(A) A discount medical plan organization shall provide to an applicant, the time of application, information that describes the terms and conditions of the discount medical plan, including limitations or restrictions on the refund of processing fees or periodic charges associated with the discount medical plan, and to a new customer, a written document that contains the terms and conditions of the discount medical plan.

(B) The written document required pursuant to subsection (A) must be clear and include:

Terms Used In South Carolina Code 37-17-52

  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Customer: means an individual who pays for the right to receive the benefits of a discount medical plan. See South Carolina Code 37-17-20
  • Discount medical plan organization: means an entity that, in exchange for fees, dues, charges, or other consideration, provides access for customers to providers of health care services and the right to receive health care services from those providers at a discount. See South Carolina Code 37-17-20

(1) the name of the customer;

(2) the benefits to be provided under the discount medical plan;

(3) processing fees and periodic charges associated with the discount medical plan including any limitations or restrictions on the refund of processing fees and periodic charges;

(4) the mode and timing of payment of processing fees and periodic charges and procedures for changing the mode of payment;

(5) any limitations, exclusions, or exceptions regarding the receipt of discount medical plan benefits;

(6) waiting periods for certain medical or ancillary services under the discount medical plan;

(7) procedures for obtaining discounts under the discount medical plan, such as requiring customers to contact the discount medical plan organization to make an appointment with a provider on the customer’s behalf;

(8) cancellation procedures including information on the customer’s thirty-day cancellation rights and refund requirements and procedures for obtaining refunds;

(9) renewal, termination, and cancellation terms and conditions;

(10) procedures for adding new customers to a family discount medical plan, if applicable;

(11) procedures for filing complaints under the discount medical plan organization’s complaint system; and

(12) the name and mailing address of the registered discount medical plan organization or other entity where the customer can make inquiries about the plan, send cancellation notices and file complaints.

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