Enrollment Forms

Account Bill

To enroll in Account Bill, please complete this form and return it to us by email, fax, or mail.

Fax:
866-209-8379

Mail to:
Accounting Dept.
Quincy Mutual Group
PO Box 699150
Quincy MA 02269-9150

Electronic Funds Transfer (EFT)

EFT enrollment forms have been replaced with an online enrollment system.

To enroll, visit your agent or log in to the Insured Access Customer Login page, navigate to Billing and select the EFT Enrollment button to initiate enrollment. We accept checking or savings accounts for EFT withdrawals.