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.