US Baseline Insurance Services
Group Quote
Home
About Us
Carriers
Our Products
Group Quote
Individuals/Families Quote
Contact Us

Would you like for us to obtain a free quote for your group?  Please fill out the inquiry form below so that we can contact you and get started!

Your Company Name:
E-Mail Address:
Your Telephone Number:
What Is Your Company's Zip Code?
Type of Company / Business
Number of Eligible Employees
SIC Code
Who Is Your Contact Person?
Are You Interested in Medical
Are You Interested in Dental?
Are You Interested in Life Insurance?
Are You Interested in Disability Insurance
  

To obtain a group quote, we need your current census information. You can obtain a copy of our Census Form here:

Click here to download USB Census file

Please email your completed census form to us at: dr@usbaseline.com

Please Note:
If you have internet security on your web browser you may not be able to send this information to our e-mail address.  If so, please give us a call at 770-777-0798 or send us an e-mail at dr@usbaseline.com.
 
ANY QUESTIONS?
WE'RE ONLY A PHONE CALL AWAY
Office: (770) 777-0798
 
 
For more information or a free quote you can send us an e-mail us at dr@usbaseline.com
 
US Baseline Insurance Services 
 11180 State Bridge Road, Suite 401  Alpharetta, GA  30022
 
lonestarstarsline2backgroundforwebsite.gif