SIMPLIFY HR - With our Online Benefits Enrollment, Administration and HR system.
powered by Employee Navigator for clients of Beckham Insurance Group
http://choosebeckham.com/employee-navigator/
We are pleased to present our clients with Human Resources, Benefits Administration, and Payroll. All in one place…
Current clients will implement at renewal and new clients will implement at effective date.
INSTRUCTIONS FOR PROPER IMPLEMENTATION.
Please answer questions 1-7 below
Answer Below
1. What is the waiting period for new hires?
2. What is the payroll frequency?
3. Does Premium Contribution vary by class? If so please explain class and contribution structure
4. Do you want to utilize our employee onboarding feature for automated new hire documents?
5. Do you want to utilize our COBRA integration feature? ($1.50 PEPM)
6. Input Y or N for Coverage the Employer would like to offer Employees. If Yes, then input Employer Contribution Amount or type "Voluntary"
Line of Coverage
Medical
Dental
Vision
Short Term Disability
Long Term Disability
Group Life
Voluntary Life
Critical Illness / Cancer
Accident
GAP Plan
Y or N
Employer Contribution ( % or $)
FYI - VOLUNTARY Participation Requirements*
N/A
Greater of 3 enrolled or 20% of group
Greater of 3 enrolled or 20% of group
5 enrolled
Greater of 10 enrolled or 25% of group
How much Coverage? 1 x salary or flat $
Greater of 10 enrolled or 25% of group
5 enrolled
5 enrolled
5 enrolled
*Participation requirements WAIVED if employer
contributes minimum $15 PEPM toward any
combination of supplemental benefits above.
7. Complete Census on next tab; green columns are required, yellow columns preferred. Census required to pre-load employees on software system prior to enrollment
**Deadline for returning form is 28 days prior to effective date if changing medical plans and 14 days prior to effective date if no medical plan change.
Company Name:
Contact Name:
Date:
Employee SSN*
Phone Number
Last Name*
Tobacco User
First Name*
On Wellness
Middle Name
Job Title
Suffix
Marital Status
Date of Birth*
Is Full Time
Hire Date*
Is Exempt
Gender*
Hourly Rate
Class* (salary or hourly)
Employee ID
Payroll Group* (if
multiple payrolls)
Payroll ID
Annual Base Salary*
Original Hire Date
Salary Effective Date
Affiliate Hire Date
Email
Department
Address 1
Division
Address 2
Business Unit
City
Office
State
Cost Center
Zip Code
Demographic Change
Date
County
Country