In addition to Employee
Disability Insurance for
your business, we also
offer affordable Employee
Health Insurance plan
premiums or choose
another NY, CT, or NJ
business insurance
coverage from the list
below.
Do you have questions about
employee disability insurance?
**Information received from this New York Group Disability Insurance quote
request form sent to Direct Access Group Benefits will be for our use only
and will not be sold, given to or distributed to any other parties. A quote will be based
on the group disability insurance plan information provided and does not guarantee
acceptance of the risk by us. The precise coverage afforded is subject to meeting
underwriting guidelines, and the terms, conditions and exclusions of the policy as
issued. By submitting this request you acknowledge that this is neither an offer to
insure nor a guarantee of insurance. Completion of this form does not entitle you
to an Employee Disability Insurance plan policy. We are licensed in New York, Connecticut,
and New Jersey, and will not provide group disability insurance quotes for other states.

"Your Local New York Employee Disability Insurance Policy Agent!"
We offer affordable New York grouo disability insurance quotes for businesses in the
following New York counties and cities: Westchester County, Putnam County,
Orange County, Rockland County, Port Chester, Harrison, Mamaroneck, Larchmont,
New Rochelle, Yonkers, White Plains, Rye Brook, Scarsdale, Rye, Ardsley, Hartsdale,
Bronxville, Mt. Vernon, Mount Vernon, Irvington, Valhalla, Elmsford, Dobbs Ferry,
Hastings on Hudson, Greenburgh, Tarrytown, Sleepy Hollow, Hawthorne,
Scarborough, Thornwood, Briarcliff Manor, Ossining, Harmon, Montrose, Crugers,
Buchanan, Peekskill, Millwood, Pleasantville Armonk, Chappaqua, North Castle, Mt.
Kisco, Bedford, Pound Ridge, Bedford Hills, Cross River, South Salem, Yorktown
Heights, Goldens Bridge, Amawalk, Yorktown, Katonah, Salem Center, Somers, North
Salem, Croton Falls, Jefferson Valley, Shrub Oak, Palisades, Sparkill, Tappan,
Orangeburg, Pearl River, West Nyack, New City, Nanuet, Chestnut Ridge,
Montebello, Suffern, Monsey, Spring Valley, Congers, Nyack, Rockland Lake,
Wesley Hills, New Hempstead, Pomona, Sloatsburg, Ramapo, Hilburn, Willow Grove,
Mt. Ivy, Thiells, Tomkins Cove, Ladentown, Haverstraw, Stony Point, Tomkins Cove,
West Haverstraw, Bear Mountain, Jones Point, Newburgh, Middletown, and
Poughkeepsie, NY.
Business Information:
Business Name:    
Premises Address:
City:     State:     Zip Code:
Contact Name:
Phone #:    Ext #:    Years in Business:
Email Address: (Required) 
Description of Operations or SIC code:


Current Insurance Company: 
Policy Expiration Date:          (mm/dd/yyyy)


Do you currently offer short term disability insurance to employees?
Do you currently offer long term disability insurance to employees? 
Length of Group Disability Coverage Needed?

Group Disability Coverage For?                      
Type of Group Disability Coverage Needed?   
How many employees to be insured?               

Monthly Benefit Amount For Each Person Insured:   
Or Enter a Different Monthly Benefit Amount:         $
Benefit Period Desired For Each Person Insured:      
Elimination Period Desired For Each Person Insured:
Payment Mode:

Does any employee to be insured have a hazardous job? Yes No
If Yes, how many have hazardous jobs? 

Are any employees to be insured active members of the military reserves? Yes No
If Yes, how many are active members of the military reserves? 

Explain Any Recent Workers Compensation Claims Below.



Additional Information



Click on the "Submit Quote Information" button below to send your
New York Group Employee Benefit Disability insurance quote request.**



New York Group Employee
Disability Insurance Quote
Copyright 2004-2010 Direct Access Group Benefits, Inc. - All rights reserved
New York Group Disability Insurance Quotes
Direct Access
Group Benefits
Somers, New York
Direct Access
Group Benefits
Somers, New York
"We're Your New York
Group Disability
Insurance Agency"
Direct Access
Group Benefits, Inc.
340 Route 202
Somers, New York 10589
Toll Free: 1-800-498-1819
(914) 276-6000
Fax: (914) 276-6002
We also offer affordable Connecticut grouo disability insurance quotes for businesses in the following
Connecticut counties and cities: Fairfield County, Stamford, Norwalk, Greenwich, Darien, Riverside, Belltown,
Springdale, Round Hill, Old Greenwich, East Norwalk, New Canaan, Glenville, Byram, Cos Cob, Mianus, North
Stamford, Glenbrook, Wilton, Weston, Long Ridge, Noroton, West Norwalk, Westport, High Ridge, Southport,
North Wilton, Winnipauk, Cannondale, Turn of River, South Wilton, Lyons Plains, Georgetown, Ridgefield,
Branchville, Redding, Topstone, Ridgebury, Redding Ridge, Branchville, Dodgingtown, West Redding, Titicus,
Hattertown, Bethel, Danbury, New Fairfield, Newtown, Hawleyville, Botsford, Monroe, Bridgeport, Stepney,
Shelton, Huntington, Upper Stepney, Long Hill, Trumbull, Stratford, Easton, Fairfield, Greenfield Hill, Stratfield,
Nichols, Oronoque, Rivercliff, Devon, Lordship, and East Bridgeport, and New Haven, CT.
Employee Disability
Insurance Plan Quote
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