Registration Information
As we process your claim, we may need to contact you regarding your bill and/or request additional information. To change any information,
do so before
selecting
Save and Continue
.
Email
*
Required
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This also serves as your
H.H.C. Group
user ID
Password
*
Required
At least 8 digits
Retype Password
*
Required
At least 8 digits
Security Question
Question
City (town, village) where you were born
Father's middle name
Favorite (or least favorite) food
Favorite (or dream) vacation location
Make/Model of your first car
Name of the hospital where you were born
Name of your first pet
*
Required
Answer
*
Required
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Your Name
First
*
Required
Format Incorrect
MI
Last
*
Required
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Address
Street
*
Required
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Ste/Apt
City
*
Required
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State
AB
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
ON
OR
PA
PR
QC
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
*
Required
Zip
*
Required
e.g. 12345
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Home
Phone No.
*
Required
e.g. (123)456-7890
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Daytime
Phone No.
*
Required
e.g. (123)456-7890
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Ext. No.
Fax No.
e.g. (123)456-7890
H.H.C. Group • 9420 Key West Avenue, Suite 330, Rockville, MD 20850
consumer@hhcgroup.com