AFLDENTALPLANS.COM REFUND/CANCELLATION

Renewal Conditions: By joining a plan, you are authorizing AFLDentalplans.com to bill your credit card or checking account for the plan you have selected. This charge shall remain in force until you notify AFLDentalplans.com of request to cancel. By joining, you indicate you have read the terms and conditions of the plan. This plan will automatically renew at the end of your membership term on an annual basis, and your credit card or bank account will be automatically charged or drafted for the appropriate amount.

Cancellation and Refund Option: If a Member is not satisfied with the Program and wishes to terminate his/her membership, the Member may cancel the membership for any reason and at any time during the membership period by notifying Alliance verbally or in writing. Membership in the Program will terminate at the end of the Membership Term following the date on which notice of cancellation is received. Membership fees will cease being collected no later than 30 days after receiving a valid cancellation notice. If the Member cancels his/her membership within the first thirty (30) days after effective date, the Member will be reimbursed for all periodic charges paid. The return of all such periodic charges will be made within thirty (30) days of the cancellation date, and if all such periodic charges have not been reimbursed within thirty (30) days of the cancellation date, interest will be assessed against Alliance as required by applicable law. If the billing frequency is less than monthly (e.g. annually or semi-annually), the Member will be provided a prorated refund of the Membership Fee paid for any unused portion of the Membership Term remaining after the next monthly anniversary of the Member’s activation. Any cancellation of membership in the Program will not affect any Services or discounts received by a canceling Member before the effective date of the cancellation.

IF A MEMBER CANCELS WITHIN THIRTY (30) DAYS OF THE EFFECTIEVE DATE, THE MEMBER WILL RECEIVE A FULL REFUND OF THE INITIAL MEMBERSHIP FEES. THE PROCESSING FEE IS NON-REFUNDABLE EXCEPT IN AR, MD, RI AND TN.

To request a refund please send a cancellation letter and a request for refund with your name and member number to AFLDentalplans.com at 159 Parliament Loop, Lake Mary, FL 32746 or fax to: 888-888-8520. You may also submit cancellation by email: members@AFLDentalplans.com

Description of Services: Please see the enclosed materials for a specific description of the programs that you have purchased.

FIND A DENTAL PLAN

Disclosures: The discount medical, health, and drug benefits of this Plan (The Plan) are NOT insurance,a health insurance policy, a Medicare Prescription Drug Plan or a qualified health plan under the Affordable Care Act. The Plan provides discounts for certain medical services, pharmaceutical supplies, prescription drugs or medical equipment and supplies offered by providers who have agreed to participate in The Plan. The range of discounts for medical, pharmacy or ancillary services offered under The Plan will vary depending on the type of provider and products or services received. The Plan does not make and is prohibited from making members’ payments to providers for products or services received under The Plan. The Plan member is required and obligated to pay for all discounted prescription drugs, medical and pharmaceutical supplies, services and equipment received under The Plan, but will receive a discount on certain identified medical, pharmaceutical supplies, prescription drugs, medical equipment and supplies from providers in The Plan. The Discount Medical Plan Organization/Discount Plan Organization is Alliance HealthCard of Florida, Inc., 5005 LBJ Freeway, Suite 1500, Dallas, TX 75244. You may call 800-565-3827 or email info-abs@member-questions.com for more information or visit the provider link for a list of providers. The Plan will make available before purchase and upon request, a list of program providers and the providers’ city, state and specialty, located in the member’s service area. The fees for The Plan are specified in the membership agreement. The Plan includes a 30-day cancellation provision.

Note to MA consumers: The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under M.G.L. c. 111M and 956 CMR 5.00.

Not available in AK, MT, ND, OK, RI, SD, TN, UT, VT, WA, WY. Medical discounts provided by Alliance HealthCard of Florida, Inc.