Please see the requirements in order to receive a quote:

• A business license and proof that your business has been in operation for one (1) year or longer.
• Two (2) subscribers or more to participate in the plan.
• A completed Group Sales Information Form or specific health related information that will be requested by your Account Executive (dependent on the size of the group)

Group Eligibility Requirements

Small Group (2-24 Employees)


Required Forms:


• Group Sales Information Form
• Individual Health Statement
• Business License
• Most recent Quarterly Wage Report (QWR) filed and stamped by your local Taxation agency

Minimum Participation:

• Minimum of two (2) eligible subscribers to participate in the plan.

*Please fax or email the forms to 671-647-3548 or email the ursula.remis@takecareasia.com to receive a quote.



Mid-size and Large Groups (25+ Employees)


Required Forms:


• Group Sales Information Form
• Demographics Form
• Request for Information form

*Please fax or email the forms to 671-647-3548 or email the ursula.remis@takecareasia.com to receive a quote.