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, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WA, WI, WV, WY
States Not Available
AK, MT, VT
Terms and Conditions Member Terms, Conditions, Acknowledgment & Proxy Revised 09/01/2016
Member Terms, Conditions and Acknowledgment of ABA Membership. I acknowledge and confirm I am enrolling as a member in the American Benefits Association (ABA). I understand that association membership, and access to the optional –supplemental ABA membership benefits, will begin on the 1st day of the 1st month immediately following the date my application is received and accepted by ABA. I understand that ABA is not an insurance company or insurance program. Insurance benefit payments are made by the association administrator to the insurance company issuing coverage to the Association for the participation of ABA members. I further understand that ABA provides benefits and services to its members through a number of third parties. Benefits and services may be modified through additions or deletions at ABA’s sole discretion.
I further acknowledge that payment to ABA for my membership and any voluntary supplemental benefit selections is due in advance of the month of membership. If I choose to cancel my membership, I understand that ABA must receive a written request for cancellation from me prior to the 19th day of the month in order for my account not to be charged for the following month’s membership dues. Membership dues may be changed for all members, but not individually, upon 30 days’ notice. I understand that my membership in ABA will automatically terminate if my membership dues are not paid on a timely basis. Returned checks, NSF notices on bank drafts for payment, or credit card denials of the membership dues is deemed to be evidence of nonpayment by me. I hereby waive any requirement for notification of said termination by ABA to me in the event that my membership dues are not paid as a result of a returned check or NSF notice. I understand that I may be reinstated in the ABA membership, at ABA’s discretion.
If for any reason the membership plan is cancelled in the first 30 days, all membership charges will be refunded except the non-refundable $9.95 activation fee.
DISCLOSURES FOR THE DISCOUNT PORTION OF THE MEMBERSHIP PLAN:
The discount medical card program is NOT health insurance. This portion of the members’ basic membership package is a discount program only. For this specific member benefit, member is defined as primary member, spouse, and all legal dependents.
a. The plan provides discounts at certain health care providers for medical services.
b. Providers are subject to change without notice. Programs may vary in some states. Providers and locations may be removed from the network at any time.
c. The plan or discount company does not reimburse, or pay any portion of any providers’ fees. These benefits may not be used with any other discount plan or program. Listed or quoted prices are subject to change without notice.
d. Providers may offer products or services to the public at prices lower than the discounted prices. In such cases members will be charged the lower price.
e. Savings are based on the providers’ normal fees. Actual savings will vary by location and the services or products purchased.
f. The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with Access One Consumer Health, Inc., a discount medical plan organization.
g. This discount program is a referral plan, and makes no warranties concerning the quality of care received. Providers are responsible for the professional advice and treatment provided.
This discount card program contains a 30 day cancellation period.
FL, LA, MS, ND, OK, RI, SC, SD and TX residents: Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days after the effective date. AR and TN residents: A refund of all fees will be issued if membership is cancelled within the first 30 days. MD Residents: The membership fee and one-time registration fee (minus $5.00) will be refunded if canceled within the first 30 days and upon return of the discount card. MA Residents: The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00. The range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received. The discount medical card program makes available, before purchase and upon request, a list of program providers, including the name, city, state, and specialty of each program provider located in the cardholder's service area.
Internet website address to obtain participating providers is home.locateproviders.com.
Regulated discount benefits are not available in the state of Washington, at this time.
NOTE TO UTAH RESIDENT:
This program is not protected by the Utah Life and Health Guaranty Association.
a. This program and the program administrators have no liability for providing or guaranteeing,
b. service nor any liability for the quality of service rendered.
c. service nor any liability for the quality of service rendered.
ATTENTION MARYLAND RESIDENTS:
Some discounts under the Physician and Hospital Referral Plan benefit are not applicable in Maryland. Discounts are not available for all In-Patient Procedures and certain Out-Patient Procedures under Maryland law. Out-Patient Procedures at network hospitals such as laboratory and diagnostics services are eligible for the discount. This discount plan is not “A Medicare Prescription Drug Plan”. Membership is the discount drug plan entitles members to discounts for:
1. Certain pharmaceutical, supplies, prescription drugs, or medical equipment and supplies offered by providers who have agreed to participate in the discount drug plan.
2. The discount drug plan organization does not pay providers of pharmaceutical supplies, prescription drugs, and medical equipment and supplies provided to plan members.
3. The discount drug plan member is required to pay for all pharmaceutical supplies.
NOTE TO TEXAS RESIDENTS:
“Note to Texas Consumers: Regulated by the: Texas Department of Licensing and Regulation,
P.O. Box 12157 Austin, Texas 78711, Telephone 1-800-803-9202 or (512) 463-6599,
To the best of my knowledge and belief, the information within this ABA membership application is true and complete. It is offered to ABA and the Insurance Company as the basis for any insurance issued under Group policy(s) listed in this terms and conditions. Members are only eligible in accordance with the terms, conditions and exclusions of the Insurance certificate issued at time of ABA Benefit Election. As an Association member applicant I have read and completed an electronic membership / participation application and acknowledge that any false statement or misrepresentation in the application may result in loss of coverage under the certificate. I understand that no insurance will be in effect until my application is approved and all necessary member contributions are paid. Any person, who with intent to defraud or knowing that he/she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement may be guilty of insurance fraud.
Revocable Proxy. In consideration of my membership in ABA and my desire to be represented at meetings of members, I hereby appoint the Secretary of ABA to cast any votes I would be entitled to cast if personally present, on any and all matters, from time to time, and from year to year, until this proxy is cancelled by writing delivered to ABA, said type of writing to include a subsequently issued proxy. I expressly authorize such Secretaries to cast my vote or votes.
ABA Membership Benefit Option – Basic and Voluntary Group Life: is issued and insured by 5Star Insurance Company. This Membership Option is NOT available in the states of AK, MT, & VT.
Voluntary - Supplemental Group Life Coverage is issued by 5Star Insurance Company, under Group Term Life policy #D0142.
ABA Membership Benefit Option - Accident Insurance: Lincoln National Life Insurance Company Group policy number 00040400222000000 – GL42-1-FP NJ This membership Option is NOT available in the states of CO, LA, MD, ME, MN, MT, NC, NH, NY, OR, SD, UT, VT, or WA.
Click HERE to Print a Copy.
By clicking on "Check Out" I Acknowledge that I, the proposed member, have read and agree to all the Terms,Conditions and Legal Disclosures associated with purchasing this exclusive member benefit available as an ABA member.