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Terms of Service
Last revised on: June 16, 2020
The websites located at www.pivothealth.com, enroll.pivothealth.com, www.pivotcarehealth.com, and www.bridgetomedicare.com (collectively or individually the “Site”) and the software provided for use on mobile devices in connection with the Site (the “App” and, together with the Site the “Properties”) are copyrighted works belonging to Pivot Health Holdings, LLC, an Florida limited liability company (“Pivot Health”, “us”, “our”, and “we”). Certain features of the Properties may be subject to additional guidelines, terms, or rules, which will be posted on the Properties in connection with such features. All such additional terms, guidelines, and rules are incorporated by reference into these Terms.
THESE TERMS OF USE (THESE “TERMS”) SET FORTH THE LEGALLY BINDING TERMS AND CONDITIONS THAT GOVERN YOUR USE OF THE PROPERTIES. BY ACCESSING OR USING THE PROPERTIES, YOU ARE ACCEPTING THESE TERMS (ON BEHALF OF YOURSELF OR THE ENTITY OR OTHER PERSON THAT YOU REPRESENT), AND YOU REPRESENT AND WARRANT THAT YOU HAVE THE RIGHT, AUTHORITY, AND CAPACITY TO ENTER INTO THESE TERMS (ON BEHALF OF YOURSELF OR THE ENTITY OR OTHER PERSON THAT YOU REPRESENT). YOU MAY NOT ACCESS OR USE THE PROPERTIES OR ACCEPT THE TERMS IF YOU ARE NOT AT LEAST 18 YEARS OLD OR DO NOT RESIDE IN THE UNITED STATES OF AMERICA. IF YOU DO NOT AGREE WITH ALL OF THE PROVISIONS OF THESE TERMS, DO NOT ACCESS AND/OR USE THE PROPERTIES. THE PROPERTIES ARE NOT INTENDED FOR USE BY RESIDENTS OF CALIFORNIA. THESE TERMS REQUIRE THE USE OF ARBITRATION (SECTION 11.2) ON AN INDIVIDUAL BASIS TO RESOLVE DISPUTES, RATHER THAN JURY TRIALS OR CLASS ACTIONS, AND ALSO LIMIT THE REMEDIES AVAILABLE TO YOU IN THE EVENT OF A DISPUTE.
1. BACKGROUND; CERTAIN REQUIRED INFORMATION.
1.1 Background. Pivot Health is a web-enabled distributor of health insurance products that can be shopped for and purchased online through our proprietary quoting and enrollment platform within the Properties. We built the Properties to be an online resource for consumers seeking to make health insurance and other healthcare purchase decisions. Pivot Health is not a health insurer and but works on behalf of health insurers through an agency relationship in providing many of the insurance products or services advertised on the Properties. We may provide users with the opportunity to submit applications for insurance offered by health insurers with whom we partner each such application, an “Application”). Once you provide us with the information required on our forms, we provide you with a quote or quotes and may permit you to submit an Application. Once an Application has been accepted by an associated health insurer, users will be able to access information about their insurance plans on a password-protected member portal area of the Site (the “Member Portal”) and on the App. Pivot Health is a subsidiary of HealthCare, Inc., a Delaware corporation.
1.2 Provision of Information. In order to access or use certain features or services offered on the Properties, you must provide certain information about yourself as prompted by the webforms displayed to you. You represent and warrant that: (a) all required information you submit is truthful and accurate; (b) you are the person described in such information or, if not, you are lawfully authorized to provide such information and to give the consent of the person described in such information, including consent to be contacted as required by the Telephone Consumer Protection Act of 1991 47 U.S.C. 227 (“TCPA”); and (c) you will maintain the accuracy of such information. Pivot Health may suspend or terminate your access to the Properties and /or any services made available on the Properties in accordance with Section 9. If you access the Properties on behalf of another person then “you”, “yourself”, “your” and “user” means and refers to you on behalf of yourself and you on behalf of such other person.
1.3 Types of Coverage Offered. Pivot Health provides Short Term Medical, Fixed Indemnity, Accident, Supplemental, Dental, and Vision insurance.
Short Term Medical is medical insurance that will protect the insured in case of accident or illness on a fixed duration. With Short Term Medical, you may be covered for medical services including hospital stays, doctors and specialist visits, x-rays, and many other procedures.
Fixed Indemnity insurance is an indemnity product that offers financial payments for commonly-needed medical services, including hospital and doctor services. When you experience a covered medical event, Fixed Indemnity insurance pays a set fee, directly to you or a provider designated by you. It does not agree to cover the full amount that a healthcare provider may charge the insured.
Accident and Supplemental insurance provide supplemental indemnity insurance in the event of an accident or critical illnesses wherein the insurance company will make a cash payment to the insured. Accident and Supplemental insurance products are not intended to replace major medical insurance.
Dental and Vision insurance are standalone plans for vision or dental benefits that can be used on top of a health insurance plan as a form of supplemental insurance.
Limitations on Coverage. Short Term Medical and Fixed Indemnity plans are not Obamacare health insurance under the Affordable Care Act. Specifically, they are not required to comply with federal market requirements for health insurance, including those contained in the Affordable Care Act (ACA). Pivot Health advises its insured members to review his or her policy carefully to make sure the insured is are aware of any exclusions or limitations regarding coverage of pre-existing conditions or health benefits (such as hospitalization, emergency care, maternity care, wellness/preventive care, prescription drugs, and mental health and substance use disorder services). The policy might also have lifetime and/or annual dollar limits on medical benefits. If this coverage expires or eligibility is lost for this coverage, the insured might have to wait until an open enrollment period under the ACA to get other health insurance coverage.
2. ACCESS TO THE PROPERTIES.
- 2.1 License. Subject to these Terms, Pivot Health grants you a non-transferable, non-exclusive, revocable, limited license to use and access the Properties solely for your own personal, noncommercial use.
- 2.2 Certain Restrictions. The rights granted to you in these Terms are subject to the following restrictions: (a) you shall not license, sell, rent, lease, transfer, assign, distribute, host, or otherwise commercially exploit the Properties, whether in whole or in part, or any content displayed on the Properties; (b) you shall not modify, make derivative works of, disassemble, reverse compile or reverse engineer any part of the Properties; (c) you shall not access the Properties in order to build a similar or competitive website, product, or service; and (d) except as expressly stated herein, no part of the Properties may be copied, reproduced, distributed, republished, downloaded, displayed, posted or transmitted in any form or by any means. Unless otherwise indicated, any future release, update, or other addition to functionality of the Properties shall be subject to these Terms. All copyright and other proprietary notices on the Properties (or on any content displayed on the Properties) must be retained on all copies thereof.
- 2.3 Modification. Pivot Health reserves the right, at any time, to modify, suspend, or discontinue the Properties (in whole or in part) with or without notice to you. You agree that Pivot Health will not be liable to you or to any third party for any modification, suspension, or discontinuation of the Properties or any part thereof.
- 2.4 No Support or Maintenance. You acknowledge and agree that Pivot Health will have no obligation to provide you with any support or maintenance in connection with the Properties.
- 2.5 Ownership. All the intellectual property rights, including copyrights, patents, trade marks, and trade secrets, in the Properties and its content are owned by Pivot Health or Pivot Health’s suppliers. Neither these Terms (nor your access to the Properties) transfers to you or any third party any rights, title or interest in or to such intellectual property rights, except for the limited access rights expressly set forth in Section 2.1. Pivot Health and its suppliers reserve all rights not granted in these Terms. You further agree and acknowledge that (i) Pivot Health (or, in the case of some Applications, the relevant health insurer) will own any information you provide when accessing the Properties or using the services made available on the Properties or that Pivot Health otherwise obtains in connection with your access to and use of the Properties and the services; and (ii) Pivot Health may deal with such information in any manner and may profit from the transfer of such information to its partner companies, including, without limitation, health insurers and their administrators provided, however, that Pivot Health’s use of such Information must be compliant with the Pivot Health Privacy Policy and these Terms. There are no implied licenses granted under these Terms.
- 2.6 Applications. In submitting an Application, you agree to allow us to refer all of the information that you provide in connection with your request to the relevant health insurer or its administrators. If any health insurer or its administrators wish to provide information to you in connection with your Application they may contact you using the details (such as telephone number, fax number or email address) that you supply in connection with the Application. We seek to work with companies that are reputable, professional and can service the needs of our users. However, we strongly recommend that you perform your own due diligence and research on each potential health insurer prior to entering into any agreement or arrangement. In addition, once we submit your Application, we have no further involvement in, or responsibility for, any transactions that occur between you and the relevant health insurer or its administrators. We are not responsible or liable for ANY expenses, losses or damages (financial or otherwise) incurred in any such transactions or such health insurers’ or administrators’ acts or omissions including, without limitation, with respect to any quotes or services they may provide, for their contact or delay or failure to contact you, for their performance or failure to perform, or for any agreement or transaction between you and them. We cannot and do not guarantee that health insurers and their administrators will consider, respond to or accept every Application received or that those who do respond to or accept your Application can in fact meet your requirements. We may reject any Application and / or elect not to forward an Application to participating health insurers at our sole discretion. MAKE SURE YOU UNDERSTAND THE TERMS OF ANY POLICY FOR WHICH YOU SUBMIT AN APPLICATION AND DO NOT CANCEL ANY EXISTING INSURANCE UNTIL YOU RECEIVE WRITTEN CONFIRMATION FROM THE INSURANCE COMPANY TO WHICH YOU ARE APPLYING THAT YOUR NEW POLICY IS IN EFFECT. We do not underwrite insurance or process insurance claims. Those matters are handled by the health insurer or its administrators.
- 2.7 Use of Member Portal and App. In order to access the Member Portal and the App, you must enter your account credentials previously provided by us or chosen by you. The Member Portal and the App may contain certain personal and non-public information regarding your insurance plans acquired through use of the Properties. It is your responsibility to keep this password confidential. The Member Portal and the App may contain links to websites or member portals of third parties that are involved in providing services to you that are associated with the products you have acquired through our Properties (including but not limited to insurance plan administrators and claims processors).
3. PRIVACY
Your use of the Properties, and any information you provide to us while using the Properties, is subject to our Privacy Policy. By using the Properties, you consent to the use of your information as we outline in our Privacy Policy. You accept that:
3.1 Pivot Health makes money when your Application is accepted by a health insurer or its administrator or when we connect you with a health insurer, administrator or agent regarding the purchase of insurance. In addition, Pivot Health may also make money outside the sale of insurance products including through referrals to other insurance companies and advertising-based revenue on related purchases on a user opt-in basis.
3.2 Our Privacy Policy governs anything you do on the Properties and the applicable health insurer or administrator’s privacy policy governs anything you do (e.g. discuss insurance) with such health insurer or administrator.
3.3 Pivot Health’s display on or through the Properties of healthcare, health insurance products or service options offered by third parties does not in any way imply, suggest, or constitute any sponsorship or approval by Pivot Health of any such third party or any affiliation between any such third party and Pivot Health, provided, however, that Pivot Health may be acting as an agent of such third party. Pivot Health’s display of specific options does not suggest a recommendation by Pivot Health of the relevant health insurer or its product/service options. You agree that Pivot Health is in no way responsible for the accuracy, timeliness or completeness of information it may obtain from health insurers, their administrators or elsewhere. Your interaction with any health insurers or administrators that originates through the Properties is at your own risk, and Pivot Health will have no liability with respect to their acts, omissions, errors, representations, warranties, breaches or negligence or for any expenses, losses or damages (financial or otherwise) resulting from your interactions with them.
3.4 If we display the telephone number of a health insurer or its administrator or other representative, transfer your phone call, or link to their website, any and all contact is undertaken at your own risk. You, not Pivot Health, are responsible for any personal information you provide to another company and we recommend as a general practice that you read a company’s privacy policy prior to sharing any personal information.
4.1 Acceptable Use Policy. The following terms constitute our “Acceptable Use Policy”:
(a) You agree not to use the Properties in violation of any law, regulation, or obligations or restrictions imposed by any third party.
(b) In addition, you agree not to: (i) upload, transmit, or distribute to or through the Properties any computer viruses, worms, or any software intended to damage or alter a computer system or data; (ii) send through the Properties unsolicited or unauthorized advertising, promotional materials, junk mail, spam, chain letters, pyramid schemes, or any other form of duplicative or unsolicited messages, whether commercial or otherwise; (iii) use the Properties to harvest, collect, gather or assemble information or data regarding other users, including e-mail addresses, without their consent; (iv) interfere with, disrupt, or create an undue burden on servers or networks connected to the Properties, or violate the regulations, policies or procedures of such networks; (v) attempt to gain unauthorized access to the Properties (or to other computer systems or networks connected to or used together with the Properties), whether through password mining or any other means; (vi) harass or interfere with any other user’s use and enjoyment of the Properties; or (vii) use software or automated agents or scripts to produce multiple accounts on the Properties, or to generate automated searches, requests, or queries to (or to strip, scrape, or mine data from) the Properties (provided, however, that we conditionally grant to the operators of public search engines revocable permission to use spiders to copy materials from the Properties for the sole purpose of and solely to the extent necessary for creating publicly available searchable indices of the materials, but not caches or archives of such materials, subject to the parameters set forth in our robots.txt file).
4.2 Enforcement. We reserve the right (but have no obligation) to investigate and/or take appropriate action against you in our sole discretion if you violate the Acceptable Use Policy or any other provision of these Terms or otherwise create liability for us or any other person. Such action may include terminating your access to or use of the Properties and/or services made available on the Properties in accordance with Section 9, and/or reporting you to law enforcement authorities.
4.3 Feedback. If you provide Pivot Health with any feedback or suggestions regarding the Properties (“Feedback”), you hereby assign to Pivot Health all rights in such Feedback and agree that Pivot Health shall have the right to use and fully exploit such Feedback and related information in any manner it deems appropriate. Pivot Health will treat any Feedback you provide to Pivot Health as non-confidential and non-proprietary. You agree that you will not submit to Pivot Health any information or ideas that you consider to be confidential or proprietary.
You agree to indemnify and hold Pivot Health (and its directors, officers, employees, and agents) harmless, including costs and attorneys’ fees, from any claim or demand made by any third party due to or arising out of (a) your use of the Properties, (b) your violation of these Terms, or (c) your violation of applicable laws or regulations. Pivot Health reserves the right, at your expense, to assume the exclusive defense and control of any matter for which you are required to indemnify us, and you agree to cooperate with our defense of these claims. You agree not to settle any matter without the prior written consent of Pivot Health. Pivot Health will use reasonable efforts to notify you of any such claim, action or proceeding upon becoming aware of it.
6.1 Our Content. Pivot Health provides the content appearing on the Properties solely for your convenience and informational purposes, and such Properties’ content (i) is not intended as a substitute for professional or financial advice; (ii) should not be construed as the provision of professional advice or recommendations; and (iii) should not be relied upon as the basis for any decision or action, including without limitation the diagnosis or treatment of any health problem, the eligibility for or appropriateness of any benefit or service, or the making of a financial decision. We are not responsible for the accuracy or reliability of any of the Properties’ content, or for expenses, losses or damages (financial or otherwise) incurred by relying upon the information presented on the Properties. The information and features included in the Properties have been compiled from a variety of sources for informational purposes and are subject to change at any time without notice.
6.2 No Professional Advice. By accessing or linking to the Properties, you assume the risk that the information on the Properties may be incomplete, inaccurate, out of date, or may not meet your needs and requirements. It is your responsibility to evaluate the accuracy, completeness, or usefulness of any content available through the Properties. The relationship between you and us is not a professional or similar relationship. Always seek the advice of a qualified professional with respect to any questions that you may have, and never disregard professional advice or postpone seeking it because of something that you have read on the Properties. We neither recommend nor endorse any specific products, services, opinions, or other content that may be made available through or mentioned on the Properties.
6.3 Third-Party Links & Ads. The Properties may contain links to third-party websites and services, and/or display advertisements for third parties (collectively, “Third-Party Links & Ads”). Such Third-Party Links & Ads are not under the control of Pivot Health, and Pivot Health is not responsible for any Third-Party Links & Ads. Pivot Health provides access to these Third-Party Links & Ads only as a convenience to you, and does not review, approve, monitor, endorse, warrant, or make any representations with respect to Third-Party Links & Ads. You use all Third-Party Links & Ads at your own risk, and should apply a suitable level of caution and discretion in doing so. When you click on any of the Third-Party Links & Ads, the applicable third party’s terms and policies apply, including the third party’s privacy and data gathering practices. You should make whatever investigation you feel necessary or appropriate before proceeding with any transaction in connection with such Third-Party Links & Ads.
THE PROPERTIES ARE PROVIDED ON AN “AS-IS” AND “AS AVAILABLE” BASIS, AND PIVOT HEALTH (AND OUR SUPPLIERS AND PARTNERS) EXPRESSLY DISCLAIM ANY AND ALL WARRANTIES AND CONDITIONS OF ANY KIND, WHETHER EXPRESS, IMPLIED, OR STATUTORY, INCLUDING ALL WARRANTIES OR CONDITIONS OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, QUIET ENJOYMENT, ACCURACY, OR NON-INFRINGEMENT. WE (AND OUR SUPPLIERS AND PARTNERS) MAKE NO WARRANTY THAT THE PROPERTIES WILL MEET YOUR REQUIREMENTS, WILL BE AVAILABLE ON AN UNINTERRUPTED, TIMELY, SECURE, OR ERROR-FREE BASIS, OR WILL BE ACCURATE, RELIABLE, FREE OF VIRUSES OR OTHER HARMFUL CODE, COMPLETE, LEGAL, OR SAFE. IF APPLICABLE LAW REQUIRES ANY WARRANTIES WITH RESPECT TO THE PROPERTIES, ALL SUCH WARRANTIES ARE LIMITED IN DURATION TO NINETY (90) DAYS FROM THE DATE OF FIRST USE. SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF IMPLIED WARRANTIES, SO THE ABOVE EXCLUSION MAY NOT APPLY TO YOU. SOME JURISDICTIONS DO NOT ALLOW LIMITATIONS ON HOW LONG AN IMPLIED WARRANTY LASTS, SO THE ABOVE LIMITATION MAY NOT APPLY TO YOU.
TO THE MAXIMUM EXTENT PERMITTED BY LAW, IN NO EVENT SHALL PIVOT HEALTH (OR OUR OR SUPPLIERS OR PARTNERS) BE LIABLE TO YOU OR ANY THIRD PARTY FOR ANY LOST PROFITS, LOST DATA, COSTS OF PROCUREMENT OF SUBSTITUTE PRODUCTS, OR ANY INDIRECT, CONSEQUENTIAL, EXEMPLARY, INCIDENTAL, SPECIAL OR PUNITIVE DAMAGES ARISING FROM OR RELATING TO THESE TERMS OR YOUR USE OF, OR INABILITY TO USE, THE PROPERTIES, EVEN IF PIVOT HEALTH HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. ACCESS TO, AND USE OF, THE PROPERTIES IS AT YOUR OWN DISCRETION AND RISK, AND YOU WILL BE SOLELY RESPONSIBLE FOR ANY DAMAGE TO YOUR DEVICE OR COMPUTER SYSTEM, OR LOSS OF DATA RESULTING THEREFROM.
TO THE MAXIMUM EXTENT PERMITTED BY LAW, NOTWITHSTANDING ANYTHING TO THE CONTRARY CONTAINED HEREIN, OUR LIABILITY TO YOU FOR ANY DAMAGES ARISING FROM OR RELATED TO THIS AGREEMENT (FOR ANY CAUSE WHATSOEVER AND REGARDLESS OF THE FORM OF THE ACTION), WILL AT ALL TIMES BE LIMITED TO A MAXIMUM OF ONE HUNDRED FIFTY US DOLLARS (U.S. $150). THE EXISTENCE OF MORE THAN ONE CLAIM WILL NOT ENLARGE THIS LIMIT. TO THE MAXIMUM EXTENT PERMITTED BY LAW, YOU AGREE THAT OUR SUPPLIERS AND PARTNERS WILL HAVE NO LIABILITY OF ANY KIND ARISING FROM OR RELATING TO THIS AGREEMENT.
SOME JURISDICTIONS DO NOT ALLOW THE LIMITATION OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES, SO THE ABOVE LIMITATION OR EXCLUSION MAY NOT APPLY TO YOU.
Subject to this Section, these Terms will remain in full force and effect while you use the Properties or any services offered on the Properties. We may suspend or terminate your rights to use the Properties at any time for any reason at our sole discretion, including for any use of the Properties in violation of these Terms. Upon termination of your rights under these Terms, your right to access and use the Properties will terminate immediately. Pivot Health will not have any liability whatsoever to you for any termination of your rights under these Terms. Even after your rights under these Terms are terminated, the following provisions of these Terms will remain in effect: Sections 2.2 through 2.6 and Sections 4 through 10.
10.1 Changes. These Terms are subject to occasional revision, and if we make any substantial changes, we may notify you by sending you an e-mail to the last e-mail address you provided to us (if any), and/or by prominently posting notice of the changes on our Properties. You are responsible for providing us with your most current e-mail address. In the event that the last e-mail address that you have provided us is not valid, or for any reason is not capable of delivering to you the notice described above, our dispatch of the e-mail containing such notice or posting of the revised terms on the Properties will nonetheless constitute effective notice of the changes described in the notice. Any changes to these Terms will be effective upon the earlier of thirty (30) calendar days following our dispatch of an e-mail notice to you (if applicable) or thirty (30) calendar days following our posting of notice of the changes on our Properties. These changes will be effective immediately for new users of our Properties. Continued use of our Properties following notice of such changes shall indicate your acknowledgement of such changes and agreement to be bound by the terms and conditions of such changes.
10.2 Dispute Resolution. Please read this Arbitration Agreement carefully. It is part of your contract with Pivot Health and affects your rights. It contains procedures for MANDATORY BINDING ARBITRATION AND A CLASS ACTION WAIVER.
(a) If, for some reason, a Dispute (defined below) arises (i) between you and Pivot Health in connection with your use of the Properties, you and Pivot Health agree to try and resolve such Dispute in good faith. If the Dispute cannot be resolved, you and Pivot Health agree that we will resolve the Dispute through individual binding arbitration in a non-representative capacity.
(b) Mandatory Arbitration and Waiver of Class Action.
(i) Instead of suing in court, you and Pivot Health are waiving the right to a trial by jury or to participate in a class action or representative action. You agree that, by entering into this Agreement, you and Pivot Health are waiving the right to a trial by jury or to participate in a class action or representative action. This agreement to arbitrate is intended to be broadly interpreted and expressly includes any claims brought under or in connection with the TCPA.
(ii) In arbitration, there is no judge or jury. Instead, a neutral third-party arbitrator resolves disputes in a less formal process than in court. In arbitration, there is limited discovery and a court review of the arbitrator’s decision is limited. However, just as a court would, the arbitrator must follow the terms of the Agreement, and can award damages and relief, including attorney’s fees authorized by law.
(c) Disputes include but are not limited to any claims or controversies against each other or in any way arising out of your use of the Properties or our services or the agreement between us, including our partners’ use of information provided by you, attempts made to contact you by us or our partners or calls, emails, text messages or faxes you actually receive from us or our partners, our policies, and contract practices and service, privacy or advertising claims, even if the claim arises after your use of the Properties or the services offered on the Properties has terminated. Disputes also include, but are not limited to, claims that: (a) you or an authorized or unauthorized user of the services or Properties bring against our employees, agents, affiliates, or other representatives; or (b) that we bring against you, but only to the extent we are or become a named party in such dispute. Disputes also include, but are not limited to, (i) claims in any way related to or arising out of the foregoing matters whether based in contract, tort, statute (expressly including any claims under or in connection with the TCPA), fraud, misrepresentation, advertising claims or any other legal theory; (ii) claims that arose before this Agreement or out of a prior agreement with Pivot Health; (iii) claims that are subject to ongoing litigation where you are not a party or class member; and/or (iv) claims that arise after the termination of this agreement. Any of the matters referenced in this paragraph is a “Dispute” for the purposes of these Terms.
(d) Before a you or Pivot Health may seek arbitration, the party must first send the others a written notice of Dispute (a “Notice”) describing the nature and basis of the claim or Dispute and the requested relief. Any Notice to Pivot Health should be sent to the address set forth in Section 10.7, below. After the Notice is received, the parties may attempt to resolve the Dispute informally. If the Dispute is not resolved within thirty (30) days of the Notice, any party may initiate arbitration.
(e) Unless you and Pivot Health agree otherwise, the arbitration will be conducted by a single, neutral arbitrator and will take place in the capital city of the state in which you resided at the time you accessed the Properties and/or used the services offered on the Properties. The arbitration will be governed by either: (a) rules that we mutually agree upon; or (b) the JAMS Comprehensive Arbitration Rules & Procedures (the “JAMS Rules”), as modified by this agreement to arbitrate, including the rules about the filing, administration, discovery and arbitrator fees. The JAMS Rules are available on the JAMS website at www.jamsadr.com. Notwithstanding any JAMS Rule to the contrary or any other provision in arbitration rules chosen, by agreement, to govern the arbitration, we each agree that all issues regarding the Dispute are delegated to the arbitrator to decide, except that only a court (and not the arbitrator) shall decide any disagreements regarding the scope and enforceability of this agreement to arbitrate.
(f) The Federal Arbitration Act (“FAA”) applies to this agreement and this arbitration provision. We each agree that the FAA’s provisions—not state law—govern all questions of whether a Dispute is subject to arbitration. To the extent that this agreement to arbitrate conflicts with the JAMS Policy on Consumer Arbitrations Pursuant to Pre-Dispute Clauses Minimum Standards for Procedural Fairness (the “Minimum Standards”), the Minimum Standards in that regard will apply. However, nothing in this paragraph will require or allow you or Pivot Health to arbitrate on a class-wide, representative or consolidated basis.
(g) The arbitrator may award declaratory or injunctive relief only in favor of the individual party seeking relief and only to the extent necessary to provide relief warranted by that party’s individual claim. YOU AND PIVOT HEALTH AGREE THAT EACH MAY BRING CLAIMS AGAINST THE OTHER ONLY IN AN INDIVIDUAL CAPACITY, AND NOT AS A CLASS MEMBER IN ANY PUTATIVE CLASS OR REPRESENTATIVE PROCEEDING. Further, unless both you and Pivot Health expressly agree otherwise, the arbitrator may not consolidate more than one person’s claims, and may not otherwise preside over any form of a representative or class proceeding. If any portion of this provision is found to be unenforceable, then the entirety of this arbitration provision shall be null and void.
(h) You and Pivot Health are each responsible for your respective costs, including counsel, experts, and witnesses. Pivot Health will pay for any filing or case management fees associated with the arbitration and the professional fees for the arbitrator’s services.
(i) An arbitrator’s award will be a written statement of the disposition of each claim and will also provide a concise written statement of the essential findings and conclusions which form the basis of the award. The arbitrator’s decision and award is final and binding, with some limited court review under the FAA, and judgment on the award may be entered in any court with jurisdiction.
(j) As an alternative to arbitration, we may resolve Disputes in small claims court in the county where you resided at the time you accessed the Properties and/or used the services offered on the Properties. In addition, this arbitration agreement does not prevent you from bringing your Dispute to the attention of any federal, state, or local government agency. Such agencies can, if the law allows, seek relief against Pivot Health on your behalf.
(k) IF FOR ANY REASON A CLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT IN ANY WAY PROCEEDS IN COURT RATHER THAN IN ARBITRATION, REGARDLESS OF WHETHER THE CLAIM IS AN ACTION, COUNTERCLAIM OR ANY OTHER COURT PROCEEDING, WE EACH AGREE THAT TO THE EXTENT ALLOWED BY LAW, THERE WILL NOT BE A JURY TRIAL OR CLASS ACTION AND WE EACH UNCONDITIONALLY (1) WAIVE ANY RIGHT TO TRIAL BY JURY AND (2) WAIVE ANY RIGHT TO PURSUE DISPUTES ON A CLASSWIDE BASIS, INCLUDING JOINING A CLAIM WITH THE CLAIM OF ANY OTHER PERSON OR ENTITY OR ASSERTING A CLAIM IN A REPRESENTATIVE CAPACTITY ON BEHALF OF ANYONE ELSE IN ANY OTHER PROCEEDING.
10.3 Export. The Properties may be subject to U.S. export control laws and may be subject to export or import regulations in other countries. You agree not to export, reexport, or transfer, directly or indirectly, any U.S. technical data acquired from Pivot Health, or any products utilizing such data, in violation of the United States export laws or regulations.
10.4 Electronic Communications. Communications between you and Pivot Health may use electronic means, whether you use the Properties or send us emails, or whether Pivot Health posts notices on the Properties or communicates with you via email. For contractual purposes, you (a) consent to receive communications from Pivot Health in an electronic form; and (b) agree that all terms and conditions, agreements, notices, disclosures, and other communications that Pivot Health provides to you electronically satisfy any legal requirement that such communications would satisfy if they were a hardcopy in writing. The foregoing does not affect your non-waivable rights.
10.5 Entire Terms. These Terms constitute the entire agreement between you and us regarding the use of the Properties. Our failure to exercise or enforce any right or provision of these Terms shall not operate as a waiver of such right or provision. The section titles in these Terms are for convenience only and have no legal or contractual effect. The word “including” means “including without limitation”. Except as otherwise expressly set forth herein, if any provision of these Terms is, for any reason, held to be invalid or unenforceable, the other provisions of these Terms will be unimpaired and the invalid or unenforceable provision will be deemed modified so that it is valid and enforceable to the maximum extent permitted by law. Your relationship to Pivot Health is that of an independent contractor, and neither party is an agent or partner of the other. These Terms, and your rights and obligations herein, may not be assigned, subcontracted, delegated, or otherwise transferred by you without Pivot Health’s prior written consent, and any attempted assignment, subcontract, delegation, or transfer in violation of the foregoing will be null and void. Pivot Health may freely assign these Terms. The terms and conditions set forth in these Terms shall be binding upon assignees.
10.6 Copyright/Trademark Information. Copyright © 2024, Pivot Health Holdings LLC All rights reserved. All trademarks, logos and service marks (“Marks”) displayed on the Properties are our property or the property of other third parties. You are not permitted to use these Marks without our prior written consent or the consent of such third party which may own the Marks.
10.7 Contact Information:
4829-0158-5856, v. 1
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IMPORTANT NOTICE ABOUT SHORT-TERM PLANS:
This coverage is not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your Policy/Certificate carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). Your Policy/Certificate might also have lifetime and/or annual dollar limits on health benefits. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage.
About the Cigna PPO Network†
Pivot Health is an independent company and is not an affiliate of Cigna. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna name, logo and other Cigna marks are owned by Cigna Intellectual Property, Inc.
† The Cigna PPO Network refers to the network of providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO Network for Shared Administration, provider counts as of November 1, 2018. Data is subject to change.
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Empowering health coverage at every life turn.
Disclaimer:
This coverage is not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your Policy/Certificate carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services).
Your Policy/Certificate might also have lifetime and/or annual dollar limits on health benefits. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage. Also, this coverage is not “minimum essential coverage.
This plan has a pre-existing limitation provision that may prevent coverage from applying to medical conditions that existed prior to the plan effective date.
PivotHealth.com is the website domain of PivotHealth Holdings, LLC (Pivot Health), a wholly-owned subsidiary of HealthCare, Inc. This website serves as an invitation for you, the customer, to inquire about further information regarding health insurance, and submission of your contact information constitutes permission for an agent to contact you with further information, including complete details on cost and coverage of insurance.
Pivot Health develops and markets a portfolio of proprietary health insurance and supplemental insurance products under the Pivot Health brand in addition to serving as a licensed broker under PivotHealth Holdings, LLC. Pivot Health may earn revenue for clicks, calls and insurance applications generated, and may be compensated by its advertisers for sponsorship. Compensation may impact where and in what order insurance products appear. Pivot Health’s platforms do not include all health insurance companies or all available insurance products.
For assistance with Medicare plans dial 844-231-3417
For other plans please dial 866-967-3416
