Request for Information
For more information about how the Christian Brothers Employee Benefit Trust can serve your organization, please complete the Request for Information form. So that we can better serve you, please fill in your contact information completely and accurately. We will never share this information with anyone outside Christian Brothers Services.

Census
To provide coverage, we will need a complete census of all eligible employees.

Census must include date of birth (or age), gender, occupation, salary/wage, and for health coverages include type of current coverage (single, spouse, child(ren), family, or waived) and employee zip code. Census must include all eligible employees regardless of participation status. If part-time or non-eligible employees are included, please indicate them as such. Individually identifiable information is not necessary.

Electronic submission of data is preferred.
Any format is acceptable as long as it contains all data elements. If census information is not available electronically, you may use the pdf form to the left of this text. Please use the latest version of Adobe Reader so you can save the form and then return it to us by email. A link to Adobe is available at the bottom of this page. You can also use the excel form to the left to provide the information and return by email.