Employee Census Form 2026

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.

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