PLAN MEMBER SERVICES

Registration



First Name  
Surname     Including middle name and initial as it appears on the OneCard.
Date of Birth  
  YYYYMMDD
  (No slashes or dashes)

Group  

Certificate/Student #  

Email Address  


Note:  Group, certificate numbers and names must be entered as they appear on your RWAM OneCard, if applicable.

I am authorized to view claims information concerning any and all dependants enrolled under my plan