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Printable
Applications
are in the process of being updated
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To request an
application and brochure, send an email to: temp@consumerbenefits.net
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Please note the
state you live in and the date you would like
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your short term plan to become
effective.
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| Your effective date of coverage will begin on the later of: 1) 12:01a.m. the day after your requested policy date; or
2) 12:01a.m. the day after the post mark date affixed by the U.S. Post office*, provided the following conditions are met. |
- Your application for temporary health
insurance and the full premium payment is received by Long Term Consumer Care, Inc. or
Assurant Health;
- Your answers on the temporary health
insurance application are correct and meet the requirements for acceptance.
- All policy's that meet these conditions
are issued immediately upon receipt and are mailed to the applicant
via first class mail.
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Temporary Health Insurance is NOT available by any insurance company in
the following states: MA,
NJ, NY or VT
Short Term
/ Temporary Health Insurance from Assurant Health Insurance Company will cover you while traveling anywhere in the United
States and Canada. If you plan on moving (within the United States) while you are
covered, simply apply in the state you currently have residence in.
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Get
a FREE Rx Savings Plan
Simply apply
for temporary health insurance through
this site and we will send you a Free Consumer Benefits Rx Savings Plan.
NOTE: This offer is only available through this site and is not
offered by, or administered by Assurant Health. If you apply by
mail or fax, simply email us at: temp@consumerbenefits.net
and include your name. We will confirm that your application has
been received and send you (by email) your Free Consumer Benefits Rx Savings
Plan download link. Your email address will not be saved, sold our used for any
reason.
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Note:
The following information is included with the application and brochure.
If paying by Credit Card, you can fax the completed application to Long Term Consumer Care, Inc. at: (262) 523-1910.
If paying by check or money order, you can mail the completed application along with payment to:
- Long Term Consumer Care, Inc.
- N27 W23960 Paul Road - Suite 201
- Pewaukee, WI 53072
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Note: Make all checks or money order payable to
Assurant Health.
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For More Information or
Assistance
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CALL TOLL FREE:
1-800-544-9505
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Product Availability Varies By State
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LTCC is a trademark of Long Term Consumer
Care, Inc. All other products
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mentioned are registered trademarks of their respective companies.
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