Discount Plan Application
PRODUCTS INCLUDED: HEALTHCARE ASSISTANCE,VISION,IDENTITY THEFT,TELEMEDICINE,DENTAL,PRESCRIPTION
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Step 1: Billing Options

Select a billing option:
 
Member Plus Family
/Month
/Year

*Plus a one-time non-refundable processing fee of $5.00


 
$11.95 billed monthly + $5.00 one time non-refundable processing fee


Total = $16.95 will be charged for your first month, $11.95 will be charged monthly thereafter



FORM CODE CICONLINEAPP


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