Payment Information

Success You have successfully added automatic payments from your checking account.

Success You have successfully edited automatic payments for your checking account.

Success You have successfully deleted automatic payments. Your insurance bill will no longer be paid automatically. You will be required to pay your bill manually.

Success You have successfully made a payment via . Your payment will be processed in .

Save & Print your Payment Confirmation Page.

Success You have chosen to submit your payment via mail. Don't forget to mail your statement along with your check. Your Payment History and associated statement will reflect your payment once we receive and process your check. This typically takes from 5 – 10 business days.

Statement	Due Date	Past Due	Current Due	Total Due		Auto-Pay
Apr,	05/01/	$0.00	$332.00	$332.00		Auto-Pay: OFF

Past Due Amount Past due amounts must be paid immediately or you risk losing your coverage.

Payment Required First automatic payment will occur on May 1, 2018. Ensure that you make a payment for the statement due on April 1, 2018.

Add Auto-Pay

Payment Method

Account Type

Bank routing number:

Institution Name:

Account number:

Note: First automatic payment will occur on May 1, 2018. Ensure that you make a payment for the statement due on April 1, 2018.

Edit Auto-Pay

Payment Method

Account Type

Bank routing number:

Institution Name:

Bank Name

Account number:

Note: First automatic payment will occur on May 1, . Ensure that you make a payment for the statement due on April 1, 2018.

Make a Payment

How would you like to pay your bill?Current Balance: $147.00 / Due Date: 04/01/2018

Credit/Debit Card (one-time)

1. You will be directed to a secure, third-party site to process your payment.

2. You will be making a payment for the Total Amount Due plus a convenience charge; you cannot make a partial payment or advance payment.

3. In addition, your Total Amount Due is based on the date the transaction is processed by the bank or card issuer.

4. Your associated benefit coverage will be delayed until your payment is processed.

5. If you are making a payment with a FSA/HSA debit card, please review your FSA/HSA plan rules and restrictions.

Pay Bill

Bank Account (one-time direct debit)

Account Type:

Bank Routing Number:

Institution Name:

Account Number:

Note: Payment typically takes 3 – 5 business days to process after your payment is submitted.

Pay Bill

Mail a check or money order

To make a payment by check or money order, select and print the appropriate statement and mail it along with your payment. It typically takes from 5 – 10 business days for us to receive and process this type of payment.

Statement	Coverage Dates	Amount Due	Payment Received
Mar,	04/01/ - 04/30/	$332.00	$332.00	Receipt
Feb,	03/01/ - 03/31/	$332.00	$332.00	Receipt
Jan,	02/01/ - 02/28/	$332.00	$332.00	Receipt

Account Number	123456789
Payment Due Date	05/01/
For coverage period	05/01/ – 05/31/
Amount Due	$332.00
Total Enclosed	$

Post Date	Description	Benefit	Amount
04/15/	Charge	Medical Plan	$212.00
04/15/	Charge	Dental Plan	$50.00
04/15/	Charge	Medical Plan - Medicare	$70.00

Post Date	Description	Benefit	Amount
03/15/	Charge	Medical Plan	$212.00
03/15/	Charge	Dental Plan	$50.00
03/15/	Charge	Medical Plan - Medicare	$70.00
03/31/	Payment		($332.00)

Coverage	Coverage Dates
Medical Plan	04/01/ – 04/30/
Dental Plan	04/01/ – 04/30/
Medical Plan - Medicare	04/01/ – 04/30/

Health & Insurance

Payment Information

Add Auto-Pay

Edit Auto-Pay

Make a Payment

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