Member Registration

Member Information To ensure security and data confidentiality, you must register to use Benefits Lookup. It's a quick authentication process. Fill in the fields below to get started.

Subscriber ID:

First Name:

Last Name:

Birthdate (mm/dd/yyyy):

    Contact Info and Security

    Set Contact and Security Information
    Username:
     

    Please choose a unique password that will identify you when you sign on. Please remember that passwords are case sensitive.
    Special characters are allowed except the following: % and &

    Password (at least 8 char):
    Retype Password:

    Email Address:
    Retype Email Address
    Phone Number:

    To help us identify you in case you forget your password in the future please choose a question to which you will remember the answer:

    Select Security Question:

    Security Answer:

      Terms of Service Agreement

      Terms

        Finish

        Complete Registration



        Registration Completed!