HealthEquity Client Activation Form

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It’s time to be agents of change. Access collaboration tools and resources that help champion equality and promote DE&I best practices in the workplace.

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HealthEquity Client Activation Form

Paycor’s Client Activation Form

To ensure our integration is configured correctly, we will need some input from you prior to Client activation.

Please take a moment to fill in below fields.

Questions? Email [email protected].

*Your Name

*Your Email

*Your Phone

*Company Name

*Company Address Line 1

Company Address Line 2

*Contact Full Name

*Contact Phone Number

*Contact Email

*WageWorks Group ID

*Federal ID Numbers (FEIN)

Please list all FEINs that will be electing the WageWorks services

*Elected Services

Please list the services Client elected

Notes

*First Pay Date

*First Funding Date

*Pay Frequency

Hold down control (Windows) or command (Mac) to select multiple

*Partner Plan Codes

Please list all applicable WageWorks plan codes. Example: Healthcare FSA: HCFSA20XX

*Priority

HealthEquity Client Activation Form

Paycor’s Client Activation Form

Your Information

Company Activation Information