Please complete census for your group only if you have less than 50 employees. Please include all eligible, full-time employees.
Please complete the attached census entirely and be sure to include all information (zip codes, dependents names, gender, date of birth).
Step 1:Download the Excel file. |
Step: 2:Complete the Excel file. |
Step 3:Save Excel file as .xlsx (CompanyName-Date-ACAForm.xlsx) |
Step 4:Complete the form below. |
Step 5:Upload Excel file to form. |
Step 6:Submit form with uploaded Excel file. |
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