1020rx.com - Join

Online Registration Form
Discount Medical Plan Application

Welcome to our online registration page.

Plans Details:

	Rx	Dental	AllCare
Prescription Plan
Physician/Hospital Plan
Aetna Dental Access ®
Vision Plan
Mail Order Pharmacy
Hearing Aids
Diabetic Supplies
Vitamins and Skin Care products

Please select services:

SPECIAL OFFER

Get $5.00 OFF your first month now

If you're not completely satisfied with your savings within
the first 30 days, we'll refund 100% of your membership fee.

Plans

†RX Plan Individual (Not available to WA, KS & UT residents)	$9.99 first month and $14.99/month thereafter

†RX Plan Family (Not available to WA, KS & UT residents)	$14.99 first month and $19.99/month thereafter

†Dental Plan Individual (Not available to WA, KS, UT, MD & VT residents)	$2.99 first month and $7.99/month thereafter

†Dental Plan Family (Not available to WA, KS, UT, MD & VT residents)	$5.99 first month and $10.99/month thereafter

†AllCare Plan Individual (Not available to WA, KS, UT, MD & VT residents)	$19.99 first month and $24.99/month thereafter

†AllCare Plan Family (Not available to WA, KS, UT, MD & VT residents)	$24.99 first month and $29.99/month thereafter

† - See table above for details

Form #1020-A101-W

Discount Medical Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box 671309, Dallas, TX 75367-1309.

This is NOT insurance.
This discount card program contains a 30 day cancellation period.

FL, LA, ND, OK, SC, SD and TX residents: Member shall receive a full refund of membership fees, excluding registration fee, if membership is cancelled within the first 30 days after the effective date. AR and TN residents: A refund of all fees will be issued if membership is cancelled within the first 30 days. MD Residents: The membership fee and one-time registration fee (minus $5.00) will be refunded if cancelled within the first 30 days and upon return of the discount card. WA residents: If a member cancels his or her membership in the discount plan organization within the first thirty days after the date of receipt of the written documents for the discount plan, the member must receive a reimbursement of all periodic charges upon return of the discount plan card to the discount plan organization. 1. (A) Cancellation occurs when notice of cancellation is given to the discount plan organization.(B) Notice of cancellation is given when delivered by hand or deposited in a mailbox, properly addressed and postage prepaid to the mailing address of the discount plan organization, or e-mailed to the e-mail address of the discount plan organization. 2. (A) discount plan organization shall return in full any periodic charge charged or collected after the member has given the discount plan organization notice of cancellation.(B) If the discount plan organization cancels a membership for any reason other than nonpayment of charges by the member, the discount plan organization shall make a pro rata reimbursement of all periodic charges to the member. If the member remains dissatisfied after completing the organization's complaint system, the plan member may contact the office of the insurance commissioner.