Please note that due to Federal HIPAA Guidelines, Claim, Payment, Appeal, and Prior Authorization information can not be discussed via email correspondence.

Register

First Name:

Last Name:

Date of Birth:

Member ID (Refer to Your Plan ID Card) OR School Assigned ID: Add leading zeros if StudentID is less than 9 characters (ex: 000123456)

Zip:

Username: Must be at least 6 characters long

Email address:

Email Address Confirmation:

Password:

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Password Confirmation:

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Security Questions: Please select your security questions and answers used when verifying your identity.

Security Question 1:

Security Question 2:

Security Question 3:

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