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Update Request
dmarko
2017-06-14T19:10:24+00:00
Step 1 of 2
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Broker Name
*
First
Last
Broker Email
*
Enter Email
Confirm Email
Do You have a registered Benefit portal with us?
*
Yes
No
Client Information
Is this a new client or exisiting?
*
New Client
Existing
Client Business Name
*
Client Logo
*
Drop files here or
Is this a new client page or existing?
New
Existing
New Page to be created
*
Client Benefits
Enter the information below to be updated on your broker portal.
Client Benefits Category 1
Enter the benefits catagory for this client. Example (BCBS of IL - Medical) or (Prescription Drug)
Catagory 1 - Plans
Enter the plan names you would like to display on the front end. Example (Blue Choice Select Benefit Highlight Sheet) 1 Document per line. Upload the documents following this step
Catagory 1 - Benefit Documents
Drop files here or
Client Benefits Category 2
Enter the benefits catagory for this client. Example (BCBS of IL - Medical) or (Prescription Drug)
Catagory 2 - Benefit Documents
Enter the plan names you would like to display on the front end. Example (Blue Choice Select Benefit Highlight Sheet) 1 Document per line. Upload the documents following this step
Catagory 2 - Benefit Documents
Drop files here or
Add More Client Resources?
No
Yes
Client Benefits Category 3
Enter the benefits catagory for this client. Example (BCBS of IL - Medical) or (Prescription Drug)
Catagory 3 - Benefit Documents
Enter the plan names you would like to display on the front end. Example (Blue Choice Select Benefit Highlight Sheet) 1 Document per line. Upload the documents following this step
Catagory 3 - Benefit Documents
Drop files here or
Client Benefits Category 4
Enter the benefits catagory for this client. Example (BCBS of IL - Medical) or (Prescription Drug)
Catagory 4 - Benefit Documents
Enter the plan names you would like to display on the front end. Example (Blue Choice Select Benefit Highlight Sheet) 1 Document per line. Upload the documents following this step
Catagory 4 - Benefit Documents
Drop files here or
Client Benefits Category 5
Enter the benefits catagory for this client. Example (BCBS of IL - Medical) or (Prescription Drug)
Catagory 5 - Benefit Documents
Enter the plan names you would like to display on the front end. Example (Blue Choice Select Benefit Highlight Sheet) 1 Document per line. Upload the documents following this step
Catagory 5 - Benefit Documents
Drop files here or
Client Benefits Category 6
Enter the benefits catagory for this client. Example (BCBS of IL - Medical) or (Prescription Drug)
Catagory 6 - Benefit Documents
Enter the plan names you would like to display on the front end. Example (Blue Choice Select Benefit Highlight Sheet) 1 Document per line. Upload the documents following this step
Catagory 6 - Benefit Documents
Drop files here or
Client Benefits Category 7
Enter the benefits catagory for this client. Example (BCBS of IL - Medical) or (Prescription Drug)
Catagory 7 - Benefit Documents
Enter the plan names you would like to display on the front end. Example (Blue Choice Select Benefit Highlight Sheet) 1 Document per line. Upload the documents following this step
Catagory 7 - Benefit Documents
Drop files here or