Pegasus Capital & Insurance Services, Inc.

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Please fill out the form under the CONTACT US page for a free no obligation quote from several different carriers. You can also contact us by phone or fax.

Pegasus Capital &
Insurance Services, Inc
550 S. Hope St. suite 2170

Los Angeles, CA 90071

(213)622-6202 office

(213)622-6212 fax

Disclaimer

Securities offered through Transamerica Financial Advisors,Inc. (TFA), a registered Broker/Dealer and Investment Advisor, member FINRA and SIPC, 1150 S. Olive Street, Los Angeles, CA 90015.
This information is intended for use in California. This website should not be considered a solicitation in any other state.

Forms & Applications



AFLAC:
	AFLAC Cancer Claim Form (PDF) Claims Authorization Form (PDF) Continuing Disability Form (PDF) Dental Claim Form (PDF) Injury/Accident Claim Form (PDF) Cancer Indemnity-Application Non-Payroll (PDF) Cancer Indemnity-Application Payroll (PDF) Continuing Disability Claim Form (PDF)	New Dental Application Non-Payroll (PDF) New Dental Policy Application (PDF) Dental Reinstatement Application (PDF) Personal Sickness Policy App.-Non-Payroll (PDF) Request For Change Application (PDF) Sickness Claim Form (PDF) Sickness-Payroll Application (PDF) Bank Draft Authorization (PDF)
Blue Cross of California:
	Apply online Health Insurance Health Insurance Individual Enrollment App. (PDF) Small Group Employee Application (PDF) Supplement for Health Application (PDF) Smilenet Dental Discount Program (PDF) Individual Dental Application PPO (PDF) Automatic Payment Option Form (PDF) Individual Medical Application (PDF)	Small Group - Affidavit Of Domestic Partnership (PDF) Small Group - Master Employer Application 2006 (PDF) Small Group - Owner-Officer Statement (PDF) Small Group - Stand Alone Life Application (PDF) Small Group - Stand Alone Vision Application (PDF)
Blue Shield of California
	Apply Online
Nationwide Health Plans
	Apply online Health Insurance