Forms Broadcast – 90 Days From Retirement

push

Schedule a Presentation

Contact Form

Free Social Security Analysis

Social Security Readiness Assessment

Social Security Readiness

4 simple questions to determine your next best steps
Please enter your name*
Full Name

Are you married?
Yes
No
Were you previously married?

I've never been married

Divorced

Widowed
Did that marriage last 10 years or more?
Yes
No
When is your spouse's birthday?
MM slash DD slash YYYY

Do you have any children under the age of 18?
Yes
No

What is your Primary Insurance Amount (PIA)?
What is PIA?
Your PIA is the benefit dollar amount you would receive if you elect to begin receiving retirement benefits at your normal retirement age.
How to determine your PIA
The Social Security Administration has a useful tool to help you calculate this number if you don’t know it already.

Click this PIA Estimator Tool and a separate window will open where you’ll be able to quickly determine your number and enter it here.

What is your email address?
Email*

Zip Code*

You are an excellent candidate to start a social security strategy
Your assets and financial positions are major factors to setting a strategy that makes sense. Most people don’t want to put that into an internet form and we want to respect your privacy.

So, if you’ll allow, one of our financial professionals can call you to better understand your situation and send you a complete Social Security Analysis. Simply enter your phone number below.

Phone
Phone
This field is for validation purposes and should be left unchanged.

Advantage vs Supplement

Advantage vs Supplement

Which is right for you?

Take this short quiz to find out.

Step 1 of 6

How important is it to you that you keep your current doctors?

Very Important

Not Important

Step 1 of 6

How important is it to you to have coverage while traveling?

Very Important

Not Important

Step 1 of 6

How important is it to you to have dental or vision coverage included in your plan?

Very Important

Not Important

Step 1 of 6

How important is it to you to have all of your benefits in one plan?
(one company, one ID card)

Very Important

Not Important

Step 1 of 6

Which is more important to you?

Lower monthly premiums

More help paying for deductibles, copays, and coinsurance

Step 1 of 6

Finishing up
Name

Email*

Zip Code*

Comments
This field is for validation purposes and should be left unchanged.

Advantage Contact

Talk to an expert

Name

Email

Supplement Contact

Talk to an expert

Name

Email

Home Contact

Your Name

Your Email

Your Phone

or call 801-901-8511

Medicare or Company Plan

Move to Medicare
or Stay on Company Plan

Which is right for you?

Take this short quiz to find out.

Step 1 of 6

When do you turn 65 years old?

I'm already 65

0-3 months

3-6 months

6 months - 1 year

1-2 years

2+ years

Step 1 of 6

Are you married?

Yes

No

Step 1 of 6

When does your spouse turn 65 years old?

My spouse is already 65

0-3 months

3-6 months

6 months - 1 year

1-2 years

2+ years

Step 1 of 6

If you move to Medicare, could your spouse stay on a company plan?

Yes

No

Step 1 of 6

Step 1 of 6

How do you currently have health insurance?

My work

My spouse's work

Individual marketplace

COBRA

I don't have health insurance

Step 1 of 6

Step 1 of 6

Who does your current health insurance plan cover?

Just me

Me and my spouse

Me, my spouse, and dependent(s)

Me and dependent(s)

Step 1 of 6

Step 1 of 6

How much is your monthly premium for health insurance?

$0 - $150 per month

$151 - $500 per month

$500+ per month

Step 1 of 6

Step 1 of 6

What is your plan deductible?

$0 - $250

$251 - $1,000

$1,000 - $3,000

$3,000+

Step 1 of 6

Step 1 of 6

What is your current Out of Pocket Maximum?

$0 - $7,000

$7,001 - $10,000

$10,000+

Step 1 of 6

Step 1 of 6

Do you have a Health Savings Account (HSA)?

Yes

No

Step 1 of 6

Finishing up

Step 1 of 6

Finishing up
Name

Email

Zip Code*

Hidden
Age - Medicare

medicare
Hidden
Age - Work

work
Hidden
Spouse - Medicare

medicare
Hidden
Spouse - Work

work
Hidden
Current Health Ins - Medicare

medicare
Hidden
Current Coverage - Medicare

medicare
Hidden
Current Premium - Work

work
Hidden
Current Premium - Medicare

medicare
Hidden
Deductible - Work

work
Hidden
Deductible - Medicare

medicare
Hidden
Out of Pocket Max - work

work
Hidden
Out of Pocket Max - medicare

medicare
Name
This field is for validation purposes and should be left unchanged.

Ebook Download

Get Yours For Free

Your Name

Your Email

Webinar Form

Register for Free

First Name(Required)

Last Name(Required)

Email

Moreton Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

Northwestern Mutual Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

EMI Health March Webinar

Register for Free

First Name(Required)

Last Name(Required)

Email

SWBH Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

Contact Form - ES

Contact Us page / Spanish Translation

Nombre

Correo Electrónico

Número de teléfono
Mensaje
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

General Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

General Medicare 101 - Spanish

Register for Free

First Name(Required)

Last Name(Required)

Email

Juab School District

Register for Free

First Name(Required)

Last Name(Required)

Email

6-22 Gallagher

Register for Free

First Name(Required)

Last Name(Required)

Email

9-21 Gallagher

Register for Free

First Name(Required)

Last Name(Required)

Email

12-21 Gallagher

Register for Free

First Name(Required)

Last Name(Required)

Email

5-18 Utah County

Register for Free

First Name(Required)

Last Name(Required)

Email

Recorded Webinar

Drop in your email for access to the workshop!

First Name(Required)

Last Name

Drop in your email for access to the webinar!(Required)

Captcha

6.1.23 LHM Group Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

6.1.23 LHM Company Afternoon Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

6.27.23 LHM Group Afternoon Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

AFCU test

Register for Free

First Name(Required)

Last Name(Required)

Email

6.27.23 Evening LHM Company Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

05.30.2023 Ultradent Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

ES - Advantage vs Suplemental

Advantage vs Suplemental

¿Cuál es el más adecuado para usted?

Responda este breve cuestionario para averiguarlo.

Step 1 of 6

¿Qué tan importante es para usted que permanezca con los mismos médicos?

Muy importante

No es importante

Step 1 of 6

¿Qué tan importante es para usted tener cobertura mientras viaja?

Muy importante

No es importante

Step 1 of 6

¿Qué tan importante es para usted tener cobertura dental o de la vista incluida en su plan?

Muy importante

No es importante

Step 1 of 6

¿Qué tan importante es para usted tener todos sus beneficios en un solo plan?
(una compañía de seguro, una tarjeta de identificación)

Muy importante

No es importante

Step 1 of 6

¿Qué es más importante para usted?

Cuotas mensuales más bajas

Más ayuda para pagar deducibles, copagos y coseguros

Step 1 of 6

Finishing up
Name

Email*

Zip Code*

Email
This field is for validation purposes and should be left unchanged.

ES -Medicare o Plan de Trabajo

Mudarse a Medicare
o permanecer en el plan de la compañía

¿Cuál es el más adecuado para usted?

Responda este breve cuestionario para averiguarlo.

Step 1 of 6

¿Cuándo cumple 65 años?

Ya cumplí 65

0-3 meses

3-6 meses

6 meses a 1 año

1-2 años

2 o más años

Step 1 of 6

¿Está casado?

Sí

No

Step 1 of 6

¿Cuándo cumple su cónyuge 65 años?

Mí cónyuge ya cumplió los 65 años

0-3 meses

3-6 meses

6 meses a 1 año

1-2 años

2 o más años

Step 1 of 6

Si se muda a Medicare, ¿podría su cónyuge permanecer en el plan de la compañía?

Si

No

Step 1 of 6

Step 1 of 6

¿Actualmente cómo tiene un seguro de salud?

Por mi trabajo

Por el trabajo de mi cónyuge

Mercado de Seguro

No tengo seguro médico

¿A quién cubre su plan de seguro médico actual?

Step 1 of 6

Step 1 of 6

¿A quién cubre su plan de seguro médico actual?

Sólo yo

Mi cónyuge y yo

Mi cónyuge, yo y mis dependientes

Mis dependientes y yo

Step 1 of 6

Step 1 of 6

¿Cuánto es su cuota mensual para el seguro de salud?

$0 - $150 Por mes

$151 - $500 Por mes

$500+ Por mes

Step 1 of 6

Step 1 of 6

¿Cuál es el deducible de su plan?

$0 - $250

$251 - $1,000

$1,000 - $3,000

$3,000+

Step 1 of 6

Step 1 of 6

¿Cuál es su máximo de cobro de su bolsillo?

$0 - $7,000

$7,001 - $10,000

$10,000+

Step 1 of 6

Step 1 of 6

¿Tiene una cuenta de ahorros para la salud (HSA)?

Si

No

Step 1 of 6

Finishing up

Step 1 of 6

Terminando
Name

Email

Zip Code*

Hidden
Age - Medicare

medicare
Hidden
Age - Work

work
Hidden
Spouse - Medicare

medicare
Hidden
Spouse - Work

work
Hidden
Current Health Ins - Medicare

medicare
Hidden
Current Coverage - Medicare

medicare
Hidden
Current Premium - Work

work
Hidden
Current Premium - Medicare

medicare
Hidden
Deductible - Work

work
Hidden
Deductible - Medicare

medicare
Hidden
Out of Pocket Max - work

work
Hidden
Out of Pocket Max - medicare

medicare
Name
This field is for validation purposes and should be left unchanged.

ES - Preparación para el Seguro Social

1
2
3
4
5
6
7
8

Preparación para el Seguro Social

4 preguntas simples para determinar sus próximos pasos
Por favor, de su nombre*
Nombre completo

¿Cuántos años tiene?

YOU ARE ELIGIBLE FOR SOCIAL SECURITY BENEFITS

You became eligible on your 62nd birthday.
Aún no es elegible para los beneficios del seguro social

Será elegible cuando cumpla 62 años.

Su estrategia de Seguro Social debe ser revisarse a medida que se acerque a los 60 años. Continúe con esta herramienta para determinar cómo preparar su estrategia de seguro social.

¿Está casado?
Si
No
Were you previously married?

I've never been married

Divorced

Widowed
Did that marriage last 10 years or more?
Yes
No
When is your spouse's birthday?
MM slash DD slash YYYY

¿Tiene hijos menores de 18 años?
Si
No

¿Cuál es su Monto de Seguro Primario (PIA)?
¿Qué es PIA?
YSu PIA es el monto en dólares del beneficio que recibiría si elige comenzar a recibir beneficios de jubilación a su edad normal de jubilación.
Cómo determinar su PIA
La administración del seguro social tiene una herramienta útil para ayudarlo a calcular este número si aún no lo sabe.

Haga clic en esta herramienta de estimación de PIA y se abrirá una ventana separada donde podrá determinar rápidamente su número e ingresarlo aquí.

¿Cuál es su dirección de correo electrónico?
Correo electrónico*

Código postal*

Usted es un candidato perfecto para iniciar una estrategia de seguridad social
Sus bienes y posiciones financieras son factores importantes para establecer una estrategia que tenga sentido. La mayoría de la gente no quiere poner esa información en una forma en el internet y queremos respetar su privacidad.

Entonces, si lo permite, uno de nuestros financieros profesionales puede llamarlo para comprender mejor su situación y enviarle un análisis completo del Seguro Social. Simplemente ingrese su número de teléfono a continuación.

Número de teléfono
Email
This field is for validation purposes and should be left unchanged.

06.15.23 EMI Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

06.14.23 Sandy City Medicare 101

Register for Free

First Name(Required)

Last Name(Required)

Email

form-on-publish

Register for Free

First Name(Required)

Last Name(Required)

Email

form-6.7.23-medicare-101-English

Register for Free

First Name(Required)

Last Name(Required)

Email

5/9

Where do you live?

push

Schedule a Presentation

Your Information

Presentation

Contact Form

Free Social Security Analysis

Social Security Readiness Assessment

Social Security Readiness

What is your email address?

You are an excellent candidate to start a social security strategy

Advantage vs Supplement

Advantage vs Supplement

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Advantage Contact

Supplement Contact

Home Contact

Medicare or Company Plan

Move to Medicare or Stay on Company Plan

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Step 1 of 6

Ebook Download

Webinar Form

Register for Free

Moreton Medicare 101

Register for Free

Northwestern Mutual Medicare 101

Register for Free

EMI Health March Webinar

Register for Free

SWBH Medicare 101

Register for Free

Contact Form - ES

General Medicare 101

Register for Free

General Medicare 101 - Spanish

Register for Free

Juab School District

Register for Free

6-22 Gallagher

Register for Free

9-21 Gallagher

Register for Free

12-21 Gallagher

Register for Free

5-18 Utah County

Register for Free

Recorded Webinar

6.1.23 LHM Group Medicare 101

Register for Free

6.1.23 LHM Company Afternoon Medicare 101

Register for Free

6.27.23 LHM Group Afternoon Medicare 101

Register for Free

AFCU test

Register for Free

6.27.23 Evening LHM Company Medicare 101

Register for Free

05.30.2023 Ultradent Medicare 101

Move to Medicare
or Stay on Company Plan

Mudarse a Medicare
o permanecer en el plan de la compañía