As a Ho’āla member, I hereby agree: (a) that the Ho’āla Dental Plan is not an insurance policy; it is an agreement for the provision of dental services with Hawaii Family Dental at a discounted price; (b) that the discounted fees provided by the Ho’āla Dental Plan are only for services provided by Hawaii Family Dental; (c) to pay the out-of-pocket costs at the time the services are received; (d) membership is 12 months and there are no refunds given for cancellations; (e) benefits will begin upon receipt of form and payment. *Policy period is for annual coverage and commitment; 12 monthly payments will be deducted starting in the month of enrollment. Must enroll in autopay (deducted on the 5th of each month), with automatic renewal. To cancel your auto-renewal, call us at 808-523-3111 at least 30 days before your membership renews.