Online application is for new companies only. Existing companies please contact us directly to add an employee.
Before starting this online application, you will need to have available:
• The full social security numbers for all employees enrolling.
• If you have a recent drug test result (within 6 months) or membership in
another consortium, you should first upload proof of it to your computer
(If you don’t have one of these, it is not needed.)
• Credit card information
“Some browsers may not work with this link. If you have trouble, please use the paper application and scan or fax it to us.”