GapPlusPlan.com for UBA Members

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

Members

Member Driven Value.

Get Access to Member Forms, Benefits
Group Insurance Certificates and more...

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Claim Forms

Click on the link below to download Claim Forms:

Check Your Member Guide to Determine the Insurance Carrier that Provides Coverage for Your Membership Plan Benefits.


 
 


 

Note: There are no claim forms to complete
when you visit a VSP participating doctor.
 
Member Guide & ID Card Reorder Forms

Click on the Image Below to Access Re-Order Form:

Reorder ID Card
 
Reorder Member Guide
Group Insurance Certificates

Click on the Plan Below to View Group Insurance Certificates

(The Group Insurance Certificates below are for plans purchased on or after September 7, 2017. If you purchased a membership plan prior to September 7, 2017, fill out the request to receive the Group Insurance Certificates for your specific membership plan.)

 Gap Dental Plan Group Insurance Certificates
Gap Dental
   Gap Vision Plan Group Insurance Certificates
Gap Vision
  Gap RX Plan Group Insurance Certificates
Gap RX
  Gap ER Plan Group Insurance Certificates
Gap ER
  Gap HCI Plan Group Insurance Certificates
Gap HCI
 

Gap AME Group Insurance Certificates
Gap AME
  Gap CI Group Insurance Certificates
Gap CI
  Gap Plus Group Insurance Certifciates
Gap Plus
  Gap Max Group Insurance Certificates
Gap Max
  Super Gap Group Insurance Certificates
Super Gap
 


Did you purchase a Gap Plan PRIOR to 9-7-17? If you purchased your plan prior to 9-7-17, the group certificates may be different than the plans listed above. Please select the Older Plan Certificates button below for access to your correct Group Insurance Certificates for your plan.


Older Gap Plan Group insurance Certificate Request
Benefit Enrollment Forms

UBA Membership Benefit Forms

Use the following forms to enroll or order the following benefits and services of the United Business Association.

Activate Your MailMyPrescriptions.com Membership - Use the Activation code in your the welcome email from MailMyPrescriptions.com   Order Free Yitamins Online
Apply to College Graduate Scholarship   Order your Gateway Medicard
Sign up for HSA Account for Individuals Sign up for HSA Account for Employers
Change Request Forms

Click on the image below to View Change Forms:

Update Email Address Update Mailing Address Add Dependent Form
Billing Forms

Click on Image Below to view Billing Forms:

Use these forms to update your bank draft account or credit card account or expiration date. Make sure to send it back securely. Don't send back through regular email. Use the Secure Email Upload Link located in the Send information to UBA Securely Tab. You can also fax back the information to 817.335.1270. Do you have a general billing question? Use the Billing Question link below to ask our billing department. Make sure to not include account information on this form. This form is for general questions only.



credit card change form   Bank Draft Change Form   General Billing Questions Form
Refund Policy & Cancellation Request

UBA Refund / Cancellation Policy

If you are not completely satisfied with your UBA Gap Plan, please call your Personal Member Concierge at 866.438.4274. 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.

Note: This membership is separate from any other insurance or supplemental plan you have purchased. Please contact your agent for any plans other than the UBA Gap Membership Plan. If you are canceling, please make sure to cancel using our cancellation phone number at 866.438.4274 or our cancellation form located at gapplusplan.com/billing.html. Please do not cancel through your agent. Cancel directly with GAP to make sure your cancellation request is handled promptly and correctly.


Cancellation Request Form


30 Day Money Back Guarantee
Provider Lookup

Click on the Image Below to View Benefit Providers

Below are links to In-Network Providers for the Insured Gap Membership Plans:
Find Dental Providers In Network Here   Find Vision Providers In Network Here   Locate Gap RX Participating Pharmacies


Below are the links for the Discount Programs in Your UBA Membership:
    Locate Retail Prescription Discount Providers   Locate Pet RX Prescription Discount Providers
Insurance Companies Who Provide Coverage

Click on the Company Name Below to View Corporate Website.

Catlin Insurance Company, Inc.
Windsor Life Insurance Company
Investors Heritage Life Insurance Company
Federal Insurance Company, a Chubb Company^
Renaissance Life & Health Insurance Company of America
PRAM Insurance Services, Inc, exclusive underwriter for Envision Insurance Company
Guarantee Trust Life Insurance Company


Insurance Coverage is provided by these insurance companies


XL Catlin is the global brand used by XL Group Ltd's insurance subsidiaries, including Catlin Insurance Company, Inc. Windsor Life Insurance Company is re-insured by Optimum Re.
^Insurance benefits are underwritten by Federal Insurance Company. Chubb NA is the U.S.-based operating division of the Chubb Group of Companies, headed by Chubb Ltd. (NYSE:CB). Insurance products and services are provided by Chubb Insurance underwriting companies and not by the parent company itself.
Causes to Support

United Business Association Proudly Supports the Following Charities.
You can too! Click on the Image Below to Donate Today!

UBA Proudly Supports Stand Up To Cancer - You can too. Donate by clicking here   UBA Proudly supports American Heart Association - You can too. Donate by clicking here
Member News - UBA Matters

UBA Matters

Click on the Calendars Below to View Past Editions of UBA Matters Newsletters, exclusively for UBA Members.
(Password=BIN# on your Retail RX Discount ID Card. Can't locate your card, call us at 866.438.4274)



Summer 2015 UBA Matters Member Newsletter
Fall 2015 UBA Matters Member Newsletter
Spring 2016 UBA Matters Member Newsletter
Fall 2016 UBA Matters Member Newsletter
More UBA Matters Member News Coming Here Soon
Fall 2014 UBA Matters Member Newsletter
Special UBA Matters Member News - 2014
Stand Up To Cancer UBA Member Contest Winners
Fall 2013 UBA Matters Member Newsletter
Summer 2013 UBA Matters Member Newsletter
Fall 2012 UBA Matters Member Newsletter
Fall 2011 UBA Matters Member Newsletter
Fall 2010 UBA Matters Member Newsletter
Fall 2009 UBA Matters Member Newsletter
Fall 2008 UBA Matters Member Newsletter


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Gap Videos

View Gap ER Video Below to learn more




View These Videos About Two of UBA's Most Popular Membership Benefits






Note: These membership benefits are for new UBA Memberships purchased on or after 090717. Any membership plans purchased prior to 090717 might vary in membership benefits and services or membership dues from the current membership plan being offered and viewed on this website. Please contact your Personal Member Concierge for questions about plans prior to 090717.
Send Information to UBA Securely

Click on the Link Below to Upload Attachments Securely:

Use this link to upload PDFs securely. Don't send private information via regular email. This email upload encrypts the files you send to make sure that your information remains secure.


Send attachments securely using this upload link
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