Reliance Standard :: New User Access Request
Request Employer Access

Full Name: (Your first and last name)
Association*: (Defined below)
Full Company Name: (Your company's name)
Policy Number:   (One policy number)
E-Mail Address:
Additional Comments: (Optional)


Employees are not required to log in to access claims or application approval status. Instead, with a few pieces of identifying information, this information is available 24/7 on our secure CustomerCare portal where you can also find forms, contact information, and more. You may also use our automated phone system at 800-351-7500.

For Dental or Vision policy inquiries, please use the contact information provided on the reverse side of your enrollment card, or email our Dental/Vision CustomerCare department or call 800-497-7044. You may also use our secure Dental/Vision e-Services portal.

Alert: It appears that you may be an Annuity Broker looking to obtain access to our Annuity Broker Extranet. If this is correct, please click "Ok" otherwise click "Cancel" to continue filling this form as a Group Benefits representative.