My Group Insurance

The Georgia Society of CPAs' Group Insurance Account offers group life insurance, group comprehensive major medical, group dental, group long-term disability, individual life insurance, individual medical insurance, and long-term care insurance.

If you would like to receive additional information on the plans sponsored by the GSCPA, please complete the following form and click on the "Submit" button. If you have additional questions, please contact Pritchard & Jerden directly as they are the Society's administrator's for all of your insurance requirements. The representatives that work closely with the Society are Patrick Bell at 404-949-1098 or Jill Bushnell at 404-949-1083.

I am Interested in:	Please check all that apply Group/Individual Medical Insurance Dental Insurance Disability Insurance Long Term Care Life Insurance
Name
Date of Birth	xx-xx-xxxx
Sex	Male Female
Phone Number	xxx-xxx-xxxx
Email
Firm Name
Mailing Address
County

My Group Insurance

The Georgia Society of CPAs' Group Insurance Account offers group life insurance, group comprehensive major medical, group dental, group long-term disability, individual life insurance, individual medical insurance, and long-term care insurance.

I am Interested in:

Name

Date of Birth

Sex

Phone Number

Email

Firm Name

Mailing Address

County