Discounted Guaranteed Issue Individual Disability Insurance exclusively available to Samaritan Health Medical Residents and Fellows A Unique Opportunity GUARANTEED Approval NO Medical Underwriting True Own Occ and Specialty Specific Language $2.5K-$15K of Monthly Benefit* Permanent 20% Discount *Additional income protection up to $30K a month with underwriting Start Here With your customized quote. If you apply elsewhere it may preclude you from this one time opportunity SHS GSI Form Name * Name Name Name Email * Cell Phone * Specialty * Age * Age18192021222324252627282930313233343536373839404142434445464748495051525354555657585960 Gender * GenderMaleFemale State * StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming REQUEST QUOTE If you are human, leave this field blank. Secure Your Coverage in 3 Simple Steps As easy as 1, 2, 3 01 Get your quote and choose your coverage 02 Complete the e-application 03 Protect your income today and in the future Start Here With your customized quote.If you apply elsewhere it may preclude you from this one time opportunity SHS GSI Form Name * Name Name Name Email * Cell Phone * Specialty * Age * Age18192021222324252627282930313233343536373839404142434445464748495051525354555657585960 Gender * GenderMaleFemale State * StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming REQUEST QUOTE If you are human, leave this field blank. Anthony C. Williams CWS, ChFC, MRFC, CLU anthony@mosaicfa.com 480-776-5920 602-770-5948 7025 N. Scottsdale Rd., Suite #115 Scottsdale, AZ 85253