George Koury | Free Benefit Audit

Group Insurance

   904-262-8400
   toll-free 866-458-8664
   info@georgekoury.com

Please complete the form below to receive a benefits audit at no charge.

Contact Information

Name*

Company*

Address

City

ST Zip

Phone

Fax

Email*

Information for Audit

Total number of employees

Employees eligiable

Number of participants

Employer Contribution

Current Carriers:

Current Premiums:

Pre-tax options? (Section 125)

Do you offer any of the following:

	Not Offered	Shared	Employer Paid	Employee Paid
Dental
Life
STD
LTD
LTC

Comments or Questions

*Required Fields

"I don't have much experience with insurance, so your knowledge and helpfulness have been invaluable. The various plans that you had presented to us were all appropriate considering our group size and budget constraints. I appreciate your help in guiding us to the plan that will best suit our needs."

- Kathy McGraw, Financial Manager, First Coast Scaffolding