Bankers Health Advantage - Terms and Conditions

This plan is NOT insurance.

The plan provides discounts at certain health care providers of medical services. The plan does not make payments directly to the providers of medical services.

The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount plan organization. The range of discounts for services offered will vary depending on the type of provider and service. Discounts on hospital services are not available in Maryland. This is not a Medicare prescription drug plan.

This plan is administered by Coverdell & Company, Inc., a discount medical plan organization at 8420 W. Bryn Mawr, Suite 700, Chicago, IL 60631, 1-800-308-0374.

You have the right to cancel this plan within 30 days of the effective date for a full refund of fees paid.

Upon successful membership, you will receive a membership booklet with your cardholder agreement. It will read as follows:

This is your Bankers Health Advantage cardholder agreement with Best Benefit Inc, a discount medical plan organization. Your membership is effective on the date of acceptance of your application for membership in the Bankers Health Advantage program.

We will provide you with a listing of participating providers. You shall excuse us, and our administrators, from any liability for errors in connection with the listing. Selection of a health care provider is a personal decision. You are responsible for choice of provider, verification that the provider is a current participant in the program, and payment for goods and services.

Bankers Health Advantage savings are based on the participating provider’s usual fees, or on national or regional fees for the service or product. Your actual savings will vary depending upon your location and the specific products or services purchased. All listed or quoted prices or fees are current prices only and are subject to change without notice. From time to time certain providers may offer certain products or services to the general public at prices lower than the Bankers Health Advantage price.

Bankers Health Advantage program features may vary in some states. Providers are subject to change without notice. The Program may be discontinued or modified at any time. Bankers Health Advantage discounts cannot be used in conjunction with any other discount program. Should you choose to cancel your membership because of a modification, our liability is limited to a refund of membership fees paid for the period subsequent to the modification.

Bankers Health Advantage is a health care discount and information program, not insurance or a pre-paid services plan. No portion of any provider’s fee will be reimbursed or otherwise paid by us. Through our administrator, Best Benefits, D.D.S., L.L.C., we have negotiated discounts with providers to obtain the best possible pricing for our Cardholders and to administer enrollment of Cardholders and participating providers. Cardholders are solely responsible for payment. We shall not be responsible for review of any purchase which is solely between the member and participating providers. Cardholders should carefully evaluate references and other indicators of quality. Although we, through our administrator, screen participating providers to ensure appropriate credentials and qualifications to provide goods and services, we do not otherwise guarantee nor are we responsible for the quality of any such service or product purchased by a Cardholder.

We may delegate our responsibilities to administrators we may appoint as we deem reasonably necessary to perform our obligations under the Program. Any administrators and participating providers are independent contractors; they are not employees, partners, or joint venturers with us. Advance PCS is currently the principal administrator of the prescription drug features of the program.
Express Scripts, Inc. is the principal administrator of the prescription drug feature of the program for members whose effective date occurred prior to September 1, 2003. The current administrator of the overall plan is Best Benefits, D.D.S., L.L.C.

Term – This Agreement shall be month to month subject to payment of the cardholder fee.

Payment – Membership fees are payable monthly by such methods and at such intervals as we may allow. We may provide discounts for payment at less frequent intervals than monthly.

We reserve the right to change monthly fees, permitted payment intervals, allowable payment methods and discounts for multiple month payments, but any such changes will not apply to any period for which payment has already been accepted.

Entire Agreement – This is the entire agreement between Cardholder and Best Benefits, Inc., a discount medical plan organization. Any representation, warranty, promise, or condition not expressly stated here shall not be binding. This Agreement including any schedules or exhibits may be amended only in writing expressing an intention to modify this Agreement. The parties agree that they will make no claim at any time or place that this Agreement has been orally altered or modified.

Governing Law and Arbitration – This agreement and its interpretation and enforcement shall be governed and controlled by the laws of the State of Illinois. Any dispute arising from or related to this agreement shall be resolved by binding, non-appealable private arbitration conducted in accordance with the Rules of American Arbitration Association in Chicago, Illinois, unless required by a member’s individual state laws to resolve in a different location. This provision shall survive the termination of this agreement and its interpretation shall be subject to the Federal Arbitration Act.

Governing Law and Arbitration for Florida Residents – This agreement and its interpretation and enforcement shall be governed and controlled by the laws of the State of Florida. Any dispute arising from or related to this agreement shall be resolved by a voluntary private arbitration conducted in accordance with the Rules of the American Arbitration Association in Leon County, Florida. This provision shall survive the termination of this agreement and its interpretation shall be subject to the Federal Arbitration Act.

Severability – If any part of this Agreement is held to be unenforceable or void for any reason, it shall be severed from the Agreement, which shall not affect the validity of the remaining provisions.

ERISA – In the event the Employee Retirement Income Act of 1974 ("ERISA") applies to a Cardholder membership in the Plan, this agreement is not intended to make us, or our administrators, a plan administrator or fiduciary within the meaning of ERISA.

Life and Health Guaranty Association – This contract is not an insurance policy and is not protected by the Life and Health Guaranty Association.

Effect of Any Ambiguity – We have attempted to draft a clear and unambiguous document. In the event we have been unsuccessful, any ambiguity is to be resolved without resort to any presumption that any ambiguity is to be construed against the drafter of a document.

No Third Party Beneficiaries – There are no persons who are intended to be third party beneficiaries under this Agreement, and no action to enforce the terms of this Agreement may be brought against us by any person who is not a party hereto.

BHA-WS10(3/05)