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Agent Overviews 
UBA/BB Agent Plan Overview
Below is a list of plans shown in the UBA/BB Agent Plan Overview:
- UBA Membership
- Gap 5000, 10000 and 25000 plans without BB
- Complement Care, UBA Accident and Gap Term
- Gap CI 25K & Gap Edge plans with BB 1.0
- Gap 5000, 10000 and 25000 plans with BB 1.0
- Gap 5000, 10000 and 25000 plans with BB 3.0
- Gap 5000, 10000 and 25000 plans with BB 4.0
- All Sm&rt Med and Bright Med plans
- Dental & Vision Plans (VSP, FCL & Renaissance)
- All Benefit Boost plans
UBA/BB Agent Plan Overview
Overview descriptions of plans, pricing, state availability and underwriting carriers available on the UBA & Benefit Boost enrollment platform.
v01/09/26
HAA/BB Agent Plan Overview
Below is a list of plans shown in the HAA/BB Agent Plan Overview:
- HAA Membership
- Short Term Medical Plans - HealthBridge TRD, VCS or DPC
- VSP Individual Vision Plan
- All Benefit Boost plans
HAA/BB Agent Plan Overview
Overview descriptions of plans, pricing, state availability, and underwriting carriers available on the HAA & Benefit Boost enrollment platform.
v03/19/26
BB Only Agent Plan Overview
Below is a list of plans shown in the BB Only Agent Plan Overview:
- Lyric Health Virtual Visits (Virtual Urgent Care & Talk Therapy)
- Lyric Health Virtual Primary Care (VPC)
- HC2U DPC Prime (Dr, urgent care, virtual visits & annual physical + 4 labs)
- HC2U DPC Plus (Dr, urgent care, virtual visits & annual physical + 4 labs)
- HC2U DPC Value (Dr, urgent care, virtual visits)
- SML Dental Discounts
- Benefit Boost Vitamins
- Paramount RX Retail & Pet Prescription Discounts
- Bundled BB Packages: BB 1.0, BB 2.0, BB 3.0, & BB 4.0
BB Only Agent Plan Overview
Overview descriptions of plans, pricing, state availability, and vendors available on the Benefit Boost enrollment platform.
v10/02/25
Association Brochures
UBA MEMBERSHIP GUIDE
United Business Association (UBA) membership benefits, details and terms.
Version: 10/25
Category: Association Brochures
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MEMBERSHIP DETAILS & BENEFITS
Membership Details
- 24-Hour Nurse Helpline
- DirectLabs - Lab Discounts
- Health Savings Account with HSA Bank
- Gateway Medicard
- MDHearingAid
- VSP Individual Savings Pass
- Emergency Travel Assist
- Marquee Health
- SafetyNet Child ID Card Services
- Graduate Scholarship Program
- TruCar Buying Network
- 24-Hr Emergency Roadside Assistance
- Car Rental Discounts (Avis & Budget)
- TavNow - Travel Discounts
- CruiseOnly
- Choice Hotel Discounts
- Savings Perks Program
- Aloe Care Health
- Tickets at Work
- 1800Flowers.com
- Heartland Payroll Processing
- UPS Delivery Services
- HUSK
- ODP Business Solutions
- Lenovo Discount
- Constant Contact Email Marketing
- Z Dental
- 3Nickels
- Business Owner's Policy
- Data Breach & Cybersecurity Policy
- Spot Pet Insurance
- OptumRX Prescription Discounts
- Finnita (Reduce Student Loan Debt Payments)
- Member Networking & Free Advertising
Pricing: $10 per month for the entire family
State Availability
All 50 U.S. States
UBA Membership Guide
United Business Association (UBA) membership benefits, details and enrollment process.
v10/25
HAA MEMBERSHIP GUIDE
Healthy America Association (HAA) membership benefits, details and terms.
Version: 07/26
Category: Association Brochures
-
MEMBERSHIP DETAILS & BENEFITS
Membership Details
- BenefitHub
- Aloe Care Health - Medical Alert System
- Car Rental Discounts (Avis & Budget)
- Chiropractic Savings
- Gateway Medicard
- Imaging Service Discounts
- GetAdvocacy - Patient Advocacy Services
- DirectLabs - Laboratory Service Discounts
- Lenovo Discounts
- Noonlight - Safety App
- ODP Business Solutions
- Podiatry Discounts
- Marquee Health - Fitness & Wellness
- Emergency Roadside Assistance
- Safelite Auto Glass Discounts
- Collette - Travel Savings
- Hearing Aid Discounts
- OptumRX - Prescription Discounts
- Finnita - Reduce Student Loan Debt Payments
Pricing: $15 per month for the entire family
State Availability
All 50 U.S. States
HAA Membership Guide
Healthy America Association (HAA) membership benefits, details and enrollment process.
v07/26
Dental & Vision Flyers
VSP Individual Vision Plan
Vision Service plan coverage options, providers, and benefit descriptions.
Version: 2026
Category: Dental & Vision Flyers
Ins Carrier: Vision Service Plan (VSP)
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PLAN DETAILS & BENEFITS
VSP Individual Vision Plan Details
For Full details and information on benefits, select to view the VSP flyer.
Benefit Highlights include:
- $15 Copay Wellvision Exams (every 12 months)
- $25 Copay Prescription Glasses (every 12 months)
- Additional Savings
- Individual insurance plan
- Does not require association membership to enroll
Network: Search Network Providers
Pricing: Get Quote Now
Claims: Start New Vision Claim for non-network providers
State Availability
AL, AR, AZ, CA, CO, CT, DE, DC, FL, GA, ID, IL, IN, IA, KS, KY, LA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NJ, NM, NV, OH, OK, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV & WY
VSP Flyer
Vision Service Plan coverage options, providers and benefit descriptions.
v2026
UBA Vision (Renaissance)
Safeguard your sight with Vision insurance available to UBA Members.
Version: 05/26
Category: Dental & Vision Flyers
Ins Carrier: Renaissance Life & Health Insurance Company of America
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PLAN DETAILS & BENEFITS
UBA Vision Plan Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- $10 Well Vision Exam (in-network every 12 months)
- $25 Copay
- $130 Frame Allowance
- Lens Enhancements
- VSP Network
- Requires Membership in UBA to enroll
- Requires SSN on enrollment
Network: Search Network Providers
Pricing: Ind ($14/mo), Ind+1 ($27/mo), Family ($43/mo)
Add $10 for UBA Dues for total
Claims: Download Claim Form for non-network providers
State Availability
AL, AR, AZ, CA, CO, CT, DE, DC, FL, GA, ID, IL, IN, KY, LA, MI, MS, MO, NE, NV, NM, ND, OH, OK, PA, SC, TN, TX, VA, VT, WV, WI & WY
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CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
UBA Vision Flyer
Safeguard your sight with Vision Insurance available to UBA Members.
v05/01/26
UBA Dental (Renaissance)
A confident smile starts with Dental Insurance available to UBA Members.
Version: 05/26
Category: Dental & Vision Flyers
Ins Carrier: Renaissance Life & Health Insurance Company of America
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PLAN DETAILS & BENEFITS
UBA Dental Plan Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- $1,000 Annual Max Benefit
- 100% Preventive
- 70% Basic
- 50% Major (12-month waiting period on major services)
- DenteMax Plus Network
- Requires Membership in UBA to enroll
- Requires SSN on enrollment
Network: Search Network Providers
Pricing:Area Ind Ind+1 Fam States 1 $41/mo $81/mo $147/mo AL, AR, LA, MS, & WV 2 $46/mo $91/mo $164/mo GA, MO, NE, SC, TX & WY 3 $52/mo $102/mo $184/mo IL, KY, OK, & TN 4 $58/mo $113/mo $205/mo AZ, DC, FL, IN, IA, NV, NJ, NM, ND, OH, PA, VA, & WI 5 $64/mo $125/mo $226/mo CO, DE, & MI 6 $71/mo $140/mo $252/mo CT & ID 7 $80/mo $157/mo $284/mo CA Add $10 for UBA Dues for total
Claims: Download Claim Form for non-network providers
State Availability
AL, AR, AZ, CA, CO, CT, DE, DC, FL, GA, IA, ID, IL, IN, KY, LA, MI, MS, MO, NE, NJ, NV, NM, ND, OH, OK, PA, SC, TN, TX, VA, WV, WI & WY
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CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
UBA Dental Flyer
A confident smile starts with Dental Insurance available to UBA Members.
v05/01/26
FCL Dental 3000
Dental insurance plan with $3,000 annual maximum coverage
Version: 10/25
Category: Dental & Vision Flyers
Ins Carrier: First Continental Life & Accident Insurance Company
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PLAN DETAILS & BENEFITS
FCL Dental 3000 Plan Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- $3,000 Annual Max Benefit
- $25 Copay per visit
- 100% Preventive
- 80% Basic
- 50% Major (12-month waiting period on major services)
- MAC Plan
- DenteMax Plus Network
- Requires Membership in UBA to enroll
Network: Search Network Providers
Pricing:
Ind ($35/mo), Ind+1 ($70/mo), Ind+Children ($80/mo), Family ($100/mo)
Add $10 for UBA Dues for total
Claims: Download Claim Form for non-network providers
State Availability
AL, AR, AZ, DE, DC, FL, GA, IA, IN, KS, KY, LA, MO, MS, MT, ND, NE, OK, TN, TX & WV
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CERTIFICATES OF INSURANCE
Click on the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
FCL Dental 3000 Flyer
Dental Insurance plan with $3,000 annual maximum coverage.
v05/01/26
FCL OraQuest DHMO
A HMO dental insurance plan in TX.
Version: 10/25
Category: Dental & Vision Flyers
Ins Carrier: First Continental Life & Accident Insurance Company
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PLAN DETAILS & BENEFITS
FCL OraQuest DHMO Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Dental HMO plan
- Must Select Primary Dentist
- $9 copay per visit
- Pays a set amount based on procedure codes in Certificate
- OraQuest Network
- Requires Membership in UBA to enroll
Network: Search Network Providers
Pricing:
Ind ($20/mo), Ind+1 ($35/mo), Ind+Children ($40/mo), Family ($50/mo)
Add $10 for UBA Dues for total
Claims: Download Claim Form for non-network providers
State Availability
TX
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CERTIFICATES OF INSURANCE
Click on the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
FCL OraQuest Dental HMO Flyer
A HMO dental insurance plan in TX.
v05/01/26
Supplemental Gap (NO Benefit Boost) Flyers
Gap 5000
$5000 Accident Medical Expense, $2500 AD&D, and $5000 Critical Illness Insurance without Benefit Boost.
Version: 05/26
Category: Supplemental Gap (NO Benefit Boost) Flyers
Ins Carrier: SiriusPoint America Insurance Company
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PLAN DETAILS & BENEFITS
Gap 5000 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $5000 Accident Medical Expense ($100 Deductible per accident)
- Up to $2500 Accidental Death & Dismemberment
- $5000 Critical Illness Insurance (after 1st year)
- $1000 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Requires Membership in UBA to enroll
Pricing: Ind ($15/mo), Ind+1 ($20/mo), Family ($30/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 5000
$5000 Accident Medical Expense, $2500 AD&D, and $5000 Critical Illness Insurance without Benefit Boost.
v05/01/26
Gap 10000
$10000 Accident Medical Expense, $5K AD&D, and $10000 Critical Illness Insurance without Benefit Boost.
Version: 05/26
Category: Supplemental Gap (NO Benefit Boost) Flyers
Ins Carrier: SiriusPoint America Insurance Company
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PLAN DETAILS & BENEFITS
Gap 10000 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $10000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $10000 Critical Illness Insurance (after 1st year)
- $1000 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Requires Membership in UBA to enroll
Pricing: Ind ($20/mo), Ind+1 ($30/mo), Family ($40/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 10000
$10000 Accident Medical Expense, $5K AD&D, and $10000 Critical Illness Insurance without Benefit Boost.
v05/01/26
Gap 25000
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance without Benefit Boost.
Version: 05/26
Category: Supplemental Gap (NO Benefit Boost) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 25000 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $25000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $25000 Critical Illness Insurance (after 1st year)
- $2500 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Requires Membership in UBA to enroll
Pricing: Ind ($30/mo), Ind+1 ($55/mo), Family ($70/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 25000
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance without Benefit Boost.
v05/01/26
Gap Term
Gap Term Insurance with a $10000 death benefit without Benefit Boost.
Version: 05/26
Category: Supplemental Gap (NO Benefit Boost) Flyers
Ins Carrier: Guarantee Trust Life Insurance Company
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PLAN DETAILS & BENEFITS
Gap Term Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- $10000 Death Benefit (primary)
- 50% of Primary Death Benefit (spouse)
- 25% of Primary Death Benefit (child)
- Subject to Waiting Period & Attained Age Benefit Reduction
- Requires Membership in UBA to enroll
- Requires SSN to enroll
Pricing: Ind ($12/mo), Ind+1 ($20/mo), Family ($20/mo)
Add $10 for UBA Dues for total
Claims & Beneficiary Change Form:
-Download Term Life Claim Form
-Download Beneficiary Change Form
State Availability
AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MI, MO, MS, ND, NE, OH, OK, RI, SC, TN, TX, VA, WI, WV & WY
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CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap Term
Gap Term Insurance with a $10000 death benefit without Benefit Boost.
v05/01/26
Complement Care
Hospital Indemnity Insurance with $125 Doctor or Urgent Care Visits and $500 ER visits without Benefit Boost.
Version: 05/26
Category: Supplemental Gap (NO Benefit Boost) Flyers
Ins Carrier: SiriusPoint America Insurance Company
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PLAN DETAILS & BENEFITS
Complement Care Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Group Hospital Indemnity Insurance
- $125 Doc Office / Urgent Care Visits
-4 visits / covered person / year - $500 Emergency Room Visits
-2 visits / covered person / year - Coverage Ends when Member turns 65
- Requires Membership in UBA to enroll
Pricing: Ind ($35/mo), Ind+1 ($70/mo), Family ($120/mo)
Add $10 for UBA Dues for total
Claims: Download Hospital Indemnity Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS, MT, NC, ND, NE, NV, OH, OK, RI, SC, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Complement Care
Hospital Indemnity Insurance with $125 Doctor or Urgent Care Visits and $500 ER visits without Benefit Boost.
v05/01/26
UBA Accident
$25000 Accident Medical Expense and $5K AD&D without Benefit Boost.
Version: 05/26
Category: Supplemental Gap (NO Benefit Boost) Flyers
Ins Carrier: SiriusPoint America Insurance Company
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PLAN DETAILS & BENEFITS
Gap 25000 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $25000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- Requires Membership in UBA to enroll
Pricing: Ind ($20/mo), Ind+1 ($30/mo), Family ($50/mo)
Add $10 for UBA Dues for total
Claims: Download Accident Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
UBA Accident
$25000 Accident Medical Expense and $5K AD&D Insurance without Benefit Boost.
v05/01/26
Supplemental Gap (with Benefit Boost 1.0) Flyers
Gap 5000 & BB 1.0
$5000 Accident Medical Expense, $2500 AD&D, and $5000 Critical Illness Insurance combined with Benefit Boost 1.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 1.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 5000 & BB 1.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $5000 Accident Medical Expense ($100 Deductible per accident)
- Up to $2500 Accidental Death & Dismemberment
- $5000 Critical Illness Insurance (after 1st year)
- $1000 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing: Ind ($40/mo), Ind+1 ($60/mo), Family ($80/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 5000 & BB 1.0
$5000 Accident Medical Expense, $2500 AD&D, and $5000 Critical Illness Insurance combined with Benefit Boost 1.0 subscription.
v05/01/26
Gap 10000 & BB 1.0
$10000 Accident Medical Expense, $5K AD&D, and $10000 Critical Illness Insurance combined with Benefit Boost 1.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 1.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 10000 & BB 1.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $10000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $10000 Critical Illness Insurance (after 1st year)
- $1000 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing: Ind ($60/mo), Ind+1 ($100/mo), Family ($120/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 10000 & BB 1.0
$10000 Accident Medical Expense, $5K AD&D, and $10000 Critical Illness Insurance combined with Benefit Boost 1.0 subscription,
v05/01/26
Gap 25000 & BB 1.0
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance combined with Benefit Boost 1.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 1.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 25000 & BB 1.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $25000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $25000 Critical Illness Insurance (after 1st year)
- $2500 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing: Ind ($75/mo), Ind+1 ($120/mo), Family ($150/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 25000 & BB 1.0
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance combined with Benefit Boost 1.0 subscription.
v05/01/26
Gap EDGE & BB 1.0
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance, Emergency Room, Doctor & Urgent Care Visits combined with Benefit Boost 1.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 1.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap Edge & BB 1.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $25000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $25000 Critical Illness Insurance (after 1st year)
- $2500 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Hospital Indemnity Insurance
-$125 Doc Office / Urgent Care Visits (4 visits / covered person / year)
-$500 Emergency Room Visits (2 visits / covered person / year)
-Coverage for Hospital Indemnity Ends at age 65. - Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing: Ind ($85/mo), Ind+1 ($170/mo), Family ($240/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
-Download Hospital Indemnity Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS, NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap Edge & BB 1.0
$25000 Accident Medical Expense, $5K AD&D, $25000 Critical Illness Insurance, Emergency Room, Doctor & Urgent Care Visits combined with Benefit Boost 1.0 subscription.
v05/01/26
Gap CI 25K & BB 1.0
$25000 Critical Illness Insurance combined with Benefit Boost 1.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 1.0) Flyers
Ins Carrier: Windsor Life Insurance Company
-
PLAN DETAILS & BENEFITS
Gap CI 25K & BB 1.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- $25000 Critical Illness Insurance (after 1st year)
- $2500 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Life-Threatening Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing: Ind ($50/mo) & Ind+Sp ($100/mo)
Add $10 for UBA Dues for total
Claims: Download Critical Illness Claim Form
State Availability
AR, AZ, MO, MS, OK & TX
Gap CI 25K & BB 1.0
$25000 Critical Illness Insurance combined with Benefit Boost 1.0 subscription.
v05/01/26
Supplemental Gap (with Benefit Boost 3.0) Flyers
Gap 5000 & BB 3.0
$5000 Accident Medical Expense, $2500 AD&D, and $5000 Critical Illness Insurance combined with Benefit Boost 3.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 3.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 5000 & BB 3.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $5000 Accident Medical Expense ($100 Deductible per accident)
- Up to $2500 Accidental Death & Dismemberment
- $5000 Critical Illness Insurance (after 1st year)
- $1000 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 3.0 non-insurance services
-HC2U Direct Primary Care - Value Tier
$25 Access Fee for Doctor Visits
$50 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing:
Ind ($70/mo), Ind+Sp ($130/mo)
Ind+Child(ren) ($150/mo), Family ($190/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 5000 & BB 3.0
$5000 Accident Medical Expense, $2500 AD&D, and $5000 Critical Illness Insurance combined with Benefit Boost 3.0 subscription.
v05/01/26
Gap 10000 & BB 3.0
$10000 Accident Medical Expense, $5K AD&D, and $10000 Critical Illness Insurance combined with Benefit Boost 3.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 3.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 10000 & BB 3.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $10000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $10000 Critical Illness Insurance (after 1st year)
- $1000 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 3.0 non-insurance services
-HC2U Direct Primary Care - Value Tier
$25 Access Fee for Doctor Visits
$50 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing:
Ind ($80/mo), Ind+Sp ($140/mo)
Ind+Child(ren) ($170/mo), Family ($210/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 10000 & BB 3.0
$10000 Accident Medical Expense, $5K AD&D, and $10000 Critical Illness Insurance combined with Benefit Boost 3.0 subscription,
v05/01/26
Gap 25000 & BB 3.0
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance combined with Benefit Boost 3.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 3.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 25000 & BB 3.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $25000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $25000 Critical Illness Insurance (after 1st year)
- $2500 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 3.0 non-insurance services
-HC2U Direct Primary Care - Value Tier
$25 Access Fee for Doctor Visits
$50 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing:
Ind ($105/mo), Ind+Sp ($190/mo)
Ind+Child(ren) ($210/mo), Family ($260/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 25000 & BB 3.0
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance combined with Benefit Boost 3.0 subscription.
v05/01/26
Supplemental Gap (with Benefit Boost 4.0) Flyers
Gap 5000 & BB 4.0
$5000 Accident Medical Expense, $2500 AD&D, and $5000 Critical Illness Insurance combined with Benefit Boost 4.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 4.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 5000 & BB 4.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $5000 Accident Medical Expense ($100 Deductible per accident)
- Up to $2500 Accidental Death & Dismemberment
- $5000 Critical Illness Insurance (after 1st year)
- $1000 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing:
Ind ($90/mo), Ind+Sp ($150/mo)
Ind+Child(ren) ($190/mo), Family ($250/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 5000 & BB 4.0
$5000 Accident Medical Expense, $2500 AD&D, and $5000 Critical Illness Insurance combined with Benefit Boost 4.0 subscription.
v05/01/26
Gap 10000 & BB 4.0
$10000 Accident Medical Expense, $5K AD&D, and $10000 Critical Illness Insurance combined with Benefit Boost 4.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 4.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 10000 & BB 4.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $10000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $10000 Critical Illness Insurance (after 1st year)
- $1000 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing:
Ind ($100/mo), Ind+Sp ($180/mo)
Ind+Child(ren) ($210/mo), Family ($280/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 10000 & BB 4.0
$10000 Accident Medical Expense, $5K AD&D, and $10000 Critical Illness Insurance combined with Benefit Boost 4.0 subscription,
v05/01/26
Gap 25000 & BB 4.0
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance combined with Benefit Boost 4.0 subscription.
Version: 05/26
Category: Supplemental Gap (with Benefit Boost 4.0) Flyers
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Gap 25000 & BB 4.0 Details
For full details and information, open up the flyer and also review the Certificate.
Benefit Highlights include:
- Up to $25000 Accident Medical Expense ($100 Deductible per accident)
- Up to $5000 Accidental Death & Dismemberment
- $25000 Critical Illness Insurance (after 1st year)
- $2500 Critical Illness Insurance (within 1st year)
-CI is Heart Attack, Stroke & Invasive Cancer
-CI is for Primary & Spouse only & ends at age 65
-CI is First Diagnosis only - Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing:
Ind ($120/mo), Ind+Sp ($220/mo)
Ind+Child(ren) ($240/mo), Family ($320/mo)
Add $10 for UBA Dues for total
Claims:
-Download Accident Claim Form
-Download Critical Illness Claim Form
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Gap 25000 & BB 4.0
$25000 Accident Medical Expense, $5K AD&D, and $25000 Critical Illness Insurance combined with Benefit Boost 4.0 subscription.
v05/01/26
First Dollar Insurance Brochures
Sm&rt Med Basic
Combining first-dollar insurance & direct primary care. Learn more about the Group Benefits Fixed Indemnity with Benefit Boost.
Version: 04/26
Category: First Dollar Insurance Brochures
Ins Carrier: United States Fire Insurance Company
-
PLAN DETAILS & BENEFITS
Sm&rt Med Basic Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- $1000 Hospital Admission first day & $2000 days 1-30 (1 time)
- $1000 Inpatient Surgery; $250 Anesthesia (1 time)
- $1000 Outpatient Surgery; $70 Anesthesia (1 time)
- $1500 Air Ambulance (1 time)
- $150 Ground or Water Ambulance (2 times)
- $25 Wellness Office Visit (4 times); $250 Wellness Tests (3 times) -Not in MI
- $25 RX (30 times); $250 Emergency Room Visits (1 time)
- $300 Outpatient Diagnostic Exam (3 times)
- $200 Outpatient X-Rays (1 time)
- $250 Outpatient Lab Tests (2 times)
- $50 Therapy Services (8 times)
- $5000 Critical Illness Benefit (see schedule for % and covered benefits)
- Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
- Simplified Underwriting Requirements
Pricing:
Ind ($196.10/mo), Ind+Sp ($371.04/mo)
Ind+Child(ren) ($388.94/mo), Family ($555.04/mo)
Add $10 for UBA Dues for total
Claims: Download Sm&rt Med Claim Form
State Availability
AR, AZ, FL, GA, IN, IA, KY, MI, MS, NE, NC, OK, RI, TN, TX & WI
Sm&rt Med Basic
Combining first-dollar insurance & direct primary care. Learn more about the Group Benefits Fixed Indemnity with Benefit Boost.
v04/26
Sm&rt Med Value
Combining first-dollar insurance & direct primary care. Learn more about the Group Benefits Fixed Indemnity with Benefit Boost.
Version: 04/26
Category: First Dollar Insurance Brochures
Ins Carrier: United States Fire Insurance Company
-
PLAN DETAILS & BENEFITS
Sm&rt Med Value Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- $1000 Hospital Admission first day & $3000 days 1-30 (1 time)
- $4000 Inpatient Surgery; $1000 Anesthesia (1 time)
- $2000 Outpatient Surgery; $250 Anesthesia (1 time)
- $1500 Air Ambulance (1 time)
- $150 Ground or Water Ambulance (2 times)
- $25 Wellness Office Visit (4 times); $250 Wellness Tests (3 times) -Not in MI
- $50 RX (15 times); $250 Emergency Room Visits (1 time)
- $500 Outpatient Diagnostic Exam (3 times)
- $200 Outpatient X-Rays (1 time)
- $250 Outpatient Lab Tests (2 times)
- $50 Therapy Services (8 times)
- $10000 Critical Illness Benefit (see schedule for % and covered benefits)
- Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
- Simplified Underwriting Requirements
Pricing:
Ind ($247.25/mo), Ind+Sp ($477.61/mo)
Ind+Child(ren) ($484.85/mo), Family ($702.10/mo)
Add $10 for UBA Dues for total
Claims: Download Sm&rt Med Claim Form
State Availability
AR, AZ, FL, GA, IN, IA, KY, MI, MS, NE, NC, OK, RI, TN, TX & WI
Sm&rt Med Value
Combining first-dollar insurance & direct primary care. Learn more about the Group Benefits Fixed Indemnity with Benefit Boost.
v04/26
Sm&rt Med Plus
Combining first-dollar insurance & direct primary care. Learn more about the Group Benefits Fixed Indemnity with Benefit Boost.
Version: 04/26
Category: First Dollar Insurance Brochures
Ins Carrier: United States Fire Insurance Company
-
PLAN DETAILS & BENEFITS
Sm&rt Med Plus Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- $2000 Hospital Admission first day & $4000 days 1-30 (1 time)
- $5000 Inpatient Surgery; $1250 Anesthesia (1 time)
- $2500 Outpatient Surgery; $350 Anesthesia (1 time)
- $1500 Air Ambulance (1 time)
- $150 Ground or Water Ambulance (2 times)
- $25 Wellness Office Visit (4 times); $300 Wellness Tests (3 times) -Not in MI
- $50 RX (15 times); $300 Emergency Room Visits (2 times)
- $600 Outpatient Diagnostic Exam (3 times)
- $250 Outpatient X-Rays (1 time)
- $350 Outpatient Lab Tests (2 times)
- $75 Therapy Services (12 times)
- $15000 Critical Illness Benefit (see schedule for % and covered benefits)
- Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
- Simplified Underwriting Requirements
Pricing:
Ind ($301.16/mo), Ind+Sp ($589.93/mo)
Ind+Child(ren) ($585.93/mo), Family ($857.10/mo)
Add $10 for UBA Dues for total
Claims: Download Sm&rt Med Claim Form
State Availability
AR, AZ, FL, GA, IN, IA, KY, MI, MS, NE, NC, OK, RI, TN, TX & WI
Sm&rt Med Plus
Combining first-dollar insurance & direct primary care. Learn more about the Group Benefits Fixed Indemnity with Benefit Boost.
v04/26
Sm&rt Med Premium
Combining first-dollar insurance & direct primary care. Learn more about the Group Benefits Fixed Indemnity with Benefit Boost.
Version: 04/26
Category: First Dollar Insurance Brochures
Ins Carrier: United States Fire Insurance Company
-
PLAN DETAILS & BENEFITS
Sm&rt Med Premium Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- $3000 Hospital Admission first day & $6000 days 1-30 (1 time)
- $9000 Inpatient Surgery; $2250 Anesthesia (1 time)
- $3000 Outpatient Surgery; $600 Anesthesia (1 time)
- $1500 Air Ambulance (1 time)
- $150 Ground or Water Ambulance (2 times)
- $25 Wellness Office Visit (4 times); $300 Wellness Tests (3 times) -Not in MI
- $75 RX (10 times); $300 Emergency Room Visits (2 times)
- $700 Outpatient Diagnostic Exam (3 times)
- $250 Outpatient X-Rays (1 time)
- $350 Outpatient Lab Tests (2 times)
- $75 Therapy Services (12 times)
- $25000 Critical Illness Benefit (see schedule for % and covered benefits)
- Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
- Simplified Underwriting Requirements
Pricing:
Ind ($385.91/mo), Ind+Sp ($766.47/mo)
Ind+Child(ren) ($744.83/mo), Family ($1100.73/mo)
Add $10 for UBA Dues for total
Claims: Download Sm&rt Med Claim Form
State Availability
AR, AZ, FL, GA, IN, IA, KY, MI, MS, NE, NC, OK, RI, TN, TX & WI
Sm&rt Med Premium
Combining first-dollar insurance & direct primary care. Learn more about the Group Benefits Fixed Indemnity with Benefit Boost.
v04/26
Bright Med
Combining first-dollar insurance & virtual care solutions. Learn more about the robust Hospital Indemnity benefits with Benefit Boost.
Version: 11/25
Category: First Dollar Insurance Brochures
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Bright Med Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- $3000 Lump Sum Hospital (1st day only) & $6000 (2-60 days)
- $6000 Daily ICU or Burn Unit (30 days)
- $2000 Inpatient Surgery (1 day, max 2 days per combined family)
- $2000 Outpatient Surgery (2 days, max 5 days per combined family)
- 25% (or $500 in NC) Administration of Anesthesia (See schedule of benefits)
- $200 Air Ambulance & $100 Ground Ambulance (1 time combined)
- $150 Office Visits (6 times) & $250 Emergency Room Visits (2 times)
- $100 Outpatient Facility Visits:
-Physical Therapy, Speech Occ Therapy (5 times) - $500 Outpatient Facility Visits:
-Kidney Dialysis (5 times)
-Chemotherapy (3 times) - $250 Outpatient Facility Visits:
-Echocardiogram (1 time)
-Exercise Stress Test (1 time) - $100 Outpatient Diagnostic Lab Tests(2 times)
- $200 Outpatient MRIs or CT Scans (1 time)
-All other Radiology tests (2 times) - $100 At Home Nursing Services (max 45 days)
- $25000 Critical Illness Benefit
-$6250 for dependent children
-See schedule for benefits & % - Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing:Ages Ind Ind+Sp Ind+Child(ren) Fam 16-29 $253.08/mo $496.14/mo $618.81/mo $856.89/mo 30-39 $342.80/mo $675.61/mo $708.55/mo $1036.36/mo 40-49 $381.59/mo $858.87/mo $747.34/mo $1219.63/mo 50-59 $618.70/mo $1266.33/mo $984.45/mo $1627.09/mo 60-65 $981.88/mo $1895.16/mo $1347.65/mo $2255.93/mo Add $10 for UBA Dues for total
Claims:
-Download Bright Med Hospital Indemnity Claim Form
-Download Bright Med Critical Illness Claim Form
-Use Policy# HASA-HI-1001 or HASA-CI-1001 when discussing claims
State Availability
AL, AR, AZ, CA, CO, DE, DC, FL, GA, IL, IN, KY, LA, MI, MS, MO, NE, NV, NJ, NC, ND, OK, RI, SC, TN, TX, VA, WV, WI & WY
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Bright Med
Combining first-dollar insurance & virtual care solution. Learn more about the robust Hospital Indemnity benefits with Benefit Boost.
v11/25
Bright Med (OH)
Combining first-dollar insurance & virtual care solutions for members in Ohio. Learn more about the robust Hospital Indemnity Insurance with Benefit Boost.
Version: 11/25
Category: First Dollar Insurance Brochures
Ins Carrier: SiriusPoint America Insurance Company
-
PLAN DETAILS & BENEFITS
Bright Med (OH) Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- $3000 Lump Sum Hospital (1st day only) & $6000 (2-60 days)
- $6000 Daily ICU or Burn Unit (15 days)
- $2000 Inpatient Surgery (2 days, max 5 days per combined family)
- $2000 Outpatient Surgery (2 days, max 5 days per combined family)
- 10% Administration of Anesthesia (See schedule of benefits)
- $200 Air Ambulance & $100 Ground Ambulance (3 times combined)
- $150 Office Visits (2 times) & $250 Emergency Room Visits (2 times)
- $100 Outpatient Facility Visits:
-Physical Therapy, Speech Occ Therapy (5 times) - $500 Outpatient Facility Visits:
-Kidney Dialysis (5 times)
-Chemotherapy (3 times) - $250 Outpatient Facility Visits:
-Echocardiogram (1 time)
-Exercise Stress Test (1 time) - $100 Outpatient Diagnostic Lab Tests(2 times)
- $200 Outpatient MRIs or CT Scans (1 time)
-All other Radiology tests (2 times) - $100 At Home Nursing Services (max 45 days)
- $25000 Critical Illness Benefit
-$6250 for dependent children
-See schedule for benefits & % - Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA - Requires Membership in UBA to enroll
Pricing:Ages Ind Ind+Sp Ind+Child(ren) Fam 16-29 $229.31/mo $448.62/mo $551.71/mo $747.02/mo 30-39 $315.01/mo $620.02/mo $637.41/mo $937.42/mo 40-49 $352.64/mo $796.64/mo $675.05/mo $1114.06/mo 50-59 $582.08/mo $1191.71/mo $904.49/mo $1509.13/mo 60-65 $934.47/mo $1804.18/mo $1257.90/mo $2121.60/mo Add $10 for UBA Dues for total
Claims:
-Download Bright Med Hospital Indemnity Claim Form
-Download Bright Med Critical Illness Claim Form
-Use Policy# HASA-HI-1001 or HASA-CI-1001 when discussing claims
State Availability
OH
-
CERTIFICATES OF INSURANCE
Click on the state to view the Certificate of Insurance for full details, terms, conditions, limitations, and exclusions.
Bright Med (OH)
Combining first-dollar insurance & virtual care solution for members in Ohio. Learn more about the robust Hospital Indemnity benefits with Benefit Boost.
v11/25
Short Term Medical Insurance Brochures
HealthBridge TRD - Group
Traditional Short Term Medical Insurance without Benefit Boost for group states.
Version: 03/26
Category: Short Term Medical Insurance Brochures
Ins Carrier: Everest Reinsurance Company
-
PLAN DETAILS & BENEFITS
HealthBridge TRD - Group Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- Short Term Medical Insurance
- $5000 or $10000 Plan Deductible Choices (3 deductibles / family)
- 80/20 Coinsurance
- $2000 Out-of-Pocket Maximum
- $1,000,000 Coverage Period Maximum ($2 Million in IN)
- $50 Doctor or Urgent Care Visit Copay (max of 3 per person then 80/20)
- $100 Wellness Copay
- $500 Advanced Diagnostic Studies (max of 3 per person)
- $500 Emergency Room Copay (max of 3 per person)
- Requires Membership in HAA to enroll
- Simplified Underwriting Requirements
- PHCS - Practitioner & Ancillary Only (Not in NE)
- Facility charges: reimbursed at 150% of Medicare Allowable Rates
- Benefit limits may apply to some of the STMI benefits as well as pre-existing condition limitations and pre-authorizations.
Network: Search Network Providers
Pricing: Get a Quote
Claims:
-Download Non-Hospital Claim Form
-Download Hospital Services Claim Form
-Complete Online Claim Forms
-Non-Hospital Claim Instructions
-Hospital Services Claim Instructions
State Availability
AL, AR, AZ, DE, FL, GA, IN, MI, MS, NE, OH, SC, TN, TX, VA, WV & WI
HealthBridge TRD - Group
Traditional Short Term Medical Insurance without Benefit Boost for group states: AL, AZ, AR, DE, FL, GA, IN, MI, MS, NE, OH, SC, TN, TX, VA, WI & WV.
v03/26
HealthBridge TRD - Individual
Traditional Short Term Medical Insurance without Benefit Boost for group states.
Version: 03/26
Category: Short Term Medical Insurance Brochures
Ins Carrier: Everest Reinsurance Company
-
PLAN DETAILS & BENEFITS
HealthBridge TRD - Individual Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- Short Term Medical Insurance
- $5000 or $10000 Plan Deductible Choices (3 deductibles / family)
- 80/20 Coinsurance
- $2000 Out-of-Pocket Maximum
- $1,000,000 Coverage Period Maximum
- $50 Doctor or Urgent Care Visit Copay (max of 3 per person then 80/20)
- $100 Wellness Copay
- $500 Advanced Diagnostic Studies (max of 3 per person)
- $500 Emergency Room Copay (max of 3 per person)
- Does NOT require Membership in HAA to enroll
- Simplified Underwriting Requirements
- PHCS - Practitioner & Ancillary Only
- Facility charges: reimbursed at 150% of Medicare Allowable Rates
- Benefit limits may apply to some of the STMI benefits as well as pre-existing condition limitations and pre-authorizations.
Network: Search Network Providers
Pricing: Get a Quote
Claims:
-Download Non-Hospital Claim Form
-Download Hospital Services Claim Form
-Complete Online Claim Forms
-Non-Hospital Claim Instructions
-Hospital Services Claim Instructions
State Availability
KS, KY, LA, MO, NV, NC, OK, & WY
HealthBridge TRD - Individual
Traditional Short Term Medical Insurance without Benefit Boost for individual insurance states: KS, KY, LA, MO, NV, NC, OK, & WY.
v03/26
HealthBridge VCS - Group
Combining short term medical insurance & virtual care solutions. Learn more about the STMI plan with Benefit Boost 1.0 for group states.
Version: 03/26
Category: Short Term Medical Insurance Brochures
Ins Carrier: Everest Reinsurance Company
-
PLAN DETAILS & BENEFITS
HealthBridge VCS - Group Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- Short Term Medical Insurance
- $5000 or $10000 Plan Deductible Choices (3 deductibles / family)
- 80/20 Coinsurance
- $2000 Out-of-Pocket Maximum
- $1,000,000 Coverage Period Maximum ($2 Million in IN)
- $50 Doctor or Urgent Care Visit Copay (max of 3 per person then 80/20)
- $100 Wellness Copay
- $500 Advanced Diagnostic Studies (max of 3 per person)
- $500 Emergency Room Copay (max of 3 per person)
- Requires Membership in HAA to enroll
- Simplified Underwriting Requirements
- PHCS - Practitioner & Ancillary Only (Not in NE)
- Facility charges: reimbursed at 150% of Medicare Allowable Rates
- Benefit limits may apply to some of the STMI benefits as well as pre-existing condition limitations and pre-authorizations.
- Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA
Network: Search Network Providers
Pricing: Get a Quote
Claims:
-Download Non-Hospital Claim Form
-Download Hospital Services Claim Form
-Complete Online Claim Forms
-Non-Hospital Claim Instructions
-Hospital Services Claim Instructions
State Availability
AL, AR, AZ, DE, FL, GA, IN, MI, MS, NE, OH, SC, TN, TX, VA, WV & WI
HealthBridge VCS - Group
Combining short term medical insurance & virtual care solutions. Learn more about the STMI plan with Benefit Boost 1.0 for group states: AL, AZ, AR, DE, FL, GA, IN, MI, MS, NE, OH, SC, TN, TX, VA, WI, & WV.
v03/26
HealthBridge VCS - Individual
Combining short term medical & virtual care solutions. Learn more about the STMI plan with Benefit Boost 1.0 for individual states.
Version: 03/26
Category: Short Term Medical Insurance Brochures
Ins Carrier: Everest Reinsurance Company
-
PLAN DETAILS & BENEFITS
HealthBridge VCS - Individual Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- Short Term Medical Insurance
- $5000 or $10000 Plan Deductible Choices (3 deductibles / family)
- 80/20 Coinsurance
- $2000 Out-of-Pocket Maximum
- $1,000,000 Coverage Period Maximum
- $50 Doctor or Urgent Care Visit Copay (max of 3 per person then 80/20)
- $100 Wellness Copay
- $500 Advanced Diagnostic Studies (max of 3 per person)
- $500 Emergency Room Copay (max of 3 per person)
- Does NOT require Membership in HAA to enroll
- Simplified Underwriting Requirements
- PHCS - Practitioner & Ancillary Only
- Facility charges: reimbursed at 150% of Medicare Allowable Rates
- Benefit limits may apply to some of the STMI benefits as well as pre-existing condition limitations and pre-authorizations.
- Includes Benefit Boost 1.0 non-insurance services
-Lyric Health Virtual Urgent Care & Talk Therapy Visits
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA
Network: Search Network Providers
Pricing: Get a Quote
Claims:
-Download Non-Hospital Claim Form
-Download Hospital Services Claim Form
-Complete Online Claim Forms
-Non-Hospital Claim Instructions
-Hospital Services Claim Instructions
State Availability
KS, KY, LA, MO, NV, NC, OK, & WY
HealthBridge VCS - Individual
Combining short term medical insurance & virtual care solutions. Learn more about the STMI plan with Benefit Boost 1.0 for individual insurance states: KS, KY, LA, MO, NV, NC, OK, & WY.
v03/26
HealthBridge DPC - Group
Combining short term medical insurance & direct primary care. Learn more about the STMI plan with Benefit Boost 4.0 for group states.
Version: 03/26
Category: Short Term Medical Insurance Brochures
Ins Carrier: Everest Reinsurance Company
-
PLAN DETAILS & BENEFITS
HealthBridge DPC - Group Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- Short Term Medical Insurance
- $5000 or $10000 Plan Deductible Choices (3 deductibles / family)
- 80/20 Coinsurance
- $2000 Out-of-Pocket Maximum
- $1,000,000 Coverage Period Maximum ($2 Million in IN)
- $500 Advanced Diagnostic Studies (max of 3 per person)
- $500 Emergency Room Copay (max of 3 per person)
- Requires Membership in HAA to enroll
- Simplified Underwriting Requirements
- PHCS - Practitioner & Ancillary Only (Not in NE)
- Facility charges: reimbursed at 150% of Medicare Allowable Rates
- Benefit limits may apply to some of the STMI benefits as well as pre-existing condition limitations and pre-authorizations.
- Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA
Network: Search Network Providers
Pricing: Get a Quote
Claims:
-Download Non-Hospital Claim Form
-Download Hospital Services Claim Form
-Complete Online Claim Forms
-Non-Hospital Claim Instructions
-Hospital Services Claim Instructions
State Availability
AL, AR, AZ, DE, FL, GA, IN, MI, MS, NE, OH, SC, TN, TX, VA, WV & WI
HealthBridge DPC - Group
Combining short term medical insurance & direct primary care. Learn more about the STMI plan with Benefit Boost 4.0 for group states: AL, AZ, AR, DE, FL, GA, IN, MI, MS, NE, OH, SC, TN, TX, VA, WI, & WV.
v03/26
HealthBridge DPC - Individual
Combining short term medical & direct primary care. Learn more about the STMI plan with Benefit Boost 4.0 for individual states.
Version: 03/26
Category: Short Term Medical Insurance Brochures
Ins Carrier: Everest Reinsurance Company
-
PLAN DETAILS & BENEFITS
HealthBridge DPC - Individual Details
For full details and information, open up the brochure and also review the Certificate.
Benefit Highlights include:
- Short Term Medical Insurance
- $5000 or $10000 Plan Deductible Choices (3 deductibles / family)
- 80/20 Coinsurance
- $2000 Out-of-Pocket Maximum
- $1,000,000 Coverage Period Maximum
- $500 Advanced Diagnostic Studies (max of 3 per person)
- $500 Emergency Room Copay (max of 3 per person)
- Does NOT require Membership in HAA to enroll
- Simplified Underwriting Requirements
- PHCS - Practitioner & Ancillary Only
- Facility charges: reimbursed at 150% of Medicare Allowable Rates
- Benefit limits may apply to some of the STMI benefits as well as pre-existing condition limitations and pre-authorizations.
- Includes Benefit Boost 4.0 non-insurance services
-HC2U Direct Primary Care - Plus Tier
$10 Access Fee for Doctor Visits
$25 Access Fee for Urgent Care Visits
$0 Access Fee for Virtual Doctor Visits
$10 Access Fee for Annual Physical + 4 Labs (after 6 months)
Must Call PAL# to schedule appointment. No Walk-ins.
Ages 2-64 only and benefits end when Member turns 65
-Dental & Prescription Discounts
-Vitamins, LifeLock Discounts & FamilySource
-Dental Discounts are not available in: AK, CT, IA, MA, RI, UT, VT & WA
Network: Search Network Providers
Pricing: Get a Quote
Claims:
-Download Non-Hospital Claim Form
-Download Hospital Services Claim Form
-Complete Online Claim Forms
-Non-Hospital Claim Instructions
-Hospital Services Claim Instructions
State Availability
KS, KY, LA, MO, NV, NC, OK, & WY
HealthBridge DPC - Individual
Combining short term medical insurance & direct primary care. Learn more about the STMI plan with Benefit Boost 4.0 for individual insurance states: KS, KY, LA, MO, NV, NC, OK, & WY.
v03/26
Benefit Boost Brochures - Non-insurance plans
Lyric Health Virtual Visits Plan
Telehealth virtual visit services through Lyric Health Subscription.
Version: 05/25
Category: Benefit Boost Brochures - Non-Insurance Plans
Vendor: Lyric Health
-
PLAN DETAILS & BENEFITS
Lyric Health Virtual Visits Details
For Full details and information on benefits, select to view the brochure.
Benefit Highlights include:
- $0 Access Fee for Virtual Urgent Care & Virtual Talk Therapy Visits
- Unlimited Visits available 24/7/365
- Access to pay per session for Virtual Psychology & Psychiatry visits
- Age Requirements: No children under age 2
- Does not require association membership to enroll
- Can be enrolled on all three platforms: BB, HAA, & UBA enrollment links
Network: Lyric Member Portal
Pricing: Ind ($10/mo), Ind+1 ($20/mo), Fam ($30/mo)
State Availability
All 50 U.S. States
Choose the brochure version based on the enrollment platform: BB, HAA or UBA.
Lyric Health Virtual Visits
Telehealth virtual visit services through Lyric Health Subscription.
v05/25
Lyric Health Virtual Primary Care (VPC) Plan
Virtual Primary Care Solutions that include virtual urgent care, talk therapy, dermatology, and an annual physical.
Version: 05/25
Category: Benefit Boost Brochures - Non-Insurance Plans
Vendor: Lyric Health
-
PLAN DETAILS & BENEFITS
Lyric Health Virtual Primary Care (VPC) Details
For Full details and information on benefits, select to view the brochure.
Benefit Highlights include:
- $0 Access to Virtual Primary Care Visits (primary care, ongoing care, medication management)
- $0 Access Fee for Virtual Urgent Care & Virtual Talk Therapy Visits
- $0 Access for 1st 3 visits for Virtual Dermatology
- Annual Virtual Physical with 4 wellness labs
- Unlimited Visits available 24/7/365
- Access to pay per session for Virtual Psychology & Psychiatry visits
- Age Requirements: No children under age 2
- Does not require association membership to enroll
- Can be enrolled on all three platforms: BB, HAA, & UBA enrollment links
Network: Lyric Member Portal
Pricing: Ind ($30/mo), Ind+1 ($60/mo), Fam ($60/mo)
State Availability
All 50 U.S. States
Choose the brochure version based on the enrollment platform: BB, HAA or UBA.
Lyric Health VPC
Virtual Primary Care Solutions that include virtual urgent care, talk therapy, dermatology, and an annual physical.
v05/25
HC2U Direct Primary Care (DPC) - Value Tier Plan
Direct primary care solutions that include in-office doctor or urgent care visits and virtual primary care visits. This is for the Value Tier.
Version: 05/25
Category: Benefit Boost Brochures - Non-Insurance Plans
Vendor: Healthcare2U (HC2U)
-
PLAN DETAILS & BENEFITS
HC2U Direct Primary Care (DPC) - Value Tier Details
For Full details and information on benefits, select to view the brochure.
Benefit Highlights include:
- $25 Access Fee for In-Office Doctor Visits
- $50 Access Fee for In-Office Urgent Care Visits
- $0 Access Fee for Virtual Primary Care Visits
- No Walk-ins allowed. Must call PAL to set appointment
- Unlimited Visits
- In-Office Visits available during business hours (M-F, 7am-6pm CST)
- Age Requirements: No children under age 2 and ends at age 65
- Does not require association membership to enroll
- HC2U is not available to members on Medicare, Medicaid or Tricare
- Can be enrolled on all three platforms: BB, HAA, & UBA enrollment links
Network: Healthcare2U Private Physician Network
All appointments must be made through PAL concierge team.
Pricing:
Ind ($50/mo), Ind+Sp ($90/mo), Ind+Child ($110/mo), Fam ($130/mo)
State Availability
All 50 U.S. States
Choose the brochure version based on the enrollment platform: BB, HAA or UBA.
HC2U DPC Value
Direct primary care solutions that include in-office doctor or urgent care visits and virtual primary care visits. This is for the Value Tier.
v05/25
HC2U Direct Primary Care (DPC) - Plus Tier Plan
Direct primary care solutions that include in-office doctor or urgent care visits, virtual primary care visits and an annual physical + 4 labs. This is for the Plus Tier.
Version: 05/25
Category: Benefit Boost Brochures - Non-Insurance Plans
Vendor: Healthcare2U (HC2U)
-
PLAN DETAILS & BENEFITS
HC2U Direct Primary Care (DPC) - Plus Tier Details
For Full details and information on benefits, select to view the brochure.
Benefit Highlights include:
- $10 Access Fee for In-Office Doctor Visits
- $25 Access Fee for In-Office Urgent Care Visits
- $0 Access Fee for Virtual Primary Care Visits
- $10 Access Fee for Annual Physical + 4 Labs (after 6 month waiting period)
- No Walk-ins allowed. Must call PAL to set appointment.
- Unlimited Visits.
- In-Office Visits available during business hours (M-F, 7am-6pm CST)
- Age Requirements: No children under age 2 and ends at age 65
- Does not require association membership to enroll
- HC2U is not available to members on Medicare, Medicaid or Tricare
- Can be enrolled on all three platforms: BB, HAA, & UBA enrollment links
Network: Healthcare2U Private Physician Network
All appointments must be made through PAL concierge team.
Pricing:
Ind ($60/mo), Ind+Sp ($110/mo), Ind+Child ($130/mo), Fam ($190/mo)
State Availability
All 50 U.S. States
Choose the brochure version based on the enrollment platform: BB, HAA or UBA.
HC2U DPC Plus
Direct primary care solutions that include in-office doctor or urgent care visits, virtual primary care visits, and an annual physical + 4 labs. This is for the Plus Tier.
v05/25
HC2U Direct Primary Care (DPC) - Prime Tier Plan
Direct primary care solutions that include in-office doctor or urgent care visits, virtual primary care visits and an annual physical + 4 labs. This is for the Prime Tier.
Version: 05/25
Category: Benefit Boost Brochures - Non-Insurance Plans
Vendor: Healthcare2U (HC2U)
-
PLAN DETAILS & BENEFITS
HC2U Direct Primary Care (DPC) - Prime Tier Details
For Full details and information on benefits, select to view the brochure.
Benefit Highlights include:
- $0 Access Fee for In-Office Doctor Visits
- $0 Access Fee for In-Office Urgent Care Visits
- $0 Access Fee for Virtual Primary Care Visits
- $0 Access Fee for Annual Physical + 4 Labs (after 6 month waiting period)
- No Walk-ins allowed. Must call PAL to set appointment.
- Unlimited Visits.
- In-Office Visits available during business hours (M-F, 7am-6pm CST)
- Age Requirements: No children under age 2 and ends at age 65
- Does not require association membership to enroll
- HC2U is not available to members on Medicare, Medicaid or Tricare
- Can be enrolled on all three platforms: BB, HAA, & UBA enrollment links
Network: Healthcare2U Private Physician Network
All appointments must be made through PAL concierge team.
Pricing:
Ind ($60/mo), Ind+Sp ($110/mo), Ind+Child ($130/mo), Fam ($190/mo)
State Availability
All 50 U.S. States
Choose the brochure version based on the enrollment platform: BB, HAA or UBA.
HC2U DPC Prime
Direct primary care solutions that include in-office doctor or urgent care visits, virtual primary care visits, and an annual physical + 4 labs. This is for the Prime Tier.
v05/25
SML Dental Discount Plan
Dental discounts using the Aetna Dental Access Network. Non-insurance option to help save on dental expenses.
Version: 05/25
Category: Benefit Boost Brochures - Non-Insurance Plans
Network: Aetna Dental Access®
-
PLAN DETAILS & BENEFITS
SML Dental Discount Details
For Full details and information on benefits, select to view the brochure.
Benefit Highlights include:
- Up to 15% to 50%* savings per visit for discounts on dental services
- Aetna Dental Access® Network
- This is not insurance but a discount card only
- Does not require association membership to enroll
- Can be enrolled on all three platforms: BB, HAA, & UBA enrollment links
- *Actual costs and savings may vary by provider, service & geographical area.
Network: Aetna Dental Access® Network
Pricing:
Ind ($10/mo), Ind+1 ($10/mo), Fam ($10/mo)
State Availability
All 50 U.S. States EXCEPT: AK, CT, IA, MA, RI, UT, VT & WA
Choose the brochure version based on the enrollment platform: BB, HAA or UBA.
SML Dental Discounts
Dental discounts using the Aetna Dental Access Network. Non-insurance option to help save on dental expenses.
v05/25
Benefit Boost Vitamins Plan
A 3 month supply of multi-vitamin gummies. Reorders and shipping are free.
Version: 05/25
Category: Benefit Boost Brochures - Non-Insurance Plans
Vendor: Healthy America
-
PLAN DETAILS & BENEFITS
Benefit Boost Vitamins Details
For Full details and information on benefits, select to view the brochure.
Benefit Highlights include:
- Strawberry and Cherry Multi-vitamin Gumdrops
- 90 day supply (180 gummies per bottle)
- Members can reorder
- No cost for shipping
- Does not require association membership to enroll
- Can be enrolled on all three platforms: BB, HAA, & UBA enrollment links
Order Form: Online Vitamin Order Form
Pricing:
Ind ($15/mo), Ind+1 ($30/mo), Fam ($30/mo)
State Availability
All 50 U.S. States
Choose the brochure version based on the enrollment platform: BB, HAA or UBA.
Benefit Boost Vitamins
A 3 month supply of multi-vitamin gummies. Reorders and shipping are free.
v05/25
Paramount RX Prescription Discount Plan
Telehealth virtual visit services through Lyric Health Subscription.
Version: 05/25
Category: Benefit Boost Brochures - Non-Insurance Plans
Vendor: Paramount RX
-
PLAN DETAILS & BENEFITS
Paramount RX Prescription Discount Details
For Full details and information on benefits, select to view the brochure.
Benefit Highlights include:
- Prescription Discounts for Retails & Pets
- Up to 40% off Generics (could vary by location & provider)
- Up to 15% off Brand (could vary by location & provider)
- Webtools for participating providers, drug look up and discounts
- Does not require association membership to enroll
- Can be enrolled on all three platforms: BB, HAA, & UBA enrollment links
Network & Web Tool (Provider, Drug & Discount Look-up):
Retail RX Web Tool (BB & HAA)
Pet RX Web Tool (BB & HAA)
Retail RX Web Tool (UBA)
Pet RX Web Tool (UBA)
Choose the Web Tool based on the enrollment platform (BB, HAA or UBA).
Pricing: NO cost for this membership plan.
State Availability
All 50 U.S. States
Choose the brochure version based on the enrollment platform: BB, HAA or UBA.
Paramount RX Discounts
Non-insurance option to help save on prescription expenses for retail medications and pet medications.
v05/25
Providers & Web Tools
Paramount RX Web Tool
Web look-up tool to search medications, drug costs and participating providers for retail prescription discounts.
Version: 05/01/26
Category: Providers & Web Tools
Vendor: Paramount RX
Web Tool - Paramount RX Retail Providers
Web look-up tool to search medications, drug costs and participating providers for retail prescription discounts.
v05/01/26
Paramount RX Pet Web Tool
Web look-up tool to search medications, drug costs and participating providers for pet medications.
Version: 05/01/26
Category: Providers & Web Tools
Vendor: Paramount RX
Web Tool - Paramount Pet RX Providers
Web look-up tool to search medications, drug costs, and participating providers for pet medications.
v05/01/26
Dental Discount Provider Search
Use this tool to search providers in the Aetna Dental Access® Network for dental discounts through various Benefit Boost plans.
Version: 05/01/26
Category: Providers & Web Tools
Network: Aetna Dental Access®
Look up Dental Discount Providers
In the Aetna Dental Access® Network
Provider Look-up - Dental Discounts
Use this tool to search providers in the Aetna Dental Access Network for dental discounts through various Benefit Boost plans. Use Code: 725324 with the Search link below under the Group or Promo code section.
v05/01/26
UBA Dental Provider Search
Use this tool to search providers for the Renaissance UBA Dental Insurance plan. Search the DenteMax Plus network.
Version: 05/01/26
Category: Providers & Web Tools
Vendor: Renaissance
Provider Look-up - UBA Dental (Renaissance)
Use this tool to search providers for the Renaissance UBA Dental insurance plan.
v05/01/26
UBA Vision Provider Search
Use this tool to search providers for the Renaissance UBA Vision Insurance plan. Search the VSP network.
Version: 05/01/26
Category: Providers & Web Tools
Vendor: Renaissance
Provider Look-up - UBA Vision (Renaissance)
Use this tool to search providers for the Renaissance UBA Vision insurance plan.
v05/01/26
VSP Provider Search
Use this tool to search providers for the VSP Individual Insurance Plan.
Version: 05/01/26
Category: Providers & Web Tools
Vendor: VSP
Provider Look-up - VSP
Use this tool to search providers for the VSP Individual insurance plan.
v05/01/26
FCL Dental 3000 Provider Search
Use this tool to search providers for the FCL Dental 3000 plan. Search the DenteMax Plus network.
Version: 05/01/26
Category: Providers & Web Tools
Vendor: FCL
Provider Look-up - FCL Dental 3000
Use this tool to search providers for the FCL Dental 3000 plan.
v05/01/26
FCL OraQuest DHMO Provider Search
Use this tool to search providers for the FCL OraQuest DHMO plan. Search the OraQuest network.
Version: 05/01/26
Category: Providers & Web Tools
Vendor: FCL
Provider Look-up - FCL OraQuest DHMO
Use this tool to search providers for the FCL OraQuest Dental HMO plan.
v05/01/26
HealthBridge STMI Provider Search
Use this tool to search providers for the HealthBridge Short Term Medical Insurance plans. Choose the PHCS Practitioner & Ancillary Network.
Version: 05/01/26
Category: Providers & Web Tools
Network: PHCS / MultiPlan
HealthBridge STMI Providers
PHCS / MultiPlan Network
Choose the PHCS Practitioner & Ancillary Network or call 800-992-4362 to find a participating provider in the Practitioner & Ancillary Network.
Facility Charges: It is important to note that PHCS contracted rates DO NOT apply to Facility charges. For such expenses, the insurance plan covers up to 150% of the rates allowed by Medicare.
For Nebraska members: the practitioner, ancillary and facility charges are reimbursed at 150% of Medicare allowable rates and the PHCS Network does not apply.
Provider Look-up - HealthBridge STMI plans
Use this tool to search providers for the HealthBridge Short Term Medical Insurance plans. Choose the PHCS Practitioner & Ancillary Network.
v05/01/26
Presentations
Fill ACA Gaps Presentation (Agent Use Only)
Learn about the Gap 10000 & Complement Care as well as how to enroll in an agent use only presentation.
Version: 11/13/25
Category: Presentations
Vendor: HealthyAmerica
Help Fill the ACA Gaps
(Agent Use Only Presentation)
Learn about how the Gap 10000 and Complmenent Care as well as how to enroll in an agent use only presentation.
v11/13/25
UBA Accident Presentation (Agent & Consumer Use)
Learn about the UBA Accident in this PowerPoint presentation (available in PDF or PPT versions).
Version: 04/07/25
Category: Presentations
Vendor: HealthyAmerica
UBA Accident
(Agent & Consumer Use Presentation)
Learn about UBA Accident in this PowerPoint presentation (available in PDF or PPT versions).
v04/07/25
Gap 5000 Presentation (Agent & Consumer Use)
Learn about the Gap 5000 base plan in this PowerPoint presentation (available in PDF or PPT versions).
Version: 04/07/25
Category: Presentations
Vendor: HealthyAmerica
Gap 5000
(Agent & Consumer Use Presentation)
Learn about Gap 5000 base plan in this PowerPoint presentation (available in PDF or PPT versions).
v04/07/25
Gap 10000 Presentation (Agent & Consumer Use)
Learn about the Gap 10000 base plan in this PowerPoint presentation (available in PDF or PPT versions).
Version: 04/07/25
Category: Presentations
Vendor: HealthyAmerica
Gap 10000
(Agent & Consumer Use Presentation)
Learn about Gap 10000 base plan in this PowerPoint presentation (available in PDF or PPT versions).
v04/07/25
Gap 25000 Presentation (Agent & Consumer Use)
Learn about the Gap 25000 base plan in this PowerPoint presentation (available in PDF or PPT versions).
Version: 04/07/25
Category: Presentations
Vendor: HealthyAmerica
Gap 25000
(Agent & Consumer Use Presentation)
Learn about Gap 25000 base plan in this PowerPoint presentation (available in PDF or PPT versions).
v04/07/25
Complement Care Presentation (Agent & Consumer Use)
Learn about the Complement Care plan in this PowerPoint presentation (available in PDF or PPT versions).
Version: 04/07/25
Category: Presentations
Vendor: HealthyAmerica
Complement Care
(Agent & Consumer Use Presentation)
Learn about the Complement Care plan in this PowerPoint presentation (available in PDF or PPT versions).
v04/07/25
Agent Guides & Sales Scripts
Accident Agent Guide - SiriusPoint
Learn about the accident medical expense and accidental death & dismemberment insurance in plans underwritten by SiriusPoint America Insurance Company. Get all state variations in one document.
Version: 05/23
Category: Agent Guides & Sales Scripts
Ins Carrier: SiriusPoint
Accident Agent Guide - SiriusPoint
Learn about the accident medical expense and accidental death & dismemberment insurance in plans underwritten by SiriusPoint America Insurance Company. Get all state variations in one document.
v05/23
Critical Illness Agent Guide - SiriusPoint
Learn about the critical illness insurance in plans underwritten by SiriusPoint America Insurance Company. Get all state variations in one document.
Version: 05/23
Category: Agent Guides & Sales Scripts
Ins Carrier: SiriusPoint
Critical Illness Agent Guide - SiriusPoint
Learn about the critical illness insurance for the Gap plans underwritten by SiriusPoint America Insurance Company. Get all state variations.
v05/23
Hospital Indemnity Agent Guide - SiriusPoint
Learn about the hospital indemnity insurance in plans underwritten by SiriusPoint America Insurance Company. Get all state variations in one document.
Version: 05/23
Category: Agent Guides & Sales Scripts
Ins Carrier: SiriusPoint
Hospital Indemnity Agent Guide - SiriusPoint
Learn about the Hospital indemnity insurance for the Complement Care and Gap Edge plans underwritten by SiriusPoint America Insurance Company. Get all state variations.
v05/23
Sm&rtMed Agent Guide - US Fire
Learn about the Group Benefits Fixed Indemnity Insurance with a Critical Illness Rider for the Sm&rt Med plans underwritten by United States Fire Insurance Company. Get all state variations in one document.
Version: 12/25
Category: Agent Guides & Sales Scripts
Ins Carrier: US Fire
Sm&rt Med Agent Guide - US Fire
Learn about the Group Benefits Fixed Indemnity Insurance with a Critical Illness Rider for the Sm&rt Med plans underwritten by United States Fire Insurance Company. Get all state variations.
v12/25
Sm&rt Med Sales Script - US Fire
Get a copy of an approved Sales Script for the Sm&rt Med plans through US Fire.
Version: 11/25
Category: Agent Guides & Sales Scripts
Ins Carrier: US Fire
Sm&rt Med Sales Script - US Fire
Get a copy of an approved Sales Script for the Sm&rt Med plans through US Fire.
v11/25
HealthBridge TRD Agent Guide - Everest (GP)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge TRD plans for the group states for plan underwritten by Everest Reinsurance Company. Get all state variations in one document.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge TRD Agent Guide - Everest (GP)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge TRD plans for the group states for plan underwritten by Everest Reinsurance Company. Get all state variations.
v03/26
HealthBridge TRD Agent Guide - Everest (Ind)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge TRD plans for the individual states for plans underwritten by Everest Reinsurance Company. Get all state variations in one document.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge TRD Agent Guide - Everest (Ind)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge TRD plans for the individual states for plans underwritten by Everest Reinsurance Company. Get all state variations.
v03/26
HealthBridge VCS Agent Guide - Everest (GP)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge VCS plans for the group states for plan underwritten by Everest Reinsurance Company. Get all state variations in one document.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge VCS Agent Guide - Everest (GP)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge VCS plans for the group states for plan underwritten by Everest Reinsurance Company. Get all state variations.
v03/26
HealthBridge VCS Agent Guide - Everest (Ind)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge VCS plans for the individual states for plan underwritten by Everest Reinsurance Company. Get all state variations in one document.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge VCS Agent Guide - Everest (Ind)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge VCS plans for the individual states for plan underwritten by Everest Reinsurance Company. Get all state variations.
v03/26
HealthBridge DPC Agent Guide - Everest (GP)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge DPC plans for the group states for plan underwritten by Everest Reinsurance Company. Get all state variations in one document.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge DPC Agent Guide - Everest (GP)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge DPC plans for the group states for plan underwritten by Everest Reinsurance Company. Get all state variations.
v03/26
HealthBridge DPC Agent Guide - Everest (Ind)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge DPC plans for the individual states for plan underwritten by Everest Reinsurance Company. Get all state variations in one document.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge DPC Agent Guide - Everest (Ind)
Learn more about the Short term medical insurance benefits and benefit limits for HealthBridge DPC plans for the individual states for plan underwritten by Everest Reinsurance Company. Get all state variations.
v03/26
HealthBridge TRD Sales Script - Everest
Get the approved Sales Script for the HealthBridge TRD short term medical insurance for plans underwritten by Everest Reinsurance Company.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge TRD Sales Script - Everest
Get the approved Sales Script for the HealthBridge TRD short term medical insurance for plans underwritten by Everest Reinsurance Company.
v03/26
HealthBridge VCS Sales Script - Everest
Get the approved Sales Script for the HealthBridge VCS short term medical insurance for plans underwritten by Everest Reinsurance Company.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge VCS Sales Script - Everest
Get the approved Sales Script for the HealthBridge VCS short term medical insurance for plans underwritten by Everest Reinsurance Company.
v03/26
HealthBridge DPC Sales Script - Everest
Get the approved Sales Script for the HealthBridge DPC short term medical insurance for plans underwritten by Everest Reinsurance Company.
Version: 03/26
Category: Agent Guides & Sales Scripts
Ins Carrier: Everest Reinsurance Company
HealthBridge DPC Sales Script - Everest
Get the approved Sales Script for the HealthBridge DPC short term medical insurance sales script for plans underwritten by Everest Reinsurance Company.
v03/26
Important & Useful Forms
Effective Date Schedule
View possible effective dates based on the date of submission. Pay attention to this schedule if you are needing a specific effective date for clients.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Effective Date Schedule
View possible effective dates based on the date of submission. Pay attention to this schedule if you are needing a specific effective date for clients.
v05/01/26
Cancellation Request Form
A simple form your member can use to cancel their membership plans.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Cancellation Request Form
A simple form your member can use to cancel their membership plans.
v05/01/26
Bank Draft Change Form
Send this link to clients to update their bank draft or change from credit card to bank draft. This form is secure using the HelloSign/DropBoxSign platform.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Bank Draft Change Form
Send this link to clients to update their bank draft or change from credit card to bank draft. This form is secure using the HelloSign/DropBoxSign platform.
v05/01/26
Credit Card Change Form
Send this link to clients to update or change from credit card information (update numbers, CVV codes, etc.). This form is secure using the HelloSign/DropBoxSign platform.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Credit Card Change Form
Send this link to clients to update or change their credit card information (update numbers, CVV codes, etc.). This form is secure using HelloSign/DropBoxSign platform.
v05/01/26
Add Dependent Form
Use this form to add members (spouse or dependent children) to already existing plans. This is a secure form using the HelloSign/DropBoxSign platform.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Add Dependent Form
Use this form to add members (spouse or dependent children) to already existing plans. This is a secure form using the HelloSign/DropBoxSign platform.
v05/01/26
Group Billing Form
This is a form agents should complete if there are multiple members using the same billing. That way we can keep track of the group, and we ensure the billing is done correctly. This is a secure form using the HelloSign/DropBoxSign platform.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Group Billing Form
This is a form agents should complete if there are multiple members using the same billing. That way we can keep track of the group, and we ensure the billing is done correctly.
v05/01/26
Vitamin Order Form
This is the link members can use to order vitamins. They can also order them through the Member portal.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Vitamin Order or Reorder Form
This is the link members can use to order vitamins. They can also order them through the Member portal.
v05/01/26
Request Additional ID Cards
This form can be used to reorder ID cards. Please note that we do not order ID cards for any of the Benefit Boost benefits or VSP. These cards are only available on the Member Portal digitally.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Request Additional ID Cards
This form can be used to reorder ID cards. Please note that we do not order ID cards for any of the Benefit Boost benefits or VSP. These cards are only available on the Member Portal digitally.
v05/01/26
Agent Back Office
This is the link for eagentcenter.com, the agent back office where you can download your weekly and monthly new business statements.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Agent Back Office
This is the link for eagentcenter.com, the agent back office where you can download your weekly and monthly new business statements.
v05/01/26
Change of Address Form
This is the link to request a change in the mailing and/or home address for the member.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Change of Address Form
This is the link to request a change in the mailing and/or home address for the member.
v05/01/26
Change of Email Address Form
This is the link to request a change in the email address for the member. The email is where members receive notices of billing issues and benefits are tied.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Change of Email Address Form
This is the link to request a change in the email address for the member. The email is where members receive notices of billing issues and benefits are tied.
v05/01/26
Secure Email Upload
Use this link to send any attachments through ShareFile to us that include any PII or need to be secured.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Secure Email Upload
Use this link to send any attachments through ShareFile to us that include any PII or need to be secured.
v05/01/26
Agent Direct Deposit Change Form
Use this form to change the direct deposit information. This is important if you are making a change as to where you want your compensation to be deposited. This form is secure using the HelloSign/DropBoxSign platform.
Version: 05/01/26
Category: Important & Useful Forms
Vendor: HealthyAmerica
Agent Direct Deposit Change Form
Use this form to change the direct deposit information. This is important if you are making a change as to where you want your compensation to be deposited.
v05/01/26
Carrier Appointment Form - SiriusPoint
This is the stand-alone appointment form for SiriusPoint America Insurance Company.
Version: 05/01/26
Category: Important & Useful Forms
Ins Carrier: SiriusPoint
Carrier Appointment Form - SiriusPoint
This is the stand-alone appointment form for SiriusPoint America Insurance Company.
v05/01/26
Carrier Appointment Form - GTL
This is the stand-alone appointment form for Guarantee Trust Life Insurance Company. If you are going to be marketing the Gap Term plan, you must be appointed with GTL through us.
Version: 05/01/26
Category: Important & Useful Forms
Ins Carrier: GTL
Carrier Appointment Form - GTL
This is the stand-alone appointment form for Guarantee Trust Life Insurance Company (GTL).
v05/01/26
Carrier Appointment Form - US Fire
This is the stand-alone appointment form for United States Fire Insurance Company, a Crum & Forster Company. If you are going to be marketing the Sm&rt Med plans, you must be appointed with US Fire through us.
Version: 05/01/26
Category: Important & Useful Forms
Ins Carrier: US Fire
Carrier Appointment Form - US Fire
This is the stand-alone appointment form for United States Insurance Company.
v05/01/26
CMS Consent Form
This is the CMS Consent permission form required for agents to complete for Marketplace ACA sales.
Expiration: 07/31/28
Category: Important & Useful Forms
Vendor: CMS / ACA
CMS Consent Form
This is the CMS Consent permission form required for agents to complete for Marketplace ACA sales.
exp07/31/28
Claim Forms - Important Forms
Bright Med Claim Form - Hospital Indemnity
Download the Bright Med Claim form for Hospital Indemnity claims.
Version: 11/25/25
Category: Claim Forms - Important Forms
Ins Carrier: SiriusPoint
Bright Med Claim Form - Hospital Indemnity
Claim's Administrator
HSR
8400 Belleview Drive, Suite 150
Plano, TX 75024
Phone: 972-512-5600
Fax: 972-512-5820
Toll-Free: 866-523-3452
Email: ubaclaims@hsri.com
Use Policy Number: HASA-HI-1001
Attach itemized bills (UB04 or CMS HCFA 1500 bill)
Bright Med Claim Form - Hospital Indemnity
Download the Bright Med Claim form for Hospital Indemnity claims.
v11/25/25
Bright Med Claim Form - Critical Illness
Download the Bright Med Claim form for Critical Illness claims.
Version: 11/19/25
Category: Claim Forms - Important Forms
Ins Carrier: SiriusPoint
Bright Med Claim Form - Critical Illness
Claim's Administrator
HSR
8400 Belleview Drive, Suite 150
Plano, TX 75024
Phone: 972-512-5600
Fax: 972-512-5820
Toll-Free: 866-523-3452
Email: ubaclaims@hsri.com
Use Policy Number: HASA-CI-1001
Bright Med Claim Form - Critical Illness
Download the Bright Med Claim Form for Critical Illness claims.
v11/19/25
Sm&rt Med Claim Forms - Hospital Indemnity & Critical Illness
Download the Sm&rt Med Claim Form for Hospital Indemnity and Critical Illness claims.
Version: 11/04/25
Category: Claim Forms - Important Forms
Ins Carrier: US Fire
Sm&rt Med Claim Forms - HI & CI
Claim's Administrator
HSR
8400 Belleview Drive, Suite 150
Plano, TX 75024
Payor ID#: 65449
Phone: 972-512-5600
Fax: 972-512-5820
Toll-Free: 800-328-1114
Email: claims@hsri.com
Use Policy Number: US2252661
Sm&rt Med Claim Form
Download the Sm&rt Med Claim Form for Hospital Indemnity and Critical Illness claims.
v11/04/25
HealthBriddge STMI Claim Forms - Non-Hospital Services
Download the Short Term Medical Form for non-hospital service claims for the HealthBridge plans.
Version: 02/18
Category: Claim Forms - Important Forms
Ins Carrier: Everest
HealthBridge STMI Claim Form - Non-Hospital Services
HCFA-1500
Claim's Administrator
InsuranceTPA.com Administrators
Po Box 241869
Apple Valley, MN 55124
EDI Payor ID#: 39182
Toll-Free: 800-279-2290
Pre-Certification#: 800-641-5566
Online Claim Filing: www.insurancetpa.com
Short Term Claim Form - Non-Hospital Services
Download the Short Term Medical Form for non-hospital service claims for the HealthBridge plans.
v02/18
HealthBriddge STMI Claim Forms - Hospital Services
Download the Short Term Medical Form for hospital service claims for the HealthBridge plans.
Version: 02/18
Category: Claim Forms - Important Forms
Ins Carrier: Everest
HealthBridge STMI Claim Form - Hospital Services
UB-04
Claim's Administrator
InsuranceTPA.com Administrators
Po Box 241869
Apple Valley, MN 55124
EDI Payor ID#: 39182
Toll-Free: 800-279-2290
Pre-Certification#: 800-641-5566
Online Claim Filing: www.insurancetpa.com
Short Term Claim Form - Hospital Services
Download the Short Term Medical Form for hospital service claims for the HealthBridge plans.
v02/18
Accident Claim Form - SiriusPoint
Download the accident claim form for accident medical expense or ad&d claims for plans underwritten by SiriusPoint America Insurance Company.
Version: 08/22/24
Category: Claim Forms - Important Forms
Ins Carrier: SiriusPoint
SiriusPoint Accident Claim form
Claim's Administrator
HSR
8400 Belleview Drive, Suite 150
Plano, TX 75024
Phone: 972-512-5600
Fax: 972-512-5820
Toll-Free: 866-523-3452
Email: ubaclaims@hsri.com
Use Policy Number: HASA-BAM-1000
Attach itemized bills (UB04 or CMS HCFA 1500 bill)
Accident Claim Form - SiriusPoint
Download the accident claim form for accident medical expense or ad&d claims for plans underwritten by SiriusPoint America Insurance Company.
v08/22/24
Critical Illness Claim Form - SiriusPoint
Download the critical illness claim form for all critical illness claims for plans underwritten by SiriusPoint America Insurance Company (except for Bright Med).
Version: 08/22/24
Category: Claim Forms - Important Forms
Ins Carrier: SiriusPoint
SiriusPoint Critical Illness Claim form
Claim's Administrator
HSR
8400 Belleview Drive, Suite 150
Plano, TX 75024
Phone: 972-512-5600
Fax: 972-512-5820
Toll-Free: 866-523-3452
Email: ubaclaims@hsri.com
Use Policy Number: HASA-CI-1000
Attach itemized bills (UB04 or CMS HCFA 1500 bill)
Critical Illness Claim Form - SiriusPoint
Download the critical illness claim form for all critical illness claims for gap plans underwritten by SiriusPoint America Insurance Company (except for Bright Med).
v05/01/26
Hospital Indemnity Claim Form - SiriusPoint
Download the hospital indemnity claim form for all Complement Care or Gap Edge claims that are underwritten by SiriusPoint America Insurance Company.
Version: 06/03/22
Category: Claim Forms - Important Forms
Ins Carrier: SiriusPoint
SiriusPoint Hospital Indemnity Claim form
Claim's Administrator
HSR
8400 Belleview Drive, Suite 150
Plano, TX 75024
Phone: 972-512-5600
Fax: 972-512-5820
Toll-Free: 866-523-3452
Email: ubaclaims@hsri.com
Use Policy Number: HASA-HI-1000
Attach itemized bills (UB04 or CMS HCFA 1500 bill)
Hospital Indemnity Claim Form - SiriusPoint
Download the hospital indemnity claim form for all Complement Care or Gap Edge claims that are underwritten by SiriusPoint America Insurance Company.
v06/03/22
Term Life Claim Form - GTL
Download the term life claim form for all term life claims underwritten by Guarantee Trust Life Insurance Company.
Version: 10/19
Category: Claim Forms - Important Forms
Ins Carrier: GTL
GTL Term Life Claim form
Claim's Administrator
Guarantee Trust Life Insurance
Po Box 1144
Glenview, IL 60025
Toll-Free: 800-338-7452
Use Association Name: United Business Association (UBA)
Claim form must be completed & signed by:
beneficiary/beneficiares or executor.
A 'Certified' copy of the death certificate
with the cause and manner of death shown.
Term Life Claim Form - GTL
Download the term life claim form for all term life claims underwritten by Guarantee Trust Life Insurance Company.
v10/19
Accident Claim Form (AME) - GTL
Download the Accident Medical Expense claim form for accident claims underwritten by Guarantee Trust life Insurance Company.
Version: 03/16
Category: Claim Forms - Important Forms
Ins Carrier: GTL
GTL Accident Claim Form (AME)
Claim's Administrator
Guarantee Trust Life Insurance
Po Box 1144
Glenview, IL 60025
Toll-Free: 800-338-7452
Fax: 847-699-1048
Email to: claims@gtlic.com
Use Association Name: United Business Association (UBA)
Attach itemized bills to the claim form.
Ask provider to print UB-04 form (for hospital expenses)
or on a CMS 1500/HCFA form (for doctor's expenses).
Itemized Bill indicates: Date of treatment, types of services, diagnosis, medical provider's name & address, ind charge for each expense.
Accident Claim Form (AME) - GTL
Download the Accident Medical Expense claim form for accident claims underwritten by Guarantee Trust life Insurance Company.
v03/16
Accidental Death Claim Form - GTL
Download the Accidental Death claim form for accident claims underwritten by Guarantee Trust Life Insurance Company.
Version: 11/15
Category: Claim Forms - Important Forms
Ins Carrier: GTL
GTL Accidental Death Claim Form
Claim's Administrator
Guarantee Trust Life Insurance
Po Box 1144
Glenview, IL 60025
Toll-Free: 800-338-7452
Email to: ameclaims@gtlic.com
Use Association Name: United Business Association (UBA)
Claim form must be completed & signed by:
beneficiary/beneficiaries or Next of Kin.
A 'Certified' copy of the death certificate
with the cause and manner of death shown.
Accident Claim Form (Accidental Death) - GTL
Download the Accidental Death claim form for accident claims underwritten by Guarantee Trust Life Insurance Company.
v11/15
Accidental Dismemberment Claim Form - GTL
Download the Accidental Dismemberment Claim form for accident claims underwritten by Guarantee Trust Life Insurance Company.
Version: 09/07
Category: Claim Forms - Important Forms
Ins Carrier: GTL
GTL Accidental Dismemberment Claim Form
Claim's Administrator
Guarantee Trust Life Insurance
Po Box 1144
Glenview, IL 60025
Toll-Free: 800-662-1993
Fax: 847-803-1835
Email to: special_riskdiv@gtlic.com
Use Association Name: United Business Association (UBA)
Accident Claim Form (Accidental Dismemberment) - GTL
Download the Accidental Dismemberment Claim form for accident claims underwritten by Guarantee Trust Life Insurance Company.
v09/07
Accident Claim Form - US Fire
Download the Accident claim forms for accidental medical expense and ad&d claims for old plans underwritten by United States Fire Insurance Company.
Version: 03/18
Category: Claim Forms - Important Forms
Ins Carrier: US Fire
US Fire Accident Claim form
Claim's Administrator
Co-ordinated Benefit Plans
Po Box 23802
Tampa, FL 33623
Toll-Free: 877-442-7029
Email: team2@cbpinsure.com
Claims Portal: cbpconnect.com
Use Policy Number: US1068696
Attach itemized bills (UB04 or CMS HCFA 1500 bill)
Accident Claim Form - US Fire
Download the Accident claim forms for accidental medical expense and ad&d claims for old plans underwritten by United States Fire Insurance Company.
v03/18
Critical Illness Claim Form - US Fire
Download the Critical Illness Rider claim form for critical illness claims for old plans underwritten by United States Fire Insurance Company.
Version: 02/12/19
Category: Claim Forms - Important Forms
Ins Carrier: US Fire
US Fire Critical Illness Claim form
Claim's Administrator
Co-ordinated Benefit Plans
Po Box 23802
Tampa, FL 33623
Toll-Free: 800-561-8084
Email: team2@cbpinsure.com
Claims Portal: cbpconnect.com
Use Policy Number: US1068698
Attach itemized bills (UB04 or CMS HCFA 1500 bill)
Critical Illness Rider Claim Form - US Fire
Download the Critical Illness Rider claim form for critical illness claims for old plans underwritten by United States Fire Insurance Company.
v02/12/19
Hospital Indemnity Claim Form - US Fire
Download the hospital fixed indemnity claim form for hospital indemnity claims for old plans underwritten by United States Fire Insurance Company.
Version: 03/18
Category: Claim Forms - Important Forms
Ins Carrier: US Fire
US Fire Hospital Indemnity Claim form
Claim's Administrator
Co-ordinated Benefit Plans
Po Box 23802
Tampa, FL 33623
Toll-Free: 877-442-7029
Email: team2@cbpinsure.com
Claims Portal: cbpconnect.com
Use Policy Number: US1068698
Attach itemized bills (UB04 or CMS HCFA 1500 bill)
Hospital Fixed Indemnity Claims - US Fire
Download the hospital fixed indemnity claim form for hospital indemnity claims for old plans underwritten by United States Fire Insurance Company.
v03/18
Gap HCI Claim Form - Chubb/Federal Ins
Download the Hospital Indemnity Claim form for the Gap HCI older membership plans underwritten by Federal Insurance Company.
Version: 04/25/17
Category: Claim Forms - Important Forms
Ins Carrier: Federal Insurance
Gap HCI Claim Form
Claim's Administrator
HSR
8400 Belleview Drive, Suite 150
Plano, TX 75024
Phone: 972-512-5600
Fax: 972-512-5820
Toll-Free: 866-523-3452
Email: ubaclaims@hsri.com
Use Policy Number: 9908-17-48
Attach itemized bills (UB04 or CMS HCFA 1500 bill)
Gap HCI Claims - Chubb / Federal Ins Co.
Download the Hospital Indemnity Claim form for the Gap HCI older membership plans underwritten by Federal Insurance Company.
v04/25/17
Critical Illness Claim Form - Windsor Life
Download the critical illness claim form for critical illness plans underwritten by Windsor Life Insurance Company.
Version: 05/01/26
Category: Claim Forms - Important Forms
Ins Carrier: Windsor Life
Windsor Critical Illness Claim Form
Claim's Administrator
Windsor Life Insurance Company
1345 River Bend Drive
Dallas, TX 75247
Phone: 214-528-2020
Fax: 214-528-2777
Website: www.optiumre.com
Use Policy Number: WL-BLCI-001005 (for 5K CI plans)
Use Policy Number: WL-BLCI-001003 (for 10K CI plans)
Use Policy Number: WL-BLCI-001006 (for 25K CI plans)
Critical Illness Claim Form - Windsor
Download the critical illness claim form for critical illness plans underwritten by Windsor Life Insurance Company.
v05/01/26
Dental Claim Form - Renaissance
Download the dental claim form for UBA Dental for claims performed by out-of-network providers.
Version: 2024
Category: Claim Forms - Important Forms
Ins Carrier: Renaissance
Renaissance Dental Claim Form
Claim's Administrator
Renaissance
Po Box 17250
Indianapolis, IN 46217
Toll Free: 888-791-5995
Email: claims@renaissancefamily.com
Use Group Name: UBA
Use Group ID: 3621
Dental Claim Form - Renaissance
Download the dental claim form for UBA Dental for claims performed by out-of-network providers.
v2024
Vision Claim Form - Renaissance
Download the vision claim form for UBA Vision for claims performed by out-of-network providers.
Version: 05/01/26
Category: Claim Forms - Important Forms
Ins Carrier: Renaissance
Renaissance Vision Claim Form
Claim's Administrator
VSP Member Claims
Po Box 495933
Cincinnati, OH 45249
Toll Free: 800-877-7195
Use Group Name: UBA
Use Group ID: 90112
Vision Claim Form - Renaissance
Download the vision claim form for UBA Vision for claims performed by out-of-network providers.
v05/01/26
Dental Claim Form - FCL
Download the dental claim form for FCL plans when using an out-of-network provider.
Version: 2024
Category: Claim Forms - Important Forms
Ins Carrier: FCL
FCL Dental Claim Form
Claim's Administrator
FCL
101 Parklane Boulevard, Suite 301
Sugar Land, TX 77478
Toll Free: 877-493-6282
Member Portal: FCL Member Portal
Use Plan ID: UBA - Dental 3000 MAC (for FCL Dental 3000)
Use Group ID: MA2297-D+ (for FCL Dental 3000)
Use Plan ID: UBA - DHMO - 110-01 (for FCL OraQuest DHMO)
Use Group ID: MB2297 (for FCL OraQuest DHMO)
Dental Claim Form - FCL
Download the dental claim form for FCL plans when using an out-of-network provider.
v2024
Vision Claim Form - VSP
Download the vision claim form for VSP Individual Vision Plan when using an out-of-network provider.
Version: 05/01/26
Category: Claim Forms - Important Forms
Ins Carrier: VSP
VSP OON Vision Claim Form
Claim's Administrator
VSP Member Claims
Po Box 495933
Cincinnati, OH 45249
Toll Free: 800-877-7195
Vision Claim Form - VSP
Download the vision claim form for VSP Individual Vision Plan when using an out-of-network provider.
v05/01/26
Personalization of Materials
Flyer & Brochure Personalization Request
Get flyers and brochures personalized with your unique QR code for your enrollment link and Apply Now buttons going to your enrollment app.
Version: 05/01/26
Category: Personalization of Materials
Vendor: HealthyAmerica
Flyer & Brochure Personalization
Get flyers and brochures to be personalized with your unique QR code for your enrollment link and Apply Now buttons going to your enrollment app.
v05/01/26
Video Personlization Request
Request some of our approved videos to be personalized with your unique enrollment link and phone numbers.
Version: 05/01/26
Category: Personalization of Materials
Vendor: HealthyAmerica
Video Personalization
Request some of our approved videos to be personalized with your unique enrollment link and phone numbers.
v05/01/26
Consumer Presentation Personlization Request
Request some of our approved consumer presentations to be personalized with your unique enrollment link and phone numbers.
Version: 05/01/26
Category: Personalization of Materials
Vendor: HealthyAmerica
Consumer Presentation Personalization
Request some of our approved consumer presentations to be personalized with your unique enrollment link and phone numbers.
v05/01/26
Training & Next Steps
Next Steps Flyer - English Version
Learn what the steps are once you get your unique enrollment link and agent code and how to complete an app.
Version: 03/26
Category: Training & Next Steps
Vendor: HealthyAmerica
Next Steps Flyer - English Version
Learn what the steps are once you get your unique enrollment link and agent code and how to complete an app.
v03/26
Next Steps Flyer - Spanish Version
Learn what the steps are once you get your unique enrollment link and agent code and how to complete an app.
Version: 03/26
Category: Training & Next Steps
Vendor: HealthyAmerica
Next Steps Flyer - Spanish Version
Learn what the steps are once you get your unique enrollment link and agent code and how to complete an app.
v03/26
Training Course
Sign up to complete the HA Compliance Training course. Required for new agents marketing insurance products.
Version: 05/01/26
Category: Training & Next Steps
Vendor: HealthyAmerica
Training Course
Sign up to complete the HA Compliance Training course. Required for new agents marketing insurance products.
v05/01/26
Demo Enrollment Links - UBABB
Learn about using the UBA and Benefit Boost enrollment platform link. Submit test dummy applications. Just make sure to use your email in the test app so that you can complete the sample enrollment from start to finish.
Version: 05/01/26
Category: Training & Next Steps
Vendor: HealthyAmerica
Demo Enrollment Links - UBABB
Ready to start actual LIVE enrollments? Start Enrolling a Real App Now
Demo Enrollment Links - UBABB
Learn about using the UBA and Benefit Boost enrollment platform link.
v05/01/26
Demo Enrollment Links - HAABB
Learn about using the HAA and Benefit Boost enrollment platform link. Submit test dummy applications. Just make sure to use your email in the test app so that you can complete the sample enrollment from start to finish.
Version: 05/01/26
Category: Training & Next Steps
Vendor: HealthyAmerica
Demo Enrollment Links - HAABB
Ready to start actual LIVE enrollments? Start Enrolling a Real App Now
Demo Enrollment Links - HAABB
Learn about using the HAA and Benefit Boost enrollment platform link.
v05/01/26
Demo Enrollment Links - BB Only
Learn about using the Benefit Boost Only enrollment platform link. Submit test dummy applications. Just make sure to use your email in the test app so that you can complete the sample enrollment from start to finish.
Version: 05/01/26
Category: Training & Next Steps
Vendor: HealthyAmerica
Demo Enrollment Links - BB Only
Ready to start actual LIVE enrollments? Start Enrolling a Real App Now
Demo Enrollment Links - BB Only
Learn about using the Benefit Boost ONLY enrollment platform link.
v05/01/26