What are your important reasons for coverage?

Burial or Cremation

Paying off Debts

Leaving behind a Legacy

Other

Check all that apply!

Are you...

Mom👩

Dad👨

What is your age?

25-35

35-50

50-75

75-85+

Do you currently have life insurance

Yes

How much coverage are you looking for?

$5,000-$8,000

$9,000-$13,000

$14,000-$20,000

$20,000+

Great! Are you a smoker?

Yes

Do you have any health conditions?

Yes

Our quiz will not ask what they are.

What state are you in?

Click the arrow below to select your state to get matched!

Great! What's your name?

Who are we making the match for?

First Name *

Last Name *

Lastly, how we can contact you? 🎉

Email *

Phone *

By clicking 'Next', I provide my electronic signature and agree that licensed representative, working with Insurance Leah may contact me. This contact may involve, artificial or prerecorded voices, automated SMS texts, or emails, and may be initiated manually or by autodialer, to my residential or cellular number. This contact will be for the purpose of discussing insurance options.