Employee:
County of Residence:
Email Address:Address 2
Phone:
Your Age
Your Gender
Use Tobacco?
Expected Income in 2025?
Married or Single?
If married,
Age of Spouse
Spouse's Expected Income in 2025
Coverage needed for Spouse
Spouse Use Tobacco?
Does spouse have cvg available through employer?
Ages of Dependent children under 26:
Do you wish to cover your children?
Questions and/or Comments:
To obtain a custom quote for health benefits, please complete the following information, and click the SUBMIT button.
Our broker will email your health plan options and premiums and information about how to enroll.
Your premiums will be payroll deducted by Greenville Literacy under a "group billing" arrangement we have with Blue Cross. Deductions will begin the first pay period after your effective date.
REQUEST QUOTE
www.glahealthplans.com
©2022 Greenville Literacy Assoc
Health Benefits Website
RESOURCE EQUITY GROUP
P.O. Box 5556
Greenville, SC 29606
864-235-9999
800-527-1397 | 863-242-0698 fax
Email: mailbox@regroupusa.com
OUR BROKER:
