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Our Simplify Plan offers you access to a variety of benefits that help put your mind at ease when life’s difficult moments interrupt your day to day living.

Simplify Plan *
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One Time Enrollment Fee
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Optional Benefits

Enhance the Simplify package with the optional benefit add-ons below

Dental Savings – administered by Careington International
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Rx Card Savings – administered by EnvisionSavings
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By enrolling in a plan, I authorize the Association, the Pharmacy Services Administrator and its participating pharmacies to share only information necessary to the fulfillment of prescriptions.

Member is required to pay the entire amount of the discounted rate. The purchase price may vary by drug and by pharmacy. Discounts are available only at participating pharmacies. No portion of the drug cost or dispensing fees for drugs purchased by members under this program is paid by Association Rx Card or EnvisionSavings. Pricing and tier positions are subject to change without notice. Pricing and tier positions are only for quantities stated; additional quantities may incur higher costs. May not be available in all states. Members may cancel the Association Rx Card program within thirty (30) days of joining the program, and shall be refunded any and all program fees paid during the initial program membership. Visit www.AssociationRXCard.com for more details on drug pricing and participating pharmacies. For additional information and assistance, please contact AIA Member Services at 1-888-861-4242. This application is not a contract. For complete details, consult your fulfillment materials.

Member Information

(must be 18 years or older)
      

Dependents

This is for Legal Dependents

 
      
Please Note: You have selected an individual add-on with dependents on the membership. The product will be added to the primary member. If you want the product to be added to one of your dependents complete this application and call member services at 1-888-861-4242;

Click 'Save and Continue' or select a different product.
Please Note: Your Careington Dental benefit will be effective August 1, 2019. Should you have any questions regarding this benefit, please contact AIA Member Services at 1-888-861-4242

Click 'Save and Continue' to continue with your membership application.

Payment schedule

      

Initial Payment

Simplify Plan
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Add Ons
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One Time Enrollment Fee
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Total Initial Payment Amount
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Initial Payment Method – Initial Payment is Credit or Debit Card ONLY

           
      

Recurring Payment

Simplify Plan
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Add Ons
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Total Recurring Payment Amount
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Recurring Payment Method

This payment method will be used for recurring payment
      

Terms and Conditions

PLEASE ENTER YOUR NAME BELOW TO ELECTRONICALLY SIGN YOUR APPLICATION.
PLEASE RE-ENTER TO CONFIRM YOUR APPLICATION.

Independent Benefits Consultant

Agent Number:

PLEASE NOTE: If you press Submit Application button twice, the credit card may be charged twice. After clicking Submit, it will take several seconds to process the application. You will see a confirmation message after the application has been processed. Benefit availability and limitations may vary by state. See Member Benefit Guide for details.

Disclosures The Benefits described are offered at the sole discretion of AIA and may vary by availability, package option, vendor and state of residence. Vendors reserve the right to withdraw or change their offers without notice. AIA makes no affirmation of fact or promise relating to the goods and services, and specifically disclaims any warranty, expressed or implied, as to the merchantability of the goods and services reflected. To be entitled to AIA Benefits you must be a Member in good standing and dues must be in a current status.



Notice of cancellation: You may cancel your membership at any time upon notification to AIA. Upon notification, you must specify the termination date of your membership. If your membership is terminated prior to your membership’s paid through date, then you will receive a refund of any unused dues, without deductions.