DENTAL, VISION, CHIROPRACTIC, Rx, RN HOTLINE
Aetna Dental Network Access
Outlook Vision Network
CHIROPRACTIC Lifecare of America
HealthTrans Rx Discount
FONEMED 24 Hour Nurse HotlineYour Cost:
$10.00 PER MONTH for an individual applicant
$20.00 PER MONTH for your entire family
A family plan covers all persons in your household, regardless of actual relationship. To be eligible, all persons listed on the application must be permanent residents of the address listed on the application.
There is a one-time, non-refundable registration fee of $15 for the Plan.Please complete the application TODAY so that we may process your request immediately. Plan benefits will begin on the 1st day of the month following receipt of your application.
If you require dental services prior to the 1st day of next month, we can, upon request (see form below), put your coverage into effect within 5 business days.(If you have a dental or chiropractic emergency, do not delay treatment. Such a delay could result serious harm or illness, and might result in expenses that exceed any savings realized by waiting for benefits to go into effect.)
Once you have completed the application below, we will send you an email message as your confirmation of receipt of your application.
The confirmation will contain instructions and telephone numbers that will allow you to make your first appointment without ID cards (they will arrive in 1-2 weeks).DentaSaver.net uses a true Secure Application system powered by Plug'n Pay Technologies to assure the confidentiality of your personal information.
If you are not comfortable enrolling online, you can complete an application, print it out and either fax or mail it to us.
READ CAREFULLY BEFORE YOU APPLY Plan Information Guide and Plan Identification Card(s) will be supplied via U.S. Postal service. Your request authorizes Comprehensive Insurance Agency, LLC to charge your credit card or debit your checking account for the initial and subsequent payments to start and continue your DentaSaver plan. Comprehensive Insurance Agency, LLC will charge your credit card or debit your checking account as each modal dues payment comes due. You must provide Comprehensive Insurance Agency, LLC 30 days written notice if you wish to cancel your DentaSaver plan.
ENROLLMENT FEE
A one time, non-recurring enrollment fee of $15.00 will be added to the
first modal dues charge that appears on your credit card statement.
TOTAL INITIAL PAYMENT CHARGE
will be your chosen plan dues PLUS $15.00.
All dues thereafter will be the chosen modal dues.
I understand that my coverage will not become effective, active and available until the 1st day of the 1st month following submission of my application unless the "Earliest Available" option was chosen on the application.
I understand that if I have chosen the "Earliest Available" option, my plan benefits will become available to me 3 business days after receipt of my application by Comprehensive Insurance Agency, LLC, that my credit card or checking account will be billed for a full month regardless of the number of days remaining in the month at the time benefits become available, and that I am not eligible for any benefits, retroactive or otherwise, prior to the actual activation date, regardless of the effective date used for billing purposes.
AGREEMENT AND AUTHORIZATIONI have read, understand and agree to the terms and conditions above. I authorize Comprehensive Insurance Agency, LLC to sign and charge my credit card or debit my checking account according to the plan and payment frequency I have chosen.
I authorize Comprehensive Insurance Agency, LLC the authority to charge my credit card or debit my checking account for all future modal renewal duess as they come due. I will notify Comprehensive Insurance Agency, LLC in writing of my wish to cancel my DentaSaver plan at least 30 days in advance.
Exclusions:
Specific procedures begun prior to the earlier of the application date or effective date are not covered.
Procedures performed by a non-network providers are not covered.
You must verify that the provider is in the network when scheduling your appointment.If you agree to these terms and conditions
Please Select Your Payment Method:
For direct electronic funds transfer from your checking account, please click HERE and complete the printable form. Recent changes in banking regulations cause us to require a signature and copy of voided check for our records.
Disclaimer: Please note that this is not health insurance and we do not make payments directly to medical services providers. It is a discount program, and you are obligated to pay for all health care services. You will receive discounts for medical services at certain health care providers who have contracted with the plan. This plan is administered by AccessOne Consumer Health, Inc., 84 Villa Rd., Greenville, S.C. 29615.
The program and its administrators have no liability for providing or guaranteeing service or the quality of service rendered.
If the Participant or the provider has a complaint regarding the program then he or she may go to www.accessonedmpo.com or write to Access One Consumer Health Inc. at the above address. This complaint will be addressed and the Participant will receive a response within 15 days of receipt of the complaint by the DMPO.
Note to Utah residents: this contract is not protected by the Utah Life and Health Guaranty Association.
All text, images and other content of this web site are protected by copyright law and shall not be used or reproduced in any medium without the express, specific written consent of the site owner. Comprehensive Insurance Agency, LLC - All rights reserved.