As of June 23rd, 2021 COBRA members will need to register for the new member portal. Please select Register New User to continue. If you have already recently registered with the new portal please login using the COBRA login option below
Select this option if you made an account recently.
Enter the Participant ID or SSN and Date of Birth for the patient on the claim(s) to be submitted for the Participant/Enrolled Employee
The completed form can be faxed to (406) 523-3187 or toll-free to 1-800-257-0950, or mailed to:
Please do not hesitate to contact us if you have any questions. Our Enrollment Department Team may be reached at 1-800-877-1122.
By submitting this information you are stating that the information, to the best of your knowledge, is correct.