Document Checklists

Please remember that using the most up-to-date checklist will help reduce the number of drafts prepared, in turn lowering the cost of your plan. Please click on the appropriate link to access your checklist.

Self-Funded Medical Plan Checklists 

Dental Only (checklist) v.01.14

Disability Only (checklist) v.01.14

Medical Only (checklist) v.12.14

RX Only (checklist) v.01.14

Vision (checklist) v.01.14


Medical & Dental (checklist) v.05.17

Medical, Dental, Vision, Disability, Rx (checklist) v.12.14

Medical, Dental, Rx (checklist) v.12.14

Medical & Rx (checklist) v.12.14

Medical & Vision (checklist) v.12.14


Flexible Spending Account Checklists

Dependent Care FSA (checklist) v.07.13

General Medical FSA, Limited Purpose FSA, Dependent Care FSA & Premium Only (checklist) v.01.18

Medical FSA (checklist) v.01.18

Medical FSA & Dependent Care FSA (checklist) v.01.18

Medical FSA, Dependent Care FSA & Premium Only (checklist) v.01.18

Medical FSA, Dependent Care FSA, Premium Only & Transportation (checklist) v.01.18

Medical FSA & POP (checklist) v.01.18

Premium Only Plan (employer paid) (checklist) v.07.13

Premium Only Plan (negative election) (checklist) v.02.14

Premium Only Plan (positive election) (checklist) v.02.14

Transportation Plan (checklist) v.01.18


HRA/HSA/MRP Checklists

HRA Wrap (checklist) v.01.14

HSA (checklist) v.04.12

MRP (checklist) v.12.14


Fully-Insured Wrap Plan Checklists

Dental Wrap (checklist) v.06.14

Group Life (checklist) v.01.14

LTD Wrap (checklist) v.01.14

Medical Wrap (checklist) v.12.14

Mega Wrap (checklist) v.02.16

STD Wrap (checklist) v.01.14

Vision Wrap (checklist) v.12.14


SBC Checklists

Full SBC  (checklist) v.12.17

HRA SBC (checklist) v.12.17

Rx SBC (checklist) v.12.17


Other Plan Checklists

Adoption Assistance (checklist) v.01.18

Behavioral Health (checklist) v.01.14

Chiropractic, Acupuncture, Massage (checklist) v.01.14

Employee Assistance Plan (checklist) v.04.15

Taft Hartley (checklist) v.12.14