The HealthShare Plan

What is an IUA? (Initial Unshareable Amount)

Thank you for your interest in joining Sedera Health. If you have questions or concerns regarding this form, please call Sedera Health toll-free at 1-855-973-3372. We are happy to help you with anything you need.

The following requirements benefit all members by assuming honor and integrity. Through adherence to these principles, members minimize medical risks and ensure proper accountability while encouraging good health practices. All Sedera members must agree with and attest to the following principles. If at any time a member no longer meets all of these membership requirements, they must notify Sedera immediately and their membership and all privileges will cease. unless otherwise indicated.

A. I believe that a community of moral, ethical, and health-conscious people can most efficiently and effectively encourage and care for one another by sharing each other's medical needs directly.

B. I understand that Sedera Health is a benevolence organization, not an insurance entity, and that while Sedera assures that every effort will be made to assure that members fulfill their monthly sharing commitment, Sedera, in and of itself, cannot guarantee payment of any medical expenses.

C. I am an eligible person of a participating entity with Sedera Health, and am eligible for membership through that relationship.

D. I agree to practice good health measures and strive for a balanced lifestyle.

E. I agree to refrain from the usage of any form of illegal substances.

F. I understand that medical needs caused by, or due to, the act of performing any illegal or unlawful activity will not be shareable.

G. I agree to submit to mediation followed by subsequent binding arbitration, if needed, for any instance of a dispute with Sedera or it's affiliates.

H. I agree to sign and submit a membership continuation agreement each renewal year to confirm my/my household's commitment to adhere to these principles.

The Primary Member assumes full-responsibility to notify and inform all persons listed on this application of these principles and responsibilities of membership. Any applicant (or their eligible dependents) who is not comfortable with the Sedera Guidelines is free to decline the offer to participate in the Sedera Medical Cost Sharing program. This does not impact your/their freedom to accept or reject any insurance program that your employer or group may provide, nor does it impact your freedom to purchase insurance from the government marketplace or directly from any private health insurance entity.

Please Note: Participating member households are required to abide by the Sedera Membership Guidelines, as referenced below. Memberships are not refused on the basis of the health status of the individual members, however medical conditions that existed prior to membership may be limited or excluded from sharing (see Sedera Guidelines, Sections 7 and 8). Additionally refusal to agree with any of the Principles & Responsibilities of membership may negatively impact whether a need is shareable. Failure to agree with and/or adher to the Principles and Responsibilities may prevent one or more needs from being shareable and Sedera May, in its sole discretion and at anytime, refuse to provide services to any person who fails to agree or comply with the principles and Guidelines.

For more information, please download Sedera's Member Guidelines at our website at www.sedera.com

Payment Authorization Terms & Conditions

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify SHMI Inc. in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH transaction being rejected for Non Sufficient Funds (NSF) I understand that SHMI Inc. may at its discretion attempt to process the charge again within 30 days, and agree to an additional charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card/bank account and will not dispute these scheduled transactions with my bank or credit card company; so long as the transactions correspond to the terms indicated in this authorization form.

While member health status has no effect on eligibility for membership, there are limitations on the sharing of needs for certain conditions that existed prior to the membership effective date. Needs that do not qualify for medical sharing may still be met in part or in whole through Special Needs Sharing. (See Sedera Guidelines, Section 5.A. See Sections 6-9 of the Guidelines for a detailed list of shareable and non-shareable needs.)

In general, needs that result from a medical condition that existed prior to membership (known or producing observable symptoms) are only shareable if the condition appears to be fully cured and thirty-six (36) months have passed without any observable symptoms (either benign or deleterious), treatment, or medication, even if the cause of the symptoms is unknown or misdiagnosed. Additional limitations apply for specific medical conditions as indicated below. See Sedera Guidelines, Sections 7 – 8 and Appendix.

Medications prescribed for chronic, long-term conditions and taken on a regular, recurring basis (i.e. maintenancemedications) are not shareable unless associated with a new diagnosis and then only for 120 days. Examples of common maintenance medications are insulin, blood pressure medicine, cholesterol medicine, etc.

Please be advised:

Medical expenses for child birth that have an expected delivery date within the first 12 months of membership are not shareable.

Medical Condition(s)

In the past 36 months (9 months for pregnancy) have you or any family member applying for membership;