FW-Change

Stay Current.

From addresses to dependents, Texas Legal makes it easy to update your info.

Welcome to the online Enrollment Change form. Making a plan change has never been easier or more secure. Simply start by letting us know who you are.

Then, make your change request from the options listed below and look for correspondence from Texas Legal notifying you when the change is made.

Name*
First, we need to need some basic information from you.
First Last
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Date of Birth*
MM
DD
YYYY
If you do not know your plan details, please contact Texas Legal for assistance with your request.
This plan is made available to me by:*
- Employer / Group / Association
Select all changes you would like to make.*
Your updates may take up to seven (7) business days to complete. Changes received between the 1st and the 25th of each month are effective on the 1st of the following month. Please note that changes received between the 26th and 31st of the month are effective on the 1st of the month after. (For example, received on March 26th, effective May 1st).
- Update Policyholder Information
- Update Address or Phone Information
- Add or Remove Dependents
- Add, Change or Update Payment Type and/or Frequency
- Cancel Coverage
Update Policyholder Information
New Name
Please update the appropriate information.
First Last
New Email
Enter Email Confirm Email
Upload copy of new ID or Marriage Certificate
If you are changing your name, you will need to provide a digital copy of your marriage certificate or new legal identification. You may upload jpg, png or pdf files. You may upload a maximum of three files. Each file must be under 2MB.
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 6 MB.
Update Address or Phone Information
New Address
Street Address Address Line 2 City State ZIP Code
New Primary Phone
New Secondary Phone
Add or Remove Dependents
Eligible Dependents means (1) Participant’s spouse; and all of Participant’s children, including step- children, legally adopted children, children for which Participant is the legal guardian, any of which are under twenty- six (26) years of age, and Participant’s children over age twenty-six (26) who suffer from a permanent and total physical or mental disability and where the Participant’s or Participant’s spouse has provided more than one half of the disabled child’s support in that Plan year; or (2) the definition of eligible dependent provided by the Master Policyholder for all other benefits offered by the Master Policyholder provided that said definition is more broad than (1) above and Master Policyholder provides a copy of same to Texas Legal. Notwithstanding the forgoing, an Eligible Dependent child may not be older than 26 unless the child has a disability.
Eligible Dependents means (1) Participant’s spouse; and all of Participant’s children, including step- children, legally adopted children, children for which Participant is the legal guardian, any of which are under twenty- six (26) years of age, and Participant’s children over age twenty-six (26) who suffer from a permanent and total physical or mental disability and where the Participant’s or Participant’s spouse has provided more than one half of the disabled child’s support in that Plan year; or (2) the definition of eligible dependent provided by the Master Policyholder for all other benefits offered by the Master Policyholder provided that said definition is more broad than (1) above and Master Policyholder provides a copy of same to Texas Legal. Notwithstanding the forgoing, an Eligible Dependent child may not be older than 26 unless the child has a disability.
Please note that dependent changes may result in a premium adjustment.

Select
Monthly/Annual Preferred
Monthly/Annual

Single Coverage
$13/$130 $22/$220

Family Coverage
$20/$200 $35/$350
Please note that dependent changes may result in a premium adjustment.

Monthly Annual

Single Coverage
$26.00 $280.00

Family Coverage
$40.00 $435.00
Do you wish to add or remove dependents?*
How many dependents do you wish to add?*
If you wish to add more than four dependents, please contact us directly at 1-800-252-9346.
How many dependents do you wish to remove?*
If you wish to remove more than four dependents, please contact us at 1-800-252-9346.
Dependent Name*
First Last
Relationship to Applicant*
- Spouse
- Child/ Step-Child/ Adopted Child
- Disabled Adult Dependent
- Domestic Partner
Dependent Date of Birth*
MM
DD
YYYY
Dependent Gender*
- Male
- Female
Dependent Name*
First Last
Relationship to Applicant*
- Spouse
- Child/ Step-Child/ Adopted Child
- Disabled Adult Dependent
- Domestic Partner
Dependent Date of Birth*
MM
DD
YYYY
Dependent Gender*
- Male
- Female
Dependent Name*
First Last
Relationship to Applicant*
- Spouse
- Child/ Step-Child/ Adopted Child
- Disabled Adult Dependent
- Domestic Partner
Dependent Date of Birth*
MM
DD
YYYY
Dependent Gender*
- Male
- Female
Dependent Name*
First Last
Relationship to Applicant*
- Spouse
- Child/ Step-Child/ Adopted Child
- Disabled Adult Dependent
- Domestic Partner
Dependent Date of Birth*
MM
DD
YYYY
Dependent Gender*
- Male
- Female
Add, Update or Change Payment Type and/or Frequency
Type of Coverage*
- Single
- Family
Please note that selecting single will cause any covered dependents to be terminated.
Payment Frequency*
- Monthly
- Annually
Group Single Monthly*
Preferred Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration. Select Plan - targeted coverage for the most used legal issues at an extremely affordable price.
- Preferred Plan - $25.00 a month
- Select Plan - $16.00 a month
Group Single Annual*
Preferred Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration. Select Plan - targeted coverage for the most used legal issues at an extremely affordable price.
- Preferred Plan - $275 a year - Save 19%
- Select Plan - $176 a year - Save 17%
Group Family Monthly*
Preferred Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration. Select Plan - targeted coverage for the most used legal issues at an extremely affordable price.
- Preferred Plan - $40.00 a month
- Select Plan - $25.00 a month
Group Family Annual*
Preferred Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration. Select Plan - targeted coverage for the most used legal issues at an extremely affordable price.
- Preferred Plan - $440 a year - Save 19%
- Select Plan - $275 a year - Save 17%
Total Monthly Charge
$0.00
Total Annual Charge
$0.00
Payment Method*
NOTICE: Returned Bank Drafts/Checks/Credit Card Payments Incur a $25 Fee.
Will the bank draft come from a Checking or Savings account?*
By signature of this application, you hereby authorize Texas Legal to charge/draft your checking/savings account from the financial institute listed. This authority is to remain in effect until Texas Legal receives written notification from you revoking the authorization. This account will be drafted at the beginning of each month. Payment is due on the 1st of each month. Your account may not reflect the debit until the 2nd and later depending on the bank or credit union transactions or guidelines. Each financial institution establishes its own guidelines.
9 Digit Bank Routing Number*
Bank Account Number*
Bank Name*
Bank Phone Number
Billing Address same as Address
- Billing Address is Same as Address
Billing Address*
Street Address Address Line 2 City State ZIP Code
Credit Card*
Credit Card Customers Please Complete Credit Card Information on this Form: I hereby authorize Texas Legal to charge the credit card above for a one‐time payment or monthly payment of my premium or due fees, depending on my selection. I certify that I am the authorized holder and signer or have the consent of the authorized holder and signer of the credit card referenced above and that all information above is complete and accurate. I understand that this information will be securely maintained.

American Express
MasterCard
Visa
Supported Credit Cards: American Express, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Cancel Coverage
Cancellations are not effective until the last date of the month if the request is received by the 25th of the month. If the cancellation request is received between the 26th and the 31st of the month, the cancellation will not be effective until the last date of the following month (i.e. a cancellation request received on May 27th will not be effective until June 30th).
Reason for Canceling*
- Cost
- I never used the plan
- I'm retiring / leaving my employer
Signature and Terms
Terms*
Group Policy: I understand that Texas Legal Protection Plan, Inc. d/b/a Texas Legal ("Texas Legal") sets forth the terms on my membership, including any exclusions or limitations, and agree to be bound by the same. The Certificate of Coverage, together with the Master Policy, Schedule of Benefits, Declarations Page, endorsements and this application constitutes the entire agreement between the company and the member with respect to the membership, and there are no agreements, understandings, warranties or representations other than as set forth herein and in the those documents. Please honor payment option listed above or below on my account by Texas Legal to its own order.
- I agree to the Terms of Service
Type in Your First and Last Name*
Electronic signature: I agree that typing my name below constitutes my signature.
Captcha

	Select Monthly/Annual	Preferred Monthly/Annual
Single Coverage	$13/$130	$22/$220
Family Coverage	$20/$200	$35/$350

	Monthly	Annual
Single Coverage	$26.00	$280.00
Family Coverage	$40.00	$435.00

FW-Change

Stay Current.

From addresses to dependents, Texas Legal makes it easy to update your info.

Update Policyholder Information

Update Address or Phone Information

Add or Remove Dependents

Add, Update or Change Payment Type and/or Frequency

Cancel Coverage

Signature and Terms