To set up an HSA Plan      AG00013_.gif (7874 bytes)

Triangle Medsaver is a member of the National Association of Alternative Benefit Consultants.   Through this network we can help you find agents or brokers who are experienced in HSAs and MSA's  for small and large groups and licensed to sell the High Deductible Health Plans approved in your state.  If you are in North Carolina, go the the "North Carolina Resident" form below. 
Step 1 Fill out  and submit the form below or send us an email message.
Step 2
We will email back  to you the information to help you get started.
 
We will not give out your name or addresses unless we have your permission to do so.    

Name: 

E-mail:      

Self employed    Individual     Employee      

Employer    Number of employees: 
                                                                       
City:  State:   

Zip

Type of business or profession:

Questions or comments?

 

 

norcarlc.gif (1711 bytes)

North Carolina Resident

Let us know if you are currently shopping for insurance or wanting to change your coverage in the next few months and we will send you some quotes.  To get quotes on the HSA compatible products available, we will need you to provide ALL the information requested in the Census block below. If you prefer, you can fax this information to 919-493-6784 or call us at 919-493-9405. 

Name: 

E-mail:      

Telephone & best time to call:  


Self employed    Individual     Employee      

Employer    Number of employees: 
                                                                                         

City:  State:   

 Zip   

Type of business or profession:

 

Census: 

Names & birthdates of people to be covered, height & weight of the parents,
general health status and smoking/tobacco use history.


Questions or comments?