Dental Insurance Quote Request:

Please complete this short questionnaire in full for your FREE no obligation quotes. These quotes will be from the plans and insurance carrier(s)
that we find best suited to your stated needs and budget.

* = Required Information

Quotes desired on the following:

Single Two person Family Group Health
 
I wish to pay no more than $ per month for dental coverage

Contact Information:

First Name*
Last Name*
Address*
City*
State*
Zip*
Primary Phone*
Alternative Phone
Email*
Best time to contact*
Preferred method
of contact
Phone Fax Email Mail

Coverage Information:

Currently Insured
Yes No
If yes, name of
dental carrier
Current monthly premium
Reason for plan change
   
For group coverage please complete the following:
Number of benefit
eligible employees
Number interested in dental coverage
Employer contribution %
Section 125 cafeteria plan established for company
Yes No
 

Direct Contact Information

Mailing Address

ABS LLC
P.O. Box 16234
Hooksett, NH 03106

Phone Numbers

Nashua, NH:
603-598-2596

Hooksett, NH
603-622-5700

Toll Free:
1-877-842-1546

Fax Number

603-218-6447

Email

Email Affordable Benefit Solutions