Employee Census Form 2026

Get Form
employee census data for benefits bid Preview on Page 1

Here's how it works

01. Edit your employee census data for benefits bid online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send employee census data via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Employee Census Form with our platform

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open the Employee Census Form in the editor.
  2. Begin by entering your company contact information, including the requested effective date, company address, and phone number. This ensures that all correspondence is directed correctly.
  3. Fill in the group name and selling agent details. Accurate information here helps streamline communication with your broker.
  4. For each employee, input their name, date of birth, gender (M/F), occupation, and annual salary. Note that occupation and salary are required only if you are requesting a life, STD, or LTD quote.
  5. Specify the county and zip code for each employee to ensure proper coverage assessment.
  6. Select the coverage type from the options provided: IND for individual coverage, PC for employee/child coverage, HW for husband and wife coverage, FAM for family coverage, or PCN for employee/children.

Start using our platform today to easily complete your Employee Census Form online for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
An employee census is a report that contains specific demographic data about each employee within an organization. Employers often use the census to create a snapshot of their employee population to meet compliance regulations and receive benefit quotes from insurers and other plan service providers.
Key components of an employee census This can include the employees name, date of birth, address, gender, contact information, Social Security number, marital status, and number of dependents. To that end, you will also want to have each dependents name, their Social Security number, and relationship to the employee.
If no response is returned or if the answers are incomplete the Census Bureau will follow up to get the information. The final population tally is used to divvy up more than $675 billion annually to states for all sorts of programs. By census law, refusal to answer all or part of the census carries a $100 fine.