Request Login ID

Please fill out the following information. After you submit this form, we will email you a confirmation link where you can set a password, attach policies to your account, and more.

Please note that this form is for people who have policies with the Ohio FAIR Plan. If you are an agent, you should use the agent login request form instead.

Customer Information
First Name:	*
Last Name:	*
Email Address:	* Our records indicate that the above email address is already assigned to an active login. Please make any changes by logging in and clicking on "Update Profile". If you do not remember your password, you can Request a New Password.

	* denotes required field

Request Login ID

Customer Information