Group Insurance Census Data Request Form
Submit and Send, Fax or Email Completed Census Form.
Submit the completed Group Insurance Census Data Form by:
- Download and complete the form using your computer and then press the SUBMIT button on the upper right hand corner to forward the document to RSI Benefits directly. Press OK on the pop-up window to send.
- Download the form, complete, save the file to your computer and print it and either fax or mail it to the address(s) below.
- Census Data Request Form
Email to: salesandservice@rsibenefits.com
Fax to: 832-218-6479
Mail To:
Employee Benefits Specialists
595 Orleans Suite 822
Beaumont, TX 77701
Phone: 409-291-5851
Contact:
Robert Saunders, Sr. Agent
Phone: 409-291-5851
