Fill out the below for your Bento ID
Primary Members/Subscribers can request the IDs for spouses/dependents. You will be emailed copies of the ID to print out.
On the plan, I am listed as
*
the Subscriber/Primary Member
the Spouse
a Dependent
Send me
*
only my ID card
the ID card for everyone on my plan
Enter the below information that we will use to verify your identity before emailing the card.*
*If we do not have your email on file, we will send your ID cards to your employer's Benefit Manager to send along to you. To update your email, download the Bento Dental app and edit the email under Manage Your Account.
Enter the below information that we will use to verify your identity before emailing the card.*
*If we do not have your email on file, we will send your ID cards to the Primary Member's email on file. To update your email, download the Bento Dental app and edit the email under Manage Your Account.
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Last 4 Digits of your Social Security Number or ITIN
*
Email on File
*
example@example.com
Submit
Should be Empty: