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Electronic Census Sheet

PW_002704
Download the blank census sheet to a disk and run a virus scan to ensure the integrity of the file. Depending on your web browser, you may need to right-mouse-click on the link and specify "Save Target As" to save the file.  
Open the spreadsheet cencalc.xls using Excel. You're ready to enter data.  
GROUP NAME
Enter the GROUP NAME.
PLAN NAME
Enter PLAN NAME, for example, ConnecticutCare HMO.
PLAN TYPE
Enter PLAN TYPE, for example, HMO, POS, PPO.
EFFECTIVE DATE
Please enter the effective date of coverage. The census sheet will automatically calculate the employee's age.
DOB
Enter Date of Birth. The member's age will be calculated and displayed on the census sheet.
M/F
Enter the member's gender.
Contract Class
Enter the following codes:
1 = Employee only
2 = Employee and spouse
3 = Employee, spouse and child(ren)
4 = Employee and child(ren)
ZIP CODE
Enter the zip code. As soon as the zip code is entered, the state will appear in column 4.
 
Formatting Makes the Difference
All of the columns except for the DOB column have been text formatted to accept data. The DOB column has been date formatted. This formatting allows us to process your information faster - without keying in data - ensuring the accuracy of the quote. If you decide to use your own spreadsheet, you can submit it to us. We ask that you use these formatting guidelines to minimize the need for our staff to re-key data.  
Submitting the Census
Whether or not you use our census sheet, you can submit your files electronically to your Anthem Blue Cross and Blue Shield sales representative. We have found that it may take up to five business days to receive information by mail. Once we've received it, depending on the number of individuals on the census, it can take up to ten business days to re-enter the data and check it. Use our Internet address to send your completed census sheet to an Anthem Blue Cross and Blue Shield sales representative. By using this format, firstname.lastname@anthem.com, your census will be here within minutes of transmission.  
We'll gladly assist you and your staff when using this census sheet. Just give us a call.  
©2005-2014 copyright of Anthem Insurance Companies, Inc.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use