GROUP OPTION 12-1895 ONLINE ENROLLMENT

Monthly Payroll Deduction Plan

Please select your plan(s):

Both Family Plans $33.90/month

Both Individual Plans $27.90/month

Family Legal Plan $18.95/month

Individual Legal Plan $18.95/month

Family IDShield $18.95/month

Individual IDShield $8.95/month

Available supplements with Legal Plan purchase:

Home Business Supplement $12.95/month

Gun Owner Supplement $12.95/month

I authorize my employer to deduct premiums from my earnings and remit to LegalShield. *

Yes

No

By submitting this form, I acknowledge that the LegalShield Legal Plan and ID Shield employee benefits were made available and explained to me completely. I have seen the brochure/factsheet and/or video listing specific benefit and benefit limitations of these plans. I authorize my employer to deduct premiums from my earnings and remit to LegalShield.

Yes, I want to receive emails about my membership!

Thanks for submitting!

Group Option 12-1895: Price Quote

Group Option 12-1895: Text

636-299-6345

Rick Shore
LegalShield Independent Associate

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