Tips to Remember

Please provide a copy of the benefit summary and most recent billing statement(s) for all of your group plans.

·     CLICK HERE to open the Excel Census File.  Please make note of all three sheets.

·         Please identify each employee with an A for Active, P for Probationary period, W for Waive, IE for Ineligible or C for COBRA in the 1st column.

·         Please refer to the Key to assign the appropriate tier for each employee.

·         Please include the number of children after the tier and their age in the Child Age(s) column.

·         Only complete Occupation and Salary if quoting Life, STD or LTD.

·       All COBRA participants need to be included in the census and identified. 

-------------------->  Click here to fill in your on-line Census Form in Excel format <---------------------