..:: GCADA - Group Insurance Quote Form ::..

Upcoming Events: Seminar Schedule

F&I Manager's Guide to Compliance - NORTH OLMSTED
Thursday, September 24, 2026 - 10:30am-1:30pm
Aloft Cleveland Airport 5550 Great Northern Blvd.
Members: $80/pp Non-Member: $160/pp

F&I Manager's Guide to Compliance - MAYFIELD
Thursday, September 17, 2026 - 10:30am-1:30pm
Holiday Inn 780 Beta Dr. Mayfield 44143
Members: $80/pp Non-Member: $160/pp

F&I Manager's Guide to Compliance - CUYAHOGA FALLS
Thursday, September 10, 2026 - 10:30am-1:30pm
Sheraton 1989 Front St. Cuyahoga Falls 44221
Members: $80/pp Non-Member: $160/pp

HAZMAT Training, Testing & Certification
Wednesday, March 25, 2026 - 9:00am-12:00pm
9150 S. Hills Blvd. Broadview Heights, OH 44147
SAFE: $0; GCADA Member: $45/pp; Non-Member:$90/pp

Service Advisor Training - Maximizing Service Opportunities
Tuesday, January 13, 2026 - 8:30am-4:30pm
GCADA 9150 S. Hills Blvd. Lower Level Conf. Room
Members: $279/pp Non-Member: $600/pp

Group Insurance Quote Form

Please complete the following information and click the "submit" button.
Contact Information:
Dealer Name
Person Requesting
Address
City, ST, ZIP
Phone
Fax
E-mail Address

Indicate number of employees only, covered in each category:
Single
Employee & Spouse
Employee & Children
Family
COBRA
Total employees currently covered

COBRA eligible, not yet covered
Emplyees eligible, not currently covered
Total emplyees eligible for coverage
Current Policy Information:
Current Group Health Carrier
Date policy expires
	Employee	Emp & Sp	Emp & Child/ren	Family
Current Rates:
Renewal rates if available:
Prior Policy Information:
Prior Group Health Carrier
Date coverage expired
	Employee	Emp & Sp	Emp & Child/ren	Family
Prior Rates:

Are you aware of any serious medical conditions, such as cancer, heart, circulatory
conditions, etc.? If so, please describe below:

Current coverage information:
	In-network	Out of network
Deductibles
Co-insurance
Out of pocket maximums
Prescription co-pays:
Generic
Name Brand
Non Preferred