• New Account Setup Form

    New Account Setup Form

  • Company Information

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  • General Benefits Information

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    Pick a Date
  • Company Contact

    We must schedule a set-up call with the group contact as soon as possible. This is for verification purposes in establishing them as a Colonial account and ensuring the invoice is correctly set up. 
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  • Payroll Information

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    Pick a Date
  • Colonial Life Billing

  • Enrollment Details

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    Pick a Date
  • New Account Enrollment Build

    Please upload all of the following:
  • Browse Files
    Cancelof
  • Census Template

  • Click here for the Colonial Life Enrollment Census Template

  • Additional Details for Employee Navigator or Ease database builds

    Please complete if this information if known, it will be needed/asked for in order to complete the database build.
  • Broker Information

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  • Clear
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    Pick a Date
  • Colonial District Office Use Only

  • Should be Empty: