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                                                    Discount Plan Application
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                                                    CAREINGTON DENTAL VISION PLUS PLAN
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                                                    PRODUCTS INCLUDED:  DENTAL, HEARING, PRESCRIPTION, LASIK VISION CORRECTION, VISION
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                                                    Espanol
                                                     
                                                     
                                                    
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                                                        Step 1: Billing Options
                                                     
                                                    
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                                                    Select a billing option:
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                                                                                        Member Plus One
                                                                                        
                                                                                            
                                                                                            
                                                                                         
                                                                                        
                                                                                            
                                                                                            
                                                                                         
                                                                                        
                                                                                            
                                                                                            
                                                                                         
                                                                                        
                                                                                            
                                                                                            /Year 
                                                                                         
                                                                                    
				 
                                                                                 
                                                                                
                                                                                    
					
                                                                                        Member Plus Family
                                                                                        
                                                                                            
                                                                                            
                                                                                         
                                                                                        
                                                                                            
                                                                                            
                                                                                         
                                                                                        
                                                                                            
                                                                                            
                                                                                         
                                                                                        
                                                                                            
                                                                                            /Year 
                                                                                         
                                                                                    
				 
                                                                                 
                                                                                
                                                                             
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                                                                    *Plus a  one-time non-refundable processing fee of
                                                                     $20.00
                                                                 
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                                                                                $99.00 
                                                                                billed annually
                                                                                + $20.00 
                                                                                one time non-refundable processing fee
                                                                                
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                                                                                Total = 
                                                                                $119.00 
                                                                                will be charged for your first year, 
                                                                                
                                                                                
                                                                                
                                                                                
                                                                                $99.00 
                                                                                will be charged annually thereafter
                                                                                
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        The plan is not insurance. The plan provides discounts at certain health care providers for medical services. 
        The plan does not make payments directly to the providers of medical services. 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 the discount
        plan organization. Discount Medical Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, Texas 75034.
         
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                                                        DVPPCJ-ONLINE-APP
                                                     
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                                                    All contents Copyright
                                                    Careington International  Corporation
                                                     
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                                                    This is not insurance.
                                                     
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                                                    Terms and Conditions
                                                     
                                                     
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