You, or the designated owner of your coverage (hereinafter referred to as “You or Your”) are participating in an insurance plan that utilizes the services of a Third-Party Administrator, Member Benefits. This means that your association, employer, group insurance plan, and/or insurance carrier has appointed Member Benefits to perform certain administrative functions on behalf of the program for which you are participating in and that you agree to the following administrative terms regarding your coverage. Member Benefits performs administrative functions and is not an insurance company. Member Benefits does not pay claims and is not responsible for the payments of benefits per your insurance contract.
All plan changes, customer service inquiries, and premium payments should be directed to Member Benefits, and not directly to your association nor the insurance carrier. You can reach Member Benefits by phone at 1-800-282-8626 or by visiting the website at www.memberbenefits.com
Maintaining Up-to-Date Account Information
You are responsible for updating your contact information with Member Benefits. This includes but is not limited to Name, Mailing and/or billing address, email, phone, and banking account information for monthly auto-pay, if applicable. Member Benefits will NOT automatically update your insurance plan contact information when you update your information through your association or if you update information directly with the insurance carrier or your employer. Failure to update your contact information with Member Benefits may result in the inability for Member Benefits to reach you in the event of matters such as customer service, plan changes, premium/billing notices, or coverage lapse.
You are responsible for timely premium payment of your full balance due. If you take advantage of Monthly Auto Pay (ACH/EFT), and in the event that you have a change to your bank account, you are responsible for providing updated banking account information in a timely manner to ensure a successful auto-pay draft. Any failed draft attempts, prior to receipt of updated bank account information, will result in applicable service fees, when permitted by law and/or lapse of coverage due to non-payment.
Administrative/Plan/Rate Changes
You will receive a notification mailed to your address on record, no less than 30-days prior to the event of any administrative change, change in plan benefits, or change in plan rates. Notifications may also be delivered electronically in addition to delivery by USPS mail. Unless notified by Member Benefits, no action will be required by you to continue or renew your coverage other than paying your premium due when invoiced. In the event of a rate or premium adjustment change, and you opt to pay your premiums via monthly auto-pay, your new monthly premium will automatically be drafted from your account beginning on the date of the change. No action or consent is required by you. If you wish not to continue your coverage, you must submit a cancelation request or cease payment of your premiums. Your coverage will not end on any date other than a specific termination date stated in your coverage documents, or if notified by Member Benefits, or if your premium due is not received in a timely manner.
Coverage Cancelation
Coverage cancelations must be submitted in writing to Member Benefits or through the Member Benefits Online Cancelation Form at www.memberbenefits.com. Upon receipt of your written cancelation request or your online Cancelation Form submission, your coverage will terminate at 11:59pm on the last day of the month in which your Cancelation Request was submitted. Cancelation of coverage does not constitute waiver of premium(s) due up to your final day of coverage. CANCELATIONS CANNOT BE BACKDATED. No partial month terminations can be accepted. All cancelation requests are final and cannot be reversed after submission of your cancelation request. Cancelation of primary coverage will also cancel any coverage that is an optional add-on/rider to the primary coverage such as dependent coverage or any other coverage that requires active primary coverage in order to remain in force. For Member Group Dental/Vision/Telehealth/Supplemental Health Cancelations, plan participants and/or dependents canceling coverage, may rejoin the group plan no earlier than 24-months from the date your coverage terminated by submitting a new application for coverage.
Eligibility
Insureds are responsible for updating their eligibility status for each insurance coverage. Members should review all eligibility requirements for each coverage and immediately notify Member Benefits in the event you no longer meet the eligibility requirements to be covered under any plan. Changing membership status with your association or affiliated organization does not constitute notification to Member Benefits of a change in your eligibility. You must notify Member Benefits in writing, and cease payment for coverage, in the event that coverage should be terminated due to no longer meeting the eligibility requirements for each plan. Failure to meeting eligibility requirements and/or failure to notify Member Benefits in a timely manner may result in overpayment of premiums and denial of claims. Refund requests will not be honored for overpayments made after the date of loss of eligibility, for any plan, and made for any period more than 6 months prior to your notification to Member Benefits. Member Benefits is not responsible for the overpayment of premiums or the denial of claims in the event that you fail to notify Member Benefits of a change in your eligibility status for any plan.
30-Day Free Look / Refunds
Upon initial approval for coverage, please carefully read your policy documents. If you are in any way not satisfied with the coverage that you have purchased, you may notify Member Benefits in writing within 30 days of your effective date to receive a full refund of any premiums that you have paid for this coverage. Refund requests must be submitted in writing and may be granted only within the first 30 days after your coverage effective date and only in the event that no payments for benefits have been made to you or on your behalf or claims have been paid or filed. Any refund owed to you will be net of all, agreed upon, non-refundable application fees, surcharges, and processing fees. Your policy documents will then be deemed void, and any monies owed to you will be paid within 30 days from your request. Refund payments by default will be paid to participants in the same manner by which participants made payment, unless otherwise requested by the participant.
Billing
Member Benefits offers two convenient billing payment modes. Direct Annual Billing and Monthly Auto-Pay (ACH/EFT). If Direct Annual billing is selected, you will receive an annual invoice in the mail at your address on record. You will be invoiced on an annual basis with premiums due on January 1st of each plan year. Member Benefits offers members the ability to make payment via written check, money order, credit card, or checking account debit. CHECK ACCEPTANCE POLICY, By using a check for payment, you agree to the following terms: In the event your check is dishonored or returned for any reason, you authorize us to electronically (or by paper draft) re-present the check to your bank account for collection of the amount, plus any applicable fees as permitted by state law.
Payments may also be made by e-payment online at memberbenefits.com through e-check (ACH) or credit/debit card payment. Applicable convenience fees may apply. Any e-payment made will require input of an email address in order to receive an email receipt of payment. Member Benefits will not mail a paper receipt or confirmation of payment.
If you choose to take advantage of our convenient Monthly Auto-Pay option, you are required to complete the authorization either during your initial application for coverage or through our paper or online Monthly Auto-Pay form at www.memberbenefits.com. You will authorize Member Benefits (MB) to initiate debit and credit entries to your Checking account and my Bank/Financial Institution to debit and/or credit the same account. MB will not be held responsible for a policy lapse or cancelation due to nonpayment if withdrawal is prepared and not honored for any reason and amount due is not paid within the payment Grace Period. You will acknowledge that the origination of ACH transactions to your account must comply with the provisions of U.S. law. Service fees, when applicable by law, may apply for ACH debit returns. MB and your Bank/Financial Institution may discontinue this service. This authority is to remain in full force and effective until MB has received written notice from me of its termination in such time and manner as to afford MB and your Bank/Financial Institution a reasonable opportunity to act on it. You will not receive a paper nor emailed billing statement if selecting Monthly Auto-Pay. Members Benefits reserves the right to decline or revoke Monthly Auto Pay privileges for any reason. In the event your Monthly Auto Pay privileges have been declined or revoked, you will automatically default to Direct Annual Billing mode.
A Grace Period of 31 days from each payment due date will be granted, during which time your coverage shall continue in force. If full payment due is not received before the expiration of the grace period, no claims incurred during that grace period will be honored and the coverage shall be deemed to have terminated on the payment due date.
After expiration of your payment Grace Period, your coverage will no longer be in force. You will have an additional 31-day Reinstatement Period for which you may reinstate your coverage without new evidence of insurability. Subject to the following conditions, each overdue certificate or policy will be reinstated: Full payment of premium due plus any required administrative fee(s) is received by Member Benefits no later than 62 days from your outstanding premium due invoice due date; The amount due must be mailed within the lifetime of the covered person and while the covered person is actively at work; Acceptance of the amount due after the expiration of the coverage and without evidence of insurability does not waive any other policy provisions; Acceptance of a late payment does not mean the Company will accept late payment in the future. Partial payments will not be accepted nor extend your reinstatement period. No further reinstatement period will be extended.
Scope of Consent
You agree to receive electronic notices, disclosures, and electronic signature documents with all related and identified documents and disclosures provided over the course of your relationship with Member Benefits. You agree to receive communications from Member Benefits regarding coverage, program availability, and other product updates via email. Your privacy is extremely important to us; we do not sell personally identifiable information to outside parties, and we follow strict security standards. You have the ability to change email delivery preferences and/or opt out at any time. For a full summary of our privacy practices, please visit the Privacy Policy page.