A Dental Plan That Is Affordable.   Most Dental Insurance plans have deductibles, claim forms and limits on services. Our Dental, Vision and Prescription Plan eliminates the negatives associated with dental insurance.

 

ENROLLMENT INFORMATION



  Enrollment

To enroll
simply fill out and mail (in the pre-paid envelope) the Enrollment Application that you will receive in the mail after filling out the Information Request Form.
     

  Individual Membership
$9 per month
     

  Family Membership

A family membership is $15 per month, which includes anyone living in your household, such as children, parents, relatives, significant others or any other permanent resident.
     

   Family Memberships

For a Family Membership, list the names and ages of others in your household.
     

  Personal Information

Fill your name and address, Social Security Number, age, telephone, and whether you are male (M) or female (F).
     

  Payment For The Plan

Payment may be made by automatic bank draft or credit card. Invoicing is done only for annual memberships paid in full upon enrollment.
     

  Payment Method

Decide whether you are paying monthly, quarterly or annually, and put the appropriate amount on the line.
     

  Registration Fee

Add the one-time Registration Fee of $20.00 to the amount of your first payment, and write in your TOTAL AMOUNT DUE.
     

  Total Amount Due

Decide how you wish to pay the TOTAL AMOUNT DUE, if you are not paying in full for the entire year, whether you wish your monthly or quaterly payments to be made by automatic bank draft or credit card.
     

  Payment in Full

If you are paying in full for the entire year by check or money order, you are finished. Make your check out for the full amount and mail it in with your completed Enrollment Application.
     
  Monthly or Quarterly Payments

If you are paying monthly or quarterly by bank draft, make out a check for the TOTAL AMOUTN DUE, and then complete the box in the lower left corner that says, "I want to pay by Bank Draft." Decide and check either "Monthly" or "Quarterly", and then check whether you want your bank draft on the 3rd or the 18th of the month. BE SURE TO SIGN WHERE IT SAYS "Signature of Applicant." Also, BE SURE TO ENCLOSE A VOIDED CHECK OR DEPOSIT SLIP.
     
  Credit Card Payment

If you are paying by credit card, either monthly, quarterly or annually, complete the middle box that says, "Please charge my membership fee to my..." Place a check mark for the credit card you wish to use.
     
  Mailing the Enrollment Application

Mail your completed Enrollment Application with your check (if appropriate) or voided check or deposit slip (if appropriate) Using the convenient pre-paid envelope enclosed in your information packet.

Within 10-14 working days, you will receive your Membership Packet.