Public review — sample data onlyReal applicant entry and submission are disabled.
PDX Benefits
Enrollment workspaceGroup benefits · Public review
Review mode

Explore a fixed example

Preview ready. All entry fields are disabled.

PDX Benefits Thoughtful benefits. Clear next steps.

Save the whole application.

The offline enrollment pilot saves every answer in an encrypted draft. Reopen the file with your own passphrase.

Complete a sample handoff with James before live use. This public page still saves only a sample checkpoint.

Earlier private-details tool

For an SSN/bank-only return already arranged with James, the earlier tool remains available. The new whole-application form includes these details in its encrypted files.

Based on the existing Group Enrollment Intake: 76 employer questions and 25 fields per person.
OFFLINE ENROLLMENT PILOT

Every answer. One encrypted draft.

Download and extract the ZIP, then open the HTML form on your computer. Save an encrypted draft and reopen it with your passphrase. To switch devices, move the tool and your encrypted draft yourself.

Download offline enrollment form
Keep your passphrase separately.

There is no reset or automatic backup. The final packet for James is a separate encrypted file. Creating a file does not send it.

Before live use, complete a sample handoff with James and confirm he can read the new final packet. Return files only through your company’s agreed restricted destination. No answers are uploaded to this public page.

Try the preview on this browser

Save only the current section, sample scenario and simulated handoff state. Reload this page, then choose Resume demo.