Whether you need to change your beneficiaries, check on the status of a claim or any other concerns, we are here to assist you.

Speak With A Local Agent

One of our local agents will contact you to answer any questions you may have about supplemental insurance, our coverage options and to provide you with a quote. Please provide us with:

  • Your contact information
  • Best time to reach you
  • Products of interest

About you

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I would like additional information regarding the following supplemental insurance products.
(Check all that apply)

By entering your name, phone number, and clicking "Submit," you are 1) electronically signing this form and 2) consenting to Combined Insurance ("our," "us" or "we") making autodialed calls to you at the landline or wireless phone number(s) you provide. You are not required to provide such consent as a condition of purchasing Combined Insurance products. This consent will not be available in paper form; you are encouraged to print this form for your records. This consent only authorizes us to call you at the phone number(s) you provide in response to this request for information. If you wish to inquire about Combined Insurance products without submitting your information online, call us at 1-800-490-1322.

Preparing for the call

To help our agent determine the best coverage for you, please have the following information available for the call:

  • Information about yourself and your dependents; such as age, sex and work status.
  • Information on current insurance policies, either through your employer or other supplemental providers.
  • Basic health information for yourself and your dependents.
  • Basic financial information; such as income and household status.


Needs Assessment

Download the Needs Assessment worksheet to see if you and your family have the insurance protection you need.

We value your privacy. To learn more about how we protect your personal information, please look at our Privacy Policy.

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