The employee benefits department of Branch-Hernandez and Associates offers a full range of insurance coverages relating to businesses or individuals. We specialize in fully insured and self-funded health plans, dental / vision plans, term / whole life insurance and supplemental insurance plans. BHA benefits department is also a provider of the Mywave / HR Connection© tools.


If you are interested in purchasing medical, dental, vision, life or supplemental benefits, please complete the following questionnaire.


Contact Name
Business Name
Business Address
Daytime Phone
Fax Number
Email Address
Type of Business
Years In Business
Current Provider/Carrier

Which Of The Following Coverages Are You Interested in?

Medical Insurance
Dental
Vision
Life
Supplemental Insurance
Other

Date Insurance Is Needed

Please complete the following questionnaire.



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