Intake Form

Overview: This intake form will help us produce your Enrollment Meeting on Demand™ and build your company Benefit Hub™. This process should take 15-20 minutes to complete. Here’s the information you’ll need handy.
  1. Client, Broker and Contact Detail’s
  2. A Zip File of All Benefit Summaries, SBC’s and Plan Documents
  3. A2P Registration Details
Ready? Let's begin.

Basic Info

Client Details Cont.

Broker Agency Detail

Eligibility & Structure

Benefit Plan Detail

Please upload your zip file for all the active benefits you wish to have covered in your Enrollment Meeting on Demandâ„¢ or linked to your Benefit Hub for employee access. Include all benefit summaries, SBC's, plan documents, and your current benefits guide. You can upload one by one, but a zip file upload is easiest.

Compliance and Company Document Upload

Please upload any additional non-benefit related documents that you would like housed on your Benefit Hub and made available to employees. Include any compliance or company policy documents here.

Capturing the Highlights and Important Focal Points

You know your group best! When we're producing your Enrollment Meeting on Demand, it's helpful to note if there is anything you wish to pay a bit more attention to, highlight, celebrate, spend more time on, or specifically market to employees. It's important we know. 😊 Do you have any specific plan funding details, contributions, plan enhancements, or other aspects you wish to highlight or focus on? Are there any benefits offered that are new or experiencing significant changes this renewal period?

Important Contacts:

Please upload all contact information that should be provided to employees during the Enrollment Meeting on Demand. This includes carrier contacts, web URLs, email addresses, phone numbers, and any other contacts that employees may need to utilize.

SMS Carrier Compliance

Note: The information below is required to apply for A2P compliance regarding SMS messaging to employees for open enrollment communications.