Secure Payroll Upload
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.

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