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Legal Notices

Terms of Use 

Oxbridge Health is a third-party administrator (TPA) and not an insurance company. We offer and market self-funded (also known as self-insured) employer-sponsored health benefit plan products and/or services. By using this website and applications, you agree that you will not use the contents of the website or applications in violation of any laws, including fraud, waste, and abuse or anti-kickback prohibitions under federal law. 

Changes to Information on our Website 

[Oxbridge Health occasionally changes, removes, or adds information to our website. To allow for accurate translation, updates to translated versions usually occur shortly after updates to the English version. 

Product & Service Offerings 

Oxbridge Health is not licensed to sell products and/or services in all states. Products and/or services may not be available in all areas and are subject to applicable laws. The product and/or service descriptions provided on this site are not intended to constitute offers to sell or deemed solicitations related to any product and/or service. Consumers interested in a particular product should contact their local Oxbridge Health representative to determine if the product and/or service is available in their area. 

Covered services and benefits are provided under the terms of the applicable health benefit plan, including any limitations and exclusions. Rates may vary and are subject to change. 

Federal No Surprises Act (NSA) 
Surprise Billing Patient Protection Notice 

Your rights and protections against surprise medical bills 

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance, and/or deductible. 

What is “balance billing” (sometimes called “surprise billing”)? 

When you see a physician or other health care professional, you may owe certain out-of-pocket costs, (i.e., copayment, coinsurance, or deductible). You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network. 

Providers and facilities that haven’t signed a contract with your health plan to provide services are considered out-of-network. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and may not count toward your plan’s deductible or annual out-of-pocket limit. 

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care, e.g., when you receive emergency care or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise bills can cost thousands of dollars depending on the procedure or service. 

You’re protected from balance billing for: 

Emergency services 
If you have an emergency medical condition and receive emergency services from an out-of- network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (i.e., copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition unless you provide written consent and give up your protections not to be balanced billed for these post-stabilization services. 

Certain services at an in-network hospital or ambulatory surgical center 
When you receive services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these situations, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. 

If you receive other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you provide written consent and give up your protections. 

You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network. 

When balance billing isn’t allowed, you also have these protections: 

  • You’re only responsible for paying your share of the cost (i.e., copayments, coinsurance, and deductible) that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly. 
  • Generally, your health plan must: 
    • Cover emergency services without requiring you to get approval for services in advance (i.e., prior authorization); 
    • Cover emergency services by out-of-network providers; 
    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits (EOB); and – Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit. 

If you think you’ve been wrongly billed, contact the Centers for Medicare and Medicaid Services (CMS) at 1-800-985-3059. You can also get answers about your medical billing situation or file a complaint. You can also visit https://www.cms.gov/medical-bill-rights for more information about your rights under federal law. 

You can also contact Oxbridge Health at 877-744-7441 for questions or concerns about your bill or surprise billing or balance billing.