By accessing nexillohealth.com or using any Nexillo Health TPA service, portal, or benefit administration platform, you agree to be bound by these Terms & Conditions. These Terms apply to all employers, brokers, members, providers, and authorized users of Nexillo Health platforms.
01 Acceptance of Terms
By accessing or using the Nexillo Health website at nexillohealth.com ("Site"), logging into any Nexillo Health portal, or receiving TPA services from Nexillo Health, you agree to be bound by these Terms & Conditions ("Terms"). If you are acting on behalf of an employer organization, brokerage, or healthcare practice, you represent that you have authority to bind that entity to these Terms.
If you do not agree to these Terms, you may not use the Site or any Nexillo Health service or portal. Use of the Site or any portal constitutes ongoing acceptance of the most current version of these Terms.
02 About Nexillo Health
Nexillo Health is a Third-Party Administrator (TPA) headquartered in Coppell, Texas, dedicated to helping self-funded and level-funded employers manage their employee health benefit plans more effectively. As a TPA, Nexillo Health does not underwrite or insure health benefits - instead, it administers them on behalf of employer plan sponsors.
Nexillo Health is powered by the technology platforms developed by its affiliate, Nexillo, Inc. (nexillo.com), which provides the underlying claims adjudication, enrollment, provider data, billing, and portal infrastructure. Together, these entities deliver a fully integrated, technology-driven benefits administration experience for employers, brokers, members, and providers.
03 Who These Terms Apply To
These Terms apply to all four groups that interact with Nexillo Health:
04 TPA Services Overview
Nexillo Health provides the following core third-party administration services to employer plan sponsors and their covered populations. All services are delivered pursuant to a written TPA Service Agreement executed between Nexillo Health and the applicable employer or plan sponsor:
05 Employer Responsibilities
As an employer plan sponsor contracting with Nexillo Health, you agree to:
- Provide accurate, timely, and complete enrollment data for all eligible employees and dependents, including accurate demographic information, coverage elections, and qualifying life event updates;
- Designate authorized plan administrators with appropriate access levels and promptly notify Nexillo Health of any personnel changes;
- Fund claims payments in accordance with your executed TPA Service Agreement and maintain sufficient funds in your claims funding account;
- Comply with all applicable federal and state laws governing employer-sponsored health benefit plans, including ERISA, ACA, COBRA, HIPAA, and applicable state insurance regulations;
- Maintain a compliant Summary Plan Description (SPD) and provide required plan documents to employees as required by law;
- Notify Nexillo Health promptly of any changes to plan design, benefit structure, or employer contributions that affect plan administration.
Employers, not Nexillo Health, are responsible for collecting employee contact information including phone numbers. Employee phone numbers are provided to Nexillo Health by the employer during the plan enrollment and onboarding process. Nexillo Health does not solicit or collect phone numbers directly from employees or members through this website or any public-facing form.
06 Broker Responsibilities
Brokers partnering with Nexillo Health agree to:
- Maintain all required state insurance licenses and comply with applicable producer regulations in all jurisdictions where they conduct business;
- Use the Nexillo Health Broker Portal and all associated tools exclusively for the purpose of serving the broker's employer clients enrolled with Nexillo Health;
- Accurately represent Nexillo Health's products, services, capabilities, and fees to employer clients and prospects;
- Submit enrollment requests, group updates, and client communications through the Broker Portal accurately and in a timely manner;
- Maintain the confidentiality of all employer and member information accessed through the Broker Portal.
07 Member Portal Use
Members enrolled in a Nexillo Health-administered benefit plan may access the Member Portal to:
- View health, dental, and vision plan details and coverage summaries;
- Request new or replacement ID cards;
- Check the real-time status of submitted claims;
- Review Explanations of Benefits (EOBs) including services covered, provider charges, plan payments, and member responsibility;
- Monitor deductible and out-of-pocket accumulations throughout the plan year;
- Search for in-network doctors, specialists, hospitals, and healthcare facilities;
- Access wellness tools and member resources.
Members agree to use the Member Portal only with their own authorized credentials and to keep login information confidential. Members are responsible for the accuracy of any information they submit through the portal. Members must promptly notify their employer or Nexillo Health of any changes to eligibility status, such as a qualifying life event, change in dependent status, or termination of employment.
For Member support, contact: +1 877-686-1901 or support@nexillohealth.com.
08 Provider Portal Use
Healthcare providers who access the Nexillo Health Provider Portal agree to use it solely for legitimate healthcare administration purposes, including verifying member eligibility, checking claims status, submitting electronic claims, and accessing Explanation of Benefits (EOB) documents.
- You may only access information for patients for whom you have a legitimate treatment, payment, or healthcare operations purpose under HIPAA;
- You agree not to access, copy, or download member or claims data in bulk or for any purpose beyond individual patient care and billing;
- Provider Portal access is subject to credentialing requirements and may be revoked if misused or if provider credentials lapse.
09 Authorized Use
All users of nexillohealth.com and Nexillo Health portals agree to use the Site and portals solely for lawful purposes in compliance with all applicable federal, state, and local laws. Prohibited uses include:
- Accessing any Nexillo Health portal beyond the scope of your authorized role;
- Attempting to reverse engineer, decompile, or extract data from any Nexillo Health platform;
- Scraping, crawling, or bulk-extracting data from any Nexillo Health portal or website;
- Uploading or transmitting malicious code, viruses, or any content that disrupts portal integrity;
- Attempting to access accounts, data, or systems that do not belong to you or your authorized employer group.
10 Account Security
All portal users are responsible for maintaining the confidentiality of their login credentials. You must notify Nexillo Health immediately of any suspected unauthorized access or security breach by contacting us at support@nexillohealth.com or by calling +1 214-550-3457.
Nexillo Health reserves the right to suspend or terminate portal access for any account that violates these Terms, applicable law, or poses a security risk to the platform or other users.
11 Privacy, Data & PHI
Nexillo Health processes health benefit data - including member eligibility records, claims data, provider information, enrollment data, and payment records - on behalf of employer plan sponsors as a HIPAA-covered business associate.
All data processed through Nexillo Health portals and platforms belongs to the respective employer plan sponsor. Nexillo Health does not use member or employer data for any purpose beyond delivering contracted TPA services. Nexillo Health does not sell member data or employer data to third parties.
Information collected through this Site's contact forms (name, company, email) is used solely to respond to inquiries. For full details, see Nexillo Health's Privacy Policy.
12 HIPAA & Regulatory Compliance
Nexillo Health operates as a HIPAA business associate for employer plan sponsors who qualify as covered entities or whose plans are subject to HIPAA. To the extent Nexillo Health processes Protected Health Information (PHI), such processing is governed by a separately executed Business Associate Agreement (BAA) and Nexillo Health's obligations under the HIPAA Privacy Rule, Security Rule, and Breach Notification Rule.
Employer plan sponsors remain responsible for their own regulatory compliance, including plan document obligations, ERISA compliance, ACA reporting requirements, COBRA administration, and applicable state continuation coverage requirements. Nexillo Health does not provide legal, tax, or compliance advice.
13 Intellectual Property
All content on the Nexillo Health Site and within all Nexillo Health portals - including source code, UI/UX designs, workflows, documentation, logos, trademarks, and marketing materials - is the exclusive property of Nexillo Health or its affiliates and is protected under applicable copyright, trademark, and trade secret laws.
Your use of the Site or portals does not grant you any ownership interest or license to reproduce, distribute, or create derivative works from any Nexillo Health content. You may not use Nexillo Health's trademarks, logos, or brand assets without prior written consent.
14 Indemnification
You agree to defend, indemnify, and hold harmless Nexillo Health and its officers, directors, employees, contractors, agents, and successors from and against any claims, damages, losses, liabilities, costs, and expenses (including reasonable attorneys' fees) arising out of or relating to:
- Your access to or use of the Site or any Nexillo Health portal beyond your authorized scope;
- Your violation of these Terms or any applicable client agreement;
- Your violation of any applicable law, including HIPAA, ERISA, ACA, state insurance law, or applicable pharmacy benefit regulations;
- Inaccurate or incomplete data you submit to or process through a Nexillo Health platform;
- Any claim by a third party arising from your use of Nexillo Health portals or your breach of these Terms.
15 Disclaimer of Warranties
16 Limitation of Liability
In no event shall Nexillo Health's total liability to you for all claims under these Terms exceed the greater of: (a) the total fees paid by you to Nexillo Health in the three months preceding the event, or (b) one hundred U.S. dollars ($100.00). The foregoing limitations do not apply to liability that cannot be excluded under applicable law.
17 Third-Party Services
Nexillo Health's platforms integrate with third-party healthcare systems, clearinghouses, pharmacy networks, and data sources. Nexillo Health does not control and is not responsible for the availability, accuracy, or performance of third-party systems or data sources connected to Nexillo Health platforms.
The Site may contain links to third-party websites for reference only. Nexillo Health does not endorse or assume responsibility for the content, security, or privacy practices of any third-party sites.
18 Modifications to Terms
Nexillo Health reserves the right to update these Terms at any time. Material changes will be communicated to active clients via email or portal notification. Changes will be posted on this page with a revised effective date. Your continued use of the Site or any Nexillo Health portal following notice of changes constitutes your acceptance of the updated Terms.
Nexillo Health also reserves the right to modify, suspend, or discontinue any portal or service at any time, with or without notice, without liability to you except as otherwise provided in your executed TPA Service Agreement.
19 SMS / Text Messaging Terms
By opting in to receive text messages from Nexillo Health, you agree to the following terms:
You consent to receive recurring SMS/MMS messages from Nexillo Health, including but not limited to account notifications, service updates, and customer support communications. Message frequency varies. Message and data rates may apply.
You may also receive one-time passcode (OTP) messages for two-factor authentication (2FA) to verify your identity when logging into Nexillo Health portals. These security messages are sent only when triggered by a login or account action and cannot be opted out of while 2FA is enabled on your account.
You may opt out of non-security messages at any time by replying STOP to any message. After opting out, you will receive a confirmation message and no further non-security messages will be sent. For assistance, reply HELP or contact us at support@nexillohealth.com.
Your mobile phone number and opt-in data will not be shared with or sold to third parties. See our Privacy Policy for full details.
20 Contact Us
For questions about these Terms, your benefit plan, portal access, or TPA services:
Nexillo Health
2999 Olympus Blvd, Ste 450, Coppell, TX 75019
