Thank you for choosing Mike Keith Insurance as your trusted insurance broker. You have indicated that your business has more than 10 employees. If so, good news, your employees don't have to fill out individual health statements!

Please complete the form below and upload your current rates, benefits details, and employee census. Please include any employee dependents that will be covered on the plan.

Have more questions? Please click here to schedule an appointment with our sales rep or call 660-924-0186

If you do not have an employee census, use the link below to download a blank census to fill out and upload.