Membership Agreement
Last updated: 09/29/2022
Hoag Compass Membership Program Agreement
This Hoag Compass Membership Program Agreement (the “Agreement”) sets forth the terms of your membership in the concierge medical program (the “Program”) offered by Hoag Memorial Hospital Presbyterian (the “Company”). The Program is designed to offer you a more personalized approach to your health care experience.
- The Program.
The Program offers a broad range of amenities and enhancements (set forth on Exhibit A and called the “Enhancements”), including nutritional services, and wellness services. The Enhancements are not professional services and do not include items or services that are covered by health insurance plans. In addition to the amenities and practice enhancements on Exhibit A, the Company will arrange for Hoag Clinic (“Hoag Clinic”) and its physicians and other care providers (the “Providers”), to provide you with professional services.
The Company does not engage in the practice of medicine, nor does it provide any diagnostic, therapeutic or clinical services. No act or service required or permitted to be rendered by the Company pursuant to this Agreement should be construed or deemed to constitute the practice of medicine or any clinical profession for which a professional license is required. The Company will work with Hoag Clinic to arrange for professional services to be provided to you by Hoag Clinic’s Providers. Your Providers retain full and free discretion to exercise their professional medical judgment on your behalf. Nothing in this Agreement is intended to affect or limit any Provider’s professional judgment. Hoag Clinic will bill you and your health insurance plan separately for any professional services it provides to you. This Agreement governs only your access to and use of the Enhancements offered by the Company.
- Membership Fees.
The Company charges a Membership Fee for access to the Enhancements. Payment of the Membership Fee to the Company is a condition of your membership, but is not a requirement to receive medical services from Hoag Clinic. The Membership Fee does not cover or pay for any professional services provided by Hoag Clinic. Certain members may have access to the Enhancements through their employers or other organizations, and as a result, the terms relating to payment of the Membership Fee will not apply to such members until such time that their employer or other organization terminates its arrangement with the Company. Hoag Clinic participates with one or more health plans, and accepts payment from those plans as payment in full for its professional services, subject to applicable deductibles, co-payments and co-insurance. Hoag Clinic will separately bill you or your health insurance plan for the professional services rendered to you by Hoag Clinic.
Membership options, and your Membership Fee, may change from time to time. You will receive at least thirty (30) days’ advance written notice of any such changes.
Your Membership Fee will be payable in the manner set forth in Section 3 of this Agreement. The initial payment must be made before your membership in the Program commences. Once paid, your Membership Fee payments are non-refundable, except as set forth in this Agreement.
You understand and agree that this Agreement is a service contract and not a contract of insurance. This Agreement does not meet any individual health insurance mandate that may be required under state or federal law. While you may, in your discretion, submit the Membership Fee for reimbursement to a flexible spending account, health reimbursement account, or medical savings account of your employer in which you participate, the Company makes no representation that any part of the Membership Fee will qualify to be reimbursed from any such account.
- Subscription Billing.
In order to participate in the Program, your Membership Fee payments will be charged to your credit card on a recurring basis. You hereby agree to allow the Company to securely store your credit/debit card information (the “Payment Method”). You agree and authorize the Payment Method to be billed automatically in accordance with the amount equal to the Membership Fee in effect for your Program, at the time of initial payment and each subsequent renewal, until you terminate this Agreement. If a credit card account is being used to pay an amount due to the Company, the Company may obtain preapproval for the amount due. If you want to designate a different Payment Method or if there is a change in your Payment Method information, you should contact Payment Financial Services at 949-764-8400, or by email at PFS@hoag.org. This may temporarily delay your ability to make online payments while the Company verifies the new payment information. You represent and warrant that: (i) any credit/debit card information you supply to the Company is true, correct and complete; (ii) charges you incur will be honored by your credit/debit card company; (iii) you will pay the charges incurred in the amounts posted, including any applicable taxes; and (iv) you are the person in whose name the credit/debit card was issued and are authorized to make purchase or other transactions with the relevant credit/debit card and information.
If the Company is unable to secure funds from your credit/debit card(s) for any reason, including, but not limited to, insufficient funds in the credit/debit card or insufficient or inaccurate information provided by you when submitting electronic payment, the Company may undertake further collection action, including application of fees to the extent permitted by law. The Company may also suspend your membership in the Program if any payment due to the Company hereunder is past-due by thirty (30) days, or the Company may terminate this Agreement.
You have the right to revoke this authorization by contacting the Company at Payment Financial Services at 949-764-8400, or by email at PFS@hoag.org, at least fifteen (15) days prior to the scheduled payment date. You understand that your membership in the Program may be cancelled or suspended if you revoke this authorization, and you remain responsible for all charges you incur or otherwise owe to the Company. This authorization will remain in full force and effect until revoked by you.
- Term and Termination.
Unless it is terminated earlier in accordance with the subsequent paragraph, the initial term of this Agreement will be for one (1) year, beginning on the date that you execute this Agreement and the Company receives your initial Membership Fee payment (the “Initial Term”). Thereafter, this Agreement will automatically renew for successive one (1) year periods (each, a “Renewal Term”), unless either you or the Company notifies the other in writing, not less than thirty (30) days prior to the effective date of termination, of the notifying party’s desire to terminate this Agreement. In the event that the Company has provided you timely notice of a change in your membership Program or Membership Fee in accordance with the terms of Section 2, above, then, unless you have provided notice of your desire to terminate the Agreement, the change in membership Program or Membership Fee will be incorporated into this Agreement beginning at the start of the applicable Renewal Term.
Either you or the Company may terminate this Agreement at any time, with or without cause, upon thirty (30) days’ prior written notice. In the event of your death, this Agreement will immediately terminate. The foregoing notwithstanding, in the event your Provider becomes unavailable during the term of this Agreement due to illness or other disability, you agree that you will not be entitled to a refund of any portion of the Membership Fees previously paid by you.
- Additional Terms.
By providing your email address below, you agree to receive electronic communications via email. You may also elect to receive electronic communications via phone or SMS text messaging by signing the Conditions of Treatment form.
If you are purchasing a membership Program on behalf of, and as a parent or legal guardian of, a minor, such minor will be treated as a Member hereunder and you will be responsible for their adherence to this Agreement. The Company will comply with state and federal rules relating to the confidentiality of any information about such minor received by the Company in connection with the Membership.
All services contemplated hereunder shall be governed by the Company’s policies of general or specific applicability, which are subject to change from time to time. This Agreement, including the exhibits hereto, sets forth the entire agreement between the parties with regard to the subject matter hereof, and supersedes all prior or contemporaneous oral or written agreements regarding the same subject matter. Except as expressly set forth herein, this Agreement may be amended only in a writing signed by the parties.
This Agreement may be executed electronically in one or more counterparts, all of which together shall constitute only one agreement.
□ ACCEPT. By clicking “Accept”, I acknowledge that I have carefully read, understand, and agree to the terms of this Hoag Compass Membership Program Agreement.
Patient’s Name: [INSERT] Date: [INSERT]
Exhibit A
Program Enhancements
All individuals using Hoag Compass at Hoag Compass-enabled location(s) will receive access to the following:
- Paperless check-ins
- Access to same-day sick appointments
- Access to in-clinic lab services
- Live support and coordination for Hoag Urgent Care visits
- Pharmacy Delivery* (Pending confirmation prior to launch)
In addition to the services listed above, Members who pay the Membership Fee will receive the following Enhancements at Hoag Compass-enabled location(s):
- Full access to Hoag Compass, our digital care plan platform
- Personalized Care Plan led by your Physician
- Unlimited health coaching via Registered Dietitian, Exercise Physiologist, and Mindfulness Coach
- Personal, dedicated care coordinator to assist with managing your care, scheduling, coordinating insurance coverage, connecting you with other health care providers, and providing education.
- Access to our Premier Lounge
- Access to our Private Vitals Pod
- Access to our Virtual Visit Rooms