eServices Agreement
eServices Selection and Terms/Conditions
Group NameGroup NumberDivision(s)
The following functions can be performed, please select the functionality your Group would like to utilize:Manage Billing (Paperless)
Manage Your Members
Terms and Conditions

1. Access to System and Policy Information.
 First Reliance Standard Life Insurance Company grants Group, identified above, the right to access the First Reliance Standard Life Insurance Company group administration system via the Internet, using the 'Processing Web Site', for the limited purpose(s) selected by Group above. Group agrees that its access to and use of the Processing Web Site shall be subject to these Terms and Conditions and any other instructions provided by First Reliance Standard Life Insurance Company. Group's access to the Processing Web Site may be restricted without notice for emergency or routine system repair and maintenance.
2. Obligations of Group.
2.1 Designated Representative.
 Group shall provide First Reliance Standard Life Insurance Company with the name of one (1) of its employees to act as the 'Designated Representative.' The Designated Representative is authorized to access the Processing Web Site or, with the prior approval of First Reliance Standard Life Insurance Company, may assign this authority to other employees or representatives of Group. Group may change the Designated Representative by notifying First Reliance Standard Life Insurance Company prior to the effective date of such change.
2.2 Controlling Access.
 Group will take all steps reasonably necessary to ensure that no unauthorized person(s) within its reasonable control shall gain access to the Processing Web Site. Additionally Group assumes all risk for errors or omissions made by Group, its Designated Representative and other employees, agents or subcontractors of Group that result in or contribute to the payment by First Reliance Standard Life Insurance Company of a claim(s) for services rendered after the date a given insured's coverage under the Policy has terminated. In the event First Reliance Standard Life Insurance Company erroneously pays a claim of the kind described in the previous sentence, Group shall be required to remit to First Reliance Standard Life Insurance Company, on an as-billed basis, that amount of premium necessary to provide insurance coverage for such insured through the latest date of dental or eye care service for which a claim was paid by First Reliance Standard Life Insurance Company. Group solely assumes all risk and liability for errors or omissions made by Group, its Designated Representative and other employees, agents or subcontractors of Group that result in the denial of coverage by First Reliance Standard Life Insurance Company
3. Obligations of First Reliance Standard Life Insurance Company.
 First Reliance Standard Life Insurance Company will provide the Group with instructions and rules relating to the access and use of the Processing Web Site which, when issued, become a part of these Terms and Conditions. Additionally, First Reliance Standard Life Insurance Company shall from time-to-time provide Group with a reasonable level of technical assistance during the normal business hours of First Reliance Standard Life Insurance Company on an as-requested basis.
4. Warranties.
 FIRST RELIANCE STANDARTRD LIFE INSURANCE COMPANY MAKES NO REPRESENTATIONS OR WARRANTIES, EITHER EXPRESS OR IMPLIED, INCLUDING ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.
5. Limitation of Liability.
 IN NO EVENT SHALL EITHER PARTY BE LIABLE TO THE OTHER FOR ANY INDIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, INCLUDING WITHOUT LIMITATION DAMAGES FOR LOSS OF PROFITS, INCURRED BY THE OTHER PARTY OR ANY THIRD PARTY, WHETHER IN AN ACTION IN CONTRACT OR TORT, EVEN IF ADVISED OF THE POSSIBILITY THEREOF.
6. Indemnification.
 To the extent permitted by applicable state and federal law, each party will indemnify, defend and hold the other harmless from and against any claims, suits, losses, expenses, costs, including reasonable attorneys fees, or damages resulting from or arising out of the violation or breach of these Terms and Conditions by the indemnifying party, its principals, employees or, in the case of Group, by any oversight, errors or omissions of whatever kind or nature made by Group or its Designated Representative or by any other employee of Group in the course of performing or failing to perform any obligations under these Terms and Conditions.
7. Duration and Termination.
 Group's right of electronic access shall continue until terminated. Either party may terminate these electronic access rights at any time and for any reason upon thirty (30) days written notice sent to the other party's last-known address. First Reliance Standard Life Insurance Company reserves the right to immediately terminate Group's electronic access if it reasonably believes Group, including its representatives, are violating any of these Terms and Conditions or that the continued access by Group poses any type of threat to the security or integrity to the Processing Web Site or administrative system of First Reliance Standard Life Insurance Company. Finally, Group's right of electronic access shall automatically and immediately terminate upon the termination of the corresponding group insurance policy issued by First Reliance Standard Life Insurance Company to Group ('Policy').
8. Confidentiality.
 Group acknowledges that information obtained via its access to the Processing Web Site and any other information, in whatever form, delivered by First Reliance Standard Life Insurance Company to Group concerning the subject matter of these Terms and Conditions is confidential information. Group, therefore, agrees to keep confidential the method, including passwords or identification codes, for accessing information through the Processing Web Site and the information so accessed as well as the information delivered by First Reliance Standard Life Insurance Company to Group concerning the subject matter hereof. Breach of this Section by Group, or any principal, employee, subcontractor or agent of Group shall constitute a material breach of these Terms and Conditions.
9. Miscellaneous.
9.1 Compliance with Laws.
 Each party shall comply with all applicable laws, ordinances, rules, regulations and orders (collectively 'Applicable Laws') issued by any public or governmental agency, body or authority, whether federal, state, local or otherwise. Such Applicable Laws include, without limitation, those relating to the protection, handling and dissemination of nonpublic personal information, whether financial or health information.
9.2 Entire Agreement; Amendment.
 These Terms and Conditions along with any additional instructions and rules delivered by First Reliance Standard Life Insurance Company form the terms and conditions by which Group's electronic access shall be performed. First Reliance Standard Life Insurance Company may, from time to time, update any of these Terms and Conditions or other rules. Group shall be bound by these updated terms and conditions but only following delivery thereof by First Reliance Standard Life Insurance Company.
9.3 Survival.
 The provisions of Sections 4, 5 and 6 shall survive the termination of Group's electronic access rights.
9.4 Impact on Policy.
 The parties acknowledge and agree that these Terms and Conditions in no way modify, alter or amend the Policy.
AcceptanceIn order to complete this preliminary step in the eServices sign-up process, a representative duly authorized to bind your company must complete the following:
Name of Authorized Representative
Title of Authorized Representative
By selecting "Agree" below, Group, through the above-named Authorized Representative, selects the above eServices and agrees to accept and be bound by the above eServices Terms and Conditions. Despite its acceptance, Group shall not have access to the selected eServices and shall not be bound by the eServices Terms and Conditions until Reliance Standard Life Insurance Company formally approves Group's request for access. Reliance Standard Life Insurance Company reserves the right to withhold such approval in its sole discretion. If approved for eServices, Reliance Standard Life Insurance Company will notify Group and provide a unique ID and password for access to the Processing Web Site. Group acknowledges and agrees that the Terms and Conditions will become effective upon Group's receipt of approval from Reliance Standard Life Insurance Company.By selecting "Agree," the Group also specifically agrees to conduct this transaction electronically.If Group does not wish to accept the eServices Terms and Conditions, please select the "Do Not Agree" option below. You will return to the Benefits Administrator Home Page.You understand that by choosing to use online e-services you will no longer receive paper copies of documents that you select to receive electronically. You may choose to receive billing statements, certificates of coverage, and/or ID cards in electronic form in lieu of physical copies. You also understand that you can unsubscribe from the online e-services, including e-enroll by calling Group Administration at 1-800-497-7044 If you choose to unsubscribe from e-services, you will no longer have access to e-services online portal and online documents including billing, certificates of coverage and ID cards.*Enrollment in this electronic service requires that you have a computer with appropriate browser software, e-mail software as well as communications access to the Internet. Browser requirements include the most current or previous version of one of the following: Netscape, Internet Explorer, Firefox Mozilla, Safari or Opera. Web pages are best viewed at an 800 x 600 screen resolution (web browser size of 760 x 480), and allowed to be viewed at various resolutions with minimal degradation of content display. Although we will not charge for electronic delivery you may incur charges from Internet Service Providers and local telephone companies. Should you wish to print materials that have been delivered electronically, you must have a printer as well. Some files are available in Adobe Acrobat Format. In order to view this format (.pdf), you will need to have Adobe Acrobat Reader software. Visit Adobe.com to obtain the most current free version of Adobe Reader.
Please complete the Contact Information section below so that we may contact you regarding your request:
Name
Phone
E-mail
Check here if Contact is the same as Security AdministratorSecurity AdministrationPlease identify the person that will be responsible for accessing the system:
Name
Address
CityStateZip
Phone
E-mail
How many people will be using this system?After you submit this agreement, a confirmation page will be displayed. Please print this next page for your records.