Medical Quotation For Health Insurance Example – [Edit & Download]
Header
- Quotation Title: Health Insurance Medical Quotation
- Date: February 21, 2025
- Quotation Number: HIQ20250221-1122
Insurance Provider Information
- Insurance Company: National Health Insurers
- Address: 123 Insurance Lane, Capital City, State, 12345
- Contact Information: (555) 987-6543, support@nhinsurers.com
Client Information
- Company Name: Global Tech Solutions
- Contact Person: Michael Roberts
- Address: 456 Technology Drive, Silicon Valley, State, 67890
- Contact Details: (666) 123-7890, m.roberts@globaltechsolutions.com
Health Insurance Plans Description
| Plan Name | Coverage Details | Number of Employees | Price per Employee | Total Price |
|---|---|---|---|---|
| Basic Health Coverage | Covers general doctor visits, basic diagnostics | 100 | $300 | $30,000 |
| Comprehensive Coverage | Includes specialist visits, advanced diagnostics | 100 | $600 | $60,000 |
| Dental and Vision | Additional dental and vision care coverage | 100 | $100 | $10,000 |
| Extended Health Care | Includes mental health services, physical therapy | 100 | $400 | $40,000 |
Summary
- Subtotal: $140,000
- Taxes: $12,600 (9% sales tax)
- Grand Total: $152,600
Terms and Conditions
- Payment Terms: Payment due within 45 days from the date of invoice
- Validity: This quotation is valid for 60 days from the date of issuance
- Additional Information: Coverage begins upon full payment and enrollment completion; all health plans are compliant with national health insurance regulations.
Signature
- Authorized Signature: [Signature of Insurance Account Manager]
- Date: February 21, 2025
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Medical Quotation For Health Insurance Example – [Edit & Download]
Header
Quotation Title: Health Insurance Medical Quotation
Date: February 21, 2025
Quotation Number: HIQ20250221-1122
Insurance Provider Information
Insurance Company: National Health Insurers
Address: 123 Insurance Lane, Capital City, State, 12345
Contact Information: (555) 987-6543, support@nhinsurers.com
Client Information
Company Name: Global Tech Solutions
Contact Person: Michael Roberts
Address: 456 Technology Drive, Silicon Valley, State, 67890
Contact Details: (666) 123-7890, m.roberts@globaltechsolutions.com
Health Insurance Plans Description
Plan Name | Coverage Details | Number of Employees | Price per Employee | Total Price |
|---|---|---|---|---|
Basic Health Coverage | Covers general doctor visits, basic diagnostics | 100 | $300 | $30,000 |
Comprehensive Coverage | Includes specialist visits, advanced diagnostics | 100 | $600 | $60,000 |
Dental and Vision | Additional dental and vision care coverage | 100 | $100 | $10,000 |
Extended Health Care | Includes mental health services, physical therapy | 100 | $400 | $40,000 |
Summary
Subtotal: $140,000
Taxes: $12,600 (9% sales tax)
Grand Total: $152,600
Terms and Conditions
Payment Terms: Payment due within 45 days from the date of invoice
Validity: This quotation is valid for 60 days from the date of issuance
Additional Information: Coverage begins upon full payment and enrollment completion; all health plans are compliant with national health insurance regulations.
Signature
Authorized Signature: [Signature of Insurance Account Manager]
Date: February 21, 2025