In accordance with the Optum Pay Enrollment Agreement and the terms and conditions set forth here, you authorize Optum Financial, Inc. to charge the accounts listed here for payment of the Optum Pay paid subscription, and agree to be bound by the Nacha Operating Rules. You certify that this is a business bank account and not an account used primarily for personal, family or household purposes.
If you have an ACH debit block filter on the bank account you elect to use to make your payment, you will need to grant us authorization to originate debits by adding the ACH Company Name "Optum Pay" and the ACH Company ID "1243848776" as an authorized ACH Company Name and ACH Company ID to debit your account. If we cannot charge your bank account for any reason (such as a debit block or insufficient funds) your account may be charged a debit block fee for each debit block charge of $10.00 and each instance of insufficient funds may result in an insufficient fund fee of $20.00.
This authorization is to remain in full force and effect until Optum Financial, Inc. has received written notification from me of its termination.