Question Title

* 1. What year were you born?

Question Title

* 2. Gender

Question Title

* 3. What is your home zip code?

Question Title

* 4. Select the tax filing status you currently hold

Question Title

* 5. If you're a managing broker, list the number of each in your agency. Place a '0' in the N/A space if this question doesn't apply to you.

Question Title

* 6. Select your annual gross income range

Question Title

* 7. How do you currently obtain health insurance?

Question Title

* 8. If you have health insurance, what type of coverage do you have?

Question Title

* 9. Indicate your level of interest in participating in group purchase of medical, dental, vision, and other benefits for your association assuming the cost is reasonable

Question Title

* 10. Check all of the products you'd be interested in purchasing through your association assuming the cost is reasonable

0 of 10 answered
 

T