Member Participation Agreement
As a member of NCE GapAfford Plus Program, you are a participant in a Discount Medical Program referred hereafter as the (DMP). Below are the terms and conditions of your membership in the DMP.
The effective date of your DMP is shown on the Member ID and shall continue from month to month until the DMP is notified of your cancellation.
The Monthly Charge and mode of payment for participation in the DMP is on your enrollment form. If you need to change your payment mode, please contact the member services number on your identification card.
- This is NOT an insurance policy;
- Discounts are provided at certain healthcare providers for healthcare services;
- The Plan does not make payments directly to the providers of healthcare services;
- You are obligated to pay for all healthcare services but will receive a discount from healthcare providers who have contracted with the Plan;
- The discount medical plan organization is: Access One Consumer Health 84 Villa Road, Greenville SC 29615 www.accessonedmpo.com.
You may find a list of participating providers at: www.ncegapaffordplus.com or you may call: 877-271-6559. You will be able to access DMP discounts at participating providers of each participating network.
This DMP includes discounts for dental, vision, prescriptions, hearing, chiropractors, speech therapy, and prepaid labs. Depending on your plan selection you may not have access to all of these benefits. The included Benefit Descriptions: Dental discounts between 15% to 50% per visit on most dental procedures; Vision discounts between 10% to 50% on vision care; Prescription discounts 15-50% at local pharmacies, up to 80% on brand-name mail-order; Hearing discounts up to 40%; Chiropractic discounts up to 30% at participating locations. The minimum discount for any service provided under the Plan is 5% and may go to as much as 50%. The Benefit Descriptions becomes part of this Membership Agreement.
You will be billed at the time of service by the participating provider who will apply the applicable discounts to that bill. In no instance can the DMP make payments directly to the provider on your behalf.
Your participation in the DMP will continue from month to month upon payment of your monthly dues and shall cease upon (i) your failure to make the monthly payment; or (ii) notification in writing (USPS, email or facsimile) of you desire to cancel.
You have the right to cancel participation in the program at any time. If you do so within 30 days of receipt of your membership materials, you will receive a full refund of all fees and or dues paid to participate in the DMP minus the one-time non-refundable processing fee. If the processing fee is more than thirty dollars, it will be refunded. After the first thirty (30) days, you may cancel participation at any time and if you have pre-paid any membership fees, the prepayment will be refunded on a pro-rata basis for months you have not used.
The DMP may terminate your participation in the program if you fail to make your membership payment when due.
You may contact Member Services for notice of change in name or address on our website, www.ncegapaffordplus.com or calling 877-271-6559.
This program includes all members of your household (you your spouse and legal dependents). You are not required to list your dependents to participate in the DMP.
If you have a complaint regarding the DMP you may go to www.accessonedmpo.com. or call 800-896-1962. You may also write to Access One Consumer Health, Inc. 84 Villa Rd. Greenville, SC 29615. The complaint will be addressed, and you will receive a response within 15 days.
This Member Participation Agreement includes an arbitration provision, a waiver of jury trial, and a prohibition on participation in class actions. These provisions can be found in the Addendum on our website at www.accessonedmpo.com/memberagreementaddendum.php and are incorporated herein by reference and made a part of this Member Participation Agreement to the same extent and with the same force as if fully set forth herein.
This Agreement and its Benefit Descriptions along with the Addendum represent the entire agreement between you and the DMP and supersede all other prior representations, statements, or written agreements between you and the DMP.
Arkansas Residents You may cancel your membership with the discount medical plan organization within the first thirty (30) days from receipt of your ID card and receive a full refund of all fees or dues paid. Illinois Residents If you are not satisfied with your resolution of your complaint, you may contact Illinois Department of Insurance. Louisiana Residents If after receiving our response and you are not satisfied with the resolution you may write of call the Louisiana Department of Insurance. You have the right to cancel participation in the program at any time. If you do so within 30 days of receipt of your membership materials you will receive a full refund of all fees and or dues paid to participate in this DMP minus the one-time non-refundable processing fee. Maryland Residents "Discounts for hospital services, if any, are not applicable in Maryland." Massachusetts Residents The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under the Affordable Care Act or Massachusetts M.G.L. c. 111M and 956 CMR 5.00. Nebraska Residents If you have cancelled at any time after the thirty (30) day period, and you have pre-paid any membership fees, the prepayment will be refunded on a pro-rata basis for months you have not used. South Carolina You may cancel your membership with the discount medical plan organization within the first thirty (30) days from receipt of your ID card and receive full refund on any fees or dues paid, less the one-time processing fee. Tennessee Residents You may cancel your membership with the discount medical plan organization within the first thirty (30) days from receipt of your ID card and receive a full refund of all fees or dues paid. Texas Residents If you remain dissatisfied after completing Access One’s complaint system, you may contact your state insurance department. Utah Residents These programs are not covered by the Utah Health Insurance Guarantee Act. West Virginia Residents If after receiving our response and you are not satisfied with the resolution you may write of call: West Virginia Insurance Commissioner.
This DMP is not available in the following states AK, MT, RI, UT, VT, WA.