Interactive Demonstration - Employer Connection

*= Required Field

User Account:
* User Name:	User name must be at least 6 characters Example: john44
* First Name:
* Last Name:
* Email Address:
* Phone:
* Password:	Password must be 8 or more characters
* Confirm Password:
Account Status:	Active Inactive
	Any password entry will force the user to change their password upon next sign on.

User Access
Claim Status Inquiry Benefits & Eligibility Inquiry View & Print Billing Invoices Claims Detail Information - HIPAA Online Enrollment

Groups this account accesses:
	FULLY INSURED	20883-000-00000-28011
	03000-00
	SELF INSURED INDIVIDUAL	93705-000-00000-00000
	FULLY INSURED JOINT	03905-000-00005-00000
	FULLY INSURED JOINT	40013-000-00000-00000
	VISION	40001-000-00000-00000