Option 2 (15/15/165)
	Option 3 (30/30/60)
	Option 4 (30/30/150)
Benefit desired:	$
NOTE: The Southern Medical Association sponsored group disability income policy coordinates with social security as well as other individual, group or franchise coverage. Please be advised benefits offered by this policy may not be payable or may be greatly reduced if social security, individual or other group or franchise coverage is in force. Please be sure to discuss with a representative the coordination between Long Term Disability and Short Term Disability.
Health Insurance
NOTE: When applying for health coverage you must also apply for or already have in force, the minimum amount of Term Life ($50,000) through the Southern Medical Association sponsored Insurance Program administered by SMA Services, Inc.
Choose from the following:
Open Access Plus: Physicians' Courtesy Plan:	$1,000 Deductible $3,000 Deductible $5,000 Deductible $1,000 Deductible $1,500 Deductible
Dental
Coverage Desired:	Member Only Member & Spouse Member & Child(ren) Member & Family
Hospital Indemnity
Coverage Desired:	Member Only Member & Spouse Member & Child(ren) Member & Family