MEMBERSHIP TERMS AND CONDITIONS
I request to become a Member of Colorado Holistic Health Plan (here in out addressed as CHHP) a
As a member I will be entitled to receive holistic and alternative medicine services at a discounted
fee from CHHP’s network of providers. I understand that I am responsible for all payments for
services rendered by the network providers. CHHP is not responsible for any service rendered by
any provider in the network. As a CHHP member I am liable for all charges incurred on my behalf. I
agree to pay such fees directly to the provider at the time services are rendered. I understand I
must present my membership card at each service to receive the CHHP rate.
CHHP makes no claims about the quality of health care you may receive from service providers.
While CHHP has negotiated fees for services, it is not recommending any service providers or able
to continually evaluate the services they provide. Each member indemnifies CHHP and their officers
and directors, for any claims the member may have against any health care provider.
There are no limits to how many visits you make.
You will receive your membership card and a provider list in 10-14 days. You may request a
temporary member card by email to: Stacey@coloradoholistichealthplan.com, which allows you to
use your benefits sooner. The provider list is also available to members online at
www.coloradoholistichealthplan.com under the provider’s information link and will be updated
monthly or as new providers are available.
MEMBERSHIP PLANS and PROGRAMS ARE NOT INSURANCE, nor are they an alternative to or
substitution for insurance coverage. If you currently have insurance, you should be aware that
canceling that policy might make it difficult to later obtain coverage. CHHP recommends that you
speak to your insurance agent or your company's insurance administrator before canceling any
health insurance policy for any reason. If you are involved in an accident please contact your
insurance carrier regarding services you may need. If you do not have insurance some providers in
the CHHP network will accept Attorneys Liens.
Our provider network and our discount plan is driven by members. To nominate a provider to our
network please forward their name and contact information via fax to 888-371-3091 or email
firstname.lastname@example.org. Please include their field of practice.
CANCELLATION OF MEMBERSHIP
If you are not satisfied with your membership you may cancel your membership at any time in
writing to the CHHP office and returning your membership card(s) to the CHHP office at P.O. BOX
473355 Aurora, CO 80047. If for any reason your membership card(s) are not returned at the time
of your cancellation request your membership will remain in full effect and CHHP will continue to
collect your membership fees until CHHP is in receipt of your cards. Final cancellations will be
effective as of the next billing date after CHHP receives written notice of cancellation and your
membership cards. After cancellation of membership, CHHP will refund the membership fees for
the following month or months of service if membership is paid in advance, and will discontinue
charging any future membership fees. If the cancellation is within 5 business days of your next
billing cycle you may be charged. CHHP will make every effort to refund your membership fee for
the following month as soon as possible. Providers receive monthly membership information and
will refuse your CHHP benefits if your membership is not active. You may still use the providers at
their standard rates.
As a provider I agree to honor my services to CHHP members at the CHHP benefit rate.
I the provider acknowledge all terms and conditions in this contact. I agree that if I no longer wish
to continue as a provider on the CHHP network I will cancel such in writing via mail to CHHP
offices, Fax to 888-371-3091, or email to email@example.com. At which time
CHHP will remove me from the provider list.
LOST MEMBERSHIP CARDS
If you lose your membership card(s) you may request new card(s) in writing to the CHHP office: PO
BOX 473355 Aurora CO 80047 with payment information or email request to
firstname.lastname@example.org please state if you would like to use the same payment
method as our records indicate, for payment of your new cards. There will be a $3 fee each for the
first 3 members and $2 for all members thereafter per request. Your cards will be mailed out
within 3-7 business days after CHHP receives your payment. You may receive a temporary card in
the interim via email if desired.
There is a one-time Enrollment fee of $10 to be included in your first payment.
Payments may be made via:
Paypal through our website, or check or money order mailed to:
CHHP P.O. Box 473355 Aurora, CO 80047
This Agreement is made between CHHP and the person submitting this Agreement (Members
Information Form). This Agreement will become effective after CHHP receives payment and the
Members Information Please sign and date your Member Information Form for verification
you agree to this contract.
You are urged to print a copy of the terms and conditions web page for your records.