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PLANS STARTING AT ONLY $10 A MONTH!


WELCOME TO FORM BENEFITS

Our Benefits provide you with real money-saving services that protect your
family, as well as save you time and money on your day-to-day expenses.

Please review the FAMILY COVERAGE Benefits we offer below, and choose the
combination of services that fit your needs and budget. We have developed a
simple menu plan that enables you to select one, three, or all six benefits… for
as low as $10 a month!

YOUR BENEFIT CHOICES











 

 

plan


PICK YOUR PLAN



IMPORTANT: Residents of Iowa, Minnesota, Wisconsin, Maine, Vermont and Utah may
ONLY purchase ELITE TELEMEDICINE 24/7 or TECH COACH EXPERTS.


OUR GUARANTEE TO YOU


NO TERM COMMITMENTS. FORM Benefit Plans are offered on a month-to-month basis,
so there are no long-term commitments required to join! Your FORM Benefit Plans
were developed to provide you with the protection you deserve and savings you
desire for just pennies per day - a mere fraction of the cost of other
comparable benefit plans. We want you to remain a member because you see the
value and savings, not because of any long-term contracts!

MONEY BACK GUARANTEE. We make it easy for you to shop with confidence with our
14 Day Money Back Guarantee. If you are not satisfied within the first 14 Days
from registering, you will receive a FULL REFUND. No questions asked.

OUR CANCELLATION POLICY. You may cancel at any time. Within the first 14 days,
you will receive a full refund. If you cancel after 14 days, you will not be
billed for another month, and you will enjoy your membership until the end of
the current term. It’s that simple!


SIGNING UP IS SIMPLE

 

 1. CLICK THE PLAN OF YOUR CHOICE.

 2. ENTER YOUR ACCESS CODE, AND CLICK "JOIN."

 3. SELECT YOUR BENEFIT(S) CHOICE.

 4. ENTER YOUR INFORMATION AND CREATE YOUR ACCOUNT PASSWORD.

 5. ENTER YOUR CREDIT CARD INFORMATION AS REQUESTED.

IMPORTANT

Upon submitting your information, you will receive a Welcome email from
system@formbenefits.com.  The Welcome email will have your selected Benefit
card(s) in a PDF attachment.  If you do not receive your Welcome email, please
be sure to check your spam folder first before reaching out to us.

Thank you, and enjoy your benefits!




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 * BENEFITS
   
 * ABOUT US
   


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 * FAQ
   
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HOME | BENEFITS | ABOUT US | PLANS | FAQ | CONTACT

Telemedicine is NOT health insurance. Telehealth plans are not considered to be
qualified health plans under the Affordable Care Act. The individual benefit
discounts are available through participating providers only. Not all services
are available in all markets.
                                                                                                                                                
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