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GGFM-ER-8514 Maxwell Health Employer Information Form 02/24 <br /> Billing and administration <br />Home Office Administration This allows you to receive an online billing statement each month and manage your <br />Sun Life policies online—with helpful features such as billing, forms, and more. <br />Advanced Billing: Applies to Basic Life, AD&D, STD, LTD, Dental and Vision coverages. <br />The billing statement is sent prior to the coverage period and premium is expected to be paid prior to the coverage <br />period. Bills will be pro-rated and employees are charged for the full period in which they are covered. On-going <br />adjustments will reflect on a future bill. <br />For example: For the coverage period of October, a bill will be available by September 25th and premium should be <br />remitted as soon as possible. <br />Arrears Billing: Applies to Accident, Critical Illness, Cancer Indemnity, Hospital Indemnity and Issue Age STD <br />coverages. Bills will be pro-rated and employees are charged for the full period in which they are covered. On-going <br />adjustments will reflect on a future bill. <br />Designed for Voluntary benefits, this allows you to pay as deducted using the deductions collected during the <br />coverage period and remitted at the end of the coverage period. <br />For example: For the coverage period of October, a bill will be available by October 25th and premium should be <br />remitted in early November. <br />Voluntary Life, AD&D, Voluntary STD, and Voluntary LTD and Paid Family and Medical Leave can be included on <br />either Advanced Billing or with other Employee- paid coverages on Arrears Billing. <br />Please select an option below: <br /> Advanced Billing Arrears Billing <br />Payroll Cycle: <br />Do all employees have the same payroll frequency? ................................................................................. Yes No <br />If “Yes,” select frequency: Weekly (52) Bi-Weekly* (26) Semi-Monthly (24) Monthly (12) <br />If “No,” Please specify below: <br />Eligible class name Payroll Frequency <br /> Weekly (52) Bi-Weekly* (26) Monthly (12) Semi-Monthly (24) <br /> Weekly (52) Bi-Weekly* (26) Monthly (12) Semi-Monthly (24) <br /> Weekly (52) Bi-Weekly* (26) Monthly (12) Semi-Monthly (24) <br />*If Bi-Weekly, are deductions taken in 26 pay cycles? ............................................................................... Yes No <br />If “No,” explain: <br />Do all employees have the same pay dates? ............................................................................................ Yes No* <br />*If “No,” please provide your implementation consultant with a copy of your payroll calendar. <br />Docusign Envelope ID: BA987120-63B9-40BD-A4CA-C6E248AD9B65 <br />X <br />X <br />X <br />N/A <br />X <br />X