Pre-Enrollment Checklist

Colonial Life — HWLF Network Partner

Use this checklist and information to ensure all tasks are completed to close and set up the client for a successful enrollment.

Client Information

Legal Business Name *

Contact Name *

Title / Role

Email Address *

Phone

Business Address

City

State

ZIP

Total Employees

Nature of Business

EIN / Tax ID

Next Payroll Date

Open Enrollment Dates

If your company currently has an open enrollment period, please provide the dates below.

Enrollment Start Date

Enrollment End Date

Additional Notes on Enrollment

Submitted by HWLF Network · Colonial Life Partner