lifestyle-protector

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					                      PROTECT YOUR INCOME IF YOU ARE FACED
                      WITH A MEDICAL, LIFE CHANGING, EVENT...

    UP TO $1,200,000 DOLLARS OF INCOME
       PROTECTION* WHEN NEEDED MOST.
                                 *(DUE TO A DISABLING ACCIDENT)




             “EVERYONE ACCEPTED"                     “NO HEALTH QUESTIONS ASKED"

                    IF YOU EXPERIENCE A CRITICAL ILLNESS
                         OR A DISABLING ACCIDENT ...

          UP TO $10,000 A MONTH CASH                              HAVE THE CASH TO PAY
         BENEFIT, FOR UP TO 10 YEARS,                            FOR WHAT YOUR HEALTH
         DUE TO A DISABLING ACCIDENT                              INSURANCE DOES NOT


          REPLACE LOST INCOME WHILE                         GET A LUMP SUM CASH PAYMENT
              RECOVERING FROM A                                 FOR COVERED CRITICAL
             DISABLING ACCIDENT                                   ILLNESS DIAGNOSIS


                        CRITICAL ILLNESS & ACCIDENT DISABILITY INCOME
                       PROTECTION BECAUSE YOU MAY SURVIVE MEDICALLY
                 BUT YOU MIGHT NOT SURVIVE FINANCIALLY … NOW YOU WILL!

THIS MATERIAL IS DESIGNED FOR AGENT USE & INFORMATIONAL PURPOSES ONLY & MERELY SUMMARIZES THE BENEFITS AVAILABLE.
    ALL BENEFITS & DECRIPTIONS HEREIN ARE SUBJECT TO THE CONTRACTS, MASTER ASSOCIATION GROUP INSURANCE POLICY
  & ANY AMENDMENTS, WHICH ALONE CONSTITUE THE AGREEMENT UNDER WHICH PAYMENTS ARE MADE AT THE TIME OF CLAIMS.
         PLANS INCLUDE: “ELITE ASSOCIATION MEMBER BENEFITS”:
         FREE W ELLNESS PROFILE, KARIS GROUP, LAB DISCOUNTS, TESTING DISCOUNTS, TELADOC,
         IDENTITY THEFT INSURANCE, ROADSIDE ASSISTANCE & AUTO TOWING, LEGAL CLUB OF AMERICA,
         EMERGENCY TRAVEL ASSISTANCE, EMERGENCY AIR RESCUE (HELICOPTER),
         SURGICAL TRIP-MEDICAL TOURISM. PLUS MUCH MORE!


      $5,000.00 CRITICAL ILLNESS (PLAN 5K) OR $10,000.00 CRITICAL ILLNESS (PLAN 10KB)
      IF YOU ARE DIAGNOSED WITH A HEART ATTACK, STROKE, KIDNEY (RENAL) FAILURE, LIFE
     THREATENING CANCER, COMA, LOSS OF SIGHT, SPEECH, OR HEARING, MAJOR ORGAN
     TRANSPLANT, PARALYSIS, OR SEVERE BURNS, YOU WILL RECEIVE $5,000.00 OR $10,000.00,
      SUBJECT TO ANY WAITING PERIODS AND/OR EXCLUSIONS.
     100% ON THE PRIMARY MEMBER, 50% ON THE SPOUSE, & 25% ON ALL DEPENDENT CHILDREN.


     L   LONG TERM ACCIDENT DISABILITY INCOME (A TOTAL OF 1.2 MILLION DOLLARS OF COVERAGE)
         If an Insured Person becomes totally & permanently disabled as a result of a covered
         accident within 90 days the accident, the Insurance Company will pay a benefit as follows:
Primary Member Coverage                               Spousal Coverage
Short Term Benefit                   $5,000/Month     Short Term Benefit                $2,500/Month
Waiting Period - No Benefits         6 Months         Waiting Period - No Benefits      6 Months
Short Term Payment Period            6 Months         Short Term Payment Period         6 Months
Long Term Benefit begins after the   $10,000/Month    Long Term Benefit begins after    $5,000/Month
Short Term Payment Period Ex-                         the Short Term Payment Period
pires                                                 Expires
Benefit Period                       Up to 10 Years   Benefit Period                    Up to 10 Years
Accidental Death Benefit             $1,000           Accidental Death Benefit          $1,000




                                     PLAN COMPARISON

                               8000 LEVEL       $1.2 MILLION
                                                 LONG TERM
                                                                       $5,000.00     $10,000.00
                               ASSOCIATION        ACCIDENT              CRITICAL        CRITICAL
                                BENEFITS         DISABILITY             ILLNESS         ILLNESS
                                                   INCOME              INSURANCE       INSURANCE

                 PLAN
                 5K
                 PLAN
                 10K
 THIS MATERIAL IS DESIGNED FOR AGENT USE & INFORMATIONAL PURPOSES ONLY & MERELY SUMMARIZES THE BENEFITS AVAILABLE.
     ALL BENEFITS & DECRIPTIONS HEREIN ARE SUBJECT TO THE CONTRACTS, MASTER ASSOCIATION GROUP INSURANCE POLICY
   & ANY AMENDMENTS, WHICH ALONE CONSTITUE THE AGREEMENT UNDER WHICH PAYMENTS ARE MADE AT THE TIME OF CLAIMS.
                                                                            TOP 10, MOST APPRECIATED BENEFITS ARE:

    $ 1,200,000.00 LONG TERM ACCIDENT DISABILITY INCOME WITH VARIED CRITICAL ILLNESS PROTECTION LEVELS.
    LAB DISCOUNTS…               ALL LAB TESTING HAS SAVINGS OF 40% TO 85%. THE TEST RESULTS CAN BE SENT DIRECTLY TO YOUR DOCTOR FOR ASSISTANCE IN
    DIAGNOSIS AND TREATMENT   . IT’S FAST, EASY & SAVES YOU MONEY.

    TESTING DISCOUNTS… ALL DIAGNOSTIC TESTING COSTS WILL RECEIVE 40% TO 85% DISCOUNTS. AS A MEMBER THIS PROVIDES YOU A SUBSTANTIAL
    SAVINGS ON NORMALLY EXPENSIVE TESTING PROCEDURES. OUR WONDERFUL CUSTOMER SERVICE STAFF WILL HELP YOU ORDER & FIND LOCATIONS FOR TESTING.

    TELADOC…          TALK TO A DOCTOR RIGHT NOW! TELADOC IS A NATIONAL NETWORK OF BOARD CERTIFIED PHYSICIANS PROVIDING CROSS COVERAGE CONSULTATIONS
    24 HOURS A DAY, 365 DAYS A YEAR. TELADOC PHYSICIANS USE BOTH MEDICAL RECORDS & TELEPHONE CONSULTATIONS TO DIAGNOSE, RECOMMEND TREATMENT &
    WRITE SHORT TERM PRESCRIPTINS WHEN APPROPRIATE. THIS DOES NOT REPLACE THE EXISTING PHYSICIAN RELATIONSHIP, BUT INSTEAD INHANCES IT.

    IDENTITY THEFT INSURANCE…              INTERNET & PERSONAL IDENTITY THEFT PROTECTION. THIS BENEFIT WILL PAY (SUBJECT TO PLAN TERMS
                  REASONABLE & NECESSARY COSTS INCURRED BY YOU FOR RE-FILING CERTAIN DOCUMENTS AS A RESULT OF A STOLEN IDENTITY EVENT.
    AND CONDITIONS),
    LOST WAGES, LEGAL DEFENSE FEES & EXPENSES, AS WELL AS RESTORATION SERIVICES ARE PROVIDED WITH THIS BENEFIT AS WELL.

    ROADSIDE ASSISTANCE & AUTO TOWING…                        SHOULD ANYONE ON YOUR PLAN NEED HELP, YOU’LL HAVE 24/7 HELP TO GET YOU BACK ON THE ROAD.
    TOWING, CAR WON’T START, FLAT TIRE, OUT OF FUEL, CAR STUCK, LOCKOUT SERVICE ARE JUST SOME OF THE BENEFITS THE 13,000 TOWING PROVIDERS
    IN THE NATIONWIDE NETWORK WILL HELP YOU WITH. A VERY HELPFUL SERVICE FOR YOU, YOUR SPOUSE, OR YOUR CHILDREN.


    LEGAL CLUB OF AMERICA… THE BEST LEGAL PLAN MONEY CAN BUY. BUT YOU DON’T HAVE TO SINCE IT IS INCLUDED IN YOUR PLAN BENEFITS.
    9 FREE SERVICES! PLUS SUBSTANTIAL DISCOUNTS & SAVINGS ON ALL LEGAL NEEDS LIKE, TRAFFIC TICKET DEFENSE, BANKRUPTCY, OR SIMPLE DIVORCE.
    YOU WILL HAVE OVER 20,000 ATTORNEYS NATIONWIDE TO HELP YOU IF YOU ARE HOME, OR ANYWHERE IN THE COUNTRY. YOU’LL ALSO HAVE PREPARED FOR YOU A
    SIMPLE WILL. 78% OF AMERICANS DO NOT HAVE A WILL. THERE IS NO AREA OF LAW THAT IS NOT COVERED BY THIS BENEFIT.

    EMERGENCY TRAVEL ASSISTANCE…            IF MORE THAN 100 MILES FROM HOME, YOU’LL HAVE EMERGENCY EVACUATION/REPATRIATION,
    TRANSPORTATION OF ESCORT, FAMILY VISITATION, MINOR CHILDREN RETURN/ESCORT, VEHICLE RETURN, LOST DOCUMENT SERVICE,
    EMERGENCY DELIVERY OF PRESCRIPTIONS, EMERGENCY CASH TRANSFER & ADVANCES … AND MUCH MORE!

    EMERGENCY AIR RESCUE …                  THIS BENEFIT, WILL REIMBURSE A MEMBER FOR THE COST OF MEDICALLY NECESSARY HELICOPTER TRANSPORTATION COST
    UP TO A MAXIMUM OF   $4,000 PER OCCURANCE. COVERAGE IS WORLDWIDE. TRANSPORTATION TO BE BY HELICOPTER ONLY.

    SURGICAL TRIP - MEDICAL TOURISM…                     FOR OVER 15 YEARS, “SURGICAL TRIP” HAS PROVIDED A PLETHORA OF EXPERT SURGEONS,
    OUTSTANDING HOSPITALS & CLINICS WHICK OFFER INEXPENSIVE “FIXED RATES” THAT ARE GENERALLY 40% TO 90% LESS THAN IN THE U.S.
    ACCREDITED HOSPITALS, BOARD CERTIFIED SURGEONS, HIPAA PROTECTION, AND PROFESSIONAL BILINGUAL COUNSELORS ARE ALL PART OF THE SERVICES PROVIDED.
                 \




               …… PLUS THE OTHER 35+ BENEFITS YOU HAVE ACCESS TO WITH THESE PLANS


•      HOSPITAL MEDIATION SERVICE                       •       THE EPIC HEARING SERVICE PLAN               •    DENTIST.NET
•      MEDICAL & DENTAL FINANCING                       •       VITAMIN DISCOUNTS                           •    24 HOUR COUNSELING
•      RX DRUG ASSISTANCE PROGRAM                       •       NUTRITIONAL SUPPLIMENTS

CONSUMER SERVICES:                                      •       INCOME TAX REVIEW                           •    AUTO RENTAL SAVINGS
•      “SHOP TILL YOU DROP”                             •       MORTAGE CONCIERGE SERVICES                  •    EXCLUSIVE TRAVEL DISCOUNTS
•      SHOPPING SERVICE                                 •       FLORAL SAVINGS                              •    VACATION MOTOR HOME RENTALS
•      MEGA MALL                                        •       CARPET SAVINGS                              •    EMPLOYEE DISCOUNT CLUB
•      CDBA VISA PREPAID CARD                           •       MOVING SAVINGS                              •    THEME PARK DISCOUNTS
•      LIVING TRUSTS                                                                                            (60 LOCATIONS)

AUTOMOBILE SERVICES:                                        MERCHANT ACCOUNT SERVICES:
•      AUTOMOBILE BODYWORK                                  •    ACH ELECTRONIC FUNDS TRANSFERS
                                                                                                                 GREAT BENEFITS & COVERAGE!
•      AUTOMOBILE PAINTING                                  •    FREE BAD CHECK COLLECTION                            EXCELLENT VALUE!
•      AUTOMOBILE DISCOUNT TIRES                            •    CHECK VERIFICATION                               GUARANTEED ACCEPTANCE!
•      AUTOMOBILE DISCOUNT RIMS                             •    CREDIT AND DEBT SERVICES
•      LIGHT TRUCK DISCOUNT TIRES                           •    EMAIL FORWARDING
•      LIGHT TRUCK DISCOUNT RIMS                            •    FREE DOMAIN NAMES
•      JIFFY LUBE                                           •    USA TODAY ADVERTISING DISCOUNT
•      MEINEKE COMPLETE CAR CENTER                          •    TOOL COMPLIANCE


       THIS MATERIAL IS DESIGNED FOR AGENT USE & INFORMATIONAL PURPOSES ONLY & MERELY SUMMARIZES THE BENEFITS AVAILABLE.
           ALL BENEFITS & DECRIPTIONS HEREIN ARE SUBJECT TO THE CONTRACTS, MASTER ASSOCIATION GROUP INSURANCE POLICY
         & ANY AMENDMENTS, WHICH ALONE CONSTITUE THE AGREEMENT UNDER WHICH PAYMENTS ARE MADE AT THE TIME OF CLAIMS.
                                                                                                    Agent Information
                                                                                                    Name: ________________
                                                                                                    Agent ID: _____________
                 8000 ASSOCIATION MEMBERSHIP / LIFESTYLE PROTECTOR APPLICATION
 Last Name                                    First           Beneficiary
 Address                                      City            State                 Zip
         Male                  Female         Date of Birth   SSN
 Home Phone                                   E-mail Address
             DEPENDENT INFORMATION (ATTACH ADDITIONAL DEPENDENTS ON A SEPARATE SHEET)
 Name                                                        Gender Date of Birth   Relationship



           MAIN PLAN CHOICE                                       Individual            Couple      Single Parent             Family
        LIFESTYLE PROTECTOR PLAN A                                $ 109.95          $ 159.95            $ 109.95          $ 159.95

       LIFESTYLE PROTECTOR PLAN B                                 $ 129.95          $ 189.95            $ 129.95          $ 189.95
     OPTIONAL ADD-ON’S (check all that apply)
         $10,000 TERM LIFE                                        $   35.00         $    50.00          $   50.00         $    50.00

         $15,000 TERM LIFE                                        $   50.00         $    70.00          $   70.00         $    70.00

         $20,000 TERM LIFE                                        $   65.00         $    90.00          $   90.00         $    90.00

         $25,000 TERM LIFE                                        $   75.00         $ 100.00            $ 100.00          $ 100.00

         AD&D $100,000                                            $   20.00         $    35.00          $   35.00         $    35.00

         AD&D $150,000                                            $   25.00         $    45.00          $   45.00         $    45.00

         AD&D $200,000                                            $   30.00         $    55.00          $   55.00         $    55.00

      AD&D $250,000                                               $ 35.00           $ 65.00             $ 65.00           $ 65.00
   ONE - TIME ASSOCIATION FEE                                     $ 120.00          $ 120.00            $ 120.00          $ 120.00
 TOTAL AMOUNT OF FIRST PAYMENT                                $                 $                   $                 $

                        PAYMENT METHOD: CHECKING ACCOUNT AUTOMATIC DEDUCTION FOR:
 □ INITIAL MONTHLY FEE & ONE TIME ASSOCIATION FEE ( $120.00 ) $_____________ / □ Monthly Membership Fee $___________

 NAME OF BANK OR FINANCIAL INSTITUTION:________________________________________________________________________

 ACCOUNT NUMBER: ______________________________________ / BANK ROUTING NUMBER:_____________________________
               SUBMIT ONE (1) MONTH’S FEE, PLUS THE INITIAL PROCESSING FEE ($120.00) & A BLANK CHECK MARKED “VOID”.
                            THE MONTHLY MEMBERSHIP FEE WILL BE DEDUCTED FROM YOUR CHECKING ACCOUNT.
                  IF THE ACCOUNT LISTED BELOW IS A JOINT ACCOUNT, BOTH ACCOUNT HOLDERS’ SIGNATURES ARE REQUIRED.
 MONTHLY CHECKING ACCOUNT DEDUCTION AUTHORIZATION — AS A CONVENIENCE TO ME, I REQUEST AND AUTHORIZE YOU TO PAY AND CHARGE TO MY
 CHECKING ACCOUNT AMOUNTS DRAWN ON THAT ACCOUNT BY AND PAYABLE TO THE ORDER OF THE CONSUMER DRIVEN BENEFITS ASSOCIATION OF
 AMERICA (CDBA), OR BENEFITS USA, LLC PROVIDED THERE ARE SUFFICIENT COLLECTED FUNDS IN SAID ACCOUNT TO PAY THE SAME UPON PRESENTATION.
 I AGREE THAT YOUR RIGHTS IN RESPECT TO EACH SUCH DEBIT SHALL BE THE SAME AS IF IT WERE A CHECK PERSONALLY WRITTEN TO YOU AND SIGNED
 PERSONALLY BY ME. IF I HAVE NOT PAID FOR MEDICAL SERVICES WITHIN 30-DAYS, I AUTHORIZE THE ADMINISTRATOR OF THE CDBA OR BENEFITS USA, LLC
 TO DEBIT MY CHECKING ACCOUNT OR CREDIT CARD FOR THE AMOUNT OWED TO A PROVIDER FOR THE TREATMENT RECEIVED BY MYSELF OR ONE OF MY
 ENROLLED DEPENDENTS. THIS AUTHORITY IS TO REMAIN IN EFFECT UNTIL REVOKED BY ME BY PROVIDING YOU A 30 DAY WRITTEN NOTICE. I AGREE THAT
 YOU SHALL BE FULLY PROTECTED IN HONORING ANY SUCH DEBIT. I FURTHER AGREE THAT IF ANY SUCH DEBIT BE DISHONORED, WHETHER WITH OR
 WITHOUT CAUSE AND WHETHER INTENTIONALLY OR INADVERTENTLY, YOU SHALL BE UNDER NO LIABILITY WHATSOEVER EVEN THOUGH SUCH DISHONOR
 RESULTS IN FORFEITURE OF BENEFITS. NOTE: SHOULD YOUR WITHDRAWAL NOT BE HONORED BY YOUR BANK, YOU WILL AUTOMATICALLY BE SUSPENDED
 FROM RECEIVING ANY BENEFITS OF THE ASSOCIATION INCLUDING THE SPECIAL DISCOUNT PRICING ON YOUR MEDICAL TREATMENT AND YOU MAY INCUR A
 $25 SERVICE CHARGE FOR ANY WITHDRAWAL NOT HONORED.
 .


AUTHORIZED SIGNATURE (AS APPEARS ON         FINANCIAL RECORDS)         AUTHORIZED SIGNATURE (AS APPEARS ON FINANCIAL RECORDS)



X                                           Date                       X                                       Date

LIFESTYLE PROTECTOR 8000 Association Membership - FAX Completed Application to 480-921-4135 Customer Service: (602) 264-7733
 Association Membership Terms and Conditions
1. The access to discount medical benefits that are provided to Association members is available to the member and member's dependents as
long as the procedures outlined in the "Guide to Member's Benefits" are followed. Any savings received are through the pre-payment
arrangements included in the provisions of the contracts with the providers and the Association. These contracts are not insurance contracts
and the medical discount program is not an insurance plan. Association Membership provides access to discounted savings for doctor visits,
laboratory and diagnostic testing, hospitalization, and surgical savings only by following the procedures contained in the "Guide to Member's
Benefits". By agreeing to pre-pay for medical services, members access the negotiated fee schedule and receive savings from the usual,
customary, and reasonable (UCR) fees normally charged. Actual savings vary depending on the nature of the services or treatment received,
and by the area of the country in which the services are performed. The Association does not make any payments to health care providers.
The discount medical benefits provided to Association Members are not an insurance policy.
2. For outpatient services, the Association has a participating provider network that guarantees a minimum 20% discount for services
rendered; however, if the member wishes to use a doctor that is not a participating provider, the member can do so but will not receive a
discount unless the member negotiates one with the non-participating provider.
3. The discounted ancillary healthcare benefits such as dental, vision, hearing, chiropractic, etc., provide discount savings to members through
a number of healthcare providers that have agreed to provide the savings for payment at the time of service. For members to qualify for and
capitalize on the savings, the member must use a participating provider and pay the provider at the time of service through an HSA or bank
draft, payment by check, cash, or by providing a credit card for payment. The savings members receive vary by provider and area of the
country. If full payment cannot be made at the time of service, it is the member's responsibility to negotiate satisfactory payment
arrangements with the provider.
4. The savings on hospitalization or surgery can only be utilized when members follow the instructions provided in this booklet, "Guide to
Member's Benefits". Although the hospital mediation service will negotiate after your hospital stay or surgical procedure, all members are
encouraged to contact the hospital mediation service PRIOR to going into the hospital or surgical center for services. If a member fails to
contact the hospital mediation service prior to receiving treatment or services or if it was due to an emergency, please do so as soon as
possible after discharge from the hospital. The earlier the mediation negotiator can contact your hospital, the better the chances of securing
maximum savings.
5. Neither the Association nor any of its affiliates or representatives shall make or be liable for any payment to a provider accessed under the
healthcare benefits. Provider contracts allow the providers the right to terminate participation in the program without notice as well as
reserving the right to refuse offering a discount or the negotiated fees to a member. (NOTICE: It is very rare for a provider to refuse to
provide a discount when the member offers to pay the discounted amount at the time of service...should this problem occur, ask the provider
to telephone our office and ask for provider relations.) The Association, its affiliates, and providers accessed through your Association
membership are not an insurer, guarantor or underwriter for the responsibility or liability for the member's medical care or any other goods or
services provided to the member.
6. The providers of our medical discount benefits are subject to change without notice. The member or dependent must call a participating
provider (when applicable) prior to scheduling an appointment and present their membership ID card at the time of treatment. See the table
of contents for more information on locating a provider participating in our health services program. You can also visit our website or call
(888) 350-1500, and follow the voice prompts to locate a provider.
7. Participating providers are independent contractors. The Association, its affiliates, and representatives are not responsible for the services
provided, or the omission of any care by a provider. The Association does not practice medicine or in any manner interfere with, or
participate in the provider-patient relationship. All health care decisions are between the patient and the provider. The final decision on the
selection of a provider is the obligation and decision of the member and is not based upon the listing of participating providers, credentialing,
or any recommendation by the Association, its affiliates, or representatives.
8. The Association reserves the right to terminate membership or deny eligibility in the program for failure to promptly pay a provider or
failure to pay the monthly Association fee. Returned checks or insufficient funds notice on a returned bank draft, is evidence of non-payment
by the member.
9. Association membership is on a month-to-month basis. Members may cancel their membership at any time upon providing written
notice by the 15th of the month. Termination from the Association will be effective on the next renewal date. The Association's one-time
nominal enrollment and processing fee is non-refundable. Member's that cancel their membership within the 30-day "Free Look" period will
be refunded the amount of the monthly fees only or in accordance with legislation enacted in your state. Cancellation requests made after the
20th of the month are too late for termination on the 1st day of the next month. Such requests will be effective on the 1st day of the month
following the 1st day of the next month. For example a termination request made on the 25th of June will terminate Association membership
on the 1st day of August.
10. For accounting purposes, all effective dates are the 1st of the month and renewal billing is due and payable on the 20th of the month
preceding the next month's renewal. If payment is not received or honored by the 25th of the month, the member and all benefits will be
suspended on midnight of the last day of the month. Payments received after the 25th of the month may cause an interruption of benefits
until notification of reinstatement is made and accepted by the providers or insurance companies. Reinstatement payments received after the
tenth of the month but prior to the 15th of the month can reinstate membership without a reactivation fee but membership and benefits shall
not be activated until the first of the next month. A request for reinstatement after the 15th of the month may require a reactivation fee. If
membership has lapsed for more than 30-days, a new application and enrollment fee may be required.
11. The Association reserves the right to assess a late charge of $15.00 if the Association Fees are not received by the 25th of the month prior
to the next renewal date. Furthermore, the Association reserves the right to assess a $25.00 charge for returned checks, for insufficient funds
on automatic bank drafts, or refusal for payment by a credit card vendor.
12. Eligibility for Emergency Medical Air Rescue Services and Emergency Travel Assistance, provided by LifeGuard, is effective after
30-days enrollment into the Association. (NOTE: Emergency Medical Air Service is limited by law to $2,500 in Hawaii and Alaska.)