General

The Websites www.abarcahealth.com, my.abarcahealth.com, Rfp.abarcahealth.com, and Rxp.abarcahealth.com are owned by Abarca Health, LLC, or any affiliate or subsidiary thereto, any of which shall have any enforcement rights hereunder (hereinafter “Abarca”). These Terms and Conditions of Use (the “Terms”) apply to all users of www.abarcahealth.com (the “Main Site”). In addition, these Terms apply to Abarca Health Providers registered to use the non-publicly available Provider’s Portal accessible through the Main Site (“Providers”), members of applicable prescription drug benefits plans managed by Abarca (“Members”) who access available Web Pages on my.abarcahealth.com [specific to their prescription drug benefit plan (a “Member Site”) as well as sponsors of plans for which Abarca manages their prescription drug benefits offered by such plan, their directors, officers, employees, agents, and authorized subcontractors (“Plan Sponsors”) who have been granted authorized access to non-publicly available Web Pages on Rxp.abarcahealth.com ( “Non-Public Site”) and companies interested in submitting proposals to Abarca, accessible through Rfp.abarcahealth.com (“RFP Tool”) (the Main Site (including the Provider’s Portal), Member Site, and Non-Public Sites comprise www.abarcahealth.com, Rfp.abarcahealth.com, Rxp.abarcahealth.com and my.abarcahealth.com shall be collectively referred to herein as the “Site”).

Abarca offers you, the user (“You” or “User”) access to the Site based strictly on the Terms and subject to Abarca´s Privacy Policy. The Site may be accessed via the World Wide Web, mobile device or through a hyperlink embedded in an email or Plan Sponsor’s site. The Member Site is a member-only account portal available through the Main Site or through my.abarcahealth.com via Internet access which enables Members who are registered with Abarca (“Registered Members”) to access their personal account information and to use certain other services offered only to Registered Members who use the Member Site. The Non-Public Site is a Plan Sponsor only account portal available through the Main Site or directly through Rxp.abarcahealth.com which enables Plan Sponsors that are registered with Abarca (“Registered Plan Sponsors”) to, among others and depending on what Plan Sponsor contracted with Abarca, access certain information regarding their Members’ drug utilization and related data including, standard and custom reporting (RxIntelligence), and other additional modules such as Coverage Determinations and RxTarget. The RFP Tool is a site available only to registered entities invited to participate in Abarca RFP’s for submission of documentation and proposals accessible directly through Rfp.abarcahealth.com. Only Registered Members and Plan Sponsors will be provided access to the Member Site and Non-Public Site, respectively. The Provider’s Portal is a Provider-only account portal available through the Main Site which enables registered Providers (“Registered Providers”) to access certain information related to the services they provide to Members. Only Registered Providers will be provided access to the Provider’s Portal. By visiting, using or accessing the Site you are accepting and agreeing to be bound by these Terms and the Abarca Privacy Policy. Abarca may discontinue or modify these Terms at any time and without notice as it deems necessary or appropriate in its sole discretion. Any amendments to the Terms set forth herein are effective upon being posted. You should, therefore, review these Terms from time to time. Your continued access and use of the Site after the effective date of any amendment to the Terms means that you have accepted such amendment and constitutes your agreement to be bound by the then current Terms. These Terms were last updated on February 27, 2015.

You may only use the Site in accordance with these Terms and the Privacy Policy.

For purposes of these Terms, to use, access or visit the Site includes visiting the Site or any of its Web Pages (with or without a log-in or registration), registering (partially or completely) in the Site, and/or logging in and out. You are the sole responsible for your use of the Site in accordance with these Terms.

The Site provides an interactive online service operated by Abarca, through which we generally respond to any e-mail questions, requests for services, and other inquiries that we receive. Any ideas, advice, recommendations, evaluations, representations of needs, proposals, improvements, or other information provided to Abarca via this interactive online service shall belong solely to Abarca and you hereby irrevocably and unconditionally grant and assign to Abarca all right, title and interest, including all intellectual property rights, in and to all such information provided to Abarca via the online service. In addition, we may retain contact information provided via this interactive online service so that we can send individual updates or other important information to such individuals in accordance with the Abarca Privacy Policy.

The right to use this Site is personal to User and is not transferable to any other person or entity. User shall be responsible for protecting the confidentiality of User’s password(s), if any. User acknowledges that, although the Internet is often a secure environment, sometimes there are interruptions in service or events that are beyond the control of Abarca, and Abarca shall not be responsible for any data lost while transmitting information on the Internet. While Abarca´s objective is to make the Site accessible 24 hours per day, 7 days per week, the Site may be unavailable from time to time for any reason including, without limitation, routine maintenance. You understand and acknowledge that due to circumstances both within and outside of the control of Abarca, access to the Site may be interrupted, suspended or terminated from time to time.

Abarca shall have the right at any time to change or discontinue any aspect or feature of the Site, including, but not limited to, content, hours of availability and equipment needed for access or use. Further, Abarca may discontinue disseminating any portion of information or category of information, may change or eliminate any transmission method and may change transmission speeds or other signal characteristics at its sole discretion.

The Site is intended for use by residents of the United States, including the Commonwealth of Puerto Rico.

Links to External Sites

This Site may contain links to other Internet websites (“External Sites”) not operated or maintained by Abarca. Users understand that these links are provided solely for the convenience of Users in locating information and services that Users may find to be relevant or of interest. Users acknowledge that External Sites are maintained by persons or organizations over which Abarca exercises no control (“Third Parties”); that the links from Abarca’s Site to these External Sites do not constitute an affiliation with or an endorsement, sponsorship or any other form of promotion of the External Sites, including any content therein, or of the Third Parties maintaining them; and that Abarca is not responsible for the content, accuracy of information, and/or quality of the products or services provided by or advertised on External Sites. Unless otherwise stated explicitly by Abarca, these links do not represent an intent to endorse, sponsor or otherwise promote content, information, products or services of External Sites or of the Third Parties maintaining them. Any information that Users provide to External Sites is not subject to or covered by the present Terms or Abarca’s Privacy Policy, and Abarca is not responsible for the treatment of any information Users provide to these External Sites and/or the privacy practices of other websites. Abarca recommends that Users review the privacy policies of any External Sites and advices caution when providing personal information to any Third Party online.

Prohibited Activities

The following activities shall be prohibited when using the Site:

1. You may not hack the Site.
2. You may not use the Site or your account within the Site for any personal, commercial or political advertisements, business, solicitations or promotions.
3. You may not upload any destructive programs, information, file, or software such as viruses, Trojan horses, worms, time bombs, cancelbots and/or self-replicating code, or take any other actions to harm, interrupt, destroy or limit the functionality of the Site, other computer software or hardware, nor any electronic or telecommunications equipment.
4. You may not send unsolicited e-mail messages, including advertising, promotional materials, spam, junk mail, chain letters, pyramid schemes, or any other form of solicitation, to any other User of the Site.
5. You may not solicit passwords or other personal information from any other Users of the Site.
6. You may not post or transmit any message which discloses private or personal matters concerning any person.
7. You may not post or transmit any message, data, image or program in a fashion that would violate the property rights of others, including unauthorized copyrighted text, images or programs, trade secrets or other confidential proprietary information, and trademarks or Site marks used in an infringing fashion.
8. You will not allow any other person other than yourself, including any former user whose account has been terminated, suspended or cancelled, to access the Member Site, Non-Public Site or Provider’s Portal through your user name, password or account.
9. You may not transmit, broadcast, retransmit, rebroadcast, distribute, redistribute, or make any commercial use of the Site. You may not copy, reproduce or prepare derivative works from, publicly perform, publicly display or distribute the Site or any content thereof in any manner not expressly authorized by Abarca.
10. You will not reverse engineer, decrypt, decompile, or otherwise alter or interfere with the Site, or attempt to do so, or assist or encourage others in doing so.
11. You may not register for an account on behalf of any person, group or entity without such person, group or entity’s written authorization.
12. You may not submit through the Site false, misleading, or incorrect information to Abarca when creating your account or at any other moment or time when using the Site.
13. You may not do any act which constitutes a violation of the Health Insurance Portability and Accountability Act of 1996, as amended, and/or its implementing regulations and any other relevant state or federal law or regulation.

You will be able to view your own claims and claims of your Dependents under age 18; however, due to Federal Privacy Laws, you will not be able to view the Protected Health Information (PHI) of your Spouse and Dependents over 18 years of age. Adult dependents (including spouses) must login to their account and grant the subscriber access before claim and benefit information is released to the subscriber.

Any conduct by a User that in Abarca´s exclusive discretion restricts or inhibits any other User from using or enjoying this Site and/or any of the External Sites is strictly prohibited. User shall not use this Site or any of the External Sites to advertise or perform any commercial, religious, political or non-commercial solicitation, including, but not limited to, the solicitation of Users of this Site and/or the External Sites to become Users of other online or offline services directly or indirectly competitive or potentially competitive with Abarca.

If you breach or infringe, or Abarca reasonably suspects that you may have breached or infringed any of the Terms of this section, or any other clauses, representations, and covenants of these Terms, Abarca may, in its sole discretion, suspend, cancel, and/or terminate your account and/or access to the Member Site, Non-Public Site, Provider’s Portal, any other site referenced herein or any part thereof with or without previous notice to you, in addition to any other available remedies in law. Also, to the extent Abarca reasonably suspects a User has engaged in fraudulent, abusive, manipulative or illegal activities, such User may be referred to the appropriate law enforcement agencies.

You understand and agree that any unauthorized use of the Site will result in irreparable injury to Abarca, its business partners, and/or licensors for which monetary compensation would be inadequate, and in such event and/or in a breach of these Terms, Abarca, its business partners, and/or licensors, as applicable, shall have the right, in addition to other remedies available at law and in equity, to seek immediate injunctive relief against you. Nothing contained in this paragraph or elsewhere in these Terms shall be construed as to limit remedies or relief available to Abarca pursuant to law or other claims that Abarca, its business partners, and/or licensors may have under other clauses of these Terms or under separate legal authority, including but not limited to, any claim for intellectual property infringement.

Copyright & Trademarks

The Abarca name and logo as well as all the content included in the Site, including without limitation the text, reports, pricing information, graphics, data, logos, icons, screens and configurations, photographs, audio and video clips, music and sound, picture images, website architecture, format, layout and data structures, product names, logos, commercial symbols, trade names and slogans are the EXCLUSIVE property of Abarca or its licensors (or is a nominative use of trademark) and are protected by United States and international copyright, trademark or other intellectual property laws. All software used in this Site is the property of Abarca or its software suppliers and is also protected by United States’ and international copyright and/or intellectual property laws. You do not acquire any ownership rights by agreeing, accepting or consenting to these Terms. You do not acquire any ownership rights by printing or downloading any information from or using the Site. You may print or download information from the Site for your personal use only and each such copy or download must include appropriate copyright and/or trademark notices. It is expressly prohibited, however, to reprint or electronically reproduce any text, document, graphic or audio-visual material for bulk or commercial use without prior written consent obtained from Abarca. Any violation of this policy may result in a copyright, trademark or other intellectual property right infringement (including contract infringement) that may subject User to civil and/or criminal penalties.

License & Rights Granted

Subject to these Terms, Abarca grants you a limited, non-exclusive, non-transferable, non-assignable and revocable right to a limited use of the Site for the purposes stated in these Terms in order to access and observe through an Internet browser its content, if available and provided by Abarca, and to use the limited functionalities of the Site such as registration, and logging in and out, as may be provided, changed and limited by Abarca from time to time.

You grant Abarca a transferable, assignable, royalty free, perpetual, irrevocable, world-wide right to use, reproduce, modify, adapt, publish, edit, translate and distribute, in whole or in part, the information, content, communications, comments, messages, information or material you supply to the Site (the “User Generated Content”) including, but not limited to, the use of the information to provide you products or services. Abarca may assign its rights that arise under these Terms without notice to you in its sole discretion. You may not assign your rights under these Terms.

By posting User Generated Content on or through this Site (if applicable), User shall be deemed to have granted to Abarca a royalty-free, perpetual, irrevocable, world-wide, non-exclusive license to use, reproduce, modify, adapt, publish, edit, translate, distribute, perform, and display the User Generated Content alone, or as part of other derivative works, in any form, media, or technology whether now known or hereafter developed without territorial or time limitations; to use such User Generated Content for promotions, advertising, market research or any other lawful purpose; and to sublicense such rights through multiple tiers of sublicenses.

No Warranty & Release

The Site, including without limitation, the member Site and non-public Site, any other Site referenced herein and any and all parts thereof, are provided on an “as is” basis with no warranties whatsoever and the use of the Site is entirely at your own risk.

Abarca and its officers, directors, representatives, independent contractors, employees, agents, affiliates, and subsidiaries make no representations or warranties of any kind, express or implied, as to the operation of the Site, the information, content, materials, products or services included in the Ste, warranties of third party merchantability and fitness for a particular purpose and the statutory warranty against non-infringement of proprietary rights.

There is no warranty that the Site will meet your requirements or that your access to the same will be uninterrupted or virus or error-free. Abarca and/or Abarca’s entities, as applicable, do not warrant, guarantee, or make any representations regarding the use or the results of the use of the Site with respect to performance, accuracy, content, completeness, legality, reliability, security capability, operability, availability of information or material, or otherwise and are not responsible for unavailable network connections, failed or incomplete or delayed computer transmissions, online failures, hardware or software, or other technical malfunctions or disturbances, or any other communications failures or circumstances affecting, disrupting or corrupting the Abarca service in any manner, including without limitation, the user’s ability to participate in any giveaways, receive notifications, or any other function of the Abarca services and Site. You will not hold Abarca and/or Abarca’s entities or instrumentalities, as applicable, responsible for any damages that result from you accessing the Site, including but not limited to, any infections or contaminations of the devices you use to access the same or to transfer information or data that may result from that use. Abarca is not responsible to you for any content provided through the Site or for any download or content you find objectionable.

Abarca has no control over the Internet and cannot prevent the interception of messages by unauthorized parties or guarantee that such unauthorized parties may not be able to decrypt encrypted messages. Accordingly, under no circumstances will Abarca be responsible for any loss or damage incurred by any user as the result of unauthorized interception or decryption of information transmitted to or by Abarca. Users must immediately notify Abarca of any known or suspected unauthorized use of a user’s account or any known or suspected breach of security, including loss, theft, or unauthorized disclosure of a user’s password, if any.

Abarca will not be liable for any alleged claim of copyright or trademark infringement resulting out of the use of the material posted on the Site by users.

Under no circumstance shall Abarca or its officers, directors, representatives, independent contractors, business partners, employees, agents, subsidiaries and affiliates, as applicable, be liable to you for any consequential, incidental, special or punitive damages (including damages for loss of business profits, business interruption, loss of business information, and the like) arising out of the use of or inability to use the Site, even if Abarca and/or its officers, directors, representatives, business partners, independent contractors, employees, agents and affiliates, as applicable, have been advised of the possibility of such damages.

Release

You hereby release and forever discharge Abarca and its officers, directors, representatives, independent contractors, agents, employees, subsidiaries and affiliates, and their respective successors and assigns, from any and all manner of liability, claims, counterclaims, demands, setoffs, damages or causes of action, which you now have or which may hereafter accrue, whether heretofore asserted or unasserted, known or unknown, arising out of, or in any way relating to the use of the Site, specifically including but not limited to any claims based in whole or in part upon the alleged negligence of Abarca in operating the Site. In any event, Abarca’s liability to you is limited to $100.00.

You agree to defend, indemnify, and hold Abarca and its officers, directors, representatives, independent contractors, employees, agents, and affiliates (collectively, the ‘Indemnitees”) harmless for, from and against any loss, costs (including reasonable attorney’s fees), claims, actions, demands, causes of action, and other proceedings (collectively the “Claims”) by reason of, in any way relating to, or arising out of: (a) your use of the Site including the Member Site, Non-Public Site or Provider’s Portal or any other site referenced herein or any part thereof and any violation of any law, rule or regulation arising out of such use; (b) any misuse of information, including email addresses and email content arising out of or relating to your use of the Site; (c) any content or information uploaded by you or through your account to the Site, the computer systems running the Site or otherwise, including any information You provide to Abarca; and (d) any violation of these Terms. You agree to reimburse any and all Indemnitees on demand for any losses, costs, judgments, fees, fines, and other expenses they incur including without limitation attorney’s fees and court and filing fees and costs, as result of any Claims. You agree to cooperate as fully as reasonably required in the defense of any claim. We reserve the right, at our own expense, to assume the exclusive defense and control of any matter otherwise subject to indemnification by you. You shall not enter into any settlement agreement that affects the rights of any of the Indemnities or requires the taking of any action by any of them, without our prior written approval.

User is solely responsible for any interactions with third party merchants, if any, and other users of the Site or external sites. To the extent permitted under applicable laws, user hereby releases Abarca from any and all claims or liability related to any product or service of third party merchants, if any, any action or in-action by such third party merchants, including a third party merchants, including a third party merchants’ failure to comply with applicable law and/or failure to abide by the terms of deals or offers, and any conduct or speech, whether online or offline, of any other user.

Applicable Law and Jurisdiction

These Terms shall be exclusively construed and governed by the laws of Puerto Rico without regard to its conflict of law provisions or the laws of any other state or country or your actual state or country of residence. You agree that the federal and state courts located in Puerto Rico shall have exclusive jurisdiction and venue over any action brought to enforce the rights and obligations in or arising from these Terms and you irrevocably submit to the jurisdiction of such courts.

Termination of Passwords (Non-Public Site) & Third-Party Responsibility

Abarca shall have the right to immediately terminate or suspend any passwords or accounts of User in the event of any conduct by User or which Abarca, in its sole discretion, considers to be unacceptable, or in the event of any breach by User of these Terms.

Your cancellation of your account is your sole right and remedy with respect to any dispute with Abarca regarding the Site, the Terms or the Privacy Policy and you agree that such right is proper and represents the allocation of risk under these Terms.

It is the responsibility of User to evaluate the accuracy, completeness, or usefulness of any information, opinion, advice, etc., or other content available by or through the Site.

Force Majeure & Export Restrictions

Abarca will not be liable in any amount for failure to perform under these Terms if such failure is caused by power, Internet or communication outages, fire, flood, earthquakes, tornadoes, hurricanes, wars, acts of God, force majeure, or the occurrence of any other unforeseen contingency or event beyond the control of Abarca. If you fail to be able to access the Site because of network congestion or unavailability, you may contact Abarca at the email provided below.

United States export laws and regulations restrict the exportation and/or re-exportation through downloading or otherwise into certain embargoed countries. By downloading from the Site, you are representing that you are not located in any of the prohibited countries. This Site is intended for use by residents of the United States, including the Commonwealth of Puerto Rico.

Representation

You represent that you are of legal age to form a binding contract. You must be at least 18 years old to be eligible to use the Site. However, if you are at least 16 years old but not yet 18, you may use the Site in conjunction with your parent or guardian who agrees to these Terms. No one under age 16 may use the Site.

You should note that parental control protections are readily and commercially available that may assist you in limiting access to material on this Site, External Sites or otherwise on the Internet that is harmful to minors.

Contacting Us & Customer Support

If you are Registered Member, Plan Sponsor (or authorized representative) or Registered Provider, you may cancel your account at any time. You may do so by contacting us at [email protected] with the subject “Cancel Membership” or call 787-523-1299. For questions or inquiries regarding other matters you may also contact us at [email protected]. If related to the Provider’s Portal, you may contact us at [email protected] or at 787-523-1295.

Severability of Agreement

These Terms and the Privacy Policy together constitute the entire agreement between you and Abarca regarding use of the Site and supersede all prior agreements and understandings, whether written or oral or otherwise, with respect to the use of the Site, unless any other agreement executed between you and Abarca contains stricter provisions, in which case, those will continue to apply with regard to the Site. If any term, provision, covenant or restriction of the Terms and/or Privacy Policy is held by a court of competent jurisdiction or other authority to be invalid, void, unenforceable or against public policy, the remainder of these Terms and Privacy Policy shall remain in full force and effect and the unenforceable portion will be construed in accordance with applicable law as nearly as possible to reflect the original intentions of the parties. Abarca’s failure to pursue any available claim or defense pursuant to these Terms will not be a waiver of such claim or defense. The headings used in these Terms are for convenience only, and will have no effect on the interpretation or legal enforceability of the terms herein.

No Professional Advice

The information provided on the Site is for informational purposes and general guidance only. It does not constitute medical, legal, or other professional advice and should not be relied upon as such. The information provided on the Site is not intended as a substitute for obtaining professional advice from a qualified person, including professional healthcare advice from a physician. You should always consult with your physician or other applicable healthcare professional to treat any health issues and for appropriate examinations, diagnoses, treatment, testing, and care recommendations. You should not rely on the information on Abarca’s Site as a tool for self-diagnosis or therapeutic advice regarding any medications you may be taking. Any risks or benefits associated with specific drugs or treatments should be considered with your physician or other applicable healthcare provider. Neither Abarca nor this Site practice medicine or dispense medical advice. Abarca does not warrant or guarantee the accuracy, completeness, adequacy or currency of any information included in the Site. You are responsible for validating the accuracy, completeness, adequacy or currency of any information provided. The receipt of any questions or feedback you submit to Abarca does not create a professional relationship. In no event shall Abarca be liable for any decision made or action taken based or otherwise influenced by the information contained in the Site. Users shall not directly or indirectly make any claim against Abarca or its affiliates with respect thereto. If you are experiencing a medical emergency or crisis, please call 911 immediately or contact your local emergency assistance service.

Adverse Events

Please do not report any adverse drug reactions or interactions on the Site or through our online interactive service, if any. Rather, please inform your health care practitioner if you are experiencing an adverse drug reaction or interaction. To the extent information posted on our Site constitutes an adverse event which is required to be reported to the Food and Drug Administration or another federal or state agency, Abarca will report the event as required by law.

Non-Discrimination Notice 

Pursuant to Section 504 of the Rehabilitation Act of 1973 (Section 504) and Section 1557 of the Affordable Care Act (Section 1557), some Health Plans, including Medicare Plans, shall not discriminate on the basis of race, color, national origin, sex age, or disability in its health programs and activities. Health Plans should provide auxiliary aids and services and language assistance services, free of charge, when necessary to provide meaningful access to people whose primary language is not English, such as: qualified interpreters and information written in other languages, and information in alternate formats (large print, audio, accessible electronic formats, other formats), free of charge, and in a timely manner, when such aids and services are necessary to ensure an equal opportunity to participate for individuals with disabilities.

If you need these services, call your Health Plan’s Customer Services in the phone number on your Plan ID card.

If you believe these services have not been appropriately provided to you or you have been discriminated against on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by mail, fax, or email with your health plan’s Civil Rights Coordinator.

You can also file a complaint of discrimination with HHS’ OCR electronically through its Complaint Portal, which is available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201.

Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html.

Such complaints must be filed within 180 days of the date of the alleged discrimination.