Get Harvard Pilgrim Account Census

Filling out the Harvard Pilgrim Account Census online is a straightforward process that helps capture essential information about your company and its employees. This guide provides step-by-step instructions to ensure you complete the form accurately and efficiently.

Follow the steps to complete the form accurately

1. Click ‘Get Form’ button to acquire the form and open it in the editor.
2. Begin by entering your company's name in the designated field. This should be the official name as registered.
3. Select the type of business from the options provided, ensuring you choose the classification that best describes your organization.
4. Provide the contact name for the primary representative handling the census, including their phone number for any follow-up.
5. Enter the total number of employees at your company in the specified field.
6. Fill in the company address, including city, state, and ZIP code. This helps in correctly identifying your location.
7. Indicate the total number of COBRA enrolled individuals, if applicable.
8. List the number of employees who are currently outside the enrollment area, if relevant.
9. Record the anniversary date of your group's insurance policy.
10. If the effective date is different from the anniversary date, provide that information in the respective field.
11. Enter the renewal rates for both individual and family coverage, indicating the employer's contribution percentage.
12. Fill in the current rates and participating carriers for the benefits that your company is offering.
13. For each eligible employee, input their name, date of birth or age, gender, and the type of coverage they have (individual or family).
14. Include information regarding COBRA coverage, whether it has been waived, and if they have waived insurance in favor of spousal coverage.
15. If you have more than the designated number of employees to report, you can copy this page to accommodate up to 50 eligible employees.
16. Finally, once all fields are filled out correctly, save your changes and choose how you wish to submit the form, whether by downloading, printing, or sharing.

Complete your Harvard Pilgrim Account Census online now to ensure accurate reporting and efficient processing.