Prizes
As soon as you’ve sold one Health Access plan with SBGI, you get a free Concorde Ballpoint Pen & Roller
Ball Gift Set. Submit this form with all the check boxes marked off and fax this form to us with your signature:
___________________________ ___________________________ __________________________
NameSignatureDate
After you’ve sold five (5) Health Access or other Major Medical policies with Assurant through SBGI,
you’ve earned a Weathertec Shoreline Jacket. The item can be found on the www.AssurantHealthSales.com site
under the Assurant Merchandise and Active Wear option. These are available for ladies and men in a range of sizes
and colors; please specify: Weathertec Shoreline Jacket size: _______________ and color: ________________.
___________________________ ___________________________ __________________________
NameSignatureDate
When eligible for your prizes, print your name, then sign, date, and fax this page to Simmons Benefit Group, Inc at
208-227-1788.
| 