Small Group Census — Trevor Snell Insurance

Small Group Census — Trevor Snell Insurance

This mirrors the census format used to request small-group quotes (fields marked * are required for a quote — matches the format used for groups under 50 employees). Fill in your company info and employee roster below; nothing here commits you to coverage.

Company information

Used to request and rate small-group quotes across carriers.

Lines you'd like quoted

Check everything you want carriers to quote. For any line you currently have, add the current deductible/benefit so quotes can be matched or improved on — leave blank if there's no current coverage.

Salary is required to quote life or disability; occupation is required to quote disability — both are optional otherwise, in the roster below.

Employee roster

One row per covered person. List each employee, then add a row for each enrolled spouse/child directly below with the same sequence number.

Seq #First nameLast nameRelationshipDOBGender StateHome ZIPCurrent medical planCurrent dental planCurrent vision plan TierSalaryOccupation
Email this census to Trevor
After you click "Prepare census," you'll get a CSV download (formatted to match the small-group quote request format Trevor's carriers use) and a pre-filled email you can send to Trevor directly. Trevor reviews it and forwards it to the general agency himself. Information submitted here is used only to request group coverage quotes and is not shared outside that purpose.

Trevor Snell Insurance is not associated with or endorsed by Medicare, the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (DHHS) or any other government agency. Medicare has neither reviewed nor endorsed this information. For a complete listing of plans in your area please contact 1-800-MEDICARE or consult www.medicare.gov (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

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