Onboarding

New Client Onboarding Form

Number of eligible lives

General Account Information

Organization type

Client tax ID number

Multiple locations?

Yes No

If so, which states located in?

Individual authorized to sign agreements (policyholder)

General administrative contact

Billing administrator(s) - list up to 3 in priority order

Billing administrator 1

Billing administrator 2

Billing administrator 3

Payroll provider

Payroll frequency

Deduction frequency

Benefit Administration

Ben Admin Platform

Integrated with payroll?

Yes No

Currently using self billing?

Yes No

Ben Admin provider

Forester Benefits Broker Other

EDI Feeds

Yes No

Wall Feeds

Yes No

If yes,

Group processed(recommended) FBM processed Third party processed

Open enrollment

Are new hires enrolled when eligible?

Yes No

New hire enrollment

Benefits to be enrolled

If yes, what carrier?

Basic life

Yes No

If yes, what carrier?

Voluntary/supplemental life

Yes No

If yes, what carrier?

Accidental death & dismemberment

Yes No

If yes, what carrier?

Basic STD

Yes No

If yes, what carrier?

Basic LTD

Yes No

If yes, what carrier?

Voluntary STD

Yes No

If yes, what carrier?

Voluntary LTD

Yes No

If yes, what carrier?

Voluntary Critical Illness

Yes No

If yes, what carrier?

Voluntary Accident

Yes No

If yes, what carrier?

Voluntary Hospital Indemnity

Yes No

If yes, what carrier?

HSA/FSA/HHRA/EAP

Yes No

If yes, what carrier and plan type?

Services being provided by FBM

Ben Admin Platform Face to face benefit counselors Call center benefit counselors for enrollment Call center benefit counselors for support only Perpetual new hire/QLE processing FMC text messaging Open enrollment communications website Employee navigator payroll import files Forester Resolve – Decision Support platform

New Client Onboarding Form

Legal Address

Mailing Address

General Account Information

Contact

Individual authorized to sign agreements (policyholder)

General administrative contact

Billing administrator(s) - list up to 3 in priority order

Billing administrator 1

Billing administrator 2

Billing administrator 3

Payroll information

Benefit Administration

Enrollment Method

Benefits to be enrolled

Forester services

Onboarding questionaire complete

© 2022 All Rights Reserved