1. Register Your Plan online at the bottom of this page.2. Pay the one-time $100 registration fee.3. Fund Your Plan via Pre-Authorized Debit Agreement.4. Submit Your Claims. Easy!
A VOID cheque or approved bank branch validation form must be attached with this agreement
to verify the Planholder bank account information. This form and bank information can be submitted
in advance or at the time of submission of the first health benefit claim. DRAltd will retain the bank
account information in its secure files so that it is only required once.
The undersigned hereby authorizes the execution of the above agreement. The Planholder’s financial
institution is authorized to treat each debit as if a cheque had been issued authorizing such payment