Reliance Standard Calculator
Please complete the form below to create a quote.
Agent/Agency Information
Name:
Email:
Phone Number:
Group Information
Employer Name:
State:
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Zip Code:
Industry Code:
Please choose...
Jewelry Business (wholesale/retail) SIC: 3911, 5094, 5944 (+20%)
Automotive Dealers SIC: 5511-5599 (+20%)
Direct Selling Establishments SIC: 5963 (+20%)
Security & Commodity Brokers/Dealers SIC: 6211-6289 (+20%)
Real Estate Agents/Developers SIC: 6531-6552 (+20%)
Beauty Shops SIC: 7231 (+20%)
Funeral Services SIC: 7261 (+20%)
Educational Services SIC: 8211-8299 (+20%)
All Other Industries
Dental Plan Design
Plan Base:
Please choose...
Plan A without MAC
Plan A with MAC
Plan B without MAC
Plan B with MAC
Plan C without MAC
Plan C with MAC
Employee Enrollment:
Please choose...
2 Lives
3-5 Lives
6-9 Lives
10-19 Lives
12 Months Comparable Prior Group Dental Coverage:
Please choose...
Yes Prior Coverage (+10%)
No Prior Coverage
Annual Maximum:
$1,000 Annual Maximum
$1,500 Annual Maximum
$2,000 Annual Maximum
$2,500 Annual Maximum
Additional Options
Add vision rider (+flat rate)
Increase rate guarantee to 24 months (+4%)
Endodontics to Basic Services (+2-3%)
Periodontal to Basic Services (+2-2.5%)
Move to 90% Out of Network Allowance (+2.5-3%)
Carve Out and High Risk Group Factor (+20%)
**Please note: 2 employee dental groups are only eligible if submitted along with at least two additional lines of coverage.
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