Plan Administrator Account Registration

If you handle the administration of your company's account and would like to take advantage of our secure website to manage your account, please complete this request form.

Important Notice: If your organization uses spam filtering software, please allow incoming messages from Colonial-PaulRevere.com. If you have any questions, please contact your systems administrator.

Call plan administrator support:
800-256-7004
Monday-Friday, 8 a.m. to 7 p.m. ET

fax:
800-561-3082

Mailing address:
1200 Colonial Life Boulevard
P.O. Box 1365
Columbia, SC 29202-1365

Who are you registering?

denotes mandatory fields

First name

Last name

Phone number

Extension number

Email address

Please select the required access level

Access levels explained

Primary Plan Administrator

The Primary Plan Administrator has the same level of access as the Standard Plan Administrator access level with the additional ability to add, remove, and edit access for other users that have access to the portal.

Standard Plan Administrator

The Standard Plan Administrator access level allows the user to edit employees, edit invoices, make payments and send files.

View Only

View Only Access allows the user to view employees, view invoices and send files but they cannot edit employees, edit invoices, or make payments.

Are you replacing someone else?

Yes

First name

Last name

Email address (if known)

Note: User access can be viewed on Colonial Life for Clients under Manage My Account. To make edits to users' access, you will need to have Primary Plan Administrator access.

What Billing Control Number(s) do you need access to? Add up to 10 BCNs.

Note: Your BCN can be found on your invoice.

BCNs should be formatted with no special characters. For example: "E1234567". Starting with the letter E followed by seven digits with no spaces or hyphens.

Tax ID numbers should be formatted with no hyphens.

Billing control number 1

EIN/tax ID number

Billing zip code

Billing control number 2

EIN/tax ID number

Billing zip code

Billing control number 3

EIN/tax ID number

Billing zip code

Billing control number 4

EIN/tax ID number

Billing zip code

Billing control number 5

EIN/tax ID number

Billing zip code

Billing control number 6

EIN/tax ID number

Billing zip code

Billing control number 7

EIN/tax ID number

Billing zip code

Billing control number 8

EIN/tax ID number

Billing zip code

Billing control number 9

EIN/tax ID number

Billing zip code

Billing control number 10

EIN/tax ID number

Billing zip code

I certify that all of the above information is true, and I authorize the user listed above to be given access to Colonial Life for Clients with the access level that I have selected above. I understand that I am responsible for notifying Colonial Life immediately in the event that any user given access to Colonial Life for Clients changes jobs or leaves the company. I also understand that, until I notify you, the user will continue to have access to this website. Upon receipt of notification, Account Services will immediately revoke access.

I certify that the above information is true

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