iCHRA SEP Notice Generator

Employer Information

Employer / Company Name *

Employer Address

HR Contact Email

HR Contact Phone

Employee & iCHRA Details

Employee Full Name *

Employee Address

Date of Letter / Notice *

Special Enrollment Date *

iCHRA Benefit Effective Date *

Monthly iCHRA Allowance

SEP Enrollment Window

Plan Year

Employer Defaults (applies to all employees)

Employer / Company Name *

Employer Address

HR Contact Email

HR Contact Phone

Default Letter Date

Default Special Enrollment Date

Default iCHRA Effective Date

Default Monthly Allowance

SEP Window

Plan Year

Upload Employee CSV

💡 CSV columns: employee_name, employee_address, letter_date, sep_date, ichra_date, allowance — all optional, fall back to defaults above. ⬇ Download template

📂

Click to upload CSV, or drag & drop here

Supports .csv files — one row per employee

iCHRA SEP Notice Generator

Employer Information

Employee & iCHRA Details

90-Day Notice Additional Details

Employer Defaults (applies to all employees)

90-Day Notice Additional Defaults

Upload Employee CSV