Legal

What you need to know

Federal Surprise Billing Notice

To read more about the Federal Surprise Billing Notice, please visit https://www.uhc.com/legal/federal-surprise-billing-notice.

Transparency in Coverage

For additional legal resources and state specific information, please visit https://www.uhc.com/legal

Terms of Use

These Terms of Use (“Terms”) apply to those mobile applications and websites that Bind Benefits, Inc. d/b/a Surest (“we”) operate (each an “Application”) and that contain a link to these Terms. We are a third party administrator and not an insurance company. All of our programs are self-insured, employer-sponsored health plans. By using our Applications you are agreeing to the following:

I. USE OF THE APPLICATIONS

The contents of the Applications – whether the content is ours or is licensed to us by a third party – are protected by copyright. We authorize you to view and download material on the Applications solely for your own use. You may not sell or modify the material or otherwise use it for any commercial purpose.

You will not use the Applications in violation of any laws, including the fraud and abuse or anti-kickback provisions of the federal Medicare and Medicaid laws.

You will not, and will not permit anyone else to: (1) modify, adapt, alter, translate or create derivative works of the Applications; (2) use or merge the Applications, or any component or element of the Applications, with other software, databases or services not provided by us; (3) sublicense, distribute, sell or otherwise transfer the Application to any other party; (4) use the Application as a service bureau, or lease, rent or loan the Applications to any third party; (5) reverse engineer, decompile, disassemble or otherwise attempt to derive the source code or structure of the Applications; (6) interfere in any manner with the operation of the Applications; (7) circumvent, or attempt to circumvent, any electronic protection measures in place to regulate or control access to the Applications; (8) create a database by systematically downloading and storing the Applications; (9) use any robot, spider, site search/retrieval application or other manual or automatic device to retrieve, index, “scrape,” “data mine” or in any way gather information from the Applications or reproduce or circumvent the navigational structure or presentation of the Applications.

II. USE OF INFORMATION AND RESOURCES

We make the Applications available for the purpose of providing information to consumers about our products and services, providing access to health-related resources, and providing members access to their health plan and financial account information. Nothing on the Applications is intended to be a substitute for professional medical advice or for the care that patients receive from their physicians. Nothing in the Applications is intended to be used for medical diagnosis or treatment. You should not disregard medical advice, or delay seeking medical advice, because of something you read on the Applications.

We are not responsible for information provided by health information content providers, third party sites linked to or framed by an Application, or other users of the Applications, and we do not make any representations regarding the content, accuracy, or timeliness of any of such information.

III. PRIVACY POLICY

By agreeing to these Terms, you agree to the terms of our Privacy Policy, which are considered as part of these Terms. Before using an Application, you acknowledge that our Privacy Policy was made available to you. You can request a copy of our Privacy Policy at any time. Any personal information you provide us as a result of your using the Applications will be handled in accordance with the Privacy Policy.

IV. PROVIDER DIRECTORY

While we make efforts to ensure that our lists of doctors and hospitals (i.e., providers) are up-to-date and accurate, it is important to understand that sometimes health care providers leave our networks without letting us know, or they switch networks, or they change employment with provider groups and hospitals. Depending on your plan, these changes may impact how much you pay out of your own pocket for services.

Not all providers are included in every plan’s network of doctors and hospitals. In order to avoid higher costs, it is important to understand whether your provider participates in your plan’s network. If you visit a provider who is not in your plan’s network, you may be required to pay a higher copay and/or be subject to a lower per visit limits and a higher out of pocket maximum.

If you are a member, logging in is the most accurate way to search for providers in your plan network.

Your doctor may refer you to another provider or facility for treatment. In-network providers are required to make best efforts to refer you to other in-network providers when possible. However, it is important to remind your doctor to refer you to in-network providers in order to avoid out-of-network costs and additional charges from the doctor by non-participating providers (also known as balance billing).

If you receive services from an in-network hospital, the hospital may have arrangements with emergency room physicians, anesthesiologists, radiologists, and/or other providers to assist in your care. These providers may not participate in your plan’s network. To avoid out-of-network costs and balance billing by non-participating providers, when you choose a hospital in your network be sure to look for messages within the hospital’s displayed information in the search results that identifies hospital-based providers not in your plan’s network.

If your health plan has out-of-network benefits, we may reimburse you up to the maximum allowed amount for covered services if you see a non-participating provider. The process and method used by us to determine reimbursement for non-participating providers depends on your health plan. However, because we do not have a contract with non-participating providers, they can bill you for services up to their full billed charges regardless of your insurance coverage of benefits, unless prohibited from doing so by your state.

Health plans vary. We recommend that you consult your benefit plan document and/or contact the member services number listed on the back of your ID card to confirm in advance that the desired service is covered. Keep in mind that some plans do not have out-of-network benefits and therefore may not reimburse for any out-of-network services except in limited circumstances.

V. INFORMATION POSTED ON THE APPLICATIONS

Certain portions of the Applications may permit users to post or transmit messages, comments, or other content. Any such content is only the opinion of the poster, is no substitute for your own research or for any professional medical advice, and should not be relied upon for any purpose. You agree not to post or transmit any content: • which is profane, libelous, defamatory, obscene, pornographic, indecent, lewd, harassing, threatening, harmful, invasive of privacy or publicity rights, abusive, inflammatory, or otherwise objectionable; or • the transmission of which could violate, or facilitate the violation of, any applicable law, regulation, or intellectual property rights. You are solely responsible for the content of any postings you submit and we assume no responsibility or liability for any content submitted by you or any other website visitor. We may, but are not obligated to, restrict or remove any and all content from a message that we determine in our sole discretion violates these Terms or is otherwise harmful to us, our customers, or any third party. We reserve the right to remove the content you provide at any time, but you understand that we may preserve and access a backup-copy, and we may disclose the content if required to do so by law or in a good faith belief that such access, preservation, or disclosure is required by law or in the best interests of us. Any content you submit is for non-commercial use only. Any content you submit may be routed through the Internet and you understand and acknowledge that you have no expectation of privacy with regard to any content you submit. If you do post content or submit material, and unless we indicate otherwise, you grant us a nonexclusive, royalty-free, perpetual, irrevocable, and fully sublicensable right to use, reproduce, modify, adapt, publish, translate, create derivative works from, distribute, and display such content throughout the world in any media. You grant us, and any of our sublicensees, the right to use the name that you submit in connection with such content. You represent and warrant that you own or otherwise control all of the rights to the content that you post; that the content is accurate; that use of the content you supply does not violate these Terms and will not cause injury to any person or entity; and that you will indemnify us for all claims resulting from content you supply.

VI. DISCOUNT OFFERS

We have arranged with various third-party vendors to make product and service discounts available to members. Access to these discounts is not part of your health plan, and the products and services offered by these discount vendors are not covered by your health plan. We are not responsible for the products, services or information provided by any discount vendor. Discount offers and vendors are subject to change without notice.

VII. PASSWORDS AND ACCOUNT

If you are a member your username and password (your “Login Information”) will allow you to access certain information about you and your plan. Your Login Information is our exclusive property and may be used solely for your individual use to access the Applications. You are solely responsible for controlling your Login Information and for authorizing, monitoring and controlling access to your account. You are prohibited from distributing, providing or otherwise making available your Login Information to any third party, and are responsible for all activities that occur under your Login Information. You agree to notify us immediately of any unauthorized use of your Login Information or of any need to deactivate the Login Information associated with your account.

VIII. USE OF EMAIL AND FAX

We may provide email, text messaging, direct messaging, chat, fax and other forms of communication (“Communication Links”) to further facilitate communication for members and their designees and caregivers. Information collected through email may be shared with our member services department, other associates, or third parties that perform services on our behalf. Unless otherwise noted, Communication Links through our website are not a completely secure and confidential means of communication. Non-encrypted email may be accessed and viewed by other Internet users without your knowledge and permission while in transit to us.

If you request that we send information about you to someone using the Communication Links available through the Applications, such communication may not be completely secure. Please verify email addresses and fax numbers carefully before submitting such a request.

If you request that we send a dependent’s card you are indicating to us you have the authority to do so.

IX. LINKING TO OTHER APPLICATIONS

From time to time we will provide links to websites not owned or controlled by us. We do this because we think the information might be of interest or use to you. A link to a third party website does not constitute or imply endorsement by us. We cannot guarantee the quality or accuracy of information presented on third party websites. While we do our best to ensure your privacy, we cannot be responsible for the privacy practices of third party websites. We encourage you to review the privacy practices of any website you visit.

X. APPROPRIATENESS OF CONTENT

The Applications is not intended to attract children under the age of 13. We do not collect personal information from any user that we know is under the age of 13. Some of the content on the Applications may not be appropriate for children. Parents or guardians are solely responsible for providing supervision of minors’ use of the Applications. Children age 13 and over may have the right to create and use their own separate instance of the Applications, which instance is subject to these Terms.

XI. DIGITAL MILLENNIUM COPYRIGHT ACT

We respect the intellectual property of others. If you believe that your copyrighted work has been copied in a way that constitutes copyright infringement and is accessible on or through the Applications, you must provide the following information to us when providing notice of the claimed infringement:

(a) A physical or electronic signature of a person authorized to act on behalf of the copyright owner and identification of the copyrighted work that is infringed;

(b) Information reasonably sufficient to permit us to contact you, such as an address, telephone number and/or email address;

(c) A statement that you have a good faith belief that the use of the material in the manner complained of is not authorized by the copyright owner, its agent or law;

(d) A statement that the information in the notification is accurate and, under penalty of perjury, that the complaining party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.

The above information must be submitted in writing to us at 3033 Excelsior Blvd, Suite 120, Minneapolis, Minnesota 55416, ATTENTION: LEGAL DEPARTMENT. This information should not be construed as legal advice. For further details on the information required for valid DMCA notifications, see 17 U.S.C. 512(c)(3).

(e) NO LIABILITY

No Liability. WE AND OUR LICENSORS AND SUPPLIERS (INCLUDING ALL PROVIDERS OF CONTENT FOR THE APPLICATIONS) SHALL NOT BE LIABLE TO YOU, UNDER ANY CIRCUMSTANCES OR UNDER ANY THEORY OF LIABILITY OR INDEMNITY, FOR ANY DAMAGES OR PENALTIES WHATSOEVER (INCLUDING, WITHOUT LIMITATION, INCIDENTAL INDIRECT, EXEMPLARY, PUNITIVE AND CONSEQUENTIAL DAMAGES, LOST PROFITS, OR DAMAGES RESULTING FROM LOST DATA OR BUSINESS INTERRUPTION) IN CONNECTION WITH THE USE OR INABILITY TO USE THE APPLICATIONS OR THE CONTENT, EVEN IF WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. WE SHALL BE LIABLE TO YOU ONLY TO THE EXTENT OF ACTUAL DAMAGES INCURRED BY YOU. THE REMEDIES STATED FOR YOU IN THESE TERMS AND CONDITIONS ARE EXCLUSIVE AND ARE LIMITED TO THOSE EXPRESSLY PROVIDED FOR IN THESE TERMS AND CONDITIONS.

We and our licensors and suppliers are not responsible for any claims you may have against any medical professionals, suppliers of products or other persons, institutions or entities identified in whole or in part through an Application.

No Warranties. THE APPLICATION AND ITS SERVICES, CONTENT AND INFORMATION ARE PROVIDED “AS IS.” WE AND OUR LICENSORS AND SUPPLIERS DISCLAIM ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, NONINFRINGEMENT OF THIRD PARTIES RIGHTS OR FITNESS FOR A PARTICULAR PURPOSE.

XII. LIMITATIONS

We are not licensed to sell products and services in all states. The descriptions of products and services contained on the Applications may not contain all of the terms, conditions, limitations and exclusions that may be applicable. Before purchasing any health plan you should read the contract or explanation of benefits that contains all exclusions and limitations on coverage.

XIII. TERMINATION

We may terminate any user’s right to use the Applications at any time. We reserve the right to block, delete or stop the uploading of materials and communications that we find unacceptable for any reason. If your right to use this site ends, you shall make no further use of this site or any information obtained from this site.

XIV. CHANGES TO THESE TERMS

We may revise, modify or amend these Terms at any time. Any such revision, modification or amendment shall be effective immediately upon either posting it to the Application or otherwise notifying you. By continued use of the Applications, you agree to the revised Terms. These terms were most recently updated August 4, 2017.

XV. MISCELLANEOUS

We make no claims that the content and information included at the Applications is appropriate or may be downloaded outside of the United States. Access to the content and information included at the Applications may not be legal by certain persons or in certain countries. If you access the Applications from outside the United States, you do so at your own risk and are solely responsible for compliance with the laws of your jurisdiction and any other applicable laws.

These Terms shall be governed and construed in accordance with the laws of the State of Minnesota without regard to the choice of law provisions of any jurisdiction. We may without notice to you assign our rights and duties under these Terms to any party at any time. Failure to enforce or insist on strict performance of any provision of these Terms shall not be construed as a waiver of any provision or right. You agree that any legal action or proceeding between us and you in any way related to these Terms shall be brought exclusively in a court of a competent jurisdiction sitting in Minneapolis, Minnesota. Any cause of action or claim you may have against or involving us must be commenced within one year after the claim or cause of action arises. Neither the course of conduct between the parties nor trade practice shall modify the provisions of these Terms. The invalidity or unenforceability of any provision shall not in any way affect the validity or enforceability of the rest of these Terms. These Terms constitutes the entire agreement between you and us regarding your use of the Applications, and it supersedes all prior agreements, representations, proposals and other communications with respect the Applications and its content.

XVI. QUESTIONS

If you have questions and comments, or if you believe that your confidentiality has been breached or that any of your communications have been intercepted, or you wish to notify us regarding a suspected violation of these Terms, please call Surest Member Services immediately at the toll-free number on the back of your ID card.

The Applications is produced by Bind Benefits, Inc. d/b/a Surest at various locations including 3033 Excelsior Blvd., Suite 400, Minneapolis, MN 55416.

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