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Genworth Life – Group LTCi Payroll Questionnaire
1. Employer Name: 2. What is your payroll deduction frequency?
Please check all that apply:
Monthly Semi-monthly Biweekly 24x 26x Weekly Other:
3. The billing frequency will be monthly unless otherwise
specified below.
Other:
Please provide a copy of your schedule of the current year's payroll cycles if billing is not monthly.
4. If monthly, indicate when you want the monthly billing data generated and sent;
Day of prior or current month
Ex. Day 20 of prior month means April 20th for May bill Ex. Day 5 of current month means May 5th for May bill Remittance at end of month should match the monthly amounts, if full deductions were taken. Any shortages will be billed to the employees directly.
5. Do you prefer to have the employee and spouse billing combined as one amount or separated?
Rolled (i.e. Eligible and spouse as one record) Not Rolled (i.e. Spouses show as a separate record)
6. Do you use a vendor for payroll processing?
Yes No Please check No if your payroll is processed in-house. If yes, please provide vendor information: Name/Company Phone Email
7. Indicate media format you prefer to accept payroll deduction information:
Paper Electronic (requires minimum of 50 employees
enrolled and on payroll deduction)
8. If paper billed, please provide the mailing address we should use for the list bills:
Attn:
9. If electronic, indicate preferred file data type:
Full File Changes Only
10. Please indicate preferred method of payment
remittance: Check Wire/ACH
11. Payroll/billing contact you wish us to work directly
with in case of further set up or billing questions: Name
Title Phone Email
12. Backup Payroll/billing contact:
Name
Title Phone Email
13. IT/File Transfer contact you wish us to work directly
with to establish file transfer method and procedures: Name
Title Phone Email
Thank you for completing this questionnaire. Please send to Genworth Life:
Attention: Policy Owner Services Phone#: 1-800-416-3624
Fax#: 952.918.5096 Email: [email protected]