Applications
Medalist II - $500-$5000 Deductible	Application
Triple Tier Plans	Application
Next Generation HSA Plans	Application
Short Term	Application	On-line App
Hippa Plan (must meet qualifications)

American Community, choice of Cleveland Clinic or University Hospital Systems.

Rates vary depending upon medical conditions and prescriptions.

Please mail your completed application and first month's premium made payable to American Community to the address below.

Have Questions?  Please contact us:                                                 
       Right Track Benefits

            Joanie M. Streets

          Director of Individual Business

        7575 Fredle Dr. Suite 202

       Concord, OH 44077

       Phone (440) 357-9993

       Fax (440) 358-0058