Contracts
- Privacy Policy
- Member Terms
- (Test) Electronic Disclosure Agreement
- (Test) Broker of Record Contract
- (Test) Selected Benefits Terms Contract
- (Test) Spousal Carve-Out Contract
- Kaiser Arbitration Agreement - CA
- Kaiser Arbitration Agreement - HI
- HCSC Blue Cross and Blue Shield of New Mexico Disclaimer
- HCSC Blue Cross and Blue Shield of Oklahoma
- HCSC Blue Cross and Blue Shield of Texas
- HCSC Blue Cross and Blue Shield of Illinois Disclaimer
- HCSC Blue Cross and Blue Shield of Montana Disclaimer
- (Test) Reimbursement Participation Statement
Privacy Policy
Effective January 4th 2019
DownloadTable of Contents
This privacy policy discloses the privacy practices for Remodel Health (www.remodelhealth.com). This privacy policy applies solely to information collected by this website. It will notify you of the following:
- What personally identifiable information is collected from you through the web site, how it is used and with whom it may be shared.
- What choices are available to you regarding the use of your data.
- The security procedures in place to protect the misuse of your information.
- How you can correct any inaccuracies in the information.
The staff of Remodel Health takes the privacy of our users’ data very seriously. Remodel Health developed and manages the systems supporting this site. All data is retained in an encrypted format.
Information submitted to Remodel Health through our website is used exclusively to assist in health insurance purchasing recommendations and plan enrollment. Remodel Health does not sell or lease any of your information to other entities.
At Remodel Health, we use secure protocols in the transmission of data entered into our site from your PC to our servers. Any personal information collected is stored in a manner that is not available to the public and its accessibility within our company is restricted to ensure that information is only accessible to individuals with a valid and authorized business purpose. Employees who violate either privacy or security policies are subject to disciplinary action, possible termination and civil and/or criminal prosecution.
Information Collection, Use, and Sharing
We are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.
We will use your information to respond to you regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g. to enroll in a health or dental insurance plan.
Unless you ask us not to, we may contact you via email in the future to tell you about specials, new products or services or changes to this privacy policy.
Your Access to and Control Over Information
You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address or phone number is given on our website:
- See what data we have about you, if any.
- Change/correct any data we have about you.
- Have us delete any data we have about you.
- Express any concern you have about our use of your data.
Enrollment
We request information from you on our enrollment page. To enroll in an insurance plan through us, you must provide contact information (like name and mailing address) and financial information (like credit card number, expiration date). This information is used for billing purposes and to complete your enrollment. If we have trouble processing an order, we’ll use this information to contact you.
Sharing of Collected Information
We partner with insurance companies to provide coverage for our users. When users sign up for these services through our site, we will share names, billing information or other contact information that is necessary for the third party to provide the health insurance coverage requested. These parties are not allowed to use personally identifiable information except for the purpose of providing these services.
Surveys and Contests
From time-to-time, our site requests information via surveys or contests. Participation in these surveys or contests is completely voluntary and you may choose whether or not to participate and therefore disclose this information. Information requested may include contact information (such as name and shipping address), and demographic information (such as zip code, age level). Contact information will be used to notify the winners and award prizes. Survey information will be used for purposes of monitoring or improving the use and satisfaction of this site.
As a company, we take precaution to protect your personal information in a manner that provides reasonable assurance of the privacy and security of your data; however, no method of data transmission over the internet or method of electronic storage is 100% secure. As such, we cannot guarantee absolute security.
Security
We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline.
Wherever we collect sensitive information (including demographic information like name, address, phone number, social security number, date of birth, etc.), that information is encrypted and transmitted to us in a secure way. You can verify this by looking for a closed lock icon at the bottom of your web browser, or looking for “https” at the beginning of the address of the web page.
While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to personally identifiable information. The computers/servers in which we store personally identifiable information are kept in a secure environment.
Cookies
We use “cookies” on this site. A cookie is a piece of data stored on a site visitor’s hard drive to help us improve your access to our site and identify repeat visitors to our site. For instance, when we use a cookie to identify you, you would not have to login a password more than once, thereby saving time while on our site.
Cookies can also enable us to track and target the interests of our users to enhance the experience on our site. Usage of a cookie is in no way linked to any personally identifiable information on our site.
Links
This web site contains links to other sites. Please be aware that we are not responsible for the content or privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of any other sites that collect personally identifiable information.
Updates
Our Privacy Policy may change from time to time and all updates will be posted on this page. If you feel that we are not abiding by this privacy policy, you should contact us immediately via telephone at 844-748-3240.
Member Terms
Effective February 11th 2025
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 02/11/2025
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has chosen either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) product for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has chosen an ICHRA product, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA product.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has chosen a Wage+ product, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number (17370453). As your health insurance agent, Remodel Health may collect a commission if you enroll in a commissionable policy.
- Information Use. You authorize Remodel Health and its authorized agents, brokers, partners, and affiliates to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, signature, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Additionally, as the primary applicant in your household, you attest that you are authorized to sign on behalf of your household, including for your spouse and/or any dependents age eighteen (18) or older. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective January 31st 2025 to February 11th 2025
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 01/31/2025
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has chosen either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) product for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has chosen an ICHRA product, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA product.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has chosen a Wage+ product, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number (17370453). As your health insurance agent, Remodel Health may collect a commission if you enroll in a commissionable policy.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, signature, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Additionally, as the primary applicant in your household, you attest that you are authorized to sign on behalf of your household, including for your spouse and/or any dependents age eighteen (18) or older. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective October 15th 2024 to January 31st 2025
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 09/09/2024
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number (17370453). As your health insurance agent, Remodel Health may collect a commission if you enroll in a commissionable policy.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, signature, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Additionally, as the primary applicant in your household, you attest that you are authorized to sign on behalf of your household, including for your spouse and/or any dependents age eighteen (18) or older. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective September 9th 2024 to October 15th 2024
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 09/09/2024
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number. As your health insurance agent, Remodel Health may collect a commission if you enroll in a commissionable policy.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, signature, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Additionally, as the primary applicant in your household, you attest that you are authorized to sign on behalf of your household, including for your spouse and/or any dependents age eighteen (18) or older. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective August 13th 2024 to September 9th 2024
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 08/06/2024
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number. As your health insurance agent, Remodel Health may collect a commission if you enroll in a commissionable policy.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, signature, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective July 12th 2024 to August 13th 2024
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 07/12/2024
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, signature, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective May 9th 2024 to July 12th 2024
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 05/09/2024
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and Remodel Health Holdings, Inc. d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, signature, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
Remodel Health Holdings, Inc. dba Remodel Health
Effective March 26th 2024 to May 9th 2024
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 02/29/2024
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and Remodel Health Holdings, Inc. d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
Remodel Health Holdings, Inc. dba Remodel Health
Effective March 5th 2024 to March 26th 2024
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 02/29/2024
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and Remodel Health Holdings, Inc. d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Remodel Health is a financial technology company, not an FDIC insured depository institution. Banking services provided by Bangor Savings Bank, Member FDIC. FDIC insurance coverage protects against the failure of an FDIC insured depository institution. Pass through FDIC insurance coverage is subject to certain conditions. The Remodel Health Mastercard® Debit Card is issued by Bangor Savings Bank, Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circle design is a trademark of Mastercard International Incorporated.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective February 29th 2024 to March 5th 2024
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 02/29/2024
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and Remodel Health Holdings, Inc. d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective December 7th 2023 to February 29th 2024
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 10/30/2023
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective December 7th 2023 to December 7th 2023
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 10/30/2023
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective October 30th 2023 to December 7th 2023
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 10/30/2023
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Austin Lehman, CEO
LINC Holdings, LLC dba Remodel Health
Effective October 26th 2023 to October 30th 2023
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 10/24/2023
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”) under Remodel Health's and/or Remodel Health's principal agent's National Producer Number.
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective October 24th 2023 to October 26th 2023
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 10/24/2023
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”).
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective October 23rd 2023 to October 24th 2023
DownloadTable of Contents
Remodel Health
Member Terms
Last Revised: 10/23/2023
Welcome! Please take a moment to carefully read and acknowledge these Member Terms (the “Terms”), because they serve as a binding agreement between you (“you,” or “Member”) and LINC Holdings, LLC d/b/a Remodel Health and its affiliates and subsidiaries (“Remodel Health,” “we,” “us,” and “our”). These Terms, along with our Terms of Use and Privacy Policy, shall govern your access to and use of any and all Remodel Health products and services, including any content or functionality offered on or through the Remodel Health member site (“Member Site”). The Member Site is published, owned, and operated by Remodel Health.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
By accessing, browsing, submitting information to, and/or using the Member Site, you agree and acknowledge on your own behalf that you have read, understand, and agree to be bound by these Terms and to comply with all applicable laws including, without limitation, all federal, state, and local tax and tariff laws, regulations, and/or directives. If you do not agree to these Terms, please do not use the Member Site or Remodel Health products and/or services.
- How These Terms Apply to You
You have been invited to access and use Remodel Health’s Member Site because your employer has adopted either a Wage+ or Individual Coverage Health Reimbursement Arrangement (“ICHRA”) strategy for its eligible employees.
This means that your employer and Remodel Health have entered into an agreement whereby you have been granted access, as an eligible employee, to use this Member Site for the purposes of reviewing information related to various health insurance plan options available to you (each a “Health Solution”) as well as enrolling in or managing your Health Solution with Remodel Health’s assistance, if applicable.
This Member Site and all associated Remodel Health services and products are not, and shall never become, a substitute for professional medical advice, diagnosis, or treatment, and shall not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Member Site or any other electronic means.
Reliance on any information provided by Remodel Health is solely at your own risk. The information provided through the Member Site is designed to support, not replace, the relationship that exists between you and your medical care provider. Never disregard or delay seeking professional medical advice because of something you read or see on the Member Site. If you have any questions about your health conditions or a medical emergency, consult your medical services provider.
All information provided by you to Remodel Health and/or your employer for the purposes of managing or administering the Health Solution or otherwise providing any services to you is, at all times any such information is in Remodel Health’s possession, subject to the terms of Remodel Health’s Privacy Policy.
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances will vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how your enrollment in a Health Solution will affect your state and federal tax obligations.
These Terms address both Wage+ services and ICHRA services in addition to any of the services provided to you by Remodel Health.
- ICHRA Services
In the event your employer has adopted ICHRA, you may be eligible to be reimbursed on a pre-tax basis for health care expenses as defined by your employer's ICHRA strategy.
Through the use of the Member Site, Remodel Health will present information related to various Health Solution options available to you based on the information you have communicated to us. You are not required to enroll in any of the Health Solutions presented to you on the Member Site. You may elect to enroll in another Health Solution or none at all. However, if you elect not to enroll in any Health Solution, you may be solely responsible for the payment of up to 100% of your health care expenses and/or you may incur federal and state tax penalties.
If and when you select a Health Solution, Remodel Health will communicate your selection to your employer.
- Wage+ Services
In the event your employer has adopted a Wage+ strategy, this means that you are given a taxable wage increase to be used at your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist you in enrolling in a Health Solution. However, you are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
- Premium Payments
Your employer may communicate with you regarding your Health Solution selection and the premiums you owe associated with your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution you selected and assist you in managing your communications with the Health Solution. Remodel Health will notify your employer of your Health Solution enrollment and will, thereafter, share information about your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for you to remember that while Remodel Health and your employer are working together to help you enroll in your selected Health Solution and to simplify your payment of the required Premium Payments, you are ultimately responsible for timely providing information necessary to ensure your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that you may be eligible to receive.
In the event your employer has an agreement with Remodel Health to remit Premium Payments to your Health Solution, you acknowledge and agree that, in order to provide Premium Payment services, Remodel Health must open an account provided by a bank that is unaffiliated with Remodel Health (“Payment Account”) on your behalf, and you must accept and comply with the Terms of Service and Privacy Policy as required by the Payment Account provider. Any funds held in or transferred through the Payment Account are held or transferred by the Payment Account provider’s financial institution partners, as described in the Payment Account provider’s Terms of Service. Remodel Health may provide support for your Payment Account or serve as a point of contact between you and the Payment Account provider to ensure you receive the requested support.
Please note that Remodel Health makes no representations or warranties about the services provided by the Payment Account provider in any manner. You hereby acknowledge and agree that Remodel Health shall not be responsible for any of the services provided to you in connection with the Payment Account even if such services are provided through or in connection with the Member Site or Remodel Health services.
You agree that you shall promptly contact Remodel Health in the event your employment is terminated so that Remodel Health may transition the payment of your premiums back over to you. Otherwise, your premiums may not be paid which may result in the expiration or suspension of your Health Solution.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.
When this information is in Remodel Health’s possession it will be subject to Remodel Health’s Privacy Policy. When this information is in the possession of the Payment Account provider, the information will be subject to the Payment Account provider’s Privacy Policy and similar terms.
- Authorization and Consent
As with the rest of these Terms, we request that you read the following authorizations and consents carefully in order to ensure you understand what is required in order for Remodel Health to provide you with certain products and services.
- Insurance Agent. In order to receive certain services as provided by Remodel Health, you hereby authorize Remodel Health and its authorized agents to serve as a health insurance agent for yourself and the individuals in your household, if applicable. This includes, without limitation, for the purposes of enrollment in a Qualified Health Plan (“QHP”) offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (“SBE”).
- Information Use. You authorize Remodel Health and its authorized agents to utilize information provided by you or your employer related to you and/or the eligible individuals within your household and which such information may include, without limitation, personally identifiable information (name, birthdate, SSN, taxable relationships, addresses, income, deductions, citizenship status, etc.) as well as previous or current insurance coverages. Remodel Health will use this information to: (i) search for existing Marketplace, Off-Exchange, or SBE applications; (ii) create, complete, edit, update, or renew an application for eligibility and enrollment in Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs (i.e., Medicaid, CHIP, APTC, or CSR) to help pay for Marketplace premiums; (iii) provide ongoing account maintenance and enrollment assistance; and (iv) respond to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding your application.
- Release. You authorize Remodel Health to release and disclose to your employer and any other persons responsible for administering the Health Solution or the agreement in place between Remodel Health and your employer the following information, without limitation: (1) the amount of Premium Payments to be withheld and forwarded to Remodel Health; (2) the type of Health Solution, including whether your plan is an individual or family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid/Medicare; and (3) the name of the insurance company or any other entity providing reimbursement to you for your covered medical expenses for the purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health’s services provided to you and your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
- Premium Payments. You hereby authorize Remodel Health to collect and share with the Payment Account provider your personal information, including, without limitation, full name, email address, and financial information, and that you remain solely liable for the accuracy and completeness of that information as provided to Remodel Health. You understand that you may access and manage your Payment Account through the Member Site, and notifications regarding your Payment Account may be sent to you by Remodel Health rather than the Payment Account provider.
- Revoking Authorization
You understand that the authorizations and consents provided by you hereunder will remain in effect until your current employment ends with the organization that is contracted with Remodel Health or if you revoke your consent and authorization at any time. You may revoke or modify your authorization and consent provided hereunder at any time by contacting Remodel Health in the Member Site, in person, by email, by phone, or over digital conferencing, and requesting to be “waived” for such reasons. You may revoke your authorization and consent for your employer to withhold Premium Payments funds from your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
- Member Requirements
Just as Remodel Health has responsibilities to you, as provided in these Terms, it is important to note that you also have certain responsibilities in order to ensure the services provided by Remodel Health meet your needs. Please review the following requirements carefully and in consideration of all other terms and conditions set forth herein.
- Accurate Information. You hereby acknowledge and agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is true and accurate at all times. You remain solely responsible for maintaining your information in an up to date manner and keeping Remodel Health apprised of any changes in your information. Remodel Health will take reasonable steps to ensure any updated information provided by you is reflected in your Marketplace, Off-Exchange, or SBE application, if applicable. Any delay by you in providing the information or documentation necessary for Remodel Health to perform the services hereunder may adversely impact your Health Solution enrollment, and Remodel Health shall have no liability for the results of your delay. By agreeing to these Terms, you agree that any and all information you provide to Remodel Health or otherwise submit through the Member Site is information that you have the legal right to provide in any such manner.
- Employment Status. In the event your current employment terminates or ends for any reason, you must notify Remodel Health immediately in order to ensure Remodel Health can transition your Premium Payments back to you. Additionally, you may request, in writing, for Remodel Health to continue providing you with services pursuant to these Terms.
- Verification Information. You agree that you shall timely provide any verification documentation requested by Remodel Health. If you do not provide such verification documentation, your enrollment in a Health Solution may be delayed, denied, or terminated, and/or you may lose otherwise available income tax credit.
- Important Information for Medicaid Coverage
If you enroll in Medicaid, you are required by state law to renew your Medicaid coverage every year. As a Medicaid member, you will be solely responsible for this renewal process. Medicaid will send you a renewal packet by regular United States Postal Service mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices nor for ensuring you renew your coverage. You acknowledge and agree that if you do not complete the renewal process, you are subject to losing your Medicaid coverage. Remodel Health shall have no responsibility or liability with respect to your Medicaid coverage.
- Dispute Resolution
As set forth in Remodel Health’s Terms of Use, it’s important to note again that all disputes arising from or related in any manner to Remodel Health’s products and services, the Member Site, or the applicable Health Solution, and which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. This provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective August 17th 2023 to October 23rd 2023
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://remodel-health.pactsafe.io/legal.html?g=3784#terms-of-use) and the Privacy Policy (https://remodel-health.pactsafe.io/legal.html?g=3784#privacy-policy).
General
Your employer has adopted a Wage+ or Individual Coverage Health Reimbursement Arrangement (ICHRA) strategy.
If your employer has implemented a Wage+ strategy, You are given a taxable wage increase to be used at Your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization, or a term medical offering (a "Health Solution"). However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
If Your employer has implemented an ICHRA strategy, You are eligible to be reimbursed on a pre-tax basis for health care expenses as defined by Your employer's ICHRA strategy.
Authorization and Consent
You authorize Austin Lehman, Remodel Health principal agent, and licensed agents in the employ of Remodel Health (hereinafter "Remodel Health Agents") to serve as health insurance agents for Yourself and Your entire household if applicable, for purposes of enrollment in a Qualified Health Plan ("QHP") offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (hereinafter "SBE").
You also authorize the aforementioned Remodel Health Agents to utilize accurate taxable household data and personally identifiable information (names, birthdates, Social Security Numbers, taxable relationships, addresses, income, deductions, citizenship status, etc, hereinafter "PII") as well as previous or current insurance coverages all given by You to Remodel Health by any means whatsoever, including but not limited to email communication, in person, by telephone, and/or by virtual conferencing for the purposes of one or more of the following:
- Searching for an existing Marketplace, Off-Exchange, or SBE application;
- Creating, completing, editing, updating, or renewing an application for eligibility and enrollment in a Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs, such as Medicaid, CHIP, APTC, or CSR to help pay for Marketplace premiums;
- Providing ongoing account maintenance and enrollment assistance, as necessary; or
- Responding to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding Your application.
Remodel Health Agents will help You explore various Health Solution options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Solutions recommended by Remodel Health. You may elect to enroll in another Health Solution or none at all. However, if You elect not to enroll in any Health Solution, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Solution, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Solution selection and the premiums You owe associated with Your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution You selected and assist You in managing Your communications with the Health Solution. Remodel Health will notify Your employer of Your Health Solution enrollment and will, thereafter, share information about Your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Solution and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Solution, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to You and to Your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
You understand that the Remodel Health Agents will not use or share Your PII for any purposes other than those listed above. The Remodel Health Agents will ensure that Your PII is kept private and safe when collecting, storing, and using Your PII for the stated purposes above.
Further, You understand that for any of the aforementioned data and information, it is Your responsibility to update Remodel Health Agents whenever this data or information changes. I acknowledge that Remodel Health Agents will then take this data and information to update Your Marketplace, Off-Exchange, or SBE application to ensure that accurate information is reflected on Your Marketplace, Off-Exchange, or SBE application.
You understand that this Authorization and Consent remains in effect until Your employment ends with the organization that is contracted with Remodel Health, or You revoke it at any time. Further, You may revoke or modify this Authorization and Consent at any time by requesting to be "waived" in the Remodel health "Platform", in person, by email, by phone, or over digital conferencing. You may revoke Your Authorization and Consent for Your employer to withhold Premium Payments funds from Your wages and/or terminate Your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
If You request Remodel Health to continue "servicing" (i.e. any or all of the 1-4 authorizations above) Your Marketplace, Off-Exchange, or SBE application after Your employment ends or Your employer is no longer in a contractual relationship, You understand this Authorization and Consent will remain in effect until such time as You revoke it in person, by email, by phone, or over digital conferencing.
This document will be held either in paper or digital format by the Remodel Health Agents and Remodel Health for no less than ten (10) years.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Solution and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Solution will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Solution may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and We which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and We agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective August 17th 2023 to August 17th 2023
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://remodel-health.pactsafe.io/legal.html?g=3784#terms-of-use) and the Privacy Policy (https://remodel-health.pactsafe.io/legal.html?g=3784#privacy-policy).
General
Your employer has adopted a WageUp or Individual Coverage Health Reimbursement Arrangement (ICHRA) strategy.
If your employer has implemented a WageUp strategy, You are given a taxable wage increase to be used at Your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization, or a term medical offering (a "Health Solution"). However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
If Your employer has implemented an ICHRA strategy, You are eligible to be reimbursed on a pre-tax basis for health care expenses as defined by Your employer's ICHRA strategy.
Authorization and Consent
You authorize Austin Lehman, Remodel Health principal agent, and licensed agents in the employ of Remodel Health (hereinafter "Remodel Health Agents") to serve as health insurance agents for Yourself and Your entire household if applicable, for purposes of enrollment in a Qualified Health Plan ("QHP") offered on the Federally Facilitated Marketplace, Off-Exchange from an insurance carrier, or any State Based Exchange (hereinafter "SBE").
You also authorize the aforementioned Remodel Health Agents to utilize accurate taxable household data and personally identifiable information (names, birthdates, Social Security Numbers, taxable relationships, addresses, income, deductions, citizenship status, etc, hereinafter "PII") as well as previous or current insurance coverages all given by You to Remodel Health by any means whatsoever, including but not limited to email communication, in person, by telephone, and/or by virtual conferencing for the purposes of one or more of the following:
- Searching for an existing Marketplace, Off-Exchange, or SBE application;
- Creating, completing, editing, updating, or renewing an application for eligibility and enrollment in a Marketplace, Off-Exchange, or SBE QHP, or other government insurance affordability programs, such as Medicaid, CHIP, APTC, or CSR to help pay for Marketplace premiums;
- Providing ongoing account maintenance and enrollment assistance, as necessary; or
- Responding to inquiries from the Marketplace, Off-Exchange carriers, or SBE regarding Your application.
Remodel Health Agents will help You explore various Health Solution options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Solutions recommended by Remodel Health. You may elect to enroll in another Health Solution or none at all. However, if You elect not to enroll in any Health Solution, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Solution, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Solution selection and the premiums You owe associated with Your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution You selected and assist You in managing Your communications with the Health Solution. Remodel Health will notify Your employer of Your Health Solution enrollment and will, thereafter, share information about Your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Solution and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Solution, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to You and to Your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
You understand that the Remodel Health Agents will not use or share Your PII for any purposes other than those listed above. The Remodel Health Agents will ensure that Your PII is kept private and safe when collecting, storing, and using Your PII for the stated purposes above.
Further, You understand that for any of the aforementioned data and information, it is Your responsibility to update Remodel Health Agents whenever this data or information changes. I acknowledge that Remodel Health Agents will then take this data and information to update Your Marketplace, Off-Exchange, or SBE application to ensure that accurate information is reflected on Your Marketplace, Off-Exchange, or SBE application.
You understand that this Authorization and Consent remains in effect until Your employment ends with the organization that is contracted with Remodel Health, or You revoke it at any time. Further, You may revoke or modify this Authorization and Consent at any time by requesting to be "waived" in the Remodel health "Platform", in person, by email, by phone, or over digital conferencing. You may revoke Your Authorization and Consent for Your employer to withhold Premium Payments funds from Your wages and/or terminate Your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
If You request Remodel Health to continue "servicing" (i.e. any or all of the 1-4 authorizations above) Your Marketplace, Off-Exchange, or SBE application after Your employment ends or Your employer is no longer in a contractual relationship, You understand this Authorization and Consent will remain in effect until such time as You revoke it in person, by email, by phone, or over digital conferencing.
This document will be held either in paper or digital format by the Remodel Health Agents and Remodel Health for no less than ten (10) years.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Solution and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Solution will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Solution may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and We which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and We agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective May 12th 2023 to August 17th 2023
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://remodel-health.pactsafe.io/legal.html?g=3784#terms-of-use) and the Privacy Policy (https://remodel-health.pactsafe.io/legal.html?g=3784#privacy-policy).
General
Your employer has adopted a WageUp or Individual Coverage Health Reimbursement Arrangement (ICHRA) strategy.
If your employer has implemented a WageUp strategy, You are given a taxable wage increase to be used at Your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization, or a term medical offering (a "Health Solution"). However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
If Your employer has implemented an ICHRA strategy, You are eligible to be reimbursed on a pre-tax basis for health care expenses as defined by Your employer's ICHRA strategy.
Remodel Health will help You explore various Health Solution options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Solutions recommended by Remodel Health. You may elect to enroll in another Health Solution or none at all. However, if You elect not to enroll in any Health Solution, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Solution, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Solution selection and the premiums You owe associated with Your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution You selected and assist You in managing Your communications with the Health Solution. Remodel Health will notify Your employer of Your Health Solution enrollment and will, thereafter, share information about Your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Solution and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Solution, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to You and to Your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Solution and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Solution will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Solution may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and We which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and We agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective May 12th 2023 to May 12th 2023
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://remodel-health.pactsafe.io/legal.html?g=3784#terms-of-use)
and the Privacy Policy (https://remodel-health.pactsafe.io/legal.html?g=3784#privacy-policy).
and the Privacy Policy (https://remodel-health.pactsafe.io/legal.html?g=3784#privacy-policy).
General
Your employer has adopted a WageUp or Individual Coverage Health Reimbursement Arrangement (ICHRA) strategy.
If your employer has implemented a WageUp strategy, You are given a taxable wage increase to be used at Your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization, or a term medical offering (a "Health Solution"). However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
If Your employer has implemented an ICHRA strategy, You are eligible to be reimbursed on a pre-tax basis for health care expenses as defined by Your employer's ICHRA strategy.
Remodel Health will help You explore various Health Solution options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Solutions recommended by Remodel Health. You may elect to enroll in another Health Solution or none at all. However, if You elect not to enroll in any Health Solution, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Solution, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Solution selection and the premiums You owe associated with Your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution You selected and assist You in managing Your communications with the Health Solution. Remodel Health will notify Your employer of Your Health Solution enrollment and will, thereafter, share information about Your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Solution and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Solution, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to You and to Your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Solution and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Solution will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Solution may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and We which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and We agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective November 8th 2022 to May 12th 2023
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://legal.remodelhealth.com/#terms-of-use) and the Privacy Policy (https://legal.remodelhealth.com/#privacy-policy).
General
Your employer has adopted a WageUp or Individual Coverage Health Reimbursement Arrangement (ICHRA) strategy.
If your employer has implemented a WageUp strategy, You are given a taxable wage increase to be used at Your discretion. If you elect to do so, the intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization, or a term medical offering (a "Health Solution"). However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
If Your employer has implemented an ICHRA strategy, You are eligible to be reimbursed on a pre-tax basis for health care expenses as defined by Your employer's ICHRA strategy.
Remodel Health will help You explore various Health Solution options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Solutions recommended by Remodel Health. You may elect to enroll in another Health Solution or none at all. However, if You elect not to enroll in any Health Solution, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Solution, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Solution selection and the premiums You owe associated with Your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution You selected and assist You in managing Your communications with the Health Solution. Remodel Health will notify Your employer of Your Health Solution enrollment and will, thereafter, share information about Your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Solution and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Solution, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to You and to Your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Solution and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Solution will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Solution may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and We which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and We agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective September 1st 2022 to November 8th 2022
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://legal.remodelhealth.com/#terms-of-use) and the Privacy Policy (https://legal.remodelhealth.com/#privacy-policy).
General
Your employer has decided to give you a taxable wage increase to be used in Your discretion. The intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization or a term medical offering (a “Health Solution”), if you elect to do so. However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
Remodel Health will help You explore various Health Solution options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Solutions recommended by Remodel Health. You may elect to enroll in another Health Solution or none at all. However, if You elect not to enroll in any Health Solution, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Solution, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Solution selection and the premiums You owe associated with Your selected Health Solution. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Solution (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Solution You selected and assist You in managing Your communications with the Health Solution. Remodel Health will notify Your employer of Your Health Solution enrollment and will, thereafter, share information about Your Health Solution coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Solution and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Solution and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Solution and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Solution, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to You and to Your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Solution and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Solutions. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Solution will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Solution may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and We which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and We agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective November 18th 2021 to September 1st 2022
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://legal.remodelhealth.com/#terms-of-use) and the Privacy Policy (https://legal.remodelhealth.com/#privacy-policy).
General
Your employer has decided to give you a taxable wage increase to be used in Your discretion. The intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization or a term medical offering (a “Health Plan”), if you elect to do so. However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
Remodel Health will help You explore various Health Plan options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Plans recommended by Remodel Health. You may elect to enroll in another Health Plan or none at all. However, if You elect not to enroll in any Health Plan, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Plan, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Plan selection and the premiums You owe associated with Your selected Health Plan. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Plan (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Plan You selected and assist You in managing Your communications with the Health Plan. Remodel Health will notify Your employer of Your Health Plan enrollment and will, thereafter, share information about Your Health Plan coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Plan and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Plan and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Plan and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Plan, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to You and to Your employer. You authorize Remodel Health to use your marginal income tax rate for the purpose of advising you about your options and alternatives for coverage for payment of some or all of your and/or your family’s health care expenses. You further authorize Remodel Health to disclose such marginal income tax rate only to those at your employer who need to know such information and then only for the purpose of determining and/or explaining any wage increase.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Plan and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Plans. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Plan will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Plan may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and Us which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and Us agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective June 14th 2021 to November 18th 2021
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://legal.remodelhealth.com/#terms-of-use) and the Privacy Policy (https://legal.remodelhealth.com/#privacy-policy).
General
Your employer has decided to give you a taxable wage increase to be used in Your discretion. The intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization or a term medical offering (a “Health Plan”), if you elect to do so. However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
Remodel Health will help You explore various Health Plan options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Plans recommended by Remodel Health. You may elect to enroll in another Health Plan or none at all. However, if You elect not to enroll in any Health Plan, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Plan, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Plan selection and the premiums You owe associated with Your selected Health Plan. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Plan (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Plan You selected and assist You in managing Your communications with the Health Plan. Remodel Health will notify Your employer of Your Health Plan enrollment and will, thereafter, share information about Your Health Plan coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Plan and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Plan and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Plan and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Plan, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to You and to Your employer.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Plan and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Plans. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Plan will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Plan may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and Us which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and Us agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective June 11th 2021 to June 14th 2021
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://legal.remodelhealth.com/#terms-of-use) and the Privacy Policy (https://legal.remodelhealth.com/#privacy-policy).
General
Your employer has decided to give you a taxable wage increase to be used in Your discretion. The intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization or a term medical offering (a “Health Plan”), if you elect to do so. However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
Remodel Health will help You explore various Health Plan options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Plans recommended by Remodel Health. You may elect to enroll in another Health Plan or none at all. However, if You elect not to enroll in any Health Plan, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Plan, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Plan selection and the premiums You owe associated with Your selected Health Plan. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Plan (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Plan You selected and assist You in managing Your communications with the Health Plan. Remodel Health will notify Your employer of Your Health Plan enrollment and will, thereafter, share information about Your Health Plan coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Plan and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Plan and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Plan and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Plan, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to me and to my employer.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Plan and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Plans. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Plan will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Plan may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and Us which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and Us agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective June 11th 2021 to June 11th 2021
DownloadSummary of changes
Added section for authorizing the sharing of certain member plan information with the member's administrator.
Table of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://legal.remodelhealth.com/#terms-of-use) and the Privacy Policy (https://legal.remodelhealth.com/#privacy-policy).
General
Your employer has decided to give you a taxable wage increase to be used in Your discretion. The intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization or a term medical offering (a “Health Plan”), if you elect to do so. However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
Remodel Health will help You explore various Health Plan options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Plans recommended by Remodel Health. You may elect to enroll in another Health Plan or none at all. However, if You elect not to enroll in any Health Plan, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Plan, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Plan selection and the premiums You owe associated with Your selected Health Plan. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Plan (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Plan You selected and assist You in managing Your communications with the Health Plan. Remodel Health will notify Your employer of Your Health Plan enrollment and will, thereafter, share information about Your Health Plan coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Plan and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Plan and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Plan and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You also authorize Remodel Health to release and disclose to your employer, including the human resources department and any other persons responsible for administering this agreement with Remodel Health, the amount of Premium Payments to be withheld and forwarded to Remodel Health, the type of Health Plan, including but not limited to whether Your plan is an individual plan, a family plan, a parent plan, a sharing plan, an ACA plan, a short term plan, or coverage through Medicaid or Medicare, and the name of the insurance company or any other entity providing reimbursement to You for Your covered medical expenses for purposes of administering the services provided by Remodel Health and analysis of the benefits of Remodel Health services provided to me and to my employer.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Plan and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Plans. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Plan will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Plan may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and Us which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and Us agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective August 19th 2020 to June 11th 2021
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://legal.remodelhealth.com/#terms-of-use) and the Privacy Policy (https://legal.remodelhealth.com/#privacy-policy).
General
Your employer has decided to give you a taxable wage increase to be used in Your discretion. The intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization or a term medical offering (a “Health Plan”), if you elect to do so. However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
Remodel Health will help You explore various Health Plan options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Plans recommended by Remodel Health. You may elect to enroll in another Health Plan or none at all. However, if You elect not to enroll in any Health Plan, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Plan, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Plan selection and the premiums You owe associated with Your selected Health Plan. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Plan (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Plan You selected and assist You in managing Your communications with the Health Plan. Remodel Health will notify Your employer of Your Health Plan enrollment and will, thereafter, share information about Your Health Plan coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Plan and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Plan and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Plan and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Plan and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Plans. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Plan will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Plan may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Important Information for Medicaid Coverage
If you enroll in Medicaid, YOU are required by state law to renew your Medicaid coverage every year. As the Member, YOU will be responsible for this renewal process.
Medicaid will send you a renewal packet by regular United States Postal Service physical mail every year, 1 to 2 months prior to your coverage start date. Remodel Health is not responsible for sending renewal notices. IF YOU DO NOT COMPLETE THE RENEWAL PROCESS, you are subject to losing your current coverage.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and Us which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and Us agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
Effective May 30th 2019 to August 19th 2020
DownloadTable of Contents
Welcome! Please read these Remodel Health Member Terms (the "Member Terms") carefully because they serve as an agreement between You ("You" or "User") and LINC Holdings, LLC, doing business as Remodel Health and its affiliates and subsidiaries ("Remodel Health", "We", or "Us") regarding all products and services offered by Us to You. In order to access the Remodel Health products and services, You must agree to these Member Terms, the on-line Terms of Use (https://legal.remodelhealth.com/#terms-of-use) and the Privacy Policy (https://legal.remodelhealth.com/#privacy-policy).
General
Your employer has decided to give you a taxable wage increase to be used in Your discretion. The intended purpose of this wage increase is to provide funds to assist You in enrolling in an individual or other health care plan, a health care sharing organization or a term medical offering (a “Health Plan”), if you elect to do so. However, You are not required to use the funds for this purpose. Your employer has sole discretion as to any adjustments to your compensation.
Remodel Health will help You explore various Health Plan options available to You, based on the specific life circumstances You have communicated to Us. You are not required to enroll in any of the Health Plans recommended by Remodel Health. You may elect to enroll in another Health Plan or none at all. However, if You elect not to enroll in any Health Plan, You may be solely responsible for the payment of up to 100% of Your health care expenses and/or You may incur federal and state tax penalties.
If and when You select a Health Plan, Remodel Health will communicate Your selection to Your employer. Your employer may communicate with you regarding your Health Plan selection and the premiums You owe associated with Your selected Health Plan. You may authorize your employer to withhold an agreed upon amount from your wages for the premiums owed for your selected Health Plan (“Premium Payments”), and for your employer to remit such Premium Payments to Remodel Health. If you do so, Remodel Health will remit the Premium Payments to the Health Plan You selected and assist You in managing Your communications with the Health Plan. Remodel Health will notify Your employer of Your Health Plan enrollment and will, thereafter, share information about Your Health Plan coverage throughout your enrollment for purposes of this arrangement.
It is important for You to remember that while Remodel Health and Your employer are working together to help You enroll in Your selected Health Plan and to simplify Your payment of the required Premium Payments, You are ultimately responsible for timely providing information necessary to ensure Your enrollment in the Health Plan and for paying the Premium Payments. You are also responsible for providing all documentation necessary to enroll in the Health Plan and to secure any income tax credit(s) or rebate(s) that You may be eligible to receive.
You may revoke Your authorization for Your employer to withhold Premium Payments funds from Your wages and/or terminate your relationship with Remodel Health at any time upon written notice to your employer and Remodel Health.
Not Medical Advice
Remodel Health has developed an interactive technology tool (the “Platform”) to provide information intended to help You select a Health Plan and to obtain general information as to health related matters. The Platform is not intended to be a substitute for professional medical advice, diagnosis or treatment, and does not constitute medical or other professional advice. Remodel Health does not recommend or endorse any specific physicians, health care facilities, ancillary health care providers, products, procedures, opinions, or other information that may be mentioned or accessed on the Platform or any other electronic means. Reliance on any information provided by Remodel Health is solely at Your own risk. The information provided through the Platform is designed to support, not replace, the relationship that exists between You and Your physician. Never disregard or delay seeking professional medical advice because of something You read or see on the Platform. If You have any questions about Your health conditions, consult Your doctor.
Not Legal Advice
You may be eligible for a federal subsidy that will offset some or all of the premium costs for certain Health Plans. However, individual circumstances vary. Remodel Health does not provide legal or tax advice. You are encouraged to contact a qualified legal or tax advisor to determine whether you are eligible for a subsidy and how Your enrollment in a Health Plan will affect your state and federal tax obligations.
Your Promises
You promise that:
- All information You provide to Remodel Health is true and accurate. If any information provided to Remodel Health becomes inaccurate, You will notify Remodel Health immediately.
- You have the right to provide any information You submit to Remodel Health.
- You will promptly contact Remodel Health in the event that Your employment is terminated so that Remodel Health can transition the payment of Your premiums over to You.
- You will timely provide any verification documentation requested by Remodel Health. If You do not provide such verification documentation, Your enrollment in a Health Plan may be delayed, denied or terminated and/or You may lose otherwise available income tax credit.
Dispute Resolution
All disputes arising from or related in any manner to Remodel Health’s products and services or the business relationship between You and Us which cannot be resolved by mutual agreement shall be submitted to binding arbitration in accordance with the JAMS Comprehensive Arbitration Rules and Procedures and shall take place in Marion County, Indiana, or another location agreed to by the parties. Judgment on any award rendered by the arbitrator(s) may be entered in any court of competent jurisdiction. Claims will be arbitrated only on an individual basis. You and Us agree to and hereby waive any right to join or consolidate claims in an arbitration or court action by or against one another, other individuals, or entities to pursue, on a class basis, any dispute; provided however, that if an arbitrator or court of competent jurisdiction determines that such waiver is unenforceable for any reason with respect to a particular dispute, then the parties agree that such dispute shall be decided instead in a court of competent jurisdiction in Marion County, Indiana. You and Us agree that arbitration is the only litigation forum for resolving covered claims, and that both parties are waiving the right to a trial before a judge or jury in federal or state court in favor of arbitration. The parties agree that this provision is subject to, and shall be interpreted in accordance with, the Federal Arbitration Act, 9 U.S.C. §§ 1-14.
(Test) Electronic Disclosure Agreement
Effective July 30th 2025
DownloadTable of Contents
Electronic Records Disclosure and Consent Agreement
Your Consent to Electronic Records
By proceeding, you consent to receive all required disclosures, agreements, notices, and other information ("Communications") from Remodel Health in electronic form.
Scope of Consent
Your consent applies to all current and future interactions with Remodel Health, including:
- Account opening
- KYC/CIP verification
- Transaction confirmations
- Regulatory notices
Hardware and Software Requirements
To access and retain records electronically, you will need:
- A device with internet access
- A current browser that supports secure connections (e.g., Chrome, Safari)
- Adobe Acrobat Reader or similar software to view PDF files
- A valid email address
Withdrawal of Consent
You may withdraw your consent at any time by contacting us at care@remodelhealth.com. Withdrawal of consent may result in the termination of services or the need to conduct business via paper documents.
Requesting Paper Copies
You may request paper copies of any electronic record by contacting care@remodelhealth.com. Fees may apply.
Consent Acknowledgment
By selecting “I Agree,” you confirm that:
- You have read and understood this disclosure
- You can access and retain electronic Communications
- You affirmatively consent to use electronic records and signatures
Effective July 30th 2025 to July 30th 2025
DownloadTable of Contents
Effective July 30th 2025 to July 30th 2025
DownloadTable of Contents
Effective July 30th 2025 to July 30th 2025
DownloadTable of Contents
(Test) Broker of Record Contract
Effective August 21st 2025
DownloadTable of Contents
Remodel Health
Authorization to Appoint Broker of Record
You’ve chosen to keep your current health insurance plan with no changes.
To complete your enrollment, we need to become your Broker of Record (BOR) so we can manage your plan and provide service going forward.
To complete your enrollment, we need to become your Broker of Record (BOR) so we can manage your plan and provide service going forward.
By signing below, you confirm and agree that:
- You are keeping your current plan — No changes to benefits or carrier.
- You are appointing Remodel Health as your Broker of Record — We will act as your official broker for this plan.
- You give consent to use your signature — You authorize the submission of the Broker of Record change form on which your signature may be used solely to submit the BOR request to your insurance carrier.
- You understand the change — This replaces your previous broker or administrator and gives Remodel Health access to your policy and payment information for service and administration.
Effective August 21st 2025 to August 21st 2025
DownloadTable of Contents
Remodel Health
Selected Benefits Terms
You’ve chosen to keep your current health insurance plan with no changes.
To complete your enrollment, we need to become your Broker of Record (BOR) so we can manage your plan and provide service going forward.
To complete your enrollment, we need to become your Broker of Record (BOR) so we can manage your plan and provide service going forward.
By signing below, you confirm and agree that:
- You are keeping your current plan — No changes to benefits or carrier.
- You are appointing Remodel Health as your Broker of Record — We will act as your official broker for this plan.
- You give consent to use your signature — You authorize the submission of the Broker of Record change form on which your signature may be used solely to submit the BOR request to your insurance carrier.
- You understand the change — This replaces your previous broker or administrator and gives Remodel Health access to your policy and payment information for service and administration.
Effective August 12th 2025 to August 21st 2025
DownloadTable of Contents
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
(Test) Selected Benefits Terms Contract
Effective October 8th 2025
DownloadTable of Contents
Remodel Health
Selected Benefit Terms
By signing below, I confirm that I have reviewed the information provided in my health insurance application and have personally selected the plan that best meets my needs and preferences.
I authorize Remodel Health and/or its licensed downline agents through its designated enrollment partner to submit my completed application to the appropriate entity responsible for processing my health insurance enrollment. This may include, but is not limited to, the Federally Facilitated Marketplace, a State-Based Exchange (SBE), or directly to the health insurance carrier I have selected.
I also authorize Remodel Health and/or its licensed downline agents to serve as the Broker of Record (BOR) for my selected plan, and I may see references to Remodel Health, LINC Holdings, LLC, Austin Lehman, or a licensed agent employed by Remodel Health in my application or plan materials.
I understand the following:
I authorize Remodel Health and/or its licensed downline agents through its designated enrollment partner to submit my completed application to the appropriate entity responsible for processing my health insurance enrollment. This may include, but is not limited to, the Federally Facilitated Marketplace, a State-Based Exchange (SBE), or directly to the health insurance carrier I have selected.
I also authorize Remodel Health and/or its licensed downline agents to serve as the Broker of Record (BOR) for my selected plan, and I may see references to Remodel Health, LINC Holdings, LLC, Austin Lehman, or a licensed agent employed by Remodel Health in my application or plan materials.
I understand the following:
- This authorization is specific to the submission of this year’s application and applies only to the plan I have selected during this enrollment period.
- I may revoke this authorization at any time by contacting Remodel Health in writing.
- Remodel Health will retain a record of this authorization in accordance with federal compliance requirements.
I affirm and acknowledge that the information I have provided is accurate to the best of my knowledge and that I am signing this authorization voluntarily.
Effective September 16th 2025 to October 8th 2025
DownloadTable of Contents
Remodel Health
Selected Benefits Terms
By signing below, I confirm that I have reviewed the information provided in my health insurance application and have personally selected the plan that best meets my needs and preferences.
I authorize Remodel Health and/or its licensed downline agents through its designated enrollment partner to submit my completed application to the appropriate entity responsible for processing my health insurance enrollment. This may include, but is not limited to, the Federally Facilitated Marketplace, a State-Based Exchange (SBE), or directly to the health insurance carrier I have selected.
I also authorize Remodel Health and/or its licensed downline agents to serve as the Broker of Record (BOR) for my selected plan, and I may see references to Remodel Health, LINC Holdings, LLC, Austin Lehman, or a licensed agent employed by Remodel Health in my application or plan materials.
I understand the following:
I authorize Remodel Health and/or its licensed downline agents through its designated enrollment partner to submit my completed application to the appropriate entity responsible for processing my health insurance enrollment. This may include, but is not limited to, the Federally Facilitated Marketplace, a State-Based Exchange (SBE), or directly to the health insurance carrier I have selected.
I also authorize Remodel Health and/or its licensed downline agents to serve as the Broker of Record (BOR) for my selected plan, and I may see references to Remodel Health, LINC Holdings, LLC, Austin Lehman, or a licensed agent employed by Remodel Health in my application or plan materials.
I understand the following:
- This authorization is specific to the submission of this year’s application and applies only to the plan I have selected during this enrollment period.
- I may revoke this authorization at any time by contacting Remodel Health in writing.
- Remodel Health will retain a record of this authorization in accordance with federal compliance requirements.
I affirm and acknowledge that the information I have provided is accurate to the best of my knowledge and that I am signing this authorization voluntarily.
Effective August 15th 2025 to September 16th 2025
DownloadTable of Contents
Remodel Health
Selected Benefits Terms
By signing below, I confirm that I have reviewed the information provided in my health insurance application and have personally selected the plan that best meets my needs and preferences.
I authorize Remodel Health and/or its licensed downline agents through its designated enrollment partner to submit my completed application to the appropriate entity responsible for processing my health insurance enrollment. This may include, but is not limited to, the Federally Facilitated Marketplace, a State-Based Exchange (SBE), or directly to the health insurance carrier I have selected.
I also authorize Remodel Health and/or its licensed downline agents to serve as the Broker of Record (BOR) for my selected plan, and I may see references to Remodel Health, LINC Holdings, LLC, Austin Lehman, or a licensed agent employed by Remodel Health in my application or plan materials.
I understand the following:
I authorize Remodel Health and/or its licensed downline agents through its designated enrollment partner to submit my completed application to the appropriate entity responsible for processing my health insurance enrollment. This may include, but is not limited to, the Federally Facilitated Marketplace, a State-Based Exchange (SBE), or directly to the health insurance carrier I have selected.
I also authorize Remodel Health and/or its licensed downline agents to serve as the Broker of Record (BOR) for my selected plan, and I may see references to Remodel Health, LINC Holdings, LLC, Austin Lehman, or a licensed agent employed by Remodel Health in my application or plan materials.
I understand the following:
- This authorization is specific to the submission of this year’s application and applies only to the plan I have selected during this enrollment period.
- I may revoke this authorization at any time by contacting Remodel Health in writing.
- Remodel Health will retain a record of this authorization in accordance with federal compliance requirements.
I affirm and acknowledge that the information I have provided is accurate to the best of my knowledge and that I am signing this authorization voluntarily.
Effective August 12th 2025 to August 15th 2025
DownloadTable of Contents
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
(Test) Spousal Carve-Out Contract
Effective September 4th 2025
DownloadTable of Contents
Remodel Health
Spousal Carve-Out Terms
By continuing, you confirm that the information you’ve provided about your spouse’s employment and access to other health insurance coverage is true, complete, and accurate to the best of your knowledge. You understand that providing false or incomplete information may result in:
- Loss of coverage
- Repayment of claims paid in error
- Disciplinary action, if applicable
Effective August 21st 2025 to September 4th 2025
DownloadTable of Contents
Remodel Health
Spousal Carve-Out Terms
By continuing, you confirm that the information you’ve provided about your spouse’s employment and access to other health insurance coverage is true, complete, and accurate to the best of your knowledge. You understand that providing false or incomplete information may result in:
- Loss of coverage
- Repayment of claims paid in error
- Disciplinary action, if applicable
Effective August 21st 2025 to August 21st 2025
DownloadTable of Contents
Spousal Coverage Terms
By continuing, you confirm that the information you’ve provided about your spouse’s employment and access to other health insurance coverage is true, complete, and accurate to the best of your knowledge. You understand that providing false or incomplete information may result in:
- Loss of coverage
- Repayment of claims paid in error
- Disciplinary action, if applicable
Effective August 12th 2025 to August 21st 2025
DownloadTable of Contents
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Lorem ipsum dolor sit amet consectetur adipiscing elit. Quisque faucibus ex sapien vitae pellentesque sem placerat. In id cursus mi pretium tellus duis convallis. Tempus leo eu aenean sed diam urna tempor. Pulvinar vivamus fringilla lacus nec metus bibendum egestas. Iaculis massa nisl malesuada lacinia integer nunc posuere. Ut hendrerit semper vel class aptent taciti sociosqu. Ad litora torquent per conubia nostra inceptos himenaeos.
Kaiser Arbitration Agreement - CA
Effective September 23rd 2025
DownloadTable of Contents
Kaiser Foundation Health Plan, Inc., California Arbitration Agreement*
I understand that (except for Small Claims Court cases, claims subject to a Medicare appeals procedure or the ERISA claims procedure regulation, and any other claims that cannot be subject to binding arbitration under governing law) any dispute between myself, my heirs, relatives, or other associated parties on the one hand and Kaiser Foundation Health Plan, Inc. (KFHP), any contracted health care providers, administrators, or other associated parties on the other hand, for alleged violation of any duty arising out of or related to membership in KFHP, including any claim for medical or hospital malpractice (a claim that medical services were unnecessary or unauthorized or were improperly, negligently, or incompetently rendered), for premises liability, or relating to the coverage for, or delivery of, services or items, irrespective of legal theory, must be decided by binding arbitration under California law and not by lawsuit or resort to court process, except as applicable law provides for judicial review of arbitration proceedings. I agree to give up our right to a jury trial and accept the use of binding arbitration. I understand that the full arbitration provision is contained in the Evidence of Coverage.
Note: If you do not agree to the arbitration agreement above you should choose a different medical plan option.
By Enrolling in a Kaiser Permanente California Plan, I understand that this action will serve as my agreement to the conditions provided in the Kaiser Foundation Health Plan Arbitration Agreement (above) and that by law this will have the same effect as a signature on a paper form.
*Disputes arising from the following fully-insured Kaiser Permanente Insurance Company coverages are not subject to binding arbitration: 1) the Preferred Provider Organization (PPO) and the Out-of-Network portion of the Point-of-Service (POS) plans; 2) Preferred Provider Organization (PPO) plans; 3) Out-of-Area Indemnity (OOA) plans; and 4) KPIC Dental plans.
Note: If you do not agree to the arbitration agreement above you should choose a different medical plan option.
By Enrolling in a Kaiser Permanente California Plan, I understand that this action will serve as my agreement to the conditions provided in the Kaiser Foundation Health Plan Arbitration Agreement (above) and that by law this will have the same effect as a signature on a paper form.
*Disputes arising from the following fully-insured Kaiser Permanente Insurance Company coverages are not subject to binding arbitration: 1) the Preferred Provider Organization (PPO) and the Out-of-Network portion of the Point-of-Service (POS) plans; 2) Preferred Provider Organization (PPO) plans; 3) Out-of-Area Indemnity (OOA) plans; and 4) KPIC Dental plans.
Effective September 23rd 2025 to September 23rd 2025
DownloadTable of Contents
Kaiser Foundation Health Plan, Inc., California Arbitration Agreement*
I understand that (except for Small Claims Court cases, claims subject to a Medicare appeals procedure or
the ERISA claims procedure regulation, and any other claims that cannot be subject to binding arbitration
under governing law) any dispute between myself, my heirs, relatives, or other associated parties on the one
hand and Kaiser Foundation Health Plan, Inc. (KFHP), any contracted health care providers, administrators,
or other associated parties on the other hand, for alleged violation of any duty arising out of or related to
membership in KFHP, including any claim for medical or hospital malpractice (a claim that medical services
were unnecessary or unauthorized or were improperly, negligently, or incompetently rendered), for premises
liability, or relating to the coverage for, or delivery of, services or items, irrespective of legal theory, must be
decided by binding arbitration under California law and not by lawsuit or resort to court process, except as
applicable law provides for judicial review of arbitration proceedings. I agree to give up our right to a jury trial
and accept the use of binding arbitration. I understand that the full arbitration provision is contained in the
Evidence of Coverage.
Note: If you do not agree to the arbitration agreement above you should choose a different medical plan
option.
By Enrolling in a Kaiser Permanente California Plan, I understand that this action will serve as my
agreement to the conditions provided in the Kaiser Foundation Health Plan Arbitration Agreement
(above) and that by law this will have the same effect as a signature on a paper form.
*Disputes arising from the following fully-insured Kaiser Permanente Insurance Company coverages are not subject to binding
arbitration: 1) the Preferred Provider Organization (PPO) and the Out-of-Network portion of the Point-of-Service (POS) plans; 2)
Preferred Provider Organization (PPO) plans; 3) Out-of-Area Indemnity (OOA) plans; and 4) KPIC Dental plans.
Effective September 23rd 2025 to September 23rd 2025
DownloadTable of Contents
Kaiser Foundation Health Plan, Inc., California Arbitration Agreement*
I understand that (except for Small Claims Court cases, claims subject to a Medicare appeals procedure or
the ERISA claims procedure regulation, and any other claims that cannot be subject to binding arbitration
under governing law) any dispute between myself, my heirs, relatives, or other associated parties on the one
hand and Kaiser Foundation Health Plan, Inc. (KFHP), any contracted health care providers, administrators,
or other associated parties on the other hand, for alleged violation of any duty arising out of or related to
membership in KFHP, including any claim for medical or hospital malpractice (a claim that medical services
were unnecessary or unauthorized or were improperly, negligently, or incompetently rendered), for premises
liability, or relating to the coverage for, or delivery of, services or items, irrespective of legal theory, must be
decided by binding arbitration under California law and not by lawsuit or resort to court process, except as
applicable law provides for judicial review of arbitration proceedings. I agree to give up our right to a jury trial
and accept the use of binding arbitration. I understand that the full arbitration provision is contained in the
Evidence of Coverage.
Note: If you do not agree to the arbitration agreement above you should choose a different medical plan
option.
By Enrolling in a Kaiser Permanente California Plan, I understand that this action will serve as my
agreement to the conditions provided in the Kaiser Foundation Health Plan Arbitration Agreement
(above) and that by law this will have the same effect as a signature on a paper form.
*Disputes arising from the following fully-insured Kaiser Permanente Insurance Company coverages are not subject to binding
arbitration: 1) the Preferred Provider Organization (PPO) and the Out-of-Network portion of the Point-of-Service (POS) plans; 2)
Preferred Provider Organization (PPO) plans; 3) Out-of-Area Indemnity (OOA) plans; and 4) KPIC Dental plans.
Kaiser Arbitration Agreement - HI
Effective September 23rd 2025
DownloadTable of Contents
Kaiser Foundation Health Plan, Inc., Hawaii Arbitration Agreement*
Binding Arbitration
Except as provided in the Dispute Resolution section of Kaiser Permanente’s Guide to Your Health Plan (Guide) or by applicable law, any and all claims, disputes, or causes of action arising out of or related to your Guide or Evidence of Coverage (EOC), its performance or alleged breach, or the relationship or conduct of the parties, including but not limited to any and all claims, disputes, or causes of action based on contract, tort, statutory law, or actions in equity, shall be resolved by binding arbitration.
This includes but is not limited to any claim asserted:
By or against a Member, a patient, the heirs or the personal representative of the estate of the Member or patient, or any other person entitled to bring an action for damages, arising from or related to harm to the member or patient as permitted by applicable federal or Hawaii state law existing at the time the claim is filed ("Member Parties"). For purposes of this Agreement, all family members of the member or patient who have derivative claims arising from such harm, shall also be deemed “Member Parties” and bound to these arbitration terms; On account of death, bodily injury, physical ailment, mental disturbance, or economic loss arising out of the rendering or failure to render medical services or the provision or failure to provide benefits under this Agreement, except when binding arbitration is explicitly not permitted by applicable law, premises liability, or arising out of any other claim of any nature, irrespective of the legal theory upon which the claim is asserted; and
By or against one or more of the following entities or their employees, officers or directors ("Kaiser Permanente Parties"):
Except as provided in the Dispute Resolution section of Kaiser Permanente’s Guide to Your Health Plan (Guide) or by applicable law, any and all claims, disputes, or causes of action arising out of or related to your Guide or Evidence of Coverage (EOC), its performance or alleged breach, or the relationship or conduct of the parties, including but not limited to any and all claims, disputes, or causes of action based on contract, tort, statutory law, or actions in equity, shall be resolved by binding arbitration.
This includes but is not limited to any claim asserted:
By or against a Member, a patient, the heirs or the personal representative of the estate of the Member or patient, or any other person entitled to bring an action for damages, arising from or related to harm to the member or patient as permitted by applicable federal or Hawaii state law existing at the time the claim is filed ("Member Parties"). For purposes of this Agreement, all family members of the member or patient who have derivative claims arising from such harm, shall also be deemed “Member Parties” and bound to these arbitration terms; On account of death, bodily injury, physical ailment, mental disturbance, or economic loss arising out of the rendering or failure to render medical services or the provision or failure to provide benefits under this Agreement, except when binding arbitration is explicitly not permitted by applicable law, premises liability, or arising out of any other claim of any nature, irrespective of the legal theory upon which the claim is asserted; and
By or against one or more of the following entities or their employees, officers or directors ("Kaiser Permanente Parties"):
- Kaiser Foundation Health Plan, Inc.,
- Kaiser Foundation Hospitals,
- Hawaii Permanente Medical Group, Inc.,
- The Permanente Federation, LLC,
- Any individual or organization that contracts with an organization named above to provide medical services to Health Plan Members, when such contract includes a provision requiring arbitration of the claim made.
Notwithstanding any provisions to the contrary in this Agreement, the following claims shall not be subject to mandatory arbitration:
- claims for monetary damages within the jurisdictional limit of the Small Claims Division of the District Courts of the State of Hawaii;
- actions for appointment of a legal guardian of a person or property subject to probate laws;
- purely injunctive orders reasonably necessary to protect Kaiser Permanente’s ability to safely render medical services (such as temporary restraining orders, and emergency court orders).
- claims that may not be subject to binding arbitration under applicable federal or state law;
- for Medicare members, claims subject to the Medicare appeals process.
Initiating Arbitration
A demand for arbitration shall be initiated by sending a registered or certified letter to each named party against whom the claim is made, with a notice of the existence and nature of the claim, the amount claimed and a demand for arbitration. Any Kaiser Permanente Parties shall be served by registered or certified letter, postage prepaid, addressed to the Kaiser Permanente Parties in care of the Health Plan at Kaiser Foundation Health Plan, Inc., Member Services, 711 Kapiolani Boulevard, Honolulu, HI 96813. The arbitrators shall have jurisdiction only over persons and entities actually served.
Arbitration Proceedings
Within 30 days after the service of the demand for arbitration, the parties shall agree on a panel of arbitrators from which to select arbitrators or shall agree on particular arbitrators who shall serve for the case. If the parties cannot agree on any panel of arbitrators or particular arbitrators within the 30 days, then the panel of arbitrators shall be that of Dispute Prevention and Resolution, Inc. (“DPR”). Unless the parties agree to any other arbitration service and rules, DPR shall administer the arbitration and its arbitration rules shall govern the arbitration (including rules for selection of arbitrators from a panel of arbitrators, if the parties have not already agreed upon particular arbitrators to serve). Kaiser Permanente shall notify DPR (or such other arbitration service as may be chosen by the parties) of the arbitration within 15 days following the expiration of the 30-day period noted above.
Within 30 calendar days after notice to DPR, the parties shall select a panel of three arbitrators from a list submitted to them by the arbitration service. In all claims seeking a total monetary recovery less than $25,000.00, and in any other case where the parties mutually agree, a panel of one arbitrator selected by both parties from a list submitted to them by the arbitration service will be allowed. The arbitrator(s) will arrange to hold a hearing in Honolulu (or such other location as agreed by the parties) within a reasonable time thereafter.
Limited civil discovery shall be permitted only for production of documents that are relevant and material, taking of brief depositions of treating physicians, expert witnesses and parties (a corporate party shall designate the person to be deposed on behalf of the corporation) and a maximum of three other critical witnesses for each side (i.e., respondents or claimants), and independent medical evaluations.
The arbitrator(s) will resolve any discovery disputes submitted by any party, including entry of protective orders or other discovery orders as appropriate to protect the parties’ rights under this paragraph.
Any payment for the fees and expenses of the arbitration service and the arbitrator(s) shall be borne one-third by the Member Parties and two-thirds by the Kaiser Permanente Parties. Each party shall bear their own attorney’s fees, witness fees, and discovery costs.
The arbitrator(s) may decide a request for summary disposition of a claim or particular issue, upon request of one party to the proceeding with notice to all other parties and a reasonable opportunity for the other parties to respond. The standards applicable to such request shall be those applicable to analogous motions for summary judgment or dismissal under the Federal Rules of Civil Procedure.
In claims involving benefits and coverage due under this Agreement or disputes involving operation of the Plan, Health Plan’s determinations and interpretations, and its decisions on these matters are subject to de novo review. The arbitration award shall be final and binding. The Member Parties and Kaiser Permanente Parties waive their rights to jury or court trial. With respect to any matter not expressly provided for herein, the arbitration will be governed by the Federal Arbitration Act, 9 U.S.C. Chapter 1.
General Provisions
All claims based upon the same incident, transaction or related circumstances regarding the same Member or same patient shall be arbitrated in one proceeding (for example, all Member Parties asserting claims arising from an injury to the same Health Plan Member, shall be arbitrated in one proceeding).
A claim for arbitration shall be waived and forever barred if on the date notice thereof is received, the claim, if it were then asserted in a civil action, would be barred by the applicable Hawaii statute of limitations. All notices or other papers required to be served or convenient in the conduct of arbitration proceedings following the initial service shall be mailed, postage prepaid, to such address as each party gives for this purpose. If the Federal Arbitration Act or other law applicable to these arbitration terms is deemed to prohibit any term in this Agreement in any particular case, then such term(s) shall be severable in that case and the remainder of this Agreement shall not be affected thereby. Class actions and consolidation of parties asserting claims regarding multiple members or patients are prohibited. The arbitration provisions in this Agreement shall supersede those in any prior Agreement.
Arbitration Confidentiality
Neither party nor the arbitrator(s) may disclose the substance of the arbitration proceedings or award, except as required by law or as necessary to file a motion regarding the award pursuant to the Federal Arbitration Act, in any federal or state court of appropriate jurisdiction within Hawaii, and in that event, the parties shall take all appropriate action to request that the records of the arbitration be submitted to the court under seal.
Special Claims
Medical Malpractice Claims Prior to initiating any arbitration proceedings alleging medical malpractice, Member Parties shall first submit the claim to a Medical Inquiry and Conciliation Panel pursuant to Chapter 671, Hawaii Revised Statutes, Sections 11-19. Following the rendering of an advisory decision by the Medical Inquiry and Conciliation Panel, if the claim has not been withdrawn or settled, Member Parties shall serve a demand for arbitration on Kaiser Permanente Parties as specified in the “Initiating arbitration” section.
Benefit Claims If the Member Party has a claim for benefits that is denied or ignored (in whole or in part), the Member Party may pursue legal action in federal or state court, as appropriate, after the Member Party has exhausted the claims and appeals process and, if applicable, external review process. The court will decide who should pay court costs and legal fees. If the Member Party is successful, the court may order the person or entity the Member Party has sued to pay these costs and fees. If the Member Party loses, the court may order the Member Party to pay these costs and fees, for example, if it finds the Member Party’s claim is frivolous. If the Member Party has any questions about the Member Party’s plan, the Member Party should contact Health Plan at 1-800-966-5955.
Although benefit-related claims may not be required to be resolved by binding arbitration pursuant to this section, Member Parties may still make a voluntary election to use binding arbitration to resolve these claims, instead of court trial, by filing a demand for arbitration upon Kaiser Permanente Parties pursuant to the provisions of the “Initiating Arbitration” section. If a voluntary election to use binding arbitration is made by a Member Party, the arbitration shall be conducted pursuant to the “Dispute Resolution” section of your Guide or EOC.
External Appeal of Internal Review Decisions If you disagree with Kaiser Permanente's final internal benefit determination, you may request voluntary binding arbitration pursuant to the procedures in this Agreement. In addition to the arbitration procedures set forth in this Agreement which may be elected by the Member (but are not mandatory), Hawaii Revised Statutes Chapter 432E also creates certain external review rights for Members to submit a request for external review to the State Insurance Commissioner within 130 days from the date of Kaiser’s final internal determination. These rights are subject to the limitations noted in the next paragraph, and are subject to the requirements and limitations in Hawaii Revised Statutes Chapter 432E (including exhausting all of Kaiser Permanente’s internal complaint and appeals procedures before requesting external review, except as specified in Chapter 432E for situations when simultaneous external review is permitted to occur or Kaiser Permanente has failed to comply with federal requirements regarding its claims and appeals process). A complete description of Kaiser Permanente’s claims and appeals process is described in the “Appeals” section of your Guide or EOC.
Chapter 432E external reviews are limited to situations where (a) the complaint is not for allegations of medical malpractice, professional negligence or other professional fault by health care providers, and (b) the complaint relates to an adverse action as defined in Hawaii Revised Statutes Chapter 432E. Health Plan may object to external reviews under Chapter 432E which do not meet the standards for external review under applicable federal and state law and Health Plan reserves its full rights and remedies in this regard. The recitation of state law provisions shall not be deemed to constitute any waiver of such objections.
Senior Advantage Member Claims
Complaints and appeals procedures for Senior Advantage Members are described in the Kaiser Permanente Senior Advantage Evidence of Coverage (KPSA EOC). The arbitration provisions of this KPSA EOC apply only to Senior Advantage Member claims asserted on account of medical malpractice or a violation of a legal duty arising out of this KPSA EOC, irrespective of the legal theory upon which the claim is asserted.
By enrolling in a Kaiser Permanente plan, I understand that this action will serve as my agreement to the conditions provided in Kaiser Foundation Health Plan Arbitration Agreement (above).
Note: If you do not agree to the arbitration agreement above you should choose a different medical plan option.
A demand for arbitration shall be initiated by sending a registered or certified letter to each named party against whom the claim is made, with a notice of the existence and nature of the claim, the amount claimed and a demand for arbitration. Any Kaiser Permanente Parties shall be served by registered or certified letter, postage prepaid, addressed to the Kaiser Permanente Parties in care of the Health Plan at Kaiser Foundation Health Plan, Inc., Member Services, 711 Kapiolani Boulevard, Honolulu, HI 96813. The arbitrators shall have jurisdiction only over persons and entities actually served.
Arbitration Proceedings
Within 30 days after the service of the demand for arbitration, the parties shall agree on a panel of arbitrators from which to select arbitrators or shall agree on particular arbitrators who shall serve for the case. If the parties cannot agree on any panel of arbitrators or particular arbitrators within the 30 days, then the panel of arbitrators shall be that of Dispute Prevention and Resolution, Inc. (“DPR”). Unless the parties agree to any other arbitration service and rules, DPR shall administer the arbitration and its arbitration rules shall govern the arbitration (including rules for selection of arbitrators from a panel of arbitrators, if the parties have not already agreed upon particular arbitrators to serve). Kaiser Permanente shall notify DPR (or such other arbitration service as may be chosen by the parties) of the arbitration within 15 days following the expiration of the 30-day period noted above.
Within 30 calendar days after notice to DPR, the parties shall select a panel of three arbitrators from a list submitted to them by the arbitration service. In all claims seeking a total monetary recovery less than $25,000.00, and in any other case where the parties mutually agree, a panel of one arbitrator selected by both parties from a list submitted to them by the arbitration service will be allowed. The arbitrator(s) will arrange to hold a hearing in Honolulu (or such other location as agreed by the parties) within a reasonable time thereafter.
Limited civil discovery shall be permitted only for production of documents that are relevant and material, taking of brief depositions of treating physicians, expert witnesses and parties (a corporate party shall designate the person to be deposed on behalf of the corporation) and a maximum of three other critical witnesses for each side (i.e., respondents or claimants), and independent medical evaluations.
The arbitrator(s) will resolve any discovery disputes submitted by any party, including entry of protective orders or other discovery orders as appropriate to protect the parties’ rights under this paragraph.
Any payment for the fees and expenses of the arbitration service and the arbitrator(s) shall be borne one-third by the Member Parties and two-thirds by the Kaiser Permanente Parties. Each party shall bear their own attorney’s fees, witness fees, and discovery costs.
The arbitrator(s) may decide a request for summary disposition of a claim or particular issue, upon request of one party to the proceeding with notice to all other parties and a reasonable opportunity for the other parties to respond. The standards applicable to such request shall be those applicable to analogous motions for summary judgment or dismissal under the Federal Rules of Civil Procedure.
In claims involving benefits and coverage due under this Agreement or disputes involving operation of the Plan, Health Plan’s determinations and interpretations, and its decisions on these matters are subject to de novo review. The arbitration award shall be final and binding. The Member Parties and Kaiser Permanente Parties waive their rights to jury or court trial. With respect to any matter not expressly provided for herein, the arbitration will be governed by the Federal Arbitration Act, 9 U.S.C. Chapter 1.
General Provisions
All claims based upon the same incident, transaction or related circumstances regarding the same Member or same patient shall be arbitrated in one proceeding (for example, all Member Parties asserting claims arising from an injury to the same Health Plan Member, shall be arbitrated in one proceeding).
A claim for arbitration shall be waived and forever barred if on the date notice thereof is received, the claim, if it were then asserted in a civil action, would be barred by the applicable Hawaii statute of limitations. All notices or other papers required to be served or convenient in the conduct of arbitration proceedings following the initial service shall be mailed, postage prepaid, to such address as each party gives for this purpose. If the Federal Arbitration Act or other law applicable to these arbitration terms is deemed to prohibit any term in this Agreement in any particular case, then such term(s) shall be severable in that case and the remainder of this Agreement shall not be affected thereby. Class actions and consolidation of parties asserting claims regarding multiple members or patients are prohibited. The arbitration provisions in this Agreement shall supersede those in any prior Agreement.
Arbitration Confidentiality
Neither party nor the arbitrator(s) may disclose the substance of the arbitration proceedings or award, except as required by law or as necessary to file a motion regarding the award pursuant to the Federal Arbitration Act, in any federal or state court of appropriate jurisdiction within Hawaii, and in that event, the parties shall take all appropriate action to request that the records of the arbitration be submitted to the court under seal.
Special Claims
Medical Malpractice Claims Prior to initiating any arbitration proceedings alleging medical malpractice, Member Parties shall first submit the claim to a Medical Inquiry and Conciliation Panel pursuant to Chapter 671, Hawaii Revised Statutes, Sections 11-19. Following the rendering of an advisory decision by the Medical Inquiry and Conciliation Panel, if the claim has not been withdrawn or settled, Member Parties shall serve a demand for arbitration on Kaiser Permanente Parties as specified in the “Initiating arbitration” section.
Benefit Claims If the Member Party has a claim for benefits that is denied or ignored (in whole or in part), the Member Party may pursue legal action in federal or state court, as appropriate, after the Member Party has exhausted the claims and appeals process and, if applicable, external review process. The court will decide who should pay court costs and legal fees. If the Member Party is successful, the court may order the person or entity the Member Party has sued to pay these costs and fees. If the Member Party loses, the court may order the Member Party to pay these costs and fees, for example, if it finds the Member Party’s claim is frivolous. If the Member Party has any questions about the Member Party’s plan, the Member Party should contact Health Plan at 1-800-966-5955.
Although benefit-related claims may not be required to be resolved by binding arbitration pursuant to this section, Member Parties may still make a voluntary election to use binding arbitration to resolve these claims, instead of court trial, by filing a demand for arbitration upon Kaiser Permanente Parties pursuant to the provisions of the “Initiating Arbitration” section. If a voluntary election to use binding arbitration is made by a Member Party, the arbitration shall be conducted pursuant to the “Dispute Resolution” section of your Guide or EOC.
External Appeal of Internal Review Decisions If you disagree with Kaiser Permanente's final internal benefit determination, you may request voluntary binding arbitration pursuant to the procedures in this Agreement. In addition to the arbitration procedures set forth in this Agreement which may be elected by the Member (but are not mandatory), Hawaii Revised Statutes Chapter 432E also creates certain external review rights for Members to submit a request for external review to the State Insurance Commissioner within 130 days from the date of Kaiser’s final internal determination. These rights are subject to the limitations noted in the next paragraph, and are subject to the requirements and limitations in Hawaii Revised Statutes Chapter 432E (including exhausting all of Kaiser Permanente’s internal complaint and appeals procedures before requesting external review, except as specified in Chapter 432E for situations when simultaneous external review is permitted to occur or Kaiser Permanente has failed to comply with federal requirements regarding its claims and appeals process). A complete description of Kaiser Permanente’s claims and appeals process is described in the “Appeals” section of your Guide or EOC.
Chapter 432E external reviews are limited to situations where (a) the complaint is not for allegations of medical malpractice, professional negligence or other professional fault by health care providers, and (b) the complaint relates to an adverse action as defined in Hawaii Revised Statutes Chapter 432E. Health Plan may object to external reviews under Chapter 432E which do not meet the standards for external review under applicable federal and state law and Health Plan reserves its full rights and remedies in this regard. The recitation of state law provisions shall not be deemed to constitute any waiver of such objections.
Senior Advantage Member Claims
Complaints and appeals procedures for Senior Advantage Members are described in the Kaiser Permanente Senior Advantage Evidence of Coverage (KPSA EOC). The arbitration provisions of this KPSA EOC apply only to Senior Advantage Member claims asserted on account of medical malpractice or a violation of a legal duty arising out of this KPSA EOC, irrespective of the legal theory upon which the claim is asserted.
By enrolling in a Kaiser Permanente plan, I understand that this action will serve as my agreement to the conditions provided in Kaiser Foundation Health Plan Arbitration Agreement (above).
Note: If you do not agree to the arbitration agreement above you should choose a different medical plan option.
Effective September 23rd 2025 to September 23rd 2025
DownloadTable of Contents
Kaiser Foundation Health Plan, Inc., Hawaii Arbitration Agreement*
Binding Arbitration
Except as provided in the Dispute Resolution section of Kaiser Permanente’s Guide to Your Health Plan (Guide) or by
applicable law, any and all claims, disputes, or causes of action arising out of or related to your Guide or Evidence of
Coverage (EOC), its performance or alleged breach, or the relationship or conduct of the parties, including but not
limited to any and all claims, disputes, or causes of action based on contract, tort, statutory law, or actions in equity, shall
be resolved by binding arbitration.
This includes but is not limited to any claim asserted:
By or against a Member, a patient, the heirs or the personal representative of the estate of the Member or patient, or any
other person entitled to bring an action for damages, arising from or related to harm to the member or patient as
permitted by applicable federal or Hawaii state law existing at the time the claim is filed ("Member Parties"). For
purposes of this Agreement, all family members of the member or patient who have derivative claims arising from such
harm, shall also be deemed “Member Parties” and bound to these arbitration terms; On account of death, bodily injury,
physical ailment, mental disturbance, or economic loss arising out of the rendering or failure to render medical services
or the provision or failure to provide benefits under this Agreement, except when binding arbitration is explicitly not
permitted by applicable law, premises liability, or arising out of any other claim of any nature, irrespective of the legal
theory upon which the claim is asserted; and
By or against one or more of the following entities or their employees, officers or directors ("Kaiser Permanente
Parties"):
- Kaiser Foundation Health Plan, Inc.,
- Kaiser Foundation Hospitals,
- Hawaii Permanente Medical Group, Inc.,
- The Permanente Federation, LLC,
- Any individual or organization that contracts with an organization named above to provide medical services to Health Plan Members, when such contract includes a provision requiring arbitration of the claim made.
Notwithstanding any provisions to the contrary in this Agreement, the following claims shall not be subject to mandatory
arbitration:
- claims for monetary damages within the jurisdictional limit of the Small Claims Division of the District Courts of the State of Hawaii;
- actions for appointment of a legal guardian of a person or property subject to probate laws;
- purely injunctive orders reasonably necessary to protect Kaiser Permanente’s ability to safely render medical services (such as temporary restraining orders, and emergency court orders).
- claims that may not be subject to binding arbitration under applicable federal or state law;
- for Medicare members, claims subject to the Medicare appeals process.
Initiating Arbitration
A demand for arbitration shall be initiated by sending a registered or certified letter to each named party against whom
the claim is made, with a notice of the existence and nature of the claim, the amount claimed and a demand for
arbitration. Any Kaiser Permanente Parties shall be served by registered or certified letter, postage prepaid, addressed to
the Kaiser Permanente Parties in care of the Health Plan at Kaiser Foundation Health Plan, Inc., Member Services, 711
Kapiolani Boulevard, Honolulu, HI 96813. The arbitrators shall have jurisdiction only over persons and entities actually
served.
Arbitration Proceedings
Within 30 days after the service of the demand for arbitration, the parties shall agree on a panel of arbitrators from which
to select arbitrators or shall agree on particular arbitrators who shall serve for the case. If the parties cannot agree on any
panel of arbitrators or particular arbitrators within the 30 days, then the panel of arbitrators shall be that of Dispute
Prevention and Resolution, Inc. (“DPR”). Unless the parties agree to any other arbitration service and rules, DPR shall
administer the arbitration and its arbitration rules shall govern the arbitration (including rules for selection of arbitrators
from a panel of arbitrators, if the parties have not already agreed upon particular arbitrators to serve). Kaiser Permanente
shall notify DPR (or such other arbitration service as may be chosen by the parties) of the arbitration within 15 days
following the expiration of the 30-day period noted above.
Within 30 calendar days after notice to DPR, the parties shall select a panel of three arbitrators from a list submitted to
them by the arbitration service. In all claims seeking a total monetary recovery less than $25,000.00, and in any other
case where the parties mutually agree, a panel of one arbitrator selected by both parties from a list submitted to them by
the arbitration service will be allowed. The arbitrator(s) will arrange to hold a hearing in Honolulu (or such other location
as agreed by the parties) within a reasonable time thereafter.
Limited civil discovery shall be permitted only for production of documents that are relevant and material, taking of brief
depositions of treating physicians, expert witnesses and parties (a corporate party shall designate the person to be
deposed on behalf of the corporation) and a maximum of three other critical witnesses for each side (i.e., respondents or
claimants), and independent medical evaluations.
The arbitrator(s) will resolve any discovery disputes submitted by any party, including entry of protective orders or other
discovery orders as appropriate to protect the parties’ rights under this paragraph.
Any payment for the fees and expenses of the arbitration service and the arbitrator(s) shall be borne one-third by the
Member Parties and two-thirds by the Kaiser Permanente Parties. Each party shall bear their own attorney’s fees, witness
fees, and discovery costs.
The arbitrator(s) may decide a request for summary disposition of a claim or particular issue, upon request of one party
to the proceeding with notice to all other parties and a reasonable opportunity for the other parties to respond. The
standards applicable to such request shall be those applicable to analogous motions for summary judgment or dismissal
under the Federal Rules of Civil Procedure.
In claims involving benefits and coverage due under this Agreement or disputes involving operation of the Plan, Health
Plan’s determinations and interpretations, and its decisions on these matters are subject to de novo review. The
arbitration award shall be final and binding. The Member Parties and Kaiser Permanente Parties waive their rights to jury
or court trial. With respect to any matter not expressly provided for herein, the arbitration will be governed by the
Federal Arbitration Act, 9 U.S.C. Chapter 1.
General Provisions
All claims based upon the same incident, transaction or related circumstances regarding the same Member or same
patient shall be arbitrated in one proceeding (for example, all Member Parties asserting claims arising from an injury to
the same Health Plan Member, shall be arbitrated in one proceeding).
A claim for arbitration shall be waived and forever barred if on the date notice thereof is received, the claim, if it were
then asserted in a civil action, would be barred by the applicable Hawaii statute of limitations. All notices or other papers
required to be served or convenient in the conduct of arbitration proceedings following the initial service shall be mailed,
postage prepaid, to such address as each party gives for this purpose. If the Federal Arbitration Act or other law
applicable to these arbitration terms is deemed to prohibit any term in this Agreement in any particular case, then such
term(s) shall be severable in that case and the remainder of this Agreement shall not be affected thereby. Class actions
and consolidation of parties asserting claims regarding multiple members or patients are prohibited. The arbitration
provisions in this Agreement shall supersede those in any prior Agreement.
Arbitration Confidentiality
Neither party nor the arbitrator(s) may disclose the substance of the arbitration proceedings or award, except as required
by law or as necessary to file a motion regarding the award pursuant to the Federal Arbitration Act, in any federal or
state court of appropriate jurisdiction within Hawaii, and in that event, the parties shall take all appropriate action to
request that the records of the arbitration be submitted to the court under seal.
Special Claims
Medical Malpractice Claims Prior to initiating any arbitration proceedings alleging medical malpractice, Member
Parties shall first submit the claim to a Medical Inquiry and Conciliation Panel pursuant to Chapter 671, Hawaii Revised
Statutes, Sections 11-19. Following the rendering of an advisory decision by the Medical Inquiry and Conciliation Panel,
if the claim has not been withdrawn or settled, Member Parties shall serve a demand for arbitration on Kaiser
Permanente Parties as specified in the “Initiating arbitration” section.
Benefit Claims If the Member Party has a claim for benefits that is denied or ignored (in whole or in part), the Member
Party may pursue legal action in federal or state court, as appropriate, after the Member Party has exhausted the claims
and appeals process and, if applicable, external review process. The court will decide who should pay court costs and
legal fees. If the Member Party is successful, the court may order the person or entity the Member Party has sued to pay
these costs and fees. If the Member Party loses, the court may order the Member Party to pay these costs and fees, for
example, if it finds the Member Party’s claim is frivolous. If the Member Party has any questions about the Member
Party’s plan, the Member Party should contact Health Plan at 1-800-966-5955.
Although benefit-related claims may not be required to be resolved by binding arbitration pursuant to this section,
Member Parties may still make a voluntary election to use binding arbitration to resolve these claims, instead of court
trial, by filing a demand for arbitration upon Kaiser Permanente Parties pursuant to the provisions of the “Initiating
Arbitration” section. If a voluntary election to use binding arbitration is made by a Member Party, the arbitration shall be
conducted pursuant to the “Dispute Resolution” section of your Guide or EOC.
External Appeal of Internal Review Decisions If you disagree with Kaiser Permanente's final internal benefit
determination, you may request voluntary binding arbitration pursuant to the procedures in this Agreement. In addition to
the arbitration procedures set forth in this Agreement which may be elected by the Member (but are not mandatory),
Hawaii Revised Statutes Chapter 432E also creates certain external review rights for Members to submit a request for
external review to the State Insurance Commissioner within 130 days from the date of Kaiser’s final internal
determination. These rights are subject to the limitations noted in the next paragraph, and are subject to the requirements
and limitations in Hawaii Revised Statutes Chapter 432E (including exhausting all of Kaiser Permanente’s internal
complaint and appeals procedures before requesting external review, except as specified in Chapter 432E for situations
when simultaneous external review is permitted to occur or Kaiser Permanente has failed to comply with federal
requirements regarding its claims and appeals process). A complete description of Kaiser Permanente’s claims and
appeals process is described in the “Appeals” section of your Guide or EOC.
Chapter 432E external reviews are limited to situations where (a) the complaint is not for allegations of medical
malpractice, professional negligence or other professional fault by health care providers, and (b) the complaint relates to
an adverse action as defined in Hawaii Revised Statutes Chapter 432E. Health Plan may object to external reviews under
Chapter 432E which do not meet the standards for external review under applicable federal and state law and Health Plan
reserves its full rights and remedies in this regard. The recitation of state law provisions shall not be deemed to constitute
any waiver of such objections.
Senior Advantage Member Claims
Complaints and appeals procedures for Senior Advantage Members are described in the Kaiser Permanente Senior
Advantage Evidence of Coverage (KPSA EOC). The arbitration provisions of this KPSA EOC apply only to Senior
Advantage Member claims asserted on account of medical malpractice or a violation of a legal duty arising out of this
KPSA EOC, irrespective of the legal theory upon which the claim is asserted.
By enrolling in a Kaiser Permanente plan, I understand that this action will serve as my agreement to the conditions
provided in Kaiser Foundation Health Plan Arbitration Agreement (above).
Note: If you do not agree to the arbitration agreement above you should choose a different medical plan
option.
HCSC Blue Cross and Blue Shield of New Mexico Disclaimer
HCSC Blue Cross and Blue Shield of Oklahoma
HCSC Blue Cross and Blue Shield of Texas
HCSC Blue Cross and Blue Shield of Illinois Disclaimer
HCSC Blue Cross and Blue Shield of Montana Disclaimer
(Test) Reimbursement Participation Statement
Effective March 2nd 2026
DownloadTable of Contents
I affirm that I or my covered family members have incurred 2026 costs for which my documented year-to-date responsibility exceeds the required plan threshold. I certify that this request represents only the amount in excess of that threshold for which I have not previously received payment.
Furthermore, I attest that these expenses have not been, and will not be, reimbursed through any other insurance coverage or reimbursement program. If I am enrolled in coverage through a spouse’s plan, I affirm that such coverage provides more than just excepted benefits.