Choose how you would like to load your companies census. We recommend the "Upload A File" option for businesses with more than 15 employees.
Please Note: A Full-Time Employee is defined as an employee working a minimum of 25 hours per week.
We require at least the first of the following employee record cards be filled out. When providing additional employee census records, all five fields within are required.
Attach File(s)
Information needed when submitting an employee census.
- Employee Name
- Birth Date
- Coverage Type:
- Employee Only
- Employee & Spouse
- Employee & Child(ren)
- Employee, Spouse & Child(ren)
- Waiving Coverage
- Employment Status:
- Full-Time Employee
- Part-Time Employee
- Retired
- Cobra/Continuation
- Age