ADD SOMEONE TO A POLICY

Add somebody to your policy

Would you like a quotation before adding this new member?
No, I’m happy for you to add the member and confirm the costs.Yes, I’d like a quote first and then we’ll decide.
Do you want quote variations to include partner and/or children?
NoYes

Please complete the details of all the people you’d like quotes for.


Please select one of the following options:

Please select your policy type:

Which policies do you want to add them to: (tick all that apply)
Medical InsuranceMedex ProtectCashplanDental InsuranceTravel InsuranceGroup Life Insurance/Death in ServiceGroup Income ProtectionGroup Critical Illness

Company information:


Employee information:



Does the employee or anyone to be added to the policy already have health insurance in place?

NoYes

Please provide details of their current insurer and renewal date:

Add another employee


Add a second employee:



Does the employee or anyone to be added to the policy already have health insurance in place?

NoYes

Please provide details of their current insurer and renewal date:

Add another employee


Add a third employee:



Does the employee or anyone to be added to the policy already have health insurance in place?

NoYes

Please provide details of their current insurer and renewal date:

Add another employee


Add a forth employee:



Does the employee or anyone to be added to the policy already have health insurance in place?

NoYes

Please provide details of their current insurer and renewal date:

Add another employee


Add a fifth employee



Does the employee or anyone to be added to the policy already have health insurance in place?

NoYes

Please provide details of their current insurer and renewal date:

You may submit a maximum of 5 employees at once using this form. To submit more employees please click submit and then start the process again.


Company information:


Employee information:


Policy holder information:


Dependant information:




Does the dependant already have a health insurance policy in place?

NoYes

Please provide details of their current insurer and renewal date:

Add another dependant


Add a second dependant:




Does the dependant already have a health insurance policy in place?

NoYes

Please provide details of their current insurer and renewal date:

Add another dependant


Add a third dependant:




Does the dependant already have a health insurance policy in place?

NoYes

Please provide details of their current insurer and renewal date:

Add another dependant


Add a forth dependant:




Does the dependant already have a health insurance policy in place?

NoYes

Please provide details of their current insurer and renewal date:

Add another dependant


Add a fifth dependant:




Does the dependant already have a health insurance policy in place?

NoYes

Please provide details of their current insurer and renewal date:

You may submit a maximum of 5 dependants at once using this form. To submit more dependants please click submit and then start the process again.