Nippon Life Calculator | Direct Benefits Inc.

Please complete the form below to create a quote. Only for Effective Dates of 7/1/2020 through 12/31/2020.

Agent/Agency Information

Name:

Email:

Phone Number:

Group Information

Employer Name:

State:

Zip Code:

Industry:

Dental Plan Design

Plan:

Eligible Employees:

Participation:

Annual Maximum:

Employer contributes less than 50% of premium (+2.5%)

Move Endo/Perio to Basic (+4%)

Available for Option 1 and Option 2

No Prior Coverage (2-4 enrolled +2% | 5-9 enrolled +7% | 10+ enrolled +10%)

Add Orthodontics

Available for 5+ Enrolled with Prior Coverage

Add Vision

Vision Plan Design

Plan Option:

Contribution: