Insurance Membership Sign-Up

Which program do you have? *

It is printed on your insurance card or in your plan’s app.

SilverSneakers or PrimeTivity Health Renew ActiveUnitedHealthcare Medicare One PassOptum

Your fitness ID or confirmation code *

Find it on your plan’s website or app. Not sure? Leave your best guess and we will check.

Your name *

First name Last name

Date of birth *

Cell phone *

This becomes your login for the RhinoFit app. No email? Leave it blank and we will help you at the front desk.

Home address

Street address

City ZIP

Emergency contact

Optional. Someone we can call if you need help.

Name Phone

The information above is correct. I understand Premia will confirm my coverage with my insurance before my membership starts.

We only use this to set up your membership and bill your insurance plan. We never charge your card for a covered membership.

Questions? Call us at (863) 342-4493

Sign Up With Your Insurance