Connect with an Agent

Connect with an Agent Near You

Getting a quote for coverage that’s right for you starts by connecting with an Agent. Submit your information below to or contact an agent directly to get a quote.


Southeast Michigan

Dennis Morier
US Health and Life Marketing, Inc.
800-529-1663

Central / Northern Michigan

Doug Janes
(989) 289-7733

Indiana / Western Lower Michigan

Jeff Lewandowski
(888) 227-7272

Ohio

Ken Uveges
(440) 349-2210

Illinois and Wisconsin

Your agent will work with you to get the information necessary to quote and begin your coverage, and will help educate you on each piece of information needed. Here’s a look at some information you can expect to submit to get a quote:

General required documents:

  • Employer Group Application (signed and dated by the agent and group’s authorized contact)
  • Employee Enrollment Forms
  • Quarterly wage and tax statement (indicating employee status, i.e. part-time or full-time; termed; waiting period)
  • USHL quote indicating plan(s) selected by employer
  • Writing Agent Transmittal Form
  • First month’s premium check

SafeGuard required documents:

  • Employer Disclosure
  • Employee Submissions
  • Group Setup Form 
  • ACH Payment Processing Form
  • Administrative Service Agreement
  • Current Carrier Billing Statement and Prior Year Rates