(All fields with * are required fields)
Basic User Information
Last four digits of your SSN*
(Username must be 8 or more characters.)
Confirm your password*
View Password Rules
Passwords should be a minimum of 8 characters long
Passwords should include at least one alpha and numeric character
Passwords should include at least one of the required characters
Passwords should include alpha, numeric and defined special characters only
The following special characters are allowed : !@#$%^*()
Passwords should not include 2 identical adjacent characters
Password and user login should not be the same
The last three passwords cannot be used
You must answer 3 questions
What is your first pets name?
What is the first high school you attended?
From which high school did you graduate?
What is your favorite vacation spot?
In what month was your father born?
What is your favorite cartoon character?
In what month was your mother born?
What color was your first car?
What is your all-time favorite board game?
Who is your favorite composer?
Who did you go to prom with?
What was your favorite teachers name?
Who was your favorite childhood hero?
What was your first phone number that you remember?
What is the last name of your all-time favorite athlete?
What was the name of your first teacher?
What is the first name of your best friend from high school?
What is your all-time favorite sports team?
Who is your all-time favorite musical artist or group?
What is your all-time favorite sports movie?
View Challenge Answer Rules
Answers should be a minimum of 3 characters long
Letters A-Z , a-z, numbers 0-9 and spaces are allowed
The following special characters and punctuation are allowed: ! @ # $ % ^ * ( ) _ . -
Each answer may only be used once in the series of questions you choose to answer
Copyright © 2017, BenefitMall. All rights reserved.