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Green Mountain Financial Services Inc.

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Free Group Benefits Quote

GREEN MOUNTAIN FINANCIAL SERVICES INC.

Get a Free Group Benefits Quote

1. Company Details:

Company Name: *

Contact Person: *

Address: *

City: *

Province: *

Postal: *

Phone: *

Email: *

Website:

Type of Business:

Number of years in Operation: :

DO YOU CURRENTLY HAVE BENEFITS PLAN IN PLACE?

YES

NO

2. Number of Employees:

Total:

Full Time:

Part Time:

3. Current or Previous Coverage (if applicable):

Do you currently have a Group Benefits Plan?

YES

NO

If Yes, who is your current provider?

Renewal Date of Current Plan:

How long have you had this plan?

4. Benefits You Are Interested In

Please check all that apply

Health Coverage (e.g. , prescription drugs, paramedical services)

Dental Coverage (e.g., preventative, restorative, orthodontics)

Vision Care

Life Insurance

Short-Term Disability

Long-Term Disability

Critical Illness Insurance

Employee Assistance Program (EAP)

Wellness Initiatives

Retirement Savings Plans (Group RRSPs, DPSPs, Pensions)

Other (please specify):

5. Plan Detail

Health:

Drugs:

Drug Cap:

Deductible:

Dental:

Major Dental:

Deductible:

Recall:

Orthodontics:

Dental Maximum:

Others (please specify):

Waiting Period for New Employees:

Others (please specify):

Budget (Optional):

6. Additional Information

Please share any specific needs, concerns, or goals for your Group Benefits Plan:

Full Name

DOB

CLASS

GENDER

MALE

FEMALE

COVERAGE

SINGLE

FAMILY

JOB TITLE & SALARY(for disability quote)

Full Name

DOB

CLASS

GENDER

MALE

FEMALE

COVERAGE

SINGLE

FAMILY

JOB TITLE & SALARY(for disability quote)

Full Name

DOB

CLASS

GENDER

MALE

FEMALE

COVERAGE

SINGLE

FAMILY

JOB TITLE & SALARY(for disability quote)

Full Name

DOB

CLASS

GENDER

MALE

FEMALE

COVERAGE

SINGLE

FAMILY

JOB TITLE & SALARY(for disability quote)

Full Name

DOB

CLASS

GENDER

MALE

FEMALE

COVERAGE

SINGLE

FAMILY

JOB TITLE & SALARY(for disability quote)

If you are human, leave this field blank.

Partners & Carriers We Work With

Independent access to multiple leading insurers across Canada.

Visit Medavie Blue Cross

Visit Assumption Life

Visit Foresters Financial

Visit Humania Assurance

Visit Canada Protection Plan

Visit Industrial Alliance

Visit Sun Life Financial

Visit Desjardins Financial Security

Visit Canada Life

Visit Empire Life

Visit RBC Insurance

Visit Equitable Life of Canada

Visit Manulife Financial

Visit Beneva Insurance

Visit Green Shield Canada

Visit Medavie Blue Cross

Visit Assumption Life

Visit Foresters Financial

Visit Humania Assurance

Visit Canada Protection Plan

Visit Industrial Alliance

Visit Sun Life Financial

Visit Desjardins Financial Security

Visit Canada Life

Visit Empire Life

Visit RBC Insurance

Visit Equitable Life of Canada

Visit Manulife Financial

Visit Beneva Insurance

Visit Green Shield Canada

Logos are trademarks of their respective owners and are used for identification only.

Welcome to Green Mountain Financial Services Inc. We are your trusted partner in financial planning, offering a wide range of services to help individuals, families, and businesses secure their financial future.

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info@gmfsi.ca
905-921-9962
140 Golden Orchard Drive | Hamilton, ON L9C 6J6

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