Terms and Conditions

Effective Date : June 1, 2024

Last Updated : March 18, 2025

1. Acceptance of Terms

Gradly ("we," "us," or "our") is committed to safeguarding your privacy. This document explains how we collect, use, disclose, and protect the personal information of users visiting insurance@gradly.us and using our health plan services.

Gradly reserves the right to update these Terms & Conditions at any time without prior notice. The latest version will always be available on our website. Continued use of our services constitutes acceptance of any modifications.

2. Eligibility

Plans provided through Gradly are available exclusively to international students studying in the United States. By purchasing a plan, you confirm that:

  • You are at least 18 years old or have obtained parental/guardian consent.
  • You are an eligible student enrolled at a U.S. university.
  • You have provided accurate and truthful information during the application process.

3. User Responsibilities

As a plan member, you agree to:

  • Provide accurate personal and academic information.
  • Maintain active student status to remain eligible for coverage.
  • Inform Gradly immediately if your university rejects your waiver request.
  • Abide by the terms of the provider and third-party partners (such as Cigna PPO, First Health, OptumRX, and USRx).
  • Not misuse, manipulate, or attempt fraudulent activities related to your plan coverage.

Failure to comply may result in cancellation or denial of services.

4. Health Plan Terms

  • Coverage is subject to the specific terms outlined in your plan documents.
  • The plan period starts on the coverage start date and ends on the coverage end date.
  • Claims must be submitted in accordance with the insurer's guidelines & reimbursement request must be submitted within 180 days from the date of service.
  • Gradly does not process claims directly—claims are managed by third-party administrators.
  • Gradly may, update, modify, or transition the plan administrators, third-party administrators (TPAs), service providers, provider networks, or affiliated partners involved in the delivery, administration, or servicing of health coverage offered through the platform.
  • Such changes may be made to improve service quality, expand provider access, enhance operational efficiency, or comply with regulatory or business requirements. These updates will not reduce the core scope of coverage provided under an active plan, though certain administrative processes, provider networks, claims handling procedures, or supporting partners may change.
  • By accessing or continuing to use the Gradly web application, mobile application, or related services, you acknowledge and consent to Gradly facilitating health coverage through its current or future affiliated partners, administrators, and networks, as applicable.
  • These updates may include access to enhanced or expanded provider networks and improvements to how plan services are accessed and managed through Gradly’s updated platform experience. Such changes are intended to improve overall usability, network availability, and service delivery; however, specific providers, network composition, and administrative processes may vary over time and by location.
  • Coverage terms, benefits, exclusions, and limitations are governed by the applicable plan documents issued by the respective provider or administrator in effect at the time of coverage.
  • Continued use of the platform following any such updates constitutes acceptance of these changes.

5. Payments & Fees

  • All plan premiums must be paid in full after the waiver is accepted.
  • Payment processing is handled by Stripe & Mercury and is subjected to their terms.
  • Chargebacks or unauthorized disputes may result in plan cancellation and additional fees.
  • Any fees related to transactions, including processing fees, are non-refundable.
  • Late Fees: If the outstanding premium is not settled within 7 days after waiver approval, a late fee of $50 per week will be incurred.

6. Privacy & Data Usage

Gradly collects and processes personal data in accordance with our Privacy Policy. By using our services, you consent to:

  • The collection of personal, academic, and plan-related data.
  • The secure sharing of data with third parties (Cigna PPO, First Health, OptumRX, USRx, and others) for plan processing.
  • SMS communications in compliance with A2P 10DLC regulations (opt-out available by replying 'STOP').
  • Secure data transfers via EDI 834 for enrollment and claims processing.

For full details, review our Privacy Policy.

7. Data Security

Gradly is committed to protecting personal and health-related information in accordance with applicable industry standards, including HIPAA where required.

  • Handling of Protected Health Information (PHI): Certain plan-related data may qualify as PHI under HIPAA regulations. We implement safeguards to protect PHI in compliance with HIPAA and other privacy laws.
  • EDI 834 Data Transfers: We securely exchange plan enrollment data with third parties using EDI 834 standards.
  • Third-Party Compliance: Partners handling PHI on our behalf are required to follow HIPAA security standards.

8. Limitation of Liability

Gradly is not responsible for:

  • Decisions made by universities, plan underwriters, or claims administrators.
  • Losses resulting from failure to comply with waiver deadlines.
  • Delays or service interruptions caused by third parties.
  • Healthcare expenses beyond plan coverage.

Gradly's liability is limited to the maximum extent permitted by law.

9. Dispute Resolution

  • Any disputes arising under these Terms & Conditions shall be resolved through binding arbitration, in accordance with AAA (American Arbitration Association) rules.
  • Users waive the right to a class-action lawsuit.
  • Claims must be filed within one year of the issue arising.

10. Governing Law & Jurisdiction

These Terms & Conditions are governed by the laws of Delaware, and any disputes shall be handled within the courts of that jurisdiction.

11. Contact Us

For any questions regarding these Terms & Conditions, contact us at: