Membership Sign Up
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Primary Member
Selected Plan
Select (NW) Plan Essence (NW) Plan Kinetic (NW) Plan Preferred (TX) Plan Preferred Plus (TX) Plan
(Same Plan as PRIMARY) Select (NW) Plan Essence (NW) Plan Kinetic (NW) Plan Preferred (TX) Plan Preferred Plus (TX) Plan
Gender
Male
Female
Marital Status
Single
Married
Social Security Number
Street Address Line 1 (Cannot list a PO Box as an address)
Street Address Line 2 (Optional)
DEPENDENT(S)
✚ ADD DEPENDENTBENEFIT SELECTIONS and ADD-ON OPTIONS
Primary Care
Option $50.00 / mo, per individual
Six (6) visits annually; locations are limited geographically to Texas .
View local Primary Care providers → Option $38.00 / mo, per individual
Nationwide Primary Care, Urgent Care and Mental Health telemedicine.
Option $50.00 / mo, per individual
Nationwide Primary Care, Urgent Care, Mental Health and Dermatology telemedicine.
24/7 Telemedicine
$5.00 / mo, per individual
Nationwide Urgent Care telemedicine.
Diagnostic Imaging
$21.00 / mo, per individual
Limited to services provided by the imaging center. Locations are limited geographically in Texas .
View Diagnostic Imaging providers →
Doc Wellbee Dental and Vision
$8.00 / mo, per individual
Dental and Vision discount program.
eHome Counseling Group
$30.00 / mo, per individual
Nationwide Mental Health telemedicine.
Magic Pill
$18.00 / mo, per individual
Access to 1,000+ medications in 90-day supplies delivered at no additional cost.
Catastrophic Coverage (Stop-Loss)
$56.00 / per month, per individual
For members with LASO Connect or an approved Primary Care provider through this or another plan. Covers catastrophic medical events starting from $50K in paid claims to Unlimited at 130% of Medicare with no lifetime limits.)
Legal Shield + ID Shield
$30.00 / per month, per individual
Get the legal help you need, anytime, anywhere. Members get unlimited consultations with a provider law firm on any legal matter. The plan also includes traffic violations assistance, trial defense reimbursement, identity theft protection services, and document preparation for wills, living wills, and powers of attorney. Learn more about Legal Shield + ID Shield
YOUR ORDER
ENROLLMENT FEE
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The membership subscription price is monthly , with a recurring monthly payment, and requires a 12-month commitment.
Cancellations MUST be made in writing. The membership subscription will end on the last day of the month in which notice was provided in writing.
If you enroll before the 25th, the effective date will be the 1st of the next month. If after the 25th, the effective date will be the 1st of the following month.
terms and conditions
