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Benefits. Simplified.

Request New Hire or Newly Eligible Enrollment

This form lets you quickly request enrollment when an employee becomes eligible for benefits. Whether you’re adding a new hire or updating coverage after a life event, we’ll review the details, coordinate with your carrier, and help you keep everything accurate and compliant.


Common employee benefits enrollment scenarios

  • New hire
  • Enrolling after the loss of other group insurance
  • Part-time to full-time
  • Adding a spouse after marriage
  • Adding a newborn or adopted child




If your health plan is self‑funded

If your group health plan is self‑funded, please use our separate intake process so we can coordinate correctly with your administrator. 

Self‑funded enrollment request

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WA 808607. OR 100171613. CA 0D20905. ID 756820. NV 769449. AZ 3995616. TX 2605615

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