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Open Enrollment Check-up

Interested in a second set of eyes on your open enrollment decisions? Use this form to sign up and help us prepare for our meeting.

When does your open enrollment period end?

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Client Contact Info

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Co-Client Contact Info (Optional)

Who is your current employer?

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Please describe your compensation (ex. hourly, salary, commission, bonus, equity compensation).

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List the benefits you currently have:

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What are your top questions & concerns about open enrollment? These topics will guide our open enrollment analysis and meeting.