Decisely Direct

Healthier employees mean a healthier bottom line for employers.

Welcome to Decisely Small Group Benefits!

Healthier employees mean a healthier bottom line for employers.

Download Census

The key to getting you a fast and accurate quote with the best pricing available is for you to collect and submit all your employees census information along with your 9-Digit FEIN/Tax ID.

Click “Download Spreadsheet” to access the employee information form.

Download Spreadsheet

If you have any questions, help is available!

Hidden
Form Name
Hidden
Form URL
Business Information
Name*
First Last
Email*
Phone*
Company*
Street Address*
City*
State*
Zip*
Number of full-time employees*
Number of part-time employees
Hidden
Number of employees
When do you want benefits to start?*
NOTE: The benefits effective date for enrollments received by the 6th of the month is the first day of the next month. The benefits effective date for enrollments received after the 6th of the month is the first day of the following month. Example: Enrollments received January 1 - 6 will have an effective date of February 1st. Enrollments received January 7 - 31 will have an effective date of March 1st.
Additional Information
Which of the following payroll providers do you use?*
Other provider? Please specify:*
Do you currently offer health insurance coverage?*
- Yes
- No
Who is your current medical carrier?*
Other medical carrier:*
Approximately how many employees are enrolled?*
What is your coverage renewal month?*
Upload Completed Census*
Max. file size: 100 MB.
Hidden
Send To
Hidden
Lead Source Detail
Hidden
Expected Opportunity Type
Hidden
Lead Source
Hidden
Lifecycle Status
Hidden
Lead Source Detail
Hidden
Channel

&&&&&

.st0{fill:#9D22E5;}

Welcome to Decisely Small Group Benefits!

Download Census

Business Information

Additional Information