Get a Quote

INSResource Inc. has over 20 years experience in helping Ohio consumers find the most affordable health insurance.  We have the expertise and knowledge to see you through the maze of plan choices available in Ohio.

Give us the opportunity to earn your business!

Simply complete the form below and submit it to us.  We will quickly shop the Ohio market for the best plans and email and mail you with the results within 24 hours.

You can also call us with your information at 1-800-604-3076

Please provide as detailed information as possible to ensure you receive an accurate quote.

Your Contact Information
First Name:
Last Name:
Street Address:
City:
State:
Zip Code:
County:
Phone:
Work / Cell Phone:
Best Time to Call:
Email Address:

Primary Insured
Date of Birth:
Age:
Height:
Weight:

Spouse
Date of Birth:
Age:
Height:
Weight:

Children
Child #1 Date of Birth:
Child #1 Age:
Child #2 Date of Birth:
Child #2 Age:
Child #3 Date of Birth:
Child #3 Age:
Child #4 Date of Birth:
Child #4 Age:

Current Coverage
Do you have coverage now? No
Yes, with what company?
Is this employer sponsored coverage? No
Yes, please provide current rate:

Medical Information
Does anybody smoke? List names:
Does anybody take medication? Please list medication name along with person taking it.
Person:   Medication:   Reason:

Person:   Medication:   Reason:

Person:   Medication:   Reason:

Person:   Medication:   Reason:

Person:   Medication:   Reason:

Person:   Medication:   Reason:

Has anybody ever been treated for the following; heart disease, cancer, diabetes, stroke, kidney disorder, chronic respiratory disorder, blood disorder, alcohol / drug abuse, or liver disorder. If yes, please provide details:

Please use this space to provide additional details on any other health conditions you or your family have:


Desired Quotes
Desired quotes: Traditional Major Medical Plan - This type of plan includes office visit co-pay, prescription drug card, and preventive coverage. Plans usually have a $500 to $1500 deductible for all other covered expenses.

Health Savings Account Plan - This high deductible plan will enable you to pay smaller medical expenses with tax deductible dollars while providing coverage for the larger bills. Deductibles usually range between $1200 and $5650.

Guaranteed Issue Health Plans - These plans are for people who have health concerns preventing them from securing an affordable health plan

All of the above
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