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Group Administration Registration

To request access to the Group Admin Portal you must complete the appropriate authorization form. Select the appropriate access form below and Email us or Fax 603-223-1129.

Authorization Form - Self Insured Authorization Form - Insured



Contact Information

All fields are required

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Group Information

Please provide all Group/Sublocation/Divisions that you would like to have access to.

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Group Number:
  
Add Additional Sublocation

Sublocation Number Division Number Status






If you have any problems registering please call 1-800-537-1715.

Finding Group Numbers
Your Group, Sublocation, and Division numbers can be found on the remittance page of your bill.

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