Alliance of Schools for Cooperative Insurance Programs

ascip

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  • COVID-19
    • Reopening Schools Planner
  • About
    • Calendar
    • Financial Strength
    • Governance
    • Members
    • News & Updates
    • FAQ’s
  • Insurance for Schools
    • Coverages
    • Property & Liability
    • Workers’ Compensation
    • Health Benefits
    • OCIP – Construction Insurance for Schools
    • Request A Quote
  • Risk Services
    • Member Shared Resources
    • Risk Management Prevention Services
    • Guidelines & Best Practices
    • Sample Agreements & Forms
    • Abuse Prevention Resources
    • Special Education Resources
    • Risk Alerts & Bulletins
    • Lessons Learned – Sharing Experiences
    • Safety Spotlight Resources
    • Additional Resources and Forms
    • FAQs
  • Training
    • 2022 Virtual Annual Membership Meeting
    • Online Training
    • Seminars & Webinars
    • Resources
  • Forms & Tools
  • Contact

Health Benefits

Home > Insurance for Schools > Health Benefits > Request Health Benefits Quote
  • Coverages
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    • Request a Quote
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    • Request a Quote
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    • Request OCIP Information
  • Request A Quote

Request Health Benefits Quote

  • Download the PDF version of this form
  • Download the Census Template
    A Benefits Specialist will provide you with the available plan options for each line of coverage upon review of this application. For questions, call (562) 404-8029 or email us at benefits@ascip.org.
  • PART 1 - CURRENT SCHOOL DISTRICT INFORMATION

  • PART 2 - CURRENT HEALTH & WELFARE PLAN INFORMATION

  • (who must enroll, cash in lieu offerings, voluntary offerings, etc.)

Email the Workbook to: hb_info@ascip.org.
For questions, call (562) 404-8029 or email us at hb_info@ascip.org

Submission of this form authorizes ASCIP to share information with service providers and carriers to obtain quotes on the District’s behalf.

Please allow a minimum of 4 weeks for quote submissions.

Contact Info

Main Office/Southern California Claims Handling:
16550 Bloomfield Avenue
Cerritos, CA 90703

Northern California Claims Handling:
1531 "I" Street, Suite 100
Sacramento, CA 95814

Email: ascip_info@ascip.org
Phone: (562) 404-8029
Fax: (562) 404-8038
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