Acceptance of Terms

The following terms and conditions ("Terms") constitute the legal agreement between you and us regarding your access and use of the Web site and your use of the Web-based services offered on the Web site ("Service(s)"). Your access to the Web site and the applicable Services will depend on the nature of your relationship with the entity that has provided you with access to the Web site or the Services. Depending on your relationship with us, Services may include information about the Health Plan and its subsidiaries, links to content and services provided by third parties, and restricted access to certain member-, provider-, benefit coordinator- and agent-specific information. Please read these Terms carefully. If you agree to these Terms then click the "Accept" button below. By clicking the Accept button below, you acknowledge your agreement that these Terms shall be a legal and binding agreement governing your use of the Web site and the Services. If you do not agree to these Terms, then do not click the Accept button and return to the previous page of this Web site.

From time to time, we may change the Terms by posting new or supplemental terms and conditions on this Web site. You agree that we may change these Terms from time to time and that you shall be bound by such changes when they are posted on this Web site. Further, some Services may require you to agree to additional terms and conditions which apply to the specific Services. If you agree to those additional terms and conditions, then those additional terms and conditions also shall form a part of the legal agreement between you and us.

You represent and warrant to us that you are over the age of 18 and that you have the legal capacity to enter into these Terms. If you are accessing the Web site or using the Services on behalf of any other person or entity, then you represent and warrant that you have the capacity and authority to enter into these Terms on behalf of such person or entity.

Use of Web Site and Services

You agree that you will use the Web site and Services only for legitimate purposes and that you shall comply with all applicable laws, regulations or other government directives regarding your use. You agree that you will not use the Web site or the Services: (i) to access any information for which you do not have the legal right to view; or (ii) to distribute or publish any defamatory statements, pornographic material, copyrighted, trademarked or other proprietary material. At any time we may modify or discontinue your access to any or all of the Web site or Services in our discretion.

Use of Information

Through the Web site and the Services you may be offered access to various types of information originating from ourselves or third parties. Some of this information may be related to dental, medical and health care issues. The information contained within this Web site and the Services is not dental, medical or health care advice. We do not engage in the practice of medicine or dentistry. Any information which you obtain on the Web site or through the Services should be used only after consulting with your appropriate health care provider.

Your Information

To enroll in the Web site and Services, you must supply certain basic information during the enrollment process and, occasionally, at other times while using the Services. Please be advised that we may share information provided by you as part of the enrollment process with third parties for the purposes of providing the Web site, Services or other benefits.

Updates

If you would like to update your personal information, you may do so either via the Web site’s Ask Customer Service or Ask Provider Services function or by calling our Customer Service department.

E-mail

You are required to provide your e-mail address in order to use the Web site and the Services. You agree we may use this e-mail address to correspond with you regarding the Web site and the Services and to send other communications to you. We also may retain this e-mail address for such future use as we may determine. Additionally, we may send e-mail responses to Ask Customer Service or Ask Provider Services questions. If you have not previously provided an e-mail address in your registration profile, we will require an e-mail address when you sign on in the future.

Security/Privacy

This site has security/privacy measures in place to protect against the loss, misuse and alteration of the information under our control. While your Username and Password are used to initially recognize you as an enrolled member, some of the functions offered by the Services may require a higher level of validation and will use your member/group/provider/agent number and date of birth to allow access to these functions. We use your Internet Protocol (IP) address to help diagnose problems with our server, and to administer our Web site. Your IP address is also used to help identify you and to help gather broad demographic information. Although we have security and privacy measures in place, we cannot guarantee that unauthorized third parties (including computer hackers) will not gain unauthorized access to your information or otherwise misuse the system. You agree to assume all risks associated with unauthorized users and further release us from any and all claims, liabilities and damages, of whatever nature, related to the Web site or the Services. You also agree to protect your user login information and to not provide such information to any third party.

Cookies

As part of the registration and sign-on process, we will create a temporary, encrypted identifying information file in your browser (commonly known as a "cookie") that identifies you as a registered member of the Web site. Cookie technology enables us to offer you convenient features, such as easier navigation through the Web site, the ability to receive services from select third parties and the ability to save customized information.

Links

As you navigate through the Web site or use the Services, you will be able to link to other sites for special offers or information. Please note that we provide these links for your convenience, but inclusion of the link does not imply endorsement by us. We do not guarantee any third party’s performance and do not guarantee any of the services or materials provided by any third party. The linked sites are not under our control and we are not responsible for the contents of any linked site or any link contained as a linked site. You may be required to accept a linked Web site’s separate terms and conditions in order to access such Web site. Some linked sites may provide particular, personalized services. For example, linked sites may provide prescription drug information that includes part of your prescription drug history. For the linked site to provide this type of detailed information, it is necessary for us to provide the linked site with specific information related to your personal information. Your acceptance of these Terms constitutes your agreement that we may provide such linked sites with necessary personal information. Because we do not control the linked sites, we encourage you to understand the privacy policies of linked sites. Obviously, we cannot be responsible for the privacy practices or the content of such Web sites. With regard to third party information, we do not endorse or otherwise recommend or approve any product or information located on or available through the Web site or Services.

Cancellation

At any time, we may, in our sole discretion, choose to terminate or limit the Services or cancel your access to the Web site or Services.

Disclaimer

AS A USER OF THIS WEB SITE AND THE SERVICES, YOU ASSUME FULL RISK AND RESPONSIBILITY FOR ANY AND ALL USE OF THE WEB SITE AND SERVICES, INCLUDING RESPONSIBILITY FOR THE INFORMATION PRESENTED TO YOU. THE WEB SITE AND THE SERVICES ARE INTENDED TO BE A GENERAL INFORMATION RESOURCE ONLY AND DO NOT CONSTITUTE MEDICAL OR DENTAL ADVICE AND ARE NOT A SUBSTITUTE FOR PROFESSIONAL MEDICAL OR DENTAL ADVICE OR TREATMENT. YOU ARE RESPONSIBLE FOR SEEKING PROFESSIONAL MEDICAL OR DENTAL ADVICE IF YOU HAVE ANY QUESTIONS ABOUT YOUR HEALTH OR A HEALTH CONDITION. THE WEB SITE AND THE SERVICES ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND. WE EXPRESSLY DISCLAIM ANY AND ALL REPRESENTATIONS AND WARRANTIES, EXPRESS OR IMPLIED, INCLUDING THOSE OF ACCURACY, COMPLETENESS, NON-INFRINGEMENT, MERCHANTABILITY AND FITNESS FOR A PARTICULAR USE OR PURPOSE.

Limitation of Damages and Liability

YOU AGREE THAT WE SHALL NOT BE LIABLE UNDER ANY CIRCUMSTANCES FOR ANY SPECIAL, INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES, INCLUDING, WITHOUT LIMITATION, LOST REVENUES OR LOST PROFITS, WHICH MAY RESULT FROM THE USE OF THE WEB SITE OR THE SERVICES. YOU AGREE THAT WE WILL NOT BE LIABLE TO YOU OR ANYONE ELSE FOR ANY HARM TO YOU OR OTHERS RESULTING FROM THE USE OF THE WEB SITE OR THE SERVICES. TO THE MAXIMUM EXTENT PERMITTED BY LAW YOU HEREBY RELEASE AND DISCHARGE US, OUR EMPLOYEES, OFFICERS AND DIRECTORS FROM ANY AND ALL DAMAGES, COSTS, EXPENSES OR LIABILITIES OF WHATSOEVER NATURE RELATED TO YOUR USE OF THIS WEB SITE OR THE SERVICES.

Indemnification

You agree to indemnify, defend and hold us and our officers, directors, employees, agents, licensors, suppliers and any third-party information providers harmless, from and against all losses, expenses, damages, liabilities, fees and costs, including reasonable attorneys’ fees, resulting from any violation of these Terms and conditions or any activity related to your account (including negligent or wrongful conduct) by you or any other person acting on your behalf or with your permission who accesses any Services using your account.

Special Access Terms

Some Services may provide you with the option to allow administrators and non-administrators (“Authorized Users”) to create profiles so as to use certain Services on your behalf. There may be different requirements, administration processes and available functions depending on the profile of the Authorized User. You are solely responsible for all acts or omissions of any Authorized User or any other person who gains access to the Web site or Services. You are solely responsible for implementing and maintaining all necessary quality and security procedures your Authorized Users will be required to follow. You shall designate one Authorized User to serve as your administrator (“Administrator”). The Administrator shall serve as your primary contact with us regarding the Web site and any applicable Services. The Administrator also is responsible for controlling which other Authorized Users are allowed to access the Web site or Services on your behalf. You represent and warrant that the Administrator will be knowledgeable concerning the statutory and regulatory requirements, including the requirements of the Health Insurance Portability and Accountability Act of 1996, and the regulations promulgated thereunder (“HIPAA”) and any state medical privacy mandates applicable to the electronic storage and transmission of patient information within and from your facilities. You agree that each Authorized User shall maintain full compliance with HIPAA, and any other laws now or hereinafter existing that are applicable to you, directly or indirectly, with respect to the gathering, use, transmission, processing, receipt, reporting, disclosure and maintenance or storage of health information. The Administrator shall be solely responsible for ensuring that each Authorized User will have his or her unique Password; that the unique Passwords are not shared with any others; and that appropriate procedures are in place for the regeneration of Passwords or adding or terminating access to the Web site or Services. You agree that Authorized Users will only access and use the Services solely for your internal business purposes in accordance with these Terms.

Survival

If we terminate your access to the Web site or applicable Services, then these Terms shall remain in full force and effect and shall survive as the governing terms of your access and use of the Web site and Services prior to your termination.

Eligibility and Benefits

Depending on your status, you may have access to eligibility and benefits information through the Web site or the Services. The information you obtain is not a guarantee of payment. Unless otherwise required by state law, any information you obtain regarding eligibility and benefits is not a guarantee of payment. Benefits are subject to all contract limits and member status on the date of service. Also, nonpayment of premiums and other contractual limitations may result in denial of benefits or refunds

Accumulated amounts such as deductibles may change as additional claims are processed. Deductible and out-of-pocket limits may not apply for all services under your benefit plan. The deductible and out-of-pocket status information is a standard calculation based on the limits for professional outpatient services performed in a hospital. If your benefit plan does not impose a limit for this service or includes different limits for other types of services, the actual amounts may vary.

The replacement deductible is for the deductible specific to the service type requested. This replaces the global deductible for this service type. Please contact Customer Service for additional information regarding benefits.

Relationship

These Terms do not establish any relationship or partnership, joint venture employment, franchise or agency between you and us.

Enforceability of Terms

If any provision of these Terms is determined to be invalid or unenforceable, then all other provisions of these Terms shall remain in full force and effect. If any of these Terms is determined to be invalid or unenforceable, then the court shall enforce these Terms to the maximum extent allowed by law or equity.

No Waiver

No waiver of any breach of any provision of these Terms shall be deemed a waiver of any repetition of such breach or in any manner affect any other terms and conditions set forth herein.

Assignability

We may assign our rights and delegate our duties under these Terms, either in whole or in part, at any time in our sole discretion and without your consent. You may not assign sublicense or otherwise transfer your rights or obligations in whole or in part under these Terms to any one else.

Governing Law

These Terms shall be interpreted and enforced according to the laws of the state of South Carolina.

Jurisdiction

You agree that any legal action or proceeding between you and us arising out of or relating to these Terms, the Web site or the Services, shall be brought solely and exclusively in a federal or state court of competent jurisdiction located in Richland County, South Carolina, and you hereby expressly and irrevocably consent to the jurisdiction and venue of such courts and waive any defenses to such jurisdiction, venue or convenience of forum.

Copyright

Copyright and other laws protect all information, content and all other materials offered through the Service and all information contained on the Web site. You may not copy or distribute any of these materials without our prior written consent.

Entire Agreement

These Terms, as they may be modified from time to time in our discretion, and any other terms to which you agree as part of your access to an applicable portion of the Web site or Services, constitute the entire agreement between you and us regarding your use of the Web site and the Services.