SAO Shared Services Contractor Access Agreement

The SHBP Employing Entity Payroll Locations below have contracted directly with SAO Shared Services for payroll processing and have authorized their access to monthly premium billing reports, daily proof bill reports, and other reports SHBP provides directly to SHBP Employing Entities. This form is specifically for SAO Shared Services to request or remove access to the SHBP Enrollment Portal and/or SHBP State Health Repository Tool (SHRT) for their Designated Benefits Administrators for participating SHBP Employing Entity Payroll Locations.

If you are not completing this agreement on behalf of a SAO Shared Services’ Designated Benefits Administrator for an SHBP Employing Entity, click here to complete the correct form.

Participating SHBP Employing Entity Payroll Locations Include:

14010 14080 14090 14100 14120 14180 14181 14210 14240
14241 14250 14310 14410 14500 14530 14570 14610 14611
14630 14701 14770 14780 14830 14831 14840 14870 14880