Lyric Transmittal and Spreadsheet upload from VIP

1
There are only 2 types of enrollment options in this system ("new hires" or "new account"). If this is an EXISTING account and you are adding people please mark NEW HIRE.
2
Agent Name* This field is required.
First Name
Last Name
3
Your email* This field is required.
example@example.com
4
Your Phone Number* This field is required.
Please enter a valid phone number.
5
Account Name* This field is required.
6
Type of Enrollment* This field is required.
NEW HIRE(s) or EXISTING CASE OPEN ENROLLMENT
FIRST ENROLLMENT
7
How many enrollees?* This field is required.
8
Which Lyric Package is this?* This field is required.
Lyric Complete (Primary Care Svs)
Lyric Basic
9
Completed Census File Upload Here:* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
Should be Empty: