EXCLUSIVE BENEFITS and DISCOUNTS FOR BUSINESS OWNERS

and their EMPLOYEES

Access to over 289,000 offers and discounts from Nationwide and Local companies.

08CB 01/2016

American Savers Club is a Not for Profit Corporation dedicated to brining Special

Savings and Benefits to Business Owners and their employees

AmericanSaversClub.com 1-800-350-5066

1410 Triad Center Dr. St. Peters MO 63376

Basic membership includes:

Access to Nationwide Discount Networks Personal Health Insurance Shopping Services

Upgraded Memberships include access to:

$10 per month discount on MedicalSavingsPlan memberships Personal Assistant & Concierge Services

Identiy Theft Protection / Discount Credit Repair Services ACCIDENT DEDUCTIBLE REDUCTION PROGRAM

Check Out The Savings at www.americansaversclub.com

08CAP 01/2016

Upgraded Membership

is A “NO BRAINER “

with High Deductible

Health Insurance!

PERFECT

High Deductible

Health Companion

ACCIDENT DEDUCTIBLE BUSTER

$2500 or $5000 levels

PROTECTS AGAINST HIGH DEDUCTIBLE

THIS IS NOT INSURANCE!

Introducing a revolutionary non-insurance deductible buster

to help with the high out of pocket medical expenses resulting

from everyday common accidents and today’s high health

insurance deductibles.

No underwriting and no occupational restrictions, we are able

to deliver a high quality accident deductible buster. This is

about half the cost of accident insurance alternatives.

We negotiate your medical expenses due to any accident

down to a guaranteed low max out of pocket and the initial

expenses still apply toward satisfying your deductible.

$2,500 Accident Buster reduces small deductibles that

are up to $2500 down to a $100 maximum per claim

$5,000 Accident Buster reduces larger clams that are

from $2500 to $5000 down to a $200 maximum per claim

Applies to first $2500 or $5000 of all medical expenses

due to an accident if expenses are not covered by insurance.

Coverage at home, work or play 24 hours per day!

BASIC MEMBERSHIP Includes: 289,000 Offers from National and Local Companies Best Available Movie Ticket Prices w/no hidden fees or taxes Online, Tablet and Mobile access Free Holistic Health Counselor Consultation Free Personal Insurance Shopping Service Free Consultation and Guide to Homeownership Free Credit & Score Analysis

UPGRADE OPTIONS Free Claims Review and Patient Advocacy Programs Access to our exclusive Accident “Deductible Buster”

See Features Options & Details Below and Monthly Pricing on Application page

Concierge / Personal Assistant Service $99 per year Individual Credit Repair Starting at only $250 Corporate Branding Options–Pricing Varies

These are available to be purchased direct from vendor after fulfi l lment

Quick Fulfillment

$10 discount on Medical Savings Plans.

The American Savers Club Guarantee:

If for any reason you are not completely 100% satisfied with

your upgraded membership savings or benefits, simply

cancel and receive a no questions asked refund.

www.AmericanSaversClub.com

1(800) 501-1559

Fax 1(877)828-2604

1410 Triad Center Dr.

St. Peters MO 63376

Do you have a High Deductible Health Plan?

Protect yourself with the Deductible Buster

Choose $2500 or $5000 of Accident Deductible reduction. Combining the

deductible buster in the upgraded membership with your high deductible insurance to fill the gap and save big!

American Savers Club Exclusive FREE CONSULTATION with certified holistic health

and nutrition counselor (a $195 value)

PLUS 20% off of additional services

Provided by The Balance Advocates

Have you been wanting to…

- Achieve your optimum weight

- Increase energy and improve sleep

- Address conditions such as High Blood Pressure, Cholesterol, Acid Reflux, Allergies, PMS, Diabetes or other health issues

- Reduce and manage stress and anxiety - Experience a lasting increase in your energy and vitality

- Stop your cravings and binges - Feel better in your body and achieve your ideal weight

Initial Amount Due $_________

Access & Enrollment Fee $200.00

Last ________________________________________ First _____________________ MI _______ Birth Date ______________________________

Address ____________________________________________________________________ Social Security # ______________________________

City ____________________________________ State ______________ Zip _____________ Email ______________________________________

Home Phone _____________________________ Work Phone ________________________________ Fax ________________________________

636-922-0048 1(800) 350-5066 Fax 1(877) 828-2604

1410 Triad Center Dr. St. Peters MO 63376

Membership Application

_____________________________________________________________________

Agent Signature Agent #

08CAP 01/2016

Last First M.I. Social Security # Date of Birth Age Sex

Spouse

Dependent

Dependent

Dependent

Dependent

PRIMARY MEMBER Please answer all questions and print clearly

ADDITIONAL FAMILY MEMBERS Please answer all questions and print clearly

Application Date __________________________________

Payment Options

Bank Draft Authorization

I have provided a voided check and I realize

with my signature below I authorize Medical

Savings Plan to automatically draft my bank

account each month in the amount of

$________________

Signature_____________________________

Bank Routing #________________________

Account # ____________________________

Checking Savings

Application Date __________________________________

_____________________________________________________________________

Applicant Signature

Credit Card By signing below I authorize

Medical Savings Plan to charge my credit card

account for the initial amount due and

For the monthly amount of $ _____________

Signature_____________________________

Name on Card ________________________

Card # _______________________________

Expiration _____________

MasterCard

Visa

Choose a Membership Leve Single Family Monthly

Basic Membership $10 $15

Level 2 - $2,500 Accident

Deductible Buster $25 $40

Level 3 - $5,000 Accident

Deductible Buster $35 $50

Discounted Premier Medical

Savings Plan (with level 2 & 3 only ) $10 $15

Discounted Premier Plus Medical

Savings Plan (with level 2 & 3 only ) $20 $25

Total Monthly Dues

Please allow 1 week for fulfillment.

Less Coupon Code Discount _______

Total Access & Enrollment Fee $_________