Protect Your Employees

Submit your company and employee information to get an insurance quote for employee benefits.

Titus Hunt from Preferred Benefits Solutions will reach out to you to discuss coverage options, or call Titus directly at 336-239-7386.

Preferred Benefits Solutions

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Company Information

Company Address*

Primary Contact

Primary Contact Name*

Coverage Types

Coverage Interests*
What type(s) of coverages are you interested in offering to your employees? (Check all that apply)
MM slash DD slash YYYY

Employee Information

While the information is not required right now, your agent will need to gather information about your employees in order to bind insurance coverage.
List of Employees
Name
Date of Birth (mm/dd/yyyy)
Hire Date (mm/dd/yyyy)
Gender
Zip
Annual Salary / Hourly Rate
 

Additional Information

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Max. file size: 2 MB, Max. files: 10.
    Consent*
    This field is for validation purposes and should be left unchanged.