Employer Proposal

Please fill out the form below, selecting which product(s) you would like to receive a quote on, and an OMNI Group, LLC representative will contact you as soon as possible.



Contact Info  (All Fields Required)
Company Name:
City and State:
Number of Employees:
Contact Name:
Telephone:
Best Time to Call:
E-mail:

Yes! I would like a proposal on:

Employer Coverage
 Business Office Package  Directors’ & Officers’ Professional Liability Insurance
 Employment Practices Liability Insurance  Flood Insurance
 Group Dental *  Group Health Reimbursement/Savings Account
 Group Life, Long/Short Term Disability  Group Long Term Care
 Group Major Medical *  Group Voluntary Benefits *
 Liability Coverage for OSHA, HIPAA, Red Flag Rules, etc.  OMNI 125 Flex Plan *
 Pension/ERISA/Notary Bonds  Professional Liability
 Workers’ Compensation

* Section 125 eligible plans