Online application for Group Insurance SGP Purchasing Network Program Please fill out the form below. Our advisors will be happy to contact you to help you assess your needs and build a customized plan that fits your profile and budget. Legal business name First and last name of the person in charge Phone number Email address Number of employees (permanent employees working more than 24 hours per week) (optional) Do you offer a group insurance plan to your employees? Yes No By submitting this form, you consent to the collection, use, and retention of your personal information by Lussier and authorize Lussier to contact you to provide you with a quote as part of our group insurance program.