Member Information Request

For questions about benefits, claims, or other plan information, please complete the form below and a LifeSynch^® customer service representative will be in contact to assist you. You also can visit our FAQ page. We look forward to assisting you.

If you or your family member is experiencing an emergency please call 911.

* Required Fields

*Member ID Number
*Member Name

*Phone Number

*Phone Type

Phone Number

Phone Type

* Good Time to Reach You 7:30 AM - 12:00 PM Central Time
12:00 PM - 5:30 PM Central Time

* Nature of your question

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A LifeSynch representative will call you regarding your request.