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Intelicare Health Membership Specific
Terms & Conditions.
This Agreement is between you, our valued Member (Member[s]), and Consumer Health Choice Association (CHCA), the sponsor of your Membership program. This Agreement shall be effective on the date your Initial Monthly Payment processes and sets forth the terms and conditions of your CHCA Intelicare Health Membership Programs.
Patriot Health Florida, Inc. Program Features*
This discount program is not a health insurance policy and is not intended as a substitute for insurance. The program provides for discounts on health services from participating providers, and the range of the discounts will vary depending on the type of provider and the health services received. The program does not make payments to providers of health care services. Members are required to pay for all health care services at the time the services are performed, but will receive a discount from contracted providers. This program is administered by Patriot Health Florida, Inc., at 160 Eileen Way, Syosset, NY, 11791 at 866.907.7851 and is offered to members of Consumer Health Choice Association, located at 8201 Peters Road Suite 1000, Plantation, FL 33324. To obtain additional information and an up-to-date list of contracted providers by name, city, state, and specialty in your service area, you may call customer service at 800-290-3869.
Program administrators have no liability for providing or guaranteeing service or for the quality of service rendered. Participating providers are subject to change without notice and are not available in all areas. Note: This contract is not protected by any state Life and Health Guarantee Association.
Description: Your CHCA Intelicare Health Membership Program provides Patriot Health Florida, Inc. Program Features* in addition to your Membership Insurance benefits.
Fulfillment: Your membership handbook and identification cards will arrive in the same package via U.S. Mail and should arrive within five (5) business days from the date of your enrollment. Your certificate of coverage and certificate schedule will arrive in a separate package via U.S. Mail.
Effective Date for Patriot Health Florida, Inc. Program Features: If you enrolled between the 1st and the 15th of the month, your first effective date will be the 1st of the following month. If you enrolled between the 16th and the last day of the month, your first effective date will be the 15th of the next month.
Insurance Benefits “Free Look” Period: You are given a ten (10) day "Free-Look” period to review your Membership program and cancel with a full refund of your initial monthly payment, first monthly association fee and one-time processing fee.
Exceptions: Residents of AZ and CO are given a thirty (30) day “Free-Look” period. The first day of the Free-Look Period shall be determined using the date of your application, plus seven (7) days - allowing for printing and standard mail delivery. A cancellation within the Free-Look Period is determined if the date stamped on the cancellation request falls within 17 days (37 days in AZ and CO) of the date of your application.
Patriot Health Florida, Inc. Program Features* “Trial Period” Refunds: Residents of AR, IL, IN, ND, NY, OH, OK, SC, TN and TX are entitled to a 30-Day Trial Period to review these features. A cancellation received after the 10-Day Free Look Period but within 37-Days of application, allowing 7 days for printing and standard mail delivery, will be considered having been received during the Trial Period and the member may receive a refund of the cost of the Patriot Health Florida, Inc. Program Features*. Residents of IL, IN, NY, OH, SC, TN and TX who cancel during their Trial Period may receive a refund of twenty dollars ($20.00). Residents of AR who cancel during their Trial Period may receive a refund of their one-time processing fee plus twenty dollars ($20.00). Residents of OK and ND may cancel at any time and receive a refund of twenty dollars ($20.00).
Monthly Payments: As authorized at the time of your application, your Monthly Payments may be paid through an automatic draft of a checking or savings account by an ACH transaction or through an automatic debit transaction to a credit card. By agreeing to make your monthly payment through either ACH transaction or automatic debit transaction to your credit card, you waive the right to any future notice of the transfer of funds via either an ACH transaction or automatic debit to your credit card. The bank draft or debit shall occur on or about the same date of each month as your Initial Monthly Payment and shall be referred to herein as your monthly due date. As a member, you agree that inquiries or challenges to ACH or Credit Card charges shall be limited to two (2) monthly payments and waive all rights to inquire into or challenge any and all other monthly payments. Your authority shall remain in affect until CHCA receives a signed, written request from you to cancel your membership and Insurance benefits. If any payment is dishonored (with or without cause, intentionally or inadvertently), CHCA assumes no liability whatsoever, even if the result of the dishonored payment is a termination of your CHCA Intelicare Health Membership Program.
Exception: If your Initial Monthly Payment occurred on the 29th, 30th, or 31st of a month, your monthly due date shall be the 28th of every month thereafter.
Cancellations: All cancellations must be requested in writing and must be delivered via mail (excluding e-mail) to CHCA Intelicare, PO Box 15460, Plantation, FL 33318 or via fax to 954-315-6325. The date of cancellation is determined by either the date stamp of a request received by fax, or the date stamped postmark on requests received through the mail. After the Trial Period, any cancellation request must reach us at least two days prior to your next Monthly payment due date to prevent another automatic draft. When a written cancellation is received after your first effective month of membership, your membership record will be reviewed. If there is a payment posted for a full future month’s coverage, the payment and association fee will be fully refunded.
Refunds: Any refund to which a member may be entitled will be processed within 10 business days from the date the written request for cancellation is received by CHCA.
Discount Medical Providers: You may see any participating provider of goods and services in order to access your discount medical features associated with your Membership program. You are responsible for the full payment of services provided by a participating provider and any related expenses. Discount medical features associated your Membership program are not available in all states. Savings may vary. Any provider’s participation is subject to change at any time without notice. CHCA does not warranty or guarantee appropriate credentials of participating providers and assumes no liability or obligation for the credentialing of participating providers. CHCA does not guarantee or warrant the quality or accessibility of discounted services delivered to our members by any affiliated network provider. Under this Agreement, CHCA only provides access to participating health care providers who have contracted with the discount medical plan organization as set forth above.
Governing Law: This Agreement shall be governed and construed in accordance with the laws of the State of Florida. Venue for judicial enforcement or review shall lie in any court of competent jurisdiction in Broward County, Florida. Any dispute arising from or relating to this Agreement, which can not be resolved after the parties use reasonable efforts to reach a mutually agreeable understanding, shall be resolved through binding, non-appealable private arbitration, conducted in accordance with the rules of the American Arbitration Association and subject to the Florida Arbitration Code. Florida Statutes, §95.11 shall apply to any arbitration as the statute of limitations. Exclusive venue for such arbitration shall be in Broward County, Florida, unless otherwise designated by CHCA or its successors. Members may submit all complaints in writing via U.S. Mail to corporate headquarters and may mail complaints to the following address: PO Box 15460, Plantation, FL 33318. These provisions shall survive termination of membership in CHCA and/ or in the Intelicare Health Membership Program. This Agreement constitutes the entire Agreement between Members and CHCA. There are no warranties, express or implied, other than those expressly stated herein. Each Member hereby waives any claim he or she may have against CHCA attributable to ministerial or typographical errors. This Agreement may only be amended in writing and only by CHCA. CHCA may, if deemed necessary, assign its duties and responsibilities hereunder to third parties, and shall be relieved of any further liability hereunder. CHCA shall not share your personally identifiable information with the general public. However, CHCA may send promotional information to its Members about services offered by us, our affiliates and/ or our business partners.
These Terms & Conditions are subject to change without notice.
*Patriot Health Florida, Inc. Program features are not available in: CA, CT, FL, ID, KS, ME, MT, NH, NV, VT and WARevision 9/2008
