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ACA Automatic Payment Terms & Conditions

Effective as of October 29, 2021

Throughout these Terms and Conditions, when we say “we”, “us”, “our” or “Sidecar Health” we mean Sidecar Health Insurance Solutions, LLC, the company authorized to charge your designated payment method(s) for the automatic recurring payments related to your insurance policy(ies). “You,” “your” and “yours” mean the individual authorizing the automatic recurring payments related to your insurance policy(ies).

“Estimated Expense” means the estimated member share of the amount charged by a provider for a medical service when the Sidecar Health VISA Benefit Card is used to pay for such medical service. “Finalized Expense” means the final member share of the amount charged by a provider for a medical service when the Sidecar Health VISA Benefit Card is used to pay for such medical service, as calculated after the itemized invoice has been uploaded and the actual Benefit Amount determined. All capitalized terms not defined herein have the meanings assigned to them in the policy(ies).

Automatic Recurring Payments

I understand that, starting immediately, the following automatic recurring payments will be charged to my designated payment method(s) on the scheduled charge dates for the amounts due.

  1. Premium Amount: I authorize Sidecar Health to charge my designated payment method for the premium amount. I understand and agree the amounts and dates of the charges are determined by the payment plan I selected for my billing account.
  1. My Portion of My Medical Invoices:
  • Estimated Expense: I authorize Sidecar Health to charge my designated payment method the Estimated Expense amount each time I use my Sidecar Health VISA Benefit Card to pay for medical services . I understand the Estimated Expense will be equal to 100% of the amount charged to my Sidecar Health VISA Benefit Card per transaction until my deductible is met. Once my deductible has been met, I will no longer be charged Estimated Expenses.
  • Finalized Expense: I authorize Sidecar Health to charge my designated payment method the Finalized Expense after 10 days’ notice that a Finalized Expense is due and owing. I understand I will owe a Finalized Expense if the Benefit Amount is less than the estimated Benefit Amount provided by Sidecar Health at the point of service via the Sidecar Health VISA Benefit Card.
  • Account Credits: I understand I will receive an account credit if the Benefit Amount is more than the estimated Benefit Amount provided by Sidecar Health at the point of service via the Sidecar Health VISA Benefit Card. I understand account credits will be automatically applied by Sidecar Health to premium payments and/or Finalized Expenses. I understand I may choose to have an account credit refunded to me instead by selecting that option in my account. I understand that payments with automatic charge dates on a Saturday, Sunday or holiday may not be processed until the following business day. I acknowledge it is my responsibility to have sufficient funds available in connection with my designated payment method(s) to cover these charges. I authorize Sidecar

Health to credit my designated payment method for any refund due to me; and if necessary, Sidecar Health may electronically debit or credit my designated payment method(s) to correct any transactions.

I agree to receive information via email regarding automatic recurring payments. I will maintain a current email address with Sidecar Health and ensure it is active and capable of receiving new emails. I will ensure my email account has sufficient space for new emails and my email server and spam-blocking software do not block emails from Sidecar Health.

Maintaining Accurate Information

It is your responsibility to ensure your billing information is current and accurate. Sidecar Health is not responsible for any payment processing errors or fees incurred if you do not provide accurate billing information. Billing information can include, but is not limited to, items such as your name, account number, address, billing zip code, and other account information, such as your routing number or expiration date, depending on the type of payment method(s) you designated. You can update this information in your account or by contacting us at 877-653-6440.

Billing Statements

Billing statements will be made available in PDF or HTML format, so you must have access to an Internet browser and Adobe® Reader® software (this software is available for download free of charge at www.adobe.com). If you wish to print documents, you must also have access to a printer. Although there is no charge associated with us presenting your billing statements online, you may incur costs associated with electronic access to the documents, such as usage charges from internet providers and/or telephone service providers. If these hardware or software requirements change such that you will no longer be capable of accessing or retaining your billing statements electronically, we will inform you of the revised hardware and software requirements. You may request a paper copy of any billing statement or notice at no charge by contacting Member Care at 877-653-6440.

Payments Not Honored

If we are unable to charge your designated payment method for your automatic recurring payments, a termination notice may be issued for the policy(ies) attached to the designated payment method(s) or use of your Sidecar Health VISA Benefit Card may be suspended.

Policy Cancellation(s)

If we receive a request to cancel the policy(ies) attached to your designated payment method, we will discontinue future automatic recurring payments for the Premium Amount once we process the request to cancel the policy(ies). However, it is possible an automatic recurring payment for the Premium Amount may be processed about the same time as the policy(ies) cancellation(s). You may also be charged Estimated Expenses incurred by you after your request to cancel and any outstanding Finalized Expenses for care received up to the date the cancellation takes effect.

Discontinuing Automatic Recurring Payments

The authorization for automatic recurring payments remains in effect until we receive notice from you of its termination. To discontinue automatic recurring payments, call 877-653-6440.

Please allow up to five (5) business days for processing your request. Automatic payments scheduled within five (5) business days after your request may still take place.

Amendments to Terms and Conditions

Sidecar Health reserves the right to change these Terms and Conditions at any time.

Non-waiver

Any failure by Sidecar Health to act upon any breach of these Terms and Conditions shall not be deemed to constitute a waiver of any subsequent breach of that or any other term or condition, or of any right to thereafter enforce these Terms and Conditions.

Contact Us

You may call Sidecar Health at 877-653-6440 during normal business hours of Monday – Friday 7:00 am to 10:00 pm Central Time, Saturday – Sunday 9:00 am to 5:00 pm Central Time.