This HSA Addendum (“Addendum”) outlines modifications to the terms and conditions for the Program Agreement executed between the undersigned, (“Patient”) and Sparks Family Medicine, Ltd (“Practice”). The Patient should review the information in this Addendum, including their rights and responsibilities, and retain a copy for future reference.
1. Required Payment
1.1. Patient has executed a Program Agreement with Practice including Attachment A with Functional Medicine Energy Center (“FMEC”) for access to the FMEC Platform.
1.2. FMEC is not a healthcare provider and cannot process Health Savings Account ("HSA") payments.
1.3. Patient desires to utilize an HSA payment method for payment required by the Program Agreement.
2. HSA Coverage
2.1. Practice’s Program Agreement provides access to integrative and functional medicine not covered by health insurance, including the FMEC Platform.
2.2. Practice makes no representations or determinations that the costs for Practice’s services or the costs to access the FMEC Platform are approved HSA expenses.
2.3. Patient should consult with their HSA administrator with any questions regarding approved HSA expenses.
3. Modification of Payment and Agreement
3.1. Patient requests that Practice processes the required FMEC Platform payment on behalf of FMEC.
3.2. Patient consents to Practice collecting the FMEC Platform payment and making recurring charges consistent with the Program Agreement and Attachment A.
3.3. Patient will not receive FMEC Platform emails, including notices of upcoming charges, notices of charges and receipts for charges.
3.4. Patient will not be able to cancel their Program Agreement through the FMEC Platform, but will instead need to notify Practice in writing consistent with Section 4 of the Program Agreement.
4. All other terms, conditions and responsibilities of the Program Agreement and Attachment A are unaffected by this Addendum.