CHS WebAccess Version 17.0
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(Entries marked with * are mandatory)

Invalid member
You have made several unsuccessful tries, so now we have to make sure you're not a robot.
Sorry. Your Service Terminated
You have already created an account
This e-mail ID is already in use by another member. Please enter another e-mail ID that you have access to.
Sorry, your account has been terminated. However, you seem to have a COBRA plan in effect.
Please use the new COBRA information to create a new web account
Sorry, your account has been terminated.
Sorry, your insured guardian has been terminated.
Your termination date is set in our records.Please contact your Employer for further procedures.
If you are a dependent attempting to create a web account after being on COBRA, please choose 'Self' as the relationship to subscriber
Your employer doesn't have web access permission.
Important! Note down this lock out tag: . Call your plan administrator and reference this lock out tag. The administrator will need this information to restore your access to the system.
You have one more try before you lose access to this portal.
Your account has been deactivated. Please contact the Plan Administrator.
You have already submitted a request to create an account with us. If you have not received a verification email as yet, please contact the Plan Administrator.
 

Subscriber Information
 First Name *
This is a required entry! Please enter your First Name.
Name Contains Invalid Characters
 Last Name *
This is a required entry! Please enter your Last Name.
Name Contains Invalid Characters
 Relationship to Subscriber *
 Date of Birth (mm/dd/yyyy) *
This is a required entry! Please enter your Date of Birth.
Invalid Date (MM/DD/YYYY)
Birth Date Should be Lesser than Current Date
The date format should be : mm/dd/yyyy
Please enter a valid month
Please enter a valid Day
Please enter a valid 4 digit year
Please enter a valid Date
 E-mail Address *
(Note: A valid e-mail address is required for registration. We will send you an e-mail notification to validate your e-mail address before you can login.)

This is a required entry! Please enter your E-mail Address.
Enter valid Email address.
 Group Code *
(Note: Group code is assigned to your employer by your health insurance carrier. Please contact your employer if you are unsure of the group code)

This is a required entry! Please enter your Group Code.
Grp Code not correct
 ID/Subscriber# *
This is a required entry! Please enter your insurance Card ID.
SubId not correct