Quotes

To request a quote for Individual Coverage, please call or email the appropriate representative below:

Individual Representatives (Divided by Agent/Agency Name)
Jami Hartman (A-G) Ext.  6621 Jami@Midwestga.com
Brittany Outlaw (H-N) Ext.  6622 Brittany@Midwestga.com
Jennifer Pascazio (O-Z) Ext.  6623 Jen@Midwestga.com

You can also fax a quote to: 847-640-8011

We will need to the following information to provide a quote:

Agent Information

  1. Agent First and Last Name
  2. Agent Phone and Fax Number

Client Information

  1. First and Last Name
  2. Mailing Address
  3. Applicant/Spouse DOB
  4. Applicant/Spouse Gender
  5. Applicant/Spouse Smoker (Y/N)
  6. Number of Children and Ages