Great Northern Benefits

Great Northern Benefits
Need a individual health plan???

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Check out GNB's NEW Get a Quote and subsidy calculator tool!


If you are a Sole Proprietor or One Subscriber Group, please see the Sole Prop/OSG New Business Document Requirements to find out if your business qualifies for group coverage rates.

If you would like a quote for Life, Disability, Dental, Vision, Long Term Care, or HSA, please contact us.

Important! If your business has between 2 and 50 full-time employees, a census is required prior to quoting for health, vision or dental coverage. The census must contain the following data for each employee: Date of Birth, Gender, Date of Hire, Contract Type (whether the employee will enroll as a one-person, two-person or family). If requesting a quote for life or disability, please add Job Description and Annual Salary in addition to the previous requirements. If any covered employee or retiree is age 65 or older, please also indicate whether they are enrolled in Medicare Part A, B or both.

* required

E-Mail Address *

Today's Date *

Requested Effective Date *

Contact Name *

Contact Title

Contact Phone *

Contact Fax

Business Name *


Business Address *

Business City, State, Zip *

Nature of Business *

Current/Previous Carrier *

Current/Past Plan *

Current/Past Office Visit Copay

Current/Past RX Copay

Current/Past Deductible

Current/Past Vision

Current/Past Dental

# Single Needed *

# Double Needed *

# Family Needed *

# Family Continuation/ Student Rider Needed *

# Retirees Needed *