As tcario said, the protection plan is like a warranty. Without it, it could cost you a bit more if you have to have a tech come out. I have the protection plan and it saved me money when a power surge blew up one of my DVRs and an LNB. I paid nothing out of pocket to have it fixed.
I believe the programming access fee is has to do with whether or not you have the reciever connected to a phone line or ethernet jack. You need to plug all of the recievers into a phone jack (or ethernet if so equipped) in order to avoid this fee. On the second page of your bill under the "Fees" column you should see an explanation of the Programming Access Fee.
