Terms and Conditions

1. Acceptance of terms of use

By registering to use this website and secure services you agree unconditionally to accept the following terms of use. If you do not agree to these terms of use, you will not be allowed to register to use these services.

This website ("website") is hosted by Capital Blue Cross for itself or one of its subsidiaries, such as Keystone Health Plan® Central, Capital Advantage Insurance Company® and Capital Advantage Assurance Company®. The Capital Blue Cross website may also provide access to websites that are hosted by 3rd parties such as, for example, National Vision Administrators, L.L.C. This website and the secure services shall be referred to collectively as the "services". The services include, but are not limited to, access to your account information, and other applications, information and activities exchanged or conducted via this website. Capital Blue Cross and, if applicable, the Capital Blue Cross subsidiary or third party that sponsors this website are sometimes referred to collectively as the "company".

The company reserves the right to change or modify any of these terms of use and any policy or guideline incorporated by reference at any time in our sole discretion. Any change or modification will become effective upon posting the revisions on the website. You are therefore advised to return to this page of the website periodically. If you do not agree to the terms of any modification, immediately discontinue any and all use of the services. Your continued use of the services following the posting of any change or modification in the terms of use constitutes your acceptance of any such changes or modifications. If you have any concerns or questions regarding such changes or modifications, please contact us at 800.962.2242. For your information, the date of the last update to these terms of use is listed at the top of this document. Your use of the website is also subject to the company's terms of service for the website and privacy statement which are incorporated herein by reference and which may be accessed on the home page of this website by clicking the legal and privacy statement links.

2. Intellectual property

Copyrights:

All of the content included on this website (the "content") is the property of the company and is protected by U.S. and international copyright laws. Except as granted in the limited license below, any use of such content, including modification, transmission, presentation, distribution or republication, is prohibited without the express prior written consent of the company.

Trademarks:

All trademarks, trade names, logos, brand names and service marks (the "marks") of the company, whether registered or unregistered, are the property of the company and are protected by U.S. and international trademark laws. All other marks appearing on the website are the property of their respective owners. Except as granted in the limited license below, nothing contained on the website should be construed as granting any license or right to use any of the marks displayed on the website without the express written permission of the company or such third-party that may own such marks.

Limited license:

As a user of the website, the company authorizes you to download or access the content solely for your own interactions with the company. This limited license is nonexclusive, nontransferable, and revocable at any time. If you violate any provision of these terms of use, your permission to use such content automatically terminates and you must immediately destroy any copies you have made of any portion of such content. This website or any portion thereof may not be reproduced, duplicated, copied, sold, resold, or otherwise exploited for any commercial purpose that is not expressly permitted by the company.

3. Legal notices

Security disclaimer:

The company works to protect this website and make it as secure as possible. Please be aware, however, that unauthorized third parties may possibly obtain illegal access to this website, and may gain access to any transmissions sent or received by any party. By agreeing to these terms of use, you acknowledge that any communications may be illegally accessed by third parties, and that the company is not responsible for any such security breaches.

Medical liability disclaimer:

The medical content on this website is for general informational purposes only and is not intended to provide individualized medical diagnosis, treatment or advice. Reliance on information provided on this website is solely at your own risk. Never disregard professional medical advice, or delay seeking it, because of something you have read on this website. If you have a medical emergency, call your physician or 911 immediately. Do not use this website for medical emergencies.

General disclaimers:

The company does not represent or guarantee the reliability, completeness, timeliness, or accuracy of any content provided by the website. Nor does the company make any representations whatsoever regarding the results to be obtained from using the website. The content may contain typographical errors or inaccuracies. Changes are periodically made to the content, and may be made at any time, without notice.

All content, products, and advice provided through the website, including all text, graphics, links, animation, and "cookies," are provided on an "as-is" basis without any warranties of any kind, either express or implied.

To the maximum extent permitted by law, the company disclaims all representations and warranties, express or implied, including, but not limited to: warranties of merchantability, fitness for a particular purpose, title, non-infringement of third parties' rights, freedom from computer virus strains and implied warranties arising from course of dealing or course of performance.

The company does not warrant that the website will operate error-free or that the website and its server are free of computer viruses and other harmful files. If your use of the website or the content results in the need for servicing or replacing equipment or data, the company is not responsible for those costs.

Limitation of liability:

In no event shall the company, or any of its members, shareholders, affiliates, directors, managers, employees, content providers or representatives, be liable for any damages whatsoever (including, without limitation, direct, indirect, special, incidental, punitive and consequential damages, lost profits, or damages resulting from lost data or business interruption) resulting from the use or inability to use the website or any malfunctions, breakdowns, delays or compatibility problems with respect to the website, whether based on warranty, negligence, strict liability, or other tort theories, contract, patent or copyright laws, or any other legal theory, regardless of whether the company is advised of the possibility of such damages.

When using the website, information will be transmitted over a medium which may be beyond the control and jurisdiction of the company and its suppliers. Accordingly, the company shall not assume any liability for, or relating to, the delay, failure, interruption or corruption of any data or other information transmitted in connection with use of the services.

If you are dissatisfied with the website or any of the content contained therein, your sole and exclusive remedy is to discontinue the use of the website.

4. Restrictions/passwords and termination

Restrictions on use:

As a condition to your use of the services you agree that you will not, directly or indirectly through agents, representatives or affiliated persons or entities: (i) use the website in order to invade the privacy of, obtain the identity of, or obtain any personal information about any other user of the website; (ii) modify, erase or damage any information contained on the computer of any user connected to the website; (iii) reverse engineer any portion of the website; (iv) use the website or the content in any manner that is inconsistent with the limited license granted herein; (v) upload or distribute in any way internet viruses, worms, trojan horses, corrupted files, or any other software or programs that may potentially cause damage to the operation of the company's computer systems or web servers or the computer systems of other users of the website; (vi) use the website to send bulk or commercial messages (i.e. "spam") or forge or misrepresent messages headers to mask the originator of the message; or (vii) use the website for illegal purposes.

Representations and warranties:

You warrant, represent, and covenant to the company that (a) you possess the legal right and ability to enter into these terms of use; (b) you will use the services only for lawful purposes and in accordance with these terms of use (without limitation, including the restrictions on use) and all applicable policies of the company; and (c) you will be responsible, financially, legally and otherwise, for all use under your account and/or password.

Passwords:

As a registered user of the services, you will select a user password in order to access the website. You are solely responsible for maintaining the confidentiality of your password and agree not to share or give your password to anyone else. You agree to immediately notify the company if you become aware of any loss, theft or unauthorized use of your password. You may contact us at 800.962.2242.

Termination:

The company reserves the right to refuse access to the website and to terminate your use of the services at any time without notice if the company believes that you have violated or acted inconsistently with any provision of these terms of use or any applicable law, policy, or regulation, or for any other reason within the company's sole discretion, with or without cause.

5. Additional terms for providers

One purpose of this website is to provide an additional medium for the submission of claims and to the status review of submitted claims, submitted referrals, pre-certifications and prior authorizations as well as to verify member eligibility. The accuracy, authenticity, security and confidentiality of the information submitted to the company is the sole responsibility of the provider submitting the information. These terms of use do not, in any manner, supersede, replace or supplement, any terms or conditions contained in any written contract or documentation disseminated by the company in any other manner, other than through this website. In the event of a conflict between these terms of use and such other documents, unless indicated otherwise, the documents published and mailed to your office shall take precedence. In the event of conflict between these terms of use and a member subscriber agreement or other evidence of the terms and conditions of benefit coverage, the member subscriber agreement or other evidence of the terms and conditions of benefits coverage shall take precedence.

By using this website you (i) agree to abide all terms and conditions regarding claims format requirements, claims submission procedures, claim timeliness and benefit interpretations standards as communicated to you by the company; and (ii) agree to the following:

  • that you will provide access to this website only to those employees and associates needing access in order to perform their jobs or to function on your behalf.
  • that you are responsible for the use of this website and any patient information by your employees and associates or others accessing this website using your logon id and password.
  • that this information is to be shared only with the patient or, where applicable, with a duly authorized representative of that patient.
  • that individuals accessing patient information exercise due care to log off or lock their workstations when leaving them unattended for long periods of time.
  • that individuals accessing patient information may not share their logon ids or passwords and will exercise due care to safeguard their logon id and password to ensure no unauthorized persons may log on to this website.
  • that you will terminate in a timely fashion all access capabilities of your employees no longer working for you or associated with your practice whose job functions no longer require access.

6. Additional terms for producers and producer administrative staff

One purpose of this website is to provide health insurance producers and their administrative support staff access to self-service tools used in support of both pre-sale and post-sale activity. The accuracy, authenticity, security and confidentiality of the information submitted to Capital Blue Cross is the sole responsibility of the producer or their staff submitting the information. These terms of use do not in any manner supersede, replace or supplement any terms or conditions contained in any written contract or documentation disseminated by the company in any other manner, other than through this website. In the event of conflict between these terms of use and the producer contract the producer contract shall take precedence.

By using this website you agree to abide to all terms and conditions regarding the use of producer tools and communications found on this website and related portals, and agree to the following:

  • that you will not share your user name and password with any individual.
  • that you are responsible for the use of this website and any customer information that is entered.
  • that in order to sell, solicit or negotiate health insurance and related lines of business in the name of Capital Blue Cross and its subsidiaries, you must maintain an active appointment with the company and be licensed by the  Insurance Department of the Commonwealth of Pennsylvania.
  • to fairly and accurately portray Capital Blue Cross, its subsidiaries and the products and services that we offer to your customers.
  • that non-licensed and non-appointed administrative staff may only provide assistance to a licensed producer in the creation of sales proposals and other materials used during the pre-sale and post-sale process.
  • that non-licensed and non-appointed administrative staff may not use the information obtained through this website in the commission of an activity that requires by licensing by the Pennsylvania Insurance Department and appointment with Capital Blue Cross and/or one of its subsidiaries.
  • that you will terminate in a timely fashion all access capabilities of your employees no longer working for you or associated with your business whose job functions no longer require access.
  • that individuals accessing information exercise due care to log off or lock their workstations when leaving them unattended for long periods of time.

7. General legal provisions

Governing law and jurisdiction:

These terms of use are governed by and construed in accordance with the laws of the state of Pennsylvania for all purposes, without giving effect to any principles of conflicts of laws. By accepting these terms of use, you hereby consent to the jurisdiction and venue of the courts of Pennsylvania.

International laws:

The company does not make any claims that the content provided by the website is appropriate or may be downloaded outside of the United States. Access to the content may not be legal by certain persons or in certain countries. If you access the website from outside the United States, you do so at your own risk and are responsible for compliance with the laws of your jurisdiction.

Indemnification:

You agree to indemnify, defend and hold harmless the company, its members, shareholders, affiliates, directors, managers, employees or other representatives from and against any claims, actions or demands, liabilities and settlements including, without limitation, reasonable legal and accounting fees, resulting from, or alleged to result from, your violation of these terms of use or any activity related to your use of the website by you or any other person accessing the website using your password.

Waiver:

Our failure to exercise or enforce any right or provision of these terms of use does not constitute a waiver of such right or provision. No waiver of any of these terms of use shall be deemed a further or continuing waiver of such term or condition or any other term or condition.

Severability:

If any provision of these terms of use is found by a court of competent jurisdiction to be invalid, the parties nevertheless agree that the court should endeavor to give effect to the parties' intentions as reflected in the provision, and the other provisions of these terms of use remain in full force and effect.

Modification:

Neither the course of conduct between the parties nor trade practice shall act to modify any provision of these terms of use.

Assignment:

The company may assign its rights and duties under these terms of use to any party at any time without notice to you and/or your approval.

Acknowledgement:

You acknowledge that the provisions, disclosures and disclaimers set forth in these terms of use are fair and reasonable and your agreement to follow and be bound by them is not the result of fraud, duress or undue influence exercised upon you by any person or entity. Notwithstanding any provisions of these terms of use, the company has available all remedies at law or equity to enforce these terms of use. There are no representations, promises, warranties or undertakings by the company contrary to those set forth above.

By clicking on "yes" you indicate your assent to be bound by these terms of use.