We welcome businesses to apply for inclusion in the “Perks & Savings” discount program. For consideration, complete this form, and we’ll get back to you shortly.

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PROGRAM TERMS

If your application is accepted the following terms govern our relationship:

  • Either You or Unity Health Plans Insurance Corporation ("Quartz") can terminate the relationship by giving the other party at least 60 days' written notice. Quartz will provide notice to the contact person listed above. You can provide notice to Quartz in writing:
    Quartz
    ATTN: Provider Relations
    840 Carolina St.
    Sauk City, WI 53583
  • Quartz may identify You, and use Your logo, on our website(s) and in print materials. Let us know if You update Your name or logo, or the discounts offered, so we can keep our members informed. You can do so by emailing: wellnessadmin@quartzbenefits.com.
  • You can identify Quartz, and use Quartz's logo, on your website and in print materials.Quartz must approve the use of its name and logo beforehand. You can submit materials for review by emailing: marketing@quartzbenefits.com.
  • You and Quartz, respectively, maintain right, title and interest in your respective name, logo, and any other graphics.

I certify that everything on this form is accurate and true. I agree to the Program Terms listed above. I certify that I have the authority to sign on behalf of the entity listed above.