for UBA Members

409 W VICKERY BLVD, FORT WORTH, TX 76104 | 866.438.4274

Member Billing

Member Driven Value.

Ask Billing Questions
Change Billing Information 

Billing Questions Request

Do You Have Billing Questions?

Click on the image below to access our Billing Questions Form. Make sure to not include any information that is considered private information like bank account information, credit card information, social security information etc. This is a generic billing questions form. You can also inquire about billing over the phone at 866.438.4274.

Billing Questions Form - Click here to ask your question
How to Cancel
How to Cancel Your Membership

How to Cancel Your Membership

In the event that you have changed your mind or needed to cancel your Gap Plan, please use the cancellation form below or call your Personal Member Concierge at 866.438.4274 in order to cancel. Please do not cancel through your agent. Cancel directly with Gap to make sure your cancellation request is handled promptly and correctly.

Note: This membership is separate from any other insurance or supplemental plans you have purchased. Please contact your agent for any plans other than the UBA Gap Membership Plan.

Click here to Cancel Your Membership
Refund Policy

Membership Refund Policy

If you are not completely satisfied with your UBA Gap Plan, please call your Personal Concierge at 866.438.4274 or use the Gap Cancellation Form in the How To Cancel Section. We will be happy to issue a complete refund of membership dues within the first thirty (30) days. We want you to be 100% satisfied with your UBA Gap benefits and services.

30 Day Money Back Guarantee
Bank Draft Billing
Bank Draft Billing

Change Request on Bank Draft Billing

If you are on bank draft billing and need to change your account information, or if you were on credit card billing and wanted to switch to bank draft billing, please use the form below.

Please don't email the form directly to us unless you use the Secure Email Upload Button located in the Send Information Securely section.

Click here to Download Bank Draft Change Form
Credit Card Billing
Credit Card Billing Changes

Change Request on Credit Card Billing

Do you need to change your credit card number on file or do you have a new expiration date that you need to update with us? Are you switching from bank draft billing to credit card billing? If you answered yes to any of the above questions, fill out the Credit Card Change Form below.

Please don't send the form back to us via regular email. Use the Secure Email Upload Button located in the Send Information Securely section.

Click here to Download the Credit Card Change Form
Send Information Securely

Send Information and PDFs Securely

Make sure your information is protected. Use the Secure Email Upload Button below to send us any information in a file format (pdf, doc, etc) Securely. Make sure not to put any private information in the body of the email - only in the file attachment you upload using the secure email upload button. Send Bank Draft Change Forms, Credit Card Change Forms, and other private information.

Click here to upload Secure Information and send by email