MEMBER AGREEMENT

Last Updated
September 2015

THERE IS NO CHARGE FOR YOU OR ANY MEMBER OF YOUR FAMILY TO PARTICIPATE IN THE PLAN.

DISCLOSURES

1.  The plan is not insurance
2.  The plan provides discounts at certain healthcare providers for medical services
3.  The plan does not make payments directly to the providers of medical services
4.  The plan member is obligated to pay for all healthcare services but will receive a discount from healthcare providers who have contracted with the discount plan organization
5.  The name and address of the licensed discount medical plan organization is:

Access One Consumer Health, Inc.
84 Villa Road, Greenville, SC 29615
(800)896-1962
www.accessonedmpo.com

All Plan members receive discounts at participating physicians, podiatrist, chiropractors, medical equipment & supplies ; rehabilitation services & diagnostic imaging centers ranging from 5% to 50% off standard billed charges, the rates for participating dentist are from 5-50% off standard billed charges and average 20%, the vision services(including lenses and frames) are available at participating providers with discounts of 5% to 50% with an average of 25% , Prepaid Labs 5% to 70%, hearing services discounts of 5% to 20% and participating pharmacies provide discounts of 5% to 50%.

This Member Agreement and the Member ID Card represent the entire agreement between you and the Plan.

At participating providers, you will be billed at the time of service, and they will apply the applicable discounts to that bill. In no instance can the Plan make payments directly to the provider on your behalf.

Your participation in the Plan will continue from month to month for as long as the Plan exists and as long as you retain your ID card. You may terminate your participation in the Plan by disposing of your ID card.

The Plan may terminate its services and discounts at any time. You will not be notified of such termination but it will be posted on www.diversehealthbenefits.com.

This Plan includes you, your spouse, and your dependent children up to age 26 at no charge. You are not required to list your dependants to participate in the Plan.

If you have a complaint regarding the Plan you may go to www.accessonedmpo.com or call 800-896-1962. You may also write to AccessOne Consumer Health, Inc. 84 Villa Rd. Greenville, SC 29615. The complaint will be addressed and you will receive a response within 15 days.

This agreement and the Benefit Descriptions represent the entire agreement between you and AccessOne Consumer Health, Inc. and supersede all other prior representations, statements, or written agreements between you and AccessOne. AccessOne Consumer Health, Inc. has no liability for providing nor guaranteeing service or any liability for the quality of services rendered.

This plan is not available in the following states AK, MT, and VT.
This is not a Medicare Part D Prescription Drug Program