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The fastest way to get a quote from LEP is to complete the form below in its entirety. Forms completed in full will yield faster results.
Quote Form
Contact Information

First Name
Last Name
Email
Phone Number

Health Information
What is insured's current medical condition? *
Very Healthy
Healthy senior with minor health problems
Some health problems
Moderate health problems
Significant health problems
AgeAndGenderInformation

Male under 72 Female under 74
Male 72 to 75
Female 74 to 77
Male 76 to 79 Female 78 to 80
Male 80 to 82 Female 81 to 83
Male 83 to 87 Female 84 to 87
Male 88 to 91 Female 88 to 90
Male 92 to 94 Female 91 to 93
Male over 94 Female over 93

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0 - $99k $500 - $999k
$100 - $249k
 $1M - $4.9M
$250 - $499k Over $5M
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Universal Life
Whole Life
Term Life
Variable Life
Survivorship Life
Group Life
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Please note all items marked with an asterik (*) are necessary. Thank you