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Check out these example monthly rates...
10-year level premium term insurance
(20 and 30 year rates also available)

$250,000 $500,000 $1,000,000
Age Male Female Male Female Male Female
30$12$11$19$15$31$27
40$15$13$26$21$38$37
50$32$24$59$43$107$78
60$75$46$134$87$259$161
(Smoker rates also available)

Take a minute to fill out the simple form below and receive a FREE quote
comparing the best values from among hundreds of the nation's top insurance companies!


*All Fields required
First Name:
Last Name:
Address:
City:
State:
Zip:
Day Phone: (xxx-xxx-xxxx)
Evening Phone:
Fax: (xxx-xxx-xxxx)
Email:
Male or Female:
Date of Birth: (mm/dd/yy)
Type of Insurance:30 Yr Guaranteed Level Term20 Yr Guaranteed Level Term15 Yr Guaranteed Level Term10 Yr Guaranteed Level TermUniversal Life2nd-to-die (Survivorship Insurance)
Insurance Amount:$100,000$150,000$200,000$250,000$300,000$350,000$400,000$450,000$500,000$550,000$600,000$650,000$700,000$750,000$800,000$850,000$900,000$950,000$1,000,000$1,500,000$2,000,000$2,500,000$3,000,000$3,500,000$4,000,000$4,500,000$5,000,000above $5,000,000
Height:
Weight: lbs
Tobacco Use:(Please Select)Have never smoked or used nicotineUsed to smoke, but quit less than 1 yr agoUsed to smoke 1-3 yrs agoUsed to smoke 3-5 yrs agoUsed to smoke over 5 yrs agoCurrently smoke cigarettesOther nicotine use-cigars/pipe/chew/patch
Health Status:(Please Select)Excellent: trim and athletic, no medicationsGood: no infirmities and no medicationsFair: slightly overweight or taking medicationPoor: have/had a serious health condition
Health conditions?
YesNo
Explain:
Prescription medications?
YesNo
Explain:
Do you engage in any hazardous activities?
(i.e. scuba,skydiving,private pilot,etc.)
YesNo
Explain:
Did your parents or siblings have
heart disease or cancer prior to age 60?
YesNo
Explain:





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All quotes will be from insurance companies rated A-, A, A+ or A++ by A.M Best. Actual premiums and coverage availability will vary depending upon age, sex, state, health history and tobacco use. All information submitted is strictly confidential.



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