Request an Individual / Family Health Insurance Quote Please give information ONLY on persons who are to be included in the quote. Form has a TAB sequence set for your convenience. If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Primary Insured First Name * Last Name * Zip Code * Email * Phone * Birth Date * Sex * Male Female Tobacco Use Yes No Spouse Information Spouse Sex Male Female Spouse Birth Date Spouse Tobacco Use Please select Yes No Children Information Child 1 Sex Male Female Child 1 Birth Date Child 2 Sex Male Female Child 2 Birth Date Child 3 Sex Male Female Child 3 Birth Date Child 4 Sex Male Female Child 4 Birth Date Child 5 Sex Male Female Child 5 Birth Date To determine if you qualify for a federal subsidy, will your "2017 household, adjusted gross income" be"? Please select Household size of 1: $11,880-$47,080 Household size of 2: $16,020-$63,720 Household size of 3: $20,160-$80,360 Household size of 4: $24,300-$97,000 Household size of 5: $28,440-$113,640 Household size of 6: $32,580-$130,280 -OR- Based on Household Size, my income exceeds these levels. From Our Blog Pros and cons of small group health insurance versus an individual or family health insurance policy. State of the upcoming 2018 Houston health insurance market for Families & Individuals What are the criteria to create small group health insurance policies in Texas? A case study of one of our clients within the Houston health insurance market Is a small group health insurance plan a better deal than a family plan?