Expatriate Health Insurance, International Health Insurance Coverage for Groups

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a Global Health Insurance Quotation
+44 (0) 191 297 2411

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2001, 2002 & 2004
Independent International
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London, UK

Medibroker > Expatriate Health Insurance and International Coverage for Groups

Request for Quotation
International Insurance Coverage - Groups

US Companies/Employers - Please note that we are unable to offer coverage to US companies/employers who are permanently based only in the USA.

If you would like someone to contact you by telephone to discuss your needs in more detail, please let us know in the "Questions" box at the end of this form and we will call you at a convenient time to give you information about our plans and answer any questions that you may have, or you can call us to speak to an advisor on +44 (0)191 297 2411.

You may be assured that all personal details entered on this form will remain confidential to Medibroker International and will not be disclosed to third parties nor will any detail or address be used for marketing purposes. Please ensure, however, that you fill out every box.

Name of your group: *
Name of group contact: *
Group contact's e-mail address: *

Group contact's daytime telephone number: *
Country in which your group is based: *
Country in which coverage is required: *

Are your group members citizens or permanent residents of the United States? *

* Required Fields

Please check any boxes that apply:
We require maternity coverage
Our members are in a high risk profession
This is a teacher's group
We require a wellness plan
We require routine dental insurance
We only require hospitalization benefits, no outpatient benefits
We would like good coverage but price is very important right now

Please list the names and dates of birth of persons to be insured on this policy?

Name: Birth date (mm/dd/yyyy): *
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If you have a current census, you may send it as an attachment to: clientservice@medibroker.com

How did you hear about Medibroker?
I read your brochure (please enter the source code on the back)
I was surfing the web (enter search engine used)
I received a letter from the Medibroker office
I was referred to you by a friend
I read your newsletter article
I've contacted Medibroker in the past

Do you have questions or comments for us?

You may be assured that all personal details entered on this form will remain confidential to Medibroker and will not be disclosed to third parties nor will any detail or address be used for marketing purposes. Please ensure, however, that you fill out every box.

Thank you! Your custom quotation will be e-mailed to you within 3 to 5 days. If you have any questions or would like to speak with an advisor prior to submitting your request, please feel free to call us at the number listed below.

Medibroker Limited is regulated in the United Kingdom by the Financial Services Authority.
Our regulated Firm number is 304773.
Full details can be found on the FSA Register
You can contact the Financial Services Authority (FSA) at:
25 The North Colonnade, Canary Wharf, London E14 5HS.
You can also call their Consumer Helpline on 0845 606 1234.
Additional information can be obtained from www.fsa.gov.uk

International healthcare insurance advisors offering a free quotation for expatriate health insurance and international health insurance coverage for groups