1 (800) 272-4783

Employee Benefits Request

Rue Insurance is here to serve you. Our staff is available during regular business hours M-F, 8:30 to 5. While we are always happy to take your calls during business hours, we also want to be available through our website or provide access to self-service when it is convenient for you.

Please fill out the Benefits Insurance Request form below and someone from our office will get back to you by the next business day.

Insurance Information

Insured Name (required)

Mailing Address

Street Address

City

State

Zip

Contact Information

Daytime Phone Number (required)

Your Email (required)

Best Method and Time to Contact (required)

Policy Information

Policy Number

Policy Type
Group HealthGroup DentalGroup LifeGroup Disability

Type of Change
Request a Medical CardRequest an Enrollment FormRequest a Benefits SummaryChange Mailing or Contact InformationAdd or Delete an EmployeeRequest a QuoteOther-write in space

Additional Comments or Instruction