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Get a Personalized Quote
Submit the group census form below to get a quote. Easily navigate this form by selecting an item from the side menu. You can also download the form here.

Disclaimer: We will NOT provide your personal information to any third party.  Privacy Policy

Tell us about your business to get started.
Select the type of coverage you're looking for:
Are you interested in Benefit Accounts?
Are you interested in Compliance?
OR, upload your current renewal here
Now, let us know whom we should contact with the quotes.
Lastly, we need a few details about your employees.

More than 50 employees? Please email us at sales@lebinsurancegroup.com or call (920) 243-4005.

Please fill out the following information for each employee:
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?
Spouse?
Children?