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New Dependent RegistrationSTEP 1/3

All fields marked with an * are required.


* Your Member ID Number: Member ID may be located on your ID card
* Your Date of Birth:  
* Your Home Zip Code:
 
   
 
For assistance in creating your web portal account,
please contact Health Portal Solutions at 855-490-6673.
To expedite your call please provide this code to the
representative: (SEAFA).

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