Census Download / Upload

Census Form Download / Upload

An employee census will need to be submitted with this form. This census will require information about the employee and his/her dependents and is required by insurance providers to provide an accurate quote. MI E-Benefits has provided two options to help you complete the census accurately and in a timely manner. You can download and complete our template or you can upload a completed census you may have on file. Information contained in the form is confidential and will only be used for the purpose of providing a quote, please see our privacy policy for more details

Download and complete census form

  • Census Form Upload

  • Max. file size: 64 MB.

+1 (800)-XXX-XXXX

MI E-Benefits offers online insurance services for all of Michigan.

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