If not currently a member, the group needs to submit an application for membership to the appropriate association before their intended effective date of coverage under the Trust. All associations require an annual membership fee which is paid directly to the association, not the Trust.  Association membership fees are due annually.

If the group is already a member of an endorsing association, instead of also joining the sponsoring association then they will just pay an annual access fee as long as they maintain membership with the endorsing association.