Benefit Admin System Build Form

Please review the Employee Navigator Pre-Build Checklist for a list of every required item needed to build a basic company profile in EE navigator.

Employee payroll contributions are required for every plan that is not 100% employer sponsored or 100% voluntary. 

Complete the downloadable contribution workbook for all applicable plans and upload below.  Alternatively, you can describe the contribution structure in the provided text box. At least one of these areas must be submitted to build the group's enrollment system

You can access our premium contribution workbook HERE

Census Requirements

This list is to include all employees of the company regardless of employment type, or job class.  The Employee Navigator census template can be downloaded here: HERE

• Employee first & last name
• Employee status (active, leave, cobra, etc.)
• Employee email address (important if using benadmin)
• Employee phone
• Gender
• Birth date
• Hire date
• Employment class (full-time, part-time, etc.)
• Job title
• Annual salary -or- hourly wage
• Scheduled hours
• SSN
• Home address (optional - include if possible)
  • Street address
  • City
  • State
  • Zip code
• Dependent names, genders, and birth dates (optional - include if possible)
• Dependent relationships (spouse, domestic partner, child, etc.)

For enrollments to be loaded for coverage not placed through link Benefits

• Election for each member (enrolled or waived) for each plan
  • Election tier for dental, vision, accident etc.
  • Name of elected plan (if multiple options)
  • Volumes for voluntary benefits (for vol. life, critical illness, vol. disability,etc.)
  • Benefit class (if applicable)
• Original effective date of coverage