1. Payment of Membership Fees
1. The full amount of annual membership fees is due and payable on the effectivity date unless a mode other than annual payment is chosen, in which case, only the initial membership fee and charges are due. Subsequent payments shall be payable on or before the due dates corresponding to the mode chosen and duly documented.
2. Membership fees are payable to Fortunecare USA with mailing address at:
   P.O. Box 4035 Glendale, CA 91222-0035
   It shall be the primary responsibility of the payor to keep their dependent’s health program membership on an active status by paying on or before due date. In case no billing statement is received by the payor or no authorized agent comes to the payors’s residence or office to collect on or before due date, the payor should forward payment directly to Fortunecare USA at the address given above.
3. Any request for change in mode of payment, i.e. annual, semi-annual, or change in type of plan shall be subjected to the prevailing policies and conditions at the time of request for change of mode or before renewal.
2. Grace Period, Lapsation, Reinstatement and Cancellation
1. All subsequent membership fees shall be paid on or before due date. During Grace Period of fifteen (15) days following due date within which the payor is given time to pay all unpaid dues so membership will not lapse, all services cease to be covered except for out-patient consultation. In-patient benefits are restored on the following day the unpaid dues are updated. Any confinement that precedes the time of payment shall not be covered.
2. The membership is considered lapsed (or suspended) if the payor fails to remit membership dues beyond the Grace Period of fifteen (15) days, in which case the member beneficiary ceases to be entitled to any medical benefits.
3. Membership that has lapsed may be reinstated within thirty (30) days following the lapsation by filing an Application for Reinstatement in the prescribed form, and upon payment of all unpaid dues to FortuneCare, which shall be treated as “Refundable Deposit” until the application is approved and validated. An approved and validated reinstatement of membership is free from the limiting provisions on pre-existing conditions being applied over again. Restoration of benefits shall commence after seventy-two (72) hours from the date of reinstatement.
4. The Contract is automatically cancelled (or terminated) after thirty (30) days from lapsation where no reinstatement has been filed and approved.
5. A cancelled/terminated membership may be reactivated by reapplication, i.e. applying over again as a new enrollee.

This notice is intended to provide You and Your beneficiary FULL DISCLOSURE of the benefits, rights, privileges, restrictions and limitations of the MANAGED HEALTH CARE SERVICES IN THE PHILIPPINES being offered. When you apply and subscribe for the services herein provided, it is understood that You and Your Beneficiary have understood and have had the opportunity to carefully review the terms and conditions, limitations and restrictions of Fortune Care’s health care services as outlined and otherwise set forth in the service literature herein provided.

WHO WE ARE:

Fortune Ventures, LLC dba Fortunecare USA is only the exclusive Marketing or Selling Agent in the United States for Fortune Medicare Inc. dba (Fortune Care) HMO policies. We are entirely separate and independent from the HMO provider in the Philippines. Fortune Ventures, LLC does not have any control over the conduct, activities, policies and procedures of Fortune Care’s managed health care services, based and operating in the Philippines, whose services we are marketing in the United States. After solicitation, marketing and selling, receipt and remittance of premiums, Fortune Ventures, LLC automatically relinquishes its role and activity with Fortune Care except for routine follow-ups and client inquiries.

WHO WE ARE REPRESENTING:

As independent marketing agents, we are limited to marketing and selling activities and we are not involved in any management, administrative, and operation functions of Fortune Care. Considering the archipelagic character of the Philippines, to operate at current level of premium payments, You and Your Beneficiary understand that Fortune Care’s operations must be limited to certain areas and for certain services. By way of management of enrolled members’ health care, Fortune Care contracts the services of independent medical health providers (doctors, hospitals, clinics, and other medical-related services).

FORTUNECARE NOT GOVERNED BY U.S. REGULATIONS:

Because Fortune Medicare Inc. dba Fortune Care provides managed health services limited to the Philippines, it is only regulated by the regulatory agencies in the Philippines, such as the Department of Health and other regulatory and administrative bodies of the Republic of the Philippines. Obviously, since its services are targeted to be perfomed outside of the United States and for non-domiciles of the United States, is is not licensed or otherwise regulated by the Financial Solvency Regulation and Enforcement and other HMO administrative regulations which apply only to California-licensed HMOs. The marketing and sales of Fortune Care’s Philippine-based services in the United States by Fortune Ventures, LLC dba Fortunecare USA may, however, be regulated by applicable laws regulating advertising and other commercial activities.

FORTUNECARE’S SCOPE OF RESPONSIBILITY: Not Umbrella Or Comprehensive Coverage But Limited By Its Restrictions And Limitations

The HMO managed health care program of Fortune Care is not an umbrella, all-embracing health insurance coverage and will cover each and every health-related problems, diseases, and illnesses of the beneficiary. Considering the limited amount of premium payments, it is anticipated by You and Your Beneficiary that coverage is restricted and limited to certain benefits as more fully set forth or discussed in the product literature. In managed health care, Fortune Care’s role is to budget, allocate and make available funds for covered health care service to the enrolled beneficiaries by independent medical provides in the Philippines. If and when you select, with informed consent and full disclosure, to purchase or subscribe to any of Fortune Care’s HMO policies, You and Your Beneficiary are seeking medical care and treatment through Fortune Care’s managed health care program which basically packages medical services by participating medical health providers. By enrolling with Fortune Care, You and Your Beneficiary subscribe, delegate, submit and otherwise designate Fortune Care to exercise its discretion and judgement as to the selection, allocation, apportionment and assignment of independent medical providers and resources for the covered health incident or occurrence. You and Your Beneficiary are encouraged to read the literature provided. Upon enrollment and payment of the premiums, it is assumed and subscriber and their beneficiaries represent that they have clearly understood the limitations and restrictions of coverage. You and Your Beneficiary cannot later assert lack of a.) Full disclosure; b.) Informed consent; and c.) Understanding and full opportunity to review and assess the impact and legal ramifications of the coverage’s restrictions and limitations.

MEDICAL PROVIDERS CONTINUE TO EXERCISE INDEPENDENT JUDGEMENT CALL ON THEIR PROFESSION. FORTUNE CARE HAS NO CONTROL OVER MEDICAL TREATMENT.

It must be emphasized that, as independent contractors, Fortune Care’s medical providers even as they are accredited providers of Fortune Care, have not relinquished and continue to exercise independently their medical judgement, which Fortune Care will not intervene or otherwise interfere with. Fortune Care does not assume any control over doctors and physicians’ decisions on medical and nursing matters.

PLACE OF RENDITION OF SERVICES: RESTRICTED TO THE PHILIPPINES AND NOT ELSEWHERE.

It is understood that the services offered are valid only and can be claimed for covered health care benefits in the Philippines, and not elsewhere. The benefits and the beneficiaries are non-assignable, and are available only in areas where Fortune Care currently makes services available. It is understood that Fortune Care’s services are limited to existing service areas, and Fortune Care is not required to open up or otherwise establish service where not available; however, after areas may be opened up, Members could thereafter avail of covered services thereat.

LIMITATION OF LIABILITY:

You, individually and on behalf of Your Beneficiary, agree and hereby waive, surrender, and abandon irrevocably and forever any right or causes of action against Fortune Ventures, LLC dba Fortunecare USA as mere marketing agents (with no control over conduct and activities of Fortune Medicare, Inc. dba Fortune Care) for any and all activities, conduct, judgement, decision, medical interventions and treatments or lack thereof, exclusions, restrictions and limitations of services by Fortune Care. You, individually and on behalf of Your Beneficiary, further agree, waive and surrender any and all rights to seek any and all kinds of damages against Fortune Ventures, LLC dba Fortunecare USA for physical injury, damage and death arising from or out of any treatment, medical intervention, operation, hospitalization, or lack thereof, including compensatory, consequential, actual and punitive damages and attorneys’ fees. You, individually and on behalf of Your Beneficiary, agree and hereby waive, surrender and abandon, forever and irrevocably, any liability and damages for any failure or delay in the provision of medical services by Fortune Care, it being understood that our liability is limited to any delay or negligence in the performance of our services as exclusive US agent for Fortune Care, such as remittance of premium payments that may have caused directly the failure or refusal to provide medical services by Fortune Care.

JURISDICTION AND VENUE:

HMO SERVICES IN THE PHILIPPINES: PHILIPPINES. It is understood that any and all actions and suits against Fortune Care, its accredited medical providers, such as doctors, nurses, hospitals, clinics, pharmacists, etc. are subject to the jurisdiction of the appropriate courts in the Philippines and venue is stipulated to be at Pasig City, Philippines. It is hereby stipulated that considering that performance of medical services and records are in the Philippines, in addition to stipulation of venue and jurisdiction, the doctrine of forum non conveniens mandates that jurisdiction and venue will be in Pasig City, Philippines.

MARKETING SERVICES IN THE U.S.: LOS ANGELES, CA. For any and all claims relating to sales and marketing of Fortune Care HMO plans by Fortune Ventures, LLC dba Fortunecare USA, parties have agreed to submit and stipulate venue and jurisdiction to be Central District of the Los Angeles Superior Court.

PUNITIVE DAMAGES WAIVED:

To discourage litigation, parties stipulate to waive punitive damages and limit claims to actual, compensatory and consequential damages. You have been admonished to read the literature provided which contains the conditions, restrictions, limitations of the health care services offered and covered for the Beneficiary. By your electronic acknowledgement, you attest that you have read and understood all of the above, including the product/service literature, and agree to be bound by these terms and conditions.