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I'm interested in:


Number of Employees*
Enter "1" if interested in coverage for yourself and/or your family.

Number of Employees currently covered by insurance

First Name*

Last Name*

Company Name*

Company Address*




Phone* (xxx-xxx-xxxx)


Do you currently work with a Broker?
If yes, what's the Broker's name?
And the Agency's name?

Indiana Restaurant & Lodging Association (InRLA) and UnitedHealthcare offer special health care pricing and solutions for InRLA members.

Here are some key features of our alliance program:
  • Exclusive savings on standard group medical plans and
    specialty benefits
  • Wellness programs and services
  • Online modular platform for easy administration and
    Affordable Care Act (ACA) compliance
  • Resources and tools for Hispanic/Latino owners, operators
    and employees
  • Lower-cost preventive medical plan that meets
    Individual Mandate requirements

Some restrictions may apply.

For more information on how we can help you with your health care needs, contact:
Clinton Wolf
(312) 348-7064
Or simply complete and submit the form below: