Upload your payroll data to generate your PHI Eligibility & Savings Estimate.
Payroll Report Requirements
To generate your PHI Eligibility & Savings Estimate, please upload payroll reports from the
most recent month, organized by individual pay cycle
(weekly, bi-weekly, or monthly).
Employee Name Details
First Name, Middle Initial, and Last Name
Gross Pay by Pay Period
Gross pay for each pay period within the most recent month
Regular gross pay only — exclude bonuses, commissions, overtime, or any additional compensation.
All Pre-Tax Deductions
Include all applicable deductions for each employee
This includes health/medical deductions, retirement contributions (dollar amounts), and any other pre-tax deductions.
Pay Frequency
Clearly indicate the payroll schedule used for each report
(Weekly, bi-weekly, or monthly payroll must be specified)
Important Note:
Payroll reports may include additional information; however, only the data outlined above will be used to generate your PHI Eligibility & Savings Estimate. Providing complete and accurate information will ensure the most accurate results.
🔐 Your Information is Secure
All payroll data submitted through this form is encrypted and securely transmitted.
This information is used solely for onboarding, payroll analysis, and benefit implementation
as part of the Project Blue PHI program.