BeniComp Select Renewal Election

Please confirm your 2027 renewal options by filling out the short form below.

Group Name
Group Number
Product Selection

We’re excited to offer you two great options at renewal! Continue with the BeniComp Select coverage you know today, or upgrade to BeniComp Select Signature, a more proactive, personalized approach to executive health. See below to compare your options.
BeniComp Select Signature Election

BeniComp Select Signature Election BeniComp Select Signature upgrade for all BeniComp Select members BeniComp Select Signature upgrade for only some BeniComp Select members BeniComp Select (current policy) for all members
Number of members who will have BeniComp Select Signature
Member 1 Name Member 1 Name First Last
Member 2 Name Member 2 Name First Last
Member 3 Name Member 3 Name First Last
Member 4 Name Member 4 Name First Last
Member 5 Name Member 5 Name First Last
Member 6 Name Member 6 Name First Last
Member 7 Name Member 7 Name First Last
Member 8 Name Member 8 Name First Last
Member 9 Name Member 9 Name First Last
Member 10 Name Member 10 Name First Last
Please upload a list of the members to enroll in BeniComp Select Signature
Census Review

Please review the email we sent with your group’s census, and confirm that all participant information is accurate.
2027 Census Confirmation

2027 Census Confirmation No changes to our current census Changes are required for 2027
Census Change Information

If you need to make changes:
Log into the BeniComp Admin Portal to add, remove, or update participants.

Need help making a change?
How do I add or term a participant?
Contact Information

Thank you for completing the renewal process. Please update communication preferences below to receive a confirmation receipt.
Preferred Contact Name Preferred Contact Name First Last
Preferred Contact Email
Preferred Contact Phone Preferred Contact Phone - ### - ### ####

BeniComp Select Renewal Election

BeniComp Select Renewal Election

Product Selection

Census Review

Census Change Information

Contact Information