MEMBER PARTICIPATION AGREEMENTMember Participation Agreement • December 15th, 2020
Contract Type FiledDecember 15th, 2020This Membership Agreement is effective as of the date shown on the Member ID and shall continue from month to month until the Plan is notified of your cancellation. The Monthly Charge and mode of payment for participation in the plan is on your enrollment form. If you need to change your payment mode, please contact the member services number on your identification card.
MEMBER PARTICIPATION AGREEMENTMember Participation Agreement • December 15th, 2020
Contract Type FiledDecember 15th, 2020This Membership Agreement is effective as of the date shown on the Member ID and shall continue from month to month until the Plan is notified of your cancellation. The Monthly Charge and mode of payment for participation in the Plan is on your enrollment form. If you need to change your payment mode, please contact the member services number on your identification card.
MEMBER PARTICIPATION AGREEMENTMember Participation Agreement • December 15th, 2020
Contract Type FiledDecember 15th, 2020This Membership Agreement is effective as of the date shown on the Member ID and shall continue from month to month until the Plan is notified of your cancellation. The Monthly Charge and mode of payment for participation in the Plan is on your enrollment form. If you need to change your payment mode, please contact the member services number on your identification card.