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The following is the Membership Agreement between the sponsoring organization ("We" and "Us") and the person who is enrolled in the Health Benefits Plus program ("You" and "Member"). All persons subscribing ("Members") agree to be bound by these Terms of Membership and are urged to read them carefully. If you have any questions regarding Your Membership, You may contact our Customer Service Department Monday through Friday, 9:00 a.m. to 8:00 p.m. EST, the toll free number is listed on Your Membership Card and throughout this Membership Agreement.

*Certain State Restrictions:
No charge for members. Colorado & Maryland residents are subject to a minimum of $1.00 fee per service and Washington State residents are subject to a minimum of $10.00 fee per service. Some restrictions apply.
Dental benefits are only available to Florida residents for an additional charge.
Hospital benefit is not available in Maryland.
The hearing instrument program is not available in Texas or Colorado.
Ophthalmologists are not available in all areas

Membership Benefits Benefit Services of America, Inc. ("BSA") and Health Benefits Plus ("HBP") are not direct providers of the benefits available to Members. As a Member, You have access to discounts on various products and services offered through the HBP program, Customer Service Department and other benefits and services offered by BSA and independent vendors ("Membership") as specified in Your Membership Agreement. The discounts provided by HBP may not be used in conjunction with any other discount plan or program. All listed or quoted prices are current prices only and are subject to change without notice. This is a discount membership program only and may be discontinued or modified at any time.

The health services provided in this program may be duplicative of services and products offered by your health insurance.

Payment of Membership Fee You agree to pay all fees and charges associated with the HBP Membership, including recurring and non-recurring charges and fees applicable to Membership. The payment of Your Membership fee is made automatically by a charge to the specified payment method authorized by You. By authorizing HBP to charge Your specified payment method, You are authorizing HBP, it's parent company BSA and their respective designated representatives or agents to automatically continue charging that account for all fees and charges associated with Your Membership. If the original account information of the specified payment method changes, You, or the credit-issuing entity, are responsible for informing BSA of such new replacement information.

Your Membership is automatically renewed monthly or annually in accordance with the payment option selected. By signing up for the Membership, You are authorizing automatic renewal of the program.

All accounts are processed during our payment processing cycle once a month. Payments by check, money order and/or cashiers check will only be accepted for our annual plan and past due balances. We do not accept these forms of payment for our monthly payment schedule.

We are unable to specify the exact date on which the charges will process to Your account.

BSA is not responsible or liable in any way for any charges or fees including, but not limited to, Non-Sufficient Funds charges, which a Member may incur from their financial institution due to BSA's attempt to withdraw payment for the Membership.

Billing Inquiries & Refunds If You believe You have been billed in error for the Membership, please notify our Customer Service Department about the error. HBP or BSA will not issue refunds after the expiration of this 60-day period.

Our refund policy requires proof of payment received by our offices before any refund/credit will be issued to the Member. Refunds will only be issued to the primary Membership account holder, unless the account clearly indicates the Membership was paid by another party or legal proof is provided showing power of attorney over the primary Membership holder's account.

If a Member disputes charges with their financial institution causing a "charge back" which results in a duplicate refund to the Member; BSA will charge the Member for the amount of the original refund offered by BSA. If the Member refuses to relinquish the funds back to BSA, the company reserves the right to follow through on our "Failure to Pay" procedures.

Cancellation You may cancel Your Membership at any time simply by calling or writing our Customer Service Department. A Member who elected the pre-paid annual payment plan will be entitled to a refund of the remaining paid months+ on the Membership. A Member who elected the monthly payment plan agrees that the monthly charge for the month in which Membership is terminated will be forfeited. As this Membership is not insurance, refunds will not be issued for non-usage of the benefits.

+Note: any "free" months offered with the pre-paid annual membership are placed at the end of the Membership unless otherwise stated. "Remaining paid months" are determined by the Membership effective date and the number of months of service made available from the effective date up to and including the month in which the Member terminated services.

Failure to Pay If BSA is unable to bill the Membership fee to Your specified payment method at any time, BSA reserves the right to terminate Your Membership without notification. However, You also agree that, should the funds not be available for whatever reason during any given billing period, BSA will continue to bill any past due and current due balances until the Membership has been brought current. BSA reserves the right to send an invoice directly to You and may assign unpaid late balances to a collection agency for appropriate action. If You fail to pay any charge when due, or if You provide false or inaccurate information that is required for the provision of the Membership or is necessary for BSA to bill You for the Membership, and such condition continues un-remedied for thirty (30) days; You will be in default and BSA reserves the right to suspend or terminate the Membership at our sole discretion.

In the event legal action is necessary to collect on balances due, You agree to reimburse BSA for all expenses incurred to recover sums due, including attorneys' fees and other legal expenses. You also agree to pay all current charges for the Membership as well as fees assessed against You or BSA for the charges and all late payments, interest and other fees stated on Your bill. BSA reserves the right to charge You a fee for any check returned to BSA relating to the Membership. BSA may modify its billing practices or late payment charges by providing You with prior written notice of the modification.


Complaint Procedure Contact BSA for any problems related to billing, service or a provider. BSA will attempt to resolve billing issues and provider issues by contacting the provider's office directly. If an issue cannot be resolved directly, it will be forwarded to the appropriate network representative with all the detailed information.

Other non-billing issues, such as the state of the facilities, discrepancies on provider's contract or quality of services rendered will be referred directly to the appropriate network contact.

All issues will be documented completely on the Member's account.

Use of Membership Your Membership is non-assignable and non-transferable. You agree that only You and Your immediate family members may use the Membership. The term "Immediate Family" shall be defined as You, Your spouse, Your children and parents whose legal address is the same as Yours. You shall be responsible for all use of Your Membership and will promptly notify Us if You become aware of any unauthorized use of Your Membership.

Product Availability It is understood that all services ordered are subject to availability of such services and any information provided to the Member is subject to change without notice or notification.

Disclaimer of Liability BSA, HBP and/or the sponsor do not guarantee, nor are responsible for, the quality of products or services provided by any independent vendors. BSA, HBP and the sponsor are making no representations with respect to those matters. Each Member acknowledges that he or she is not relying on the skill or judgment of BSA or HBP in selecting the benefits and services available to Members. In the event any benefit is deemed unsatisfactory to the Member, the Member will look solely to the provider or manufacturer of the product, benefit or service for satisfaction and/or rectification of a claim relative to the benefits, products or services rendered.

Accordingly, BSA, HBP and the sponsor make no warranty, expressed or implied, including but not limited to the warranty of merchantability or fitness for a particular purpose with respect to any of the Membership services or products obtained by a Member through Membership in BSA and HBP. All warranties, expressed or implied, are the responsibility of the manufacturer or independent vendor. Our liability shall not exceed Your current Membership fee and under no circumstance shall We be liable for incidental, consequential or exemplary damages. BSA and HBP may revoke, repossess, modify or cancel the services at any time. Use of the Membership is governed by the conditions set forth herein when issued and retained, and any use or non-use of this Membership constitutes acceptance thereof.

Entire Agreement This agreement contains all of the terms and conditions of Membership and no representations, inducements, promises or agreements concerning the Membership not included in this agreement shall be effective or enforceable. If any of the terms of this agreement shall become invalid or unenforceable, the remaining terms shall not be effected.

Reservation of Rights We reserve the right to eliminate, add, change and substitute benefits and participating vendors without notice to You. We further reserve the right to change the terms and conditions of this agreement and any Membership policies at any time without notice. Every effort will be made to ensure that the number of providers is maintained.

Governing Law This agreement and the terms of the Membership shall be interpreted, construed and enforced exclusively according to the laws of the State of Florida. For any disputes regarding this agreement, You irrevocably consent to exclusive jurisdiction and venue before any federal or state court residing in Seminole County, Florida to whose personal jurisdiction You agree to submit. However, nothing in this agreement is intended or shall be construed to negate or otherwise affect the consumer protection laws of the state in which You reside.

General Release Each Member, for himself/herself, and on behalf of any person who uses the benefits or services under the BSA and HBP Member ("Membership Beneficiary"), hereby forever releases, acquits and discharges BSA and HBP from any and all liabilities, claims, demands, actions and cause of action that such Member or such Member's legal representative may have by reason of any monetary damage or personal injury sustained as a result of the use of any benefits, products or services available through BSA and HBP.

Lost or Stolen Cards Replacement Membership Cards may be obtained by calling the Customer Service Department; once the request is placed, a new card will be sent to You. There will be a $5.00 charge for each card requested.

Additional Cards Additional Membership Cards may be obtained by calling the Customer Service Department; once the request is placed, the additional card will be sent to You. There will be a $5.00 charge for each additional card requested.

Membership Changes Please contact our Customer Service Department if You need to make any changes to the details of Your Membership.

We will inform You if Your HBP coverage is impacted in any way including availability of services and prices in a new area if You have changed locations.

Benefit Services of America, Inc.
101 South Wymore Road, Suite 300
Altamonte Springs, Florida 32714-4313

1-877-9MD-PLUS (963-7587)
Monday to Friday - 9:00 a.m. to 8:00 p.m. (EST)
Fax toll free: 1 (866) SMILE-28 (764-5328)
Email: custserv@healthbenefitsplus.com

Please remember to include Your Membership ID Number on ALL correspondence.

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Disclosures
THIS PROGRAM IS NOT INSURANCE

This plan provides contracted discounts at certain providers for services and does not make payments to the providers. The plan member is obligated to pay for all services when services are rendered. Not available in all areas. Hospital discounts are not available in Maryland. Plan offered and administered by Benefit Services of America Inc., a Florida licensed Discount Medical Plan Organization, located at 101 Wymore Road, Suite 300, Altamonte Springs, FL 32714. This discount program contains a 30-day money back guarantee. +The dental network is provided by Signature Agency, Inc. a GE Financial Company. **Prices are monthly plus a one-time activation fee of $10.00. ++Activation fee is refundable if cancelled within 60 Days.The range of discounts for medical and ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received. Not available in all areas.