Activate My Benefit

Please enter the required information below and activate your membership. All family members are activated and will have access to the membership benefits.

Group Number* Please enter your group number.

First Name * Please enter your first name.

Last Name * Please enter your Last name.

Date of Birth mm/dd/yyyy * Please enter Date of Birth in mm/dd/yyyy format.

Gender *

Please select your gender.

Email * Please enter your email address.

Phone * Please enter phone number.

The Benefit Plan is administered by Alliance Direct Benefits. By clicking below, you agree to the Alliance of service.