Template:Json Request Insurance

    {
         companyName: "companyName",
         phoneNumber: "phoneNumber",
         address1: "address1",
         address2: "address2",
         city: "city",
         state: "state",
         zip: "zip",
         policyNumber: "policyNumber",
         groupNumber: "groupNumber",
         planName: "planName",
         groupName: "groupName",
         effectiveDate: "effectiveDate",
         expirationDate: "expirationDate",
         guarantorRelationship: "guarantorRelationship",
         guarantorName: "guarantorName",
         guarantorFirstName: "guarantorFirstName",
         guarantorMiddleName: "guarantorMiddleName",
         guarantorLastName: "guarantorLastName",
         guarantorDob: "guarantorDob",
         guarantorGender: "guarantorGender",
         copayAmount: "copayAmount"
    }