Request for Quotation


Kindly fill up the quotation form below


Company Name:
Company Address:
Estimated number of Principals:
Estimated number of Dependents:
Name:
Email Address:
Contact Number:
Notes:

Minimum of 20 enrollees to qualify for a corporate account

PRINCIPAL MEMBER
From 18 years to below 60 years old

DEPENDENTS
For MARRIED Employees
1st Priority - Legal Spouse from 18 years to 60 years old;
2nd Priority - Eldest to youngest child 90 days to not over 21 years old; single and unemployed.

For SINGLE Employees
1st Priority - Father up to below 60 years old;
2nd Priority - Mother up to below 60 years old;
3rd Priority - Brothers/Sisters 90 days to not over 21 years old; single and unemployed.