Loading
Choose an Option:
I'm a Member
I'm a Provider
I'm a Employer
I Am Enrolling
Employee Benefits
Group Benefits
Medical
Life
Disability
Dental and Vision
Voluntary Benefits
Life
Accident
Short Term Disability
Long Term Disability
Cancer
Personal Insurance
Life, Medical, Accident
Life
Medical
Accident
Disability
Dental
Vision
Cancer
Annuities
Senior Insurance Plans
Medicare Supplements
Medicare Rx
Long Term Care
Life Insurance
Personal Property Insurance
Homeowners
Renters
Flood
Auto
Business Insurance
General Liability
Professional Liability
Commercial Property
Commercial Auto
Workers Compensation
Flood
Sign up for our Email Newsletter
Get a Quote
Please fill out the form below to contact us directly.
Bold
labels and
*
indicate required information.
Name
First Name
Last Name
Address
Address
City
State
Postal / Zip Code
E-Mail Address
Phone Number
-
Area Code
Phone Number
ADDvantage CARE is licensed to sell insurance in Louisiana, Texas, Mississippi and Alabama. If you live
outside of Louisiana, please mark "other" in the Parish field.
Parish
Acadia
Allen
Ascension
Assumption
Avoyelles
Beauregard
Bienville
Bossier
Caddo
Calcasieu
Caldwell
Cameron
Catahoula
Claiborne
Concordia
DeSoto
East Baton Rouge
East Carroll
East Feliciana
Evangeline
Franklin
Grant
Iberia
Iberville
Jackson
Jefferson
Jefferson Davis
Lafayette
Lafourche
LaSalle
Lincoln
Livingston
Madison
Morehouse
Natchitoches
Orleans
Ouachita
Plaquemines
Pointe Coupee
Rapides
Red River
Richland
Sabine
St. Bernard
St. Charles
St. Helena
St. James
St. John
St. Landry
St. Martin
St. Mary
St. Tammany
Tangipahoa
Tensas
Terrebonne
Union
Vermilion
Vernon
Washington
Webster
West Baton Rouge
West Carroll
West Feliciana
Winn
Additional Info
Female
Male
Gender
Date of Birth
Height
Weight
Please check if you use any tobacco products
Spouse Info
Female
Male
Gender
Date of Birth
Height
Weight
Please check if you use any tobacco products
Interested In
Interested in individual insurance benefits for you and/or
spouse and children
Company Owner/Human Resources Manager interested
in benefits for your employees
Please check off the insurance products you are interested in below:
Medical
Health
Dental
Long Term Care
Disability
Life Insurance
Vision
Cancer
Accident
Heart/Stroke
Healthcare Discount Organization
Hospital Indemnity
401-k and Cafeteria Plans
Other:
Your Comments
*Please enter childrens
info. if relevant