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About us...

KEMPTON FINANCIAL GRP LLC has been helping people in Tampa Bay find the right insurance coverage and get the most for their health care dollars for over 11 years. If you're ready to compare popular plans online. Get your free quotes now. If you'd like to talk about your options, please contact us. Our services are free and it doesn't stop once you purchase a plan.

 

Group Health Insurance Census Form

Please fill-in as much information as possible.  Also, please list any general comments or concerns so we can properly quote your group.  A Group Health Insurance Specialist will contact you within 8-hours. We look forward to serving you.

Business Name:
Point of Contact Name:
Number of Employees: email:
Present Plan :
Day Time Phone:
Desired Annual Deductible:
Address:
Coverage Types:
(check all that apply)
Health
Short Term Disability
Long Term Disability
Dental
Life
City:
  State:
  Zip :
Please list any general comments, questions, or concerns here.