Legal

Premier Health Solutions, LLC (“PHS”) is a Texas-based insurance agency and third party administrator (“TPA”) that provides comprehensive benefits administration, management services and TPA services to agents, associations and carriers nationwide.  Our licensed internal agents, and the licensed third-party call center agents who contract with us, sell various insurance and non-insurance products to consumers (“Individuals”) throughout the United States.  We also bill, collect and remit insurance premium on behalf of our association and carrier partners.

Almost all insurance sales are conducted telephonically and include a recorded verification script which is required with each sale. The purpose of this recorded verification call is to ensure that the Individual understands, among other things, what product they are purchasing, what benefits are included with that product, how much they are paying at the initial time of sale, how much they will pay monthly thereafter, and that all subsequent monthly payments will be automatically drafted from the credit or banking account provided by the Individual.

Each Individual agrees that they are signing up for benefits, products or services that include an automatic payment plan. Each Individual expressly authorizes PHS to automatically debit their bank account or Credit Card on the payment due date provided to collect any and all fees for their membership(s), product(s) or plan(s). Each Individual acknowledges and agrees upon the membership(s), product(s) or plan(s) effective date and the initial payment amount (this is comprised of the first month’s premiums and, if applicable, the association’s monthly membership dues, plus a one-time, enrollment processing fee (which may or may not be non-refundable, depending on the membership(s), product(s) or plan purchased). Each Individual also acknowledges and agrees that their monthly premiums and, if applicable, the association’s monthly membership dues, will be automatically charged or drafted every month from the credit card, debit card or bank account they provide to us. Further, each Individual attests that they are the holder of the credit card, debit card or bank account provided to us for payment of the membership(s), product(s) or plan(s) purchased.

Each Individual may cancel automatic payments at any time by calling Customer Service at (855) 351-7535. Each Individual understands that they may terminate the scheduled payments by providing written notification to the Customer Service team five (5) business day prior to the next scheduled payment date.  This advance notice allows processing time to ensure the termination occurs prior to the next scheduled payment date.  Automatic payment termination cannot be guaranteed with respect to notice provided outside of this window.  Each Individual understands and agrees that the insurance agent or broker, if any, who assisted or is assisting the Individual with any insurance application, is a representative of the Individual. If an application acknowledgment is signed by a representative of the Individual, the signatory represents his/her capacity to so act.

If an Individual is not satisfied with their membership(s), product(s) or plan(s), depending on the membership(s), product(s) or plan(s) purchased, they may cancel within ten (10) to thirty (30) days from their membership’s effective date and they may be eligible to receive a full refund on the monthly membership dues collected for that month.  Please review your member, product or plan materials or call Customer Service at (855) 351-7535 to confirm the cancellation notification period required.  All cancellations must be directed to Customer Service. Cancellations are processed Monday–Thursday from 8 a.m. – 5 p.m. Central Standard Time (“CST”) and Friday 8 a.m. – 4 p.m. CST.  All cancellation requests must be made five (5) days prior to the billing date in order to cancel the membership, product or plan, as applicable, for that month. This advance notice allows processing time to ensure the cancellation occurs prior to the next scheduled payment date.  Cancellations cannot be guaranteed with respect to notice provided outside of this window.  If a cancellation request is received on or after the recurring billing date and the payment has been drafted, the membership, product or plan will terminate prior to the next billing date and the Individual will be covered through the next month. Each Individual acknowledges and understands that the one-time enrollment fee may be non-refundable.  The PHS billing department will aggressively rebut and dispute any cancellation attempts made by Individuals via a “friendly” fraud chargeback, or similar—especially if there is no documentation in the Individual’s record of an effort made by the Individual to resolve the issue by first contacting Customer Service.

By submitting a claim to the applicable vendor or carrier during the first ten (10) to thirty (30) days (time limit is dependent upon membership[s], product[s] or plan[s] purchased) under any of the membership(s), product(s) or plan(s) purchased, each Individual acknowledges and agrees that such a submission constitutes acceptance of the membership, product or plan, and their terms and submission of such a claim constitutes a waiver of any and all refund rights, including those noted in the foregoing paragraphs.

Each Individual acknowledges and agrees that some of the benefits purchased may have pre-existing condition limitations and also may not be considered “minimum essential coverage” under the federal Affordable Care Act and therefore, depending upon each Individual’s family and financial situation, the Individual may be subject to the individual shared fee.  Only certain major medical products are compliant with the Affordable Care Act.  It is the Individual’s responsibility to read their materials and certificates thoroughly to ensure a comprehensive understanding of the membership(s), product(s) or plan(s) purchased.  Call Customer Service at (855) 351-7535 if there are any questions.

Each Individual acknowledges and agrees that if there is any discrepancy between what they thought the selling Agent told them about the membership(s), product(s) or plan(s) purchased and what the actual materials or policy states, the materials and policy terms govern. EACH INDIVIDUAL IS STRONGLY ENCOURAGED AND ADVISED TO READ ALL POLICY, AND IF APPLICABLE, MEMBERSHIP MATERIALS CAREFULLY AND TO GO OVER ANY QUESTIONS OR CONCERNS WITH THEIR AGENT, A FAMILY MEMBER, OR A TRUSTED INDIVIDUAL WHO MAY BETTER UNDERSTAND SUCH POLICY OR MEMBERSHIP MATERIALS.

By enrolling in the membership(s), product(s) or plan(s), each Individual agrees to receive their materials and policy information via email, in addition to important notifications regarding their membership or plan, as applicable.

Each Individual acknowledges and agrees that they will receive a “welcome” email within 24 hours of their membership(s), product(s) or plan(s) enrollment, which will include the membership, product or plan information purchased. Individuals may have the ability to download all materials, including ID cards, and depending on the membership(s), product(s) or plan(s) purchased, may also receive official cards in the mail. It is each Individual’s responsibility to thoroughly review all materials furnished, whether it be via email, regular mail or other means. Questions can be directed to Customer Service at (855) 351-7535.

NOTICE OF VOICE CONSENT AND CONSENT TO ELECTRONIC TRANSACTIONS, SIGNATURES AND DOCUMENTS

Each Individual consents and agrees that their voice consent shall serve as their signature.  Each Individual agrees they will be fully responsible for reviewing their application carefully to ensure their full understanding of all provisions of the membership, product or plan coverage, as applicable.

Each Individual consents and agrees to the use of electronic signatures of documents (collectively, with the foregoing paragraph, the “Authorization”).  I understand and agree that an electronic or typed signature has the same legal effect and can be enforced in the same way as a written or manual signature.  I agree that, by using this website and by purchasing any membership(s), product(s) or plan(s) by or through PHS, my agreement or consent to do, either by voice or electronic means, shall be legally binding and enforceable.

Each Individual agrees that this Authorization may be terminated by the Individual or the Company at any time and for any reason by providing written notice of such termination to the nonterminating party and may be terminated by the Company immediately if any debit is not honored by the depository named for any reason. Each Individual further understands and agrees that PHS shall incur no liability if the credit card company or banking institution dishonors any amount charged under this Authorization and may terminate this Authorization immediately if any charges are not paid. Each Individual agrees to hold PHS harmless against any liability pursuant to this Authorization.

Premier Health Solutions, LLC markets and sells under the name PHSI Insurance Agency, LLC in California and under the name PremierHS, LLC in Kentucky, Ohio, Pennsylvania, South Carolina and Utah.