Terms of Use

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Legal

Information on this website may not reflect the most recent transactions or account balances.

Terms of Use

By using Simply Healthcare Plans, Inc. (Simply) and its affiliates (collectively Simply) provider website, you agree to abide by the following terms of use, which are in addition to any general requirements listed on the Simply website or any website operated for or on behalf of a Simply subsidiary.

Encryption

To ensure the security of valuable and personal information, users of the website may only access our services using a browser equipped with 128-bit encryption or higher.

Use of material

The contents of this website are protected by copyright. The collective work of this website may also include work that is the property of others, which work is also protected by copyright or other intellectual property laws. Unauthorized use may violate copyright, trademark and other laws. Simply authorizes you to view and download material on the website solely for your own use. You must keep all copyright and other proprietary notices on any copies you make. You may not sell or modify the material or otherwise use it for any public or commercial purpose.

You will not use this website in violation of any laws including, without limitation, those pertaining to the fraud and abuse or anti-kickback provisions of the federal Medicare and Medicaid laws. Any advertisement, links with other websites, co-hosts or references to third parties are not endorsements of such third parties’ products or services and are not intended to result in any referrals or compensation to you or Simply.

Use of information and resources

Simply makes this site available for the sole purposes of providing general educational information on health-related issues and providing access to health-related resources. This site and its health-related information and resources are not intended to be a substitute for professional medical advice or for the care that patients receive from their physicians. Nothing in this site is intended to be used for medical diagnosis or treatment. Always seek the advice of your physician before beginning any new treatment or if you have any questions regarding a medical condition. You should not disregard medical advice or delay seeking medical advice because of something you read in this site.

This site and its health-related information and resources are not intended, and must not be taken, to be the rendering of medical, nursing, or professional health care advice or services, or the practice of medicine, nursing, or professional health care, in any jurisdiction. Additionally, Simply is not responsible for information provided by health information content providers, third-party sites linked to or framed by the website or third-party sites, and does not make any representations regarding the content, accuracy or timeliness of any of such information.

By health-related information, we mean the health-related, medical, and wellness information available through the website that includes but is not limited to text, graphics, video and images; information created by health information content providers, licensors, suppliers and other third parties; advertisements; and any other material, information or health information content accessible on third-party websites to which Simply may have links.

Provider finder

Simply has made reasonable efforts to validate that its lists of providers displayed are up-to-date and accurate. Please call the provider prior to scheduling an appointment to verify that the provider continues to be part of the network. Simply shall not be liable for any losses, damages or noncovered charges as a result of using the provider locator tool or receiving care from a provider listed on our site.

Caregiver access

Simply allows you to authorize a designated individual to view and edit your Simply member information as it appears on the website (caregiver access). This ability is subject to your acceptance of the specific terms that accompany the caregiver access function (contained in the relevant section of this website).

Out of network reimbursement

It is important to understand how in-network providers may be able to help you save money. In network doctors, health care professionals, dentists and X-ray laboratories have agreed in a contract with us to accept specific amounts for various covered services. Because there is no similar contract with out-of-network providers, absent of regulation or law, out-of-network providers may not be able to provide services to you unless they receive a prior authorization from Simply.

Services provided by doctors, health care professionals, dentists and X-ray laboratories who have not contracted to treat members (nonparticipating providers) and who do not receive prior authorization from Simply may not be considered covered benefits. Providers may seek to hold you financially liable for noncovered benefits. If that occurs, providers should notify you in advance that you will be financially liable for these noncovered benefits. In that event, such providers may seek to hold you responsible for their full billed charges and not just the amounts that would be due from Simply for covered benefits to a participating provider.

Medicare plans

The Medicare Advantage and Medicare Part D plans are health plans with a Medicare contract or a standalone prescription drug plan with a Medicare contract. The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed.

Passwords and account

Your username and password (collectively, the password) will allow you to access the website and certain information about you or your plan. Your password is the exclusive property and confidential information of Simply and may be used solely for your individual use of and access to the website. You are solely responsible for controlling your passwords and for authorizing, monitoring and controlling access to your account. You are prohibited from distributing, providing or otherwise making available your password to any third party and are responsible for all activities that occur under your password. You agree to notify Simply immediately of any unauthorized use of your password or of any need to deactivate the password associated with your account.

Linking to other sites

From time to time, we provide links to other websites not owned or controlled by Simply. We do this because we think this information might be of interest or use to you or where, as a member, we can provide you with value-added services. While we do our best to ensure your privacy, we cannot be responsible for the privacy practices of other sites. A link to a non-Simply website does not constitute or imply endorsement by Simply. Additionally, we cannot guarantee the quality or accuracy of information presented on non-Simply websites. We encourage you to review the privacy practices of any website you visit.

Appropriateness of content

This website is not intended to attract children under the age of 13. We do not collect personal information from any person we know is under the age of 13. Some of the content on this website may not be appropriate for children. Parents or guardians are solely responsible for providing supervision of minors’ use of the Simply website.

Your submissions

Generally, communications that you post to the website are not confidential. If particular webpages permit the submission of communications that will be treated by Simply as confidential, that fact will be stated on those pages. You are responsible for your own communications and the consequences of such posting.

You may not:

• Communicate material that is copyrighted, without the permission of the copyright owner.
• Communicate material that reveals trade secrets, unless you have permission of the owner.
• Communicate material that infringes on any other intellectual property rights of others or on the privacy or publicity rights of others.
• Communicate material that is obscene, defamatory, threatening, harassing, abusive, hateful or embarrassing to any person or entity.
• Communicate a sexually explicit image.
• Communicate chain letters or pyramid schemes.
• Impersonate another person.
• Violate the Children’s On Line Privacy Protection Act.

Simply does not represent or guarantee the truthfulness, accuracy or reliability of any communications posted by other users or endorse any opinions expressed by other users. Any reliance on material posted by others is at your own risk.

Digital Millennium Copyright Act

Simply respects the intellectual property of others and expects users of our services to do the same. If you believe that your copyrighted work has been copied in a way that constitutes copyright infringement and is accessible on this site or through this service, you must provide the following information when providing notice of the claimed infringement to Simply:

• A physical or electronic signature of a person authorized to act on behalf of the copyright owner and identification of the copyrighted work that is infringed
• Information reasonably sufficient to permit Simply to contact you, such as an address, telephone number and electronic mail address
• A statement that you have a good faith belief that the use of the material in the manner complained of is not authorized by the copyright owner, its agent or law
• A statement that the information in the notification is accurate and under penalty of perjury, that the complaining party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed

The above information must be submitted as a written notification to Simply through Member Services at the toll-free number on the front of the member ID card or by writing us at:

Simply Healthcare Plans, Inc.
Legal Department/DMCA Complaint
120 Monument Circle
Indianapolis, IN 46204

This information should not be construed as legal advice. For further details on the information required for valid DMCA notifications, see 17 U.S.C. 512(c)(3).

Privacy and security

The Simply privacy statement describes the type of information Simply and its licensors and suppliers collect from you when you visit the website and how Simply uses that information. You can review the Simply privacy statement by clicking on the Privacy button on the Log In Screen, or by going to www.simplyhealthcare.com and selecting the Privacy link at the bottom of the page.

Liability of Simply and its licensors and suppliers

No liability. Simply and its licensors and suppliers (including, for the purposes of this entire section, all providers of content for this website) shall not be liable to you, under any circumstances or under any theory of liability or indemnity, for any damages or penalties whatsoever (including, without limitation, incidental indirect, exemplary, punitive and consequential damages; lost profits; or damages resulting from lost data or business interruption) in connection with the use or inability to use this site or the content even if any of them have been advised of the possibility of such damages. Simply shall be liable to you only to the extent of actual damages incurred by you. The remedies stated for you in these terms and conditions are exclusive and are limited to those expressly provided for in these terms and conditions.

Simply and its licensors and suppliers are not responsible for any claims you may have against any medical professionals; suppliers of products; or other persons, institutions or entities identified in whole or in part through this website.

No Warranties. The site, services, content and information are provided as is. Simply, its licensors and suppliers disclaim all warranties of any kind, whether express or implied, statutory or otherwise, including but not limited to the implied warranties of merchantability, noninfringement of third parties’ rights or fitness for a particular purpose.

Simply, its licensors and suppliers make no representations or warranties that the information in or links or searches conducted through this site is complete, exhaustive, reliable, current or accurate. No claims or endorsements are made for any drug, herb, supplement, compound, therapy or treatment.

Limitations

The descriptions of Simply products and services contained in the website are not offers to sell or solicitations for any product or service. Simply is not licensed to sell products and services in all states. The descriptions of products and services contained on the website are offered as a convenience and do not contain all of the terms, conditions, limitations and exclusions that may be applicable.

Termination

Simply may terminate user rights to use this site at any time. Simply reserves the right to block, delete or stop the uploading of materials and communications that it in its sole discretion finds unacceptable for any reason. Your right to use this site will end at the close of your membership in the Simply plan. If your right to use this site ends, you shall make no further use of this site or any information obtained from this site.

Changes to This Terms of Use Statement

Simply may revise, modify or amend these terms of use at any time. Any such revision, modification or amendment shall be effective immediately upon either posting it to the website or otherwise notifying you.

Miscellaneous

Simply Healthcare Plans, Inc. is a subsidiary of Anthem, Inc., which is based in Indianapolis, Indiana, in the United States of America and makes no claims that the content and information included at this site is appropriate or may be downloaded outside of the United States. Access to the content and information included at this site may not be legal by certain persons or in certain countries. If you access this site from outside the United States, you do so at your own risk and are solely responsible for compliance with the laws of your jurisdiction and any other applicable laws.

This user agreement shall be governed and construed in accordance with the laws of the state of Indiana without regard to the choice of law provisions of any jurisdiction. Simply may — without notice to you — assign its rights and duties under this agreement to any party at any time. Failure to enforce or insist on strict performance of any provision of this agreement shall not be construed as a waiver of any provision or right. You agree that any legal action or proceeding between Simply and you in any way related to this agreement shall be brought exclusively in a court of a competent jurisdiction sitting in Indianapolis, Indiana. Any cause of action or claim you may have against or involving Simply must be commenced within one year after the claim or cause of action arises. Neither the course of conduct between the parties nor trade practice shall modify the provisions of this agreement. The invalidity or unenforceability of any provision shall not in any way affect the validity or enforceability of the rest of this agreement. This agreement constitutes the entire agreement between you and Simply, and it supersedes all prior agreements, representations, proposals and other communications with respect to the Simply website and content.

Notices

To the extent that the law and any applicable regulation allows for the provision of notice electronically, and further provide that any group health plan agreement by which you are covered does not require notice by mail, you hereby agree to receive all such notices electronically, including but not limited to notices required by state or federal privacy laws, and all financial information pertinent to, or required in connection with the operation of, your account at this online health site. By accepting the terms of this agreement, you are acknowledging receipt of all privacy notices linked to this site as a necessary step to obtaining the services in connection with this plan and health site.

Questions

If you have questions and comments, or if you believe that your confidentiality has been breached or that any of your communications have been intercepted, or you wish to notify us regarding a suspected violation of these terms, please call Member Services at Simply immediately at the toll free number on the back of the member ID card.