Enrollment Application
Please See Member Fee Payment Options Below:
Pay with Credit Card
| Individual | Family Plan | |
|---|---|---|
| Monthly Only | $6.00 | $10.00 |
There is a one time application fee of $20.00.
Enroll NowPay with Bank Draft
| Individual | Family Plan | |
|---|---|---|
| Monthly Only | $6.00 | $10.00 |
There is a one time application fee of $20.00.
Enroll NowPay with Check or Money Order
| Individual | Family Plan | |
|---|---|---|
| Annual Only | $72.00 | $120.00 |
There is a one time application fee of $20.00.
Printable Application