You understand that you are enrolling voluntarily into the Delta Dental and Vision Plan and that you are authorizing Aegis Administrative Services, Inc. to charge your credit card for the premium listed according to the mode you selected. This is a recurring charge and will remain in effect until you cancel in writing. You are agreeing not to dispute this recurring billing with your bank so long as the transactions correspond to the terms indicated during the enrollment process. You agree that if you dispute the charge you will be responsible for the $30.00 fee that the merchant assesses for disputes.

Your effective date will be the first of the following month after the date of the enrollment.

Your cancellation becomes effective at the end of the month of cancellation date. Retroactive terminations will not be authorized.