Create Your Cash Plan
Fill out this form to create a new Cash Plan for your employees. Once submitted, a support manager will reach out to confirm final details. No charges will be made until you plan is live and members are uploaded.
For any questions, email smile@bento.net.
Name of Client/Company Implementing Bento
*
Your Name
*
Your Email
*
example@example.com
Your/Company Phone Number
*
Please enter a valid phone number.
Number of Employees at Company
When do you want to launch the plan?
-
Month
-
Day
Year
Date
Enter in the annual max you want for your plan?
Your/Company Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your/Company Tax ID
*
The TIN, EIN, or SSN of your business
Any questions about this plan?
Your support manager will review your questions and reach out to you before creating the plan.
Bank Details
Banking details will be needed before members can be uploaded into Bento. To prevent any delay in your plan setup, please fill out the details below.
Bank Account Holder's Name
Bank account is used to deduct all claims as well as the monthly fee.
Contact for Bank Verification
Bento will be verifying the bank account with two test deposits. Please enter the name and contact details of whom bento should reach out to in order to complete verification.
Bank Account #
Bank Routing #
Submit
Should be Empty: