Enrollment Change — Texas Legal

Stay Current

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.

To make a PAST DUE PAYMENT, visit our Pay My Bill page

IMPORTANT: Any changes made now through the end of the month will be effective the 1st of the month following the next. (For example, changes received on March 26th will be effective May 1st, not April).

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*

If you do not know your plan details, please contact Texas Legal for assistance with your request.

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 Dependent Information

Update Address or Phone Information

Add or Remove Dependents

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 Dependent Information

New Name

Please update the appropriate information.

First Last

Upload copy of new ID or Marriage Certificate

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

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

Domestic Partner Independent Secure Policy only

Child/ Step-Child/ Adopted Child

Dependent Date of Birth*

Dependent Gender*

Male

Female

Dependent Name*

First Last

Relationship to Applicant*

Spouse

Domestic Partner

Child/ Step-Child/ Adopted Child

Dependent Date of Birth*

Dependent Gender*

Male

Female

Dependent Name*

First Last

Relationship to Applicant*

Spouse

Domestic Partner

Child/ Step-Child/ Adopted Child

Dependent Date of Birth*

Dependent Gender*

Male

Female

Dependent Name*

First Last

Relationship to Applicant*

Spouse

Domestic Partner

Child/ Step-Child/ Adopted Child

Dependent Date of Birth*

Dependent Gender*

Male

Female

Add, Update or Change Payment Type and/or Frequency

This form is only for updating your payment method on file. This is not to make a past due payment. All payment changes received after the 25th will NOT be in effect until the 1st of the following month (i.e. April 26 submissions effective June 1)

This plan is made available to me by:*

Employer / Group / Association

Independent - not associated with an Employer/ Group or Association

Have you received notice by Texas Legal of a rate change?*

Texas Legal is implementing rate changes for members as their plans renew. Members are notified 31 days in advance of these changes. If you are not sure if you have received a rate change, please select "No / Not sure". Our team will verify you are being billed correctly.

Yes

No / Not sure

Type of Coverage*

Single

Family

Please note that selecting single will cause any covered dependents to be terminated.

Payment Frequency*

Monthly

Annually (Note: Annual Premium payments are nonrefundable.)

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 - $28.00 a month

Select Plan - $18.00 a month

Group Single Monthly (Old Rate)*

Preferred Plan - $25.00 a month

Select Plan - $16.00 a month

Group Single Annual*

Preferred Plan - $309 a year - Save 19%

Select Plan - $198 a year - Save 17%

Group Single Annual (Old Rate)*

Preferred Plan - $275 a year - Save 19%

Select Plan - $176 a year - Save 17%

Group Family Monthly*

Preferred Plan - $45.00 a month

Select Plan -$28.00 a month

Group Family Monthly (Old Rate)*

Preferred Plan - $40.00 a month

Select Plan -$25.00 a month

Group Family Annual*

Preferred Plan - $495 a year - Save 19%

Select Plan - $309 a year - Save 17%

Group Family Annual (Old Rate)*

Preferred Plan - $440 a year - Save 19%

Select Plan - $275 a year - Save 17%

Independent Single Monthly*

Secure Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration.

Secure Plan - $50.00 a month

Independent Single Monthly*

Secure Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration.

Secure Plan - $60.00 a month

Independent Single Annual*

Secure Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration.
Note: Annual Premium payments are nonrefundable.

Secure Plan - $550 a year - Save 20%

Independent Single Annual*

Secure Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration.
Note: Annual Premium payments are nonrefundable.

Secure Plan - $650 a year - One Month Free

Independent Family Monthly*

Secure Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration.

Secure Plan - $70.00 a month

Independent Family Monthly*

Secure Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration.

Secure Plan - $80.00 a month

Independent Family Annual*

Secure Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration.
Note: Annual Premium payments are nonrefundable.

Secure Plan - $770 a year - Save 20%

Independent Family Annual*

Secure Plan - our most comprehensive coverage offers protection in every area of law, plus identity theft monitoring and restoration.
Note: Annual Premium payments are nonrefundable.

Secure Plan - $900 a year - One Month Free

Total Monthly Charge

Total Annual Charge

Note: Annual Premium payments are nonrefundable.

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*

Billing Address is Same as 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

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*

Other

Signature and Terms

Terms*

Independent 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 Policy for Individual Benefits ("Independent Plan"), Schedule of Benefits, Declarations Page, 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

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.

Update My Info

Stay Current

Update Policyholder Information

Update Dependent Information

Update Address or Phone Information

Add or Remove Dependents

Add, Update or Change Payment Type and/or Frequency

Signature and Terms

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