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Leland T. Proshek
EA, CBC, CRPC


7952 Secor Rd.
Lambertville, MI. 48144
(734) 847-6777
www.Insured4Life.com
  Employers / Group Health

At Chart Advisors, we understand the unique needs of Southern Michigan and Northwest Ohio employers in search of the right group health insurance policy. From our office in Lambertville, we scour through various health insurance providers to find you the best coverage at the lowest cost.

Finding the perfect policy for you and your employees should be without hassle! For more information about our employer/group health insurance policies, please complete the short questionnaire below and click the send button. Afterward, Leland T. Proshek will contact you to speak with you personally about the information you have requested.

Group Health Insurance Health Form
Complete the form below now or print a blank form to fax later by clicking here.
Use your TAB key to move quickly between fields.

Company Name: Contact Name:
Street Address: Area code: ( )   Phone:
City:   State:   Zip: Area code: ( )   Fax:
           
Employee Name Gender Age Spouses Age # of Children Health Issues & Medications
#1:


           
#2:
           
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#7:
           
#8:
           
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#10:
           

Current Health Insurance Company:
Deductable:  $
Co-insurance:
Maximum Co-insurance:
Monthly Premium: $

Other Employees Not Listed Above:

Additional information:



 







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Due to various state regulations and registration requirements concerning the dissemination of information regarding insurance or investment advice, products and services. We are currently required to limit access of the following pages to individuals residing in states where we are currently registered or licensed.

We hold a securities license or are registered as an Investment Advisor Representative in the following states: (OH) Ohio, (MI) Michigan, (IL) Illinois, (NM) New Mexico, (TX) Texas. All securities are offered through Sigma Financial Corporation. Member FINRA/SIPC.  Investment Advisory Services are offered through Sigma Planning Corporation a Registered Investment Advisor.

Leland T. Proshek is licensed to sell insurance in the following states: (OH) Ohio, (MI) Michigan, (IL) Illinois. By entering this site, I acknowledge that I am a resident of one of the states listed above.