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How to enroll in DeltaCare for new members

Please select one of the following payment methods below.

 

Enroll Online

Or Enroll by Mail

Click Here To Print an Enrollment Form: Wolfpack DeltaCare Program

 

The minimum enrollment period is 12 months.

Monthly payment via automatic deduction. 
Month Rates; One person: $30.30, Two persons: $53.50, Three persons or more: $76.80.
A one time enrollment fee of $5.00 is charged to with all new applications.

  1. Submit the first months premium and enrollment fee payment.  Complete the enrollment form and sign the Automatic Payment Authorization section on the enrollment form.  Be sure to enclose a voided blank check from this account.  Also, please call your bank to obtain the ABA number (bank routing number).  Starting with your second month, the dues will be deducted from the account specified on the 15th of each month prior to the coverage month (e.g., April dues will be deducted on March 15th).  Your coverage will automatically be terminated if your automatic deduction is declined by your bank for insufficient funds, a closed account, etc.
  2. Return the enrollment materials and your first months payment to:
        Gordon Paul
        7108 N. Fresno St, Suite 150
        Fresno, CA 93720

OR

Calendar Year Quarterly payment via check. 
Quarterly Rates; One person: $90.90, Two persons $157.50, Three persons or more: $ 235.80.
Quarterly clients are also charged a $3.00 administration fee with each invoice.
A one time enrollment fee of $5.00 is charged to with all new applications.

  1. Submit the first quarterly payment with your enrollment form.  Once enrolled, you will be billed on a calendar year quarterly basis.  Dues must be paid in full by the 15th of the month prior to the coverage month or your coverage will be automatically terminated.  You cannot have a break in coverage.
  2. Return the enrollment form and the first quarterly payment to:
        Gordon Paul
        7108 N. Fresno St, Suite 150
        Fresno, CA 93720

OR

Voluntary List Bill Groups
Month Rates; One person: $30.30, Two persons: $53.50, Three persons or more: $78.60.
A one time enrollment fee of $5.00 is charged to with all new applications.
Voluntary List Bill Groups are invoiced monthly and are charged a $5.00 administration fee with each monthly invoice.

  1. Submit the first payment with your enrollment form.  Once enrolled, the employer group will be billed on a monthly basis.  Dues must be paid in full by the 15th of the month prior to the coverage month or your coverage will be automatically terminated.  You cannot have a break in coverage.
  2. Return the enrollment form and the first monthly payment along with the enrollment fee and administration fee to:
        Gordon Paul
        7108 N. Fresno St, Suite 150
        Fresno, CA 93720

 

Note: The enrollment information must be received at the latest by the 15th of the month for coverage to begin the 1st of the following month. Incomplete. inaccurate information will cause a delay in your enrollment into the program

 
 

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