Membership Agreement
1. Disclosures: The Pinnacle Choice Discount Savings Card is NOT an insurance program and is not protected by any state Life and Heath Guaranty Association. The Pinnacle Choice Discount Savings Card is a discount plan that provides members with access to discounts pursuant to fee schedules negotiated by the provider networks with participating providers. Pinnacle Choice does not make payments directly to the providers of the services. Member is obligated to pay all applicable fees and charges directly to the provider at the time of visit.
2. Pinnacle Choice is the discount medical plan organization located at 82 Bloomfield Ave, Pine Brook, NJ 07058. Pinnacle Choice is responsible for the administration and customer service for its members who have enrolled in the Pinnacle Choice Discount Savings Card.
3. In order for a member to have access to the discounts available under the Pinnacle Choice Discount Savings Card, he/she must be enrolled in and deemed an eligible member of the Pinnacle Choice Discount Savings Card at the time the underlying service or product is actually received. Providers are instructed to contact Pinnacle Choice prior to providing service to a member to confirm the member’s eligibility.
4. The amount of discount will vary among participating providers and those procedures not included on the negotiated fee schedule may not be subject to a discount. When necessary to re-price, Pinnacle Choice may provide network fee information to dental providers under this program and send a copy of the re-price to our member.
5. The discounts available under the Pinnacle Choice Discount Savings Card may not be used in conjunction with any other discount program or insurance program.
6. Neither the provider networks nor Pinnacle Choice provide or guarantee the provision of any care or service provided and shall not be liable for the payment of any fees or charges for the care or service to members, participating providers or otherwise. Neither Pinnacle Choice, its affiliates nor the Pinnacle Choice Discount Savings Card are an insurer, guarantor or underwriter of the responsibility or liability of member for the service or product provided to the member.
7. The network of contracted providers participating in the Pinnacle Choice Discount Savings Card is subject to change and members are responsible for verifying that a specific provider is participating in the Pinnacle Choice Discount Savings Card immediately prior to receiving each and every service. Information to access a directory of participating providers is provided to member on enrollment. Member may call Pinnacle Choice’s customer service line for current provider information or utilize the find a provider search functions available at www.pinnaclechoice.com.
8. Although all providers participating in the Pinnacle Choice Discount Savings Card go through a credentialing process to assure that they are appropriately licensed and qualified, neither provider networks nor Pinnacle Choice do otherwise guarantee or are responsible for the quality of any services or products purchased by members. All care decisions are between the member and the provider. The selection of a provider is the obligation and decision of the member and is not based upon the credentialing of providers or any recommendation by the provider networks, Pinnacle Choice, or their affiliates.
9. To add additional members of your household to your plan, simply call the Pinnacle Choice Customer Service department.
10. Payments for the Pinnacle Choice program are due in advance (annually) or paid monthly through payroll deductions, e-checks or credit card. Pinnacle Choice reserves the right to terminate any enrollment or deny eligibility in the program for lack of payment to Pinnacle Choice. Returned checks, insufficient funds or denial by the member’s credit card company for payment of the periodic program fee is deemed evidence of non-payment by member. There will be a twenty-five ($25.00) charge to be reinstated in the program after such denial. To change your method of payment or frequency, simply call our customer service department. Each program has a one time, non-refundable enrollment fee of thirty dollars ($30.00), included with the first month's payment.
11. For annual payment plans, your membership will automatically renew on your anniversary date. We will charge your bank account or credit card on file upon renewal. Monthly installment payment plans will be charged on a monthly basis until you choose to cancel.
12. Members shall have up to thirty (30) days from their effective date to cancel, in writing, and receive a full refund of their first month’s program cost, excluding any one-time non-refundable enrollment fee. Use of the program within the first 30 days does not negate any right to a refund. Members may cancel at any time upon written notice. Please note, if cancellation is requested after the first thirty (30) day period, members will not receive a refund and the cancellation will become effective at the conclusion of the current billing period. Members may cancel at any other time in the membership period and the monthly membership fees will no longer be collected no later than 30 days from the receipt of a valid cancellation.
13. All requests to cancel must be provided in writing to Pinnacle Choice via (a) facsimile at 973-284-1655, (b) via email at cancel@pinnaclechoice.com, or (c) via U.S. mail at 82 Bloomfield Avenue, Pine Brook, New Jersey 07058.
14. Any and all complaints should be brought to the attention of the Pinnacle Choice Customer Service Department immediately. Complaints can be submitted directly to Pinnacle Choice via (a) telephone at 866-746-5678, (b) facsimile at 973-284-1655, (c) via email at customerservice@pinnaclechoice.com, or (d) via U.S. mail at 82 Bloomfield Avenue, Pine Brook, New Jersey 07058. Members may file a complaint under the discount health care program's complaint resolution procedure for any matter relating to availability of contracted discounts, services or other matters relating to the contractual obligations of the program. Upon receipt of a complaint, Pinnacle Choice will acknowledge the complaint within 5 business days and shall investigate and provide the complainant with the results of its investigation not later than 30 days after receipt of the complaint. All necessary steps will be taken in order to resolve any and all complaints.
15. The Membership Fulfillment Packet, Application and Membership Cards all constitute part of the Membership Agreement.
