Gabriel Care SMS Program Terms
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1. Parties
This Membership and Benefits Agreement (the "Agreement") is between Gabriel Care LLC, a Nevada limited liability company ("Gabriel Care," "Gabriel," "we," "us," or "our"), and the individual who enrolls in Gabriel Care or receives access through an employer or sponsoring organization ("Member," "you," or "your"). Gabriel Care is offered by Gabriel Care LLC. Insurance brokerage, plan enrollment, and Agent-of-Record services described in this Agreement are provided by Gabriel Labs LLC, a separately licensed Nevada insurance agency. Gabriel Care LLC and Gabriel Labs LLC are affiliated but separate legal entities. References in this Agreement to insurance brokerage, plan enrollment, or Agent-of-Record services refer to services provided by Gabriel Labs LLC.
If you enroll through an employer, sponsor, family account, or other group, this Agreement applies to your individual use of Gabriel Care. Your sponsor may also have a separate agreement with Gabriel.
2. Key Definitions
"Benefits Schedule" means the tier-specific or sponsor-specific schedule that describes membership fees, reimbursement limits, eligible categories, exclusions, documentation requirements, waiting periods, pre-approval rules, and any special terms that apply to a member.
"Covered Member" means a person who is listed in Gabriel's records as eligible to use Gabriel Care benefits under an active individual, household, or sponsor-paid membership.
"Family Membership" means a household membership covering a Primary Member, optional Adult Dependents, and Child Dependents as described in Section 15.
"Monthly Benefit Period" means the recurring one-month cycle that begins on your enrollment or membership billing date and renews on the same date each month, aligned to your membership billing date rather than the calendar month. For enrollment dates that do not occur in a given month, such as the 29th through the 31st, the Monthly Benefit Period ends on the last day of that month and resumes on your regular date the following month. Your monthly wellness reimbursement amount is available during your Monthly Benefit Period, does not roll over, and resets at the start of your next Monthly Benefit Period. Because members enroll on different dates, wellness amounts reset on different dates throughout the month rather than all on the first.
"Primary Member" means the individual responsible for payment of the membership and the contact of record for the household.
"Sponsor" means an employer, organization, family account holder, or other third party that pays for, subsidizes, or makes Gabriel Care available to a Member.
"Standalone Wellness Membership" means a membership in which the Member does not also receive insurance enrollment, plan brokerage, or Agent of Record services through Gabriel, as described in Section 16.
"Third-Party Provider" means any clinician, practitioner, pharmacy, lab, telehealth group, marketplace, broker, insurer, carrier, facility, merchant, wellness provider, or other independent party that provides products or services outside Gabriel.
"Clinical Care Component" means the fixed portion of the membership fee that purchases access to clinical and medical-care services furnished by licensed Third-Party Providers arranged through Gabriel, as described in Section 16A.
"Wellness & Concierge Component" means the portion of the membership fee that covers non-clinical health navigation, concierge coordination, wellness reimbursement administration, member support, and technology access, as described in Section 16A.
"Wellness Credits" and "Wellness Pool" mean Gabriel's internal monthly reimbursement limit for eligible expenses under a Benefits Schedule. These are not cash, stored value, wages, insurance benefits, a health savings account, a flexible spending account, or a member-owned account.
3. Agreement to Terms
By creating an account, enrolling in a paid Gabriel Care membership, clicking "I agree," using Gabriel Care benefits, submitting a reimbursement request, asking Gabriel to coordinate care, or continuing to use Gabriel Care after receiving notice of updated terms, you agree to this Agreement, the Gabriel Care Terms of Service, Privacy Policy, applicable consent forms, and the Benefits Schedule provided to you.
If you do not agree, do not enroll or use Gabriel Care benefits.
3A. Founding Member Access
You're joining as a founding member of Gabriel Care. During this early period, we're intentionally welcoming a limited number of members from our waitlist so we can deliver an exceptional, high-touch experience and build Gabriel around what our members actually need. As a founding member, you get early access to our wellness benefits, AI-powered care team, and coverage layer, and your experience directly shapes what Gabriel becomes.
Gabriel Care is actively evolving, and our commitment is simple: we intend to maintain the benefits we've described and to keep improving them over time. As the program grows, certain details, including tiers, pricing, Wellness Credit amounts, Balance Build schedules, eligible categories, and program features, may be refined or expanded. If we ever need to make a material change that reduces a benefit you're receiving, we'll give you advance notice, and you may cancel before that change takes effect. You're never locked into a change you don't accept.
From time to time we may update this Agreement and the Benefits Schedule. When a change is material, we'll present the updated terms for your review and acceptance before you continue, and your continued membership or re-acceptance confirms the update. If you don't accept a material update, you may cancel before its effective date as described in this Agreement.
4. What Gabriel Care Is
Gabriel Care is a membership service that combines health navigation, AI-assisted support, wellness reimbursement administration, care coordination, plan optimization, claims support, provider routing, and member concierge services.
Depending on your membership tier and location, Gabriel Care may include:
Access to Gabriel's AI health operating system and member support channels.
Insurance and benefits navigation support.
Wellness reimbursement administration subject to eligibility rules and monthly limits.
Provider search, appointment booking, and concierge coordination.
Claims, receipt, and benefit document review.
Health Vault document storage and organization.
Optional wearable, lab, supplement, protocol, and health data integrations.
Access to third-party products or services through independent providers.
5. What Gabriel Care Is Not
Gabriel Care is not health insurance unless you separately enroll in an insurance product issued by a licensed insurer. Gabriel Care does not itself guarantee payment of medical expenses, does not replace comprehensive health insurance, and does not satisfy any legal requirement to maintain health coverage unless a separate regulated product expressly says so.
Gabriel is not a hospital, physician group, emergency service, pharmacy, insurer, third-party administrator, or medical provider. Gabriel does not practice medicine. Gabriel's AI and staff support are informational, administrative, navigation, and coordination tools. Medical decisions must be made by you and your licensed healthcare providers.
Gabriel Care is not for emergencies. If you believe you may have a medical emergency, call 911 or seek emergency medical care immediately.
6. Membership Tiers and Benefits Schedule
Your benefits are defined by the Benefits Schedule active for your membership tier at the time of service. The Benefits Schedule may include monthly reimbursement limits, waiting periods, pre-approval requirements, documentation requirements, covered categories, excluded categories, member cost-sharing, and reimbursement timing.
Emerald, Sapphire, and Onyx are available to adults of every age on the same tier terms. A member's age does not change the selected tier's fee, Wellness Pool, wearable engagement bonus, Balance Build, or other published tier benefits. Medicare-eligible members may receive optional Senior and Medicare coordination as a service overlay, but that overlay is not a separately priced membership tier and does not change the selected tier's pricing or benefits.
All wellness benefits, reimbursement limits, benefit categories, wearable increases, deductible assistance, catastrophic assistance, and other membership benefits are discretionary program features, not vested rights, cash entitlements, insurance benefits, or guaranteed monthly amounts. Gabriel may increase, decrease, pause, replace, limit, or discontinue benefits prospectively for a sponsor group, tier, category, geography, family structure, other objectively defined eligibility class, or the program as a whole based on utilization, pool health, reserve levels, fraud or abuse risk, regulatory concerns, provider availability, pricing changes, financial sustainability, operational constraints, or other business reasons. No per-category dollar caps currently apply. Gabriel reserves the right to introduce prospective, published category limits for a tier or other objectively defined eligibility class under this Agreement's notice provisions.
Gabriel does not guarantee any minimum or maximum wellness benefit, reimbursement amount, deductible assistance amount, catastrophic assistance amount, or monthly benefit value. References to "up to" amounts are maximum possible amounts under the then-current Benefits Schedule, not promised amounts and not amounts Gabriel is obligated to reimburse in any month.
Gabriel intends to operate the program in good faith and to support members whenever reasonably possible, but Gabriel must preserve flexibility to protect the long-term health and sustainability of the membership program.
Wearable Engagement Bonus
The wearable engagement bonus is a discretionary wellness-reward feature that may increase a member's Monthly Wellness Cap when the member connects an eligible wearable and maintains qualifying engagement. The bonus is framed as a base pool plus potential upside, not as a guaranteed benefit. For example, Sapphire may offer up to $150 per month in wearable engagement upside: $45 for qualifying connection and up to $105 more for qualifying activity. The healthier and more consistently engaged a member is, the more of the available bonus the member may earn, subject to the Benefits Schedule and all program rules.
The then-current wearable engagement bonus is divided into two parts: a Connection Bonus equal to 30 percent of the tier's maximum wearable engagement bonus, and an Activity Bonus equal to 70 percent of the tier's maximum wearable engagement bonus. For the current tiers, the Connection Bonus is Emerald $30 per month, Sapphire $45 per month, and Onyx $60 per month. The Activity Bonus is Emerald up to $70 per month, Sapphire up to $105 per month, and Onyx up to $140 per month.
Wearable bonus timing. Neither the Connection Bonus nor the Activity Bonus is available during the first two Monthly Benefit Periods. A wearable engagement bonus may first increase the Monthly Wellness Cap in Period 3, provided the member has satisfied all then-current connection, activity, and eligibility requirements. Wearable data collected during Periods 1 and 2 may count toward the applicable measurement windows, but no wearable engagement bonus is applied before Period 3. This timing rule applies to Flex and Full Access across every tier and enrollment type that offers a wearable engagement bonus, including Emerald, Sapphire, Onyx, Family Memberships, and Teams.
Reaching Period 3 does not automatically earn a wearable engagement bonus. To first qualify for the Connection Bonus, a member must complete 30 days of connected, actively syncing wearable data. Both the Period 3 timing requirement and the connection requirement must be satisfied. After qualification, the Connection Bonus is maintained when Gabriel receives wearable data for at least 20 of the trailing 30 days. If the member falls below that maintenance threshold, Gabriel may provide one Monthly Benefit Period of grace during which the Connection Bonus remains active and Gabriel notifies the member to reconnect or resume syncing. If the member remains below the threshold at the next monthly check, the Connection Bonus is removed for the following benefit period. A removed Connection Bonus is re-earnable by reconnecting and meeting the then-current maintenance threshold; there is no additional waiting penalty beyond the applicable measurement window.
The Activity Bonus is calculated monthly using a trailing 30-day window and then-current measurable health engagement metrics. In V1, a "goal-day" means a day on which the member records either at least 10,000 steps or at least 7 hours of sleep through the connected wearable data source. Twenty or more goal-days in the trailing 30-day window earns the full Activity Bonus. Ten through 19 goal-days earns one-half of the Activity Bonus. Fewer than 10 goal-days earns no Activity Bonus for the following benefit period. The Activity Bonus decays or increases with behavior, is recalculated monthly, and is re-earnable.
All wearable engagement bonus amounts, percentages, metrics, thresholds, measurement windows, eligible devices, data-source rules, grace rules, and activity tiers are discretionary program features. Gabriel may change, reweight, pause, replace, or discontinue them prospectively under this Agreement's change provisions. Bonus changes affect future benefit periods only and do not claw back already approved reimbursements or retroactively alter expenses with a date of service before the effective change date, except as otherwise permitted under this Agreement for fraud, mistake, ineligibility, payment reversal, safety, legal, or plan-integrity reasons.
Beyond the connection and activity engagement bonuses, Gabriel may from time to time, in its sole discretion, provide additional member rewards, credits, discounts, brand-partnership perks, product benefits, service benefits, or other root-cause, holistic, or preventative-health benefits, including discretionary bonuses in months of strong pool health. These additional bonuses are not guaranteed, are not vested rights, and may be offered, varied, limited, paused, or discontinued at any time.
Membership prices below are Gabriel Care membership prices only. Insurance premiums, ACA plan selection, subsidy effects, network costs, and other external coverage costs are separate.
Emerald
Membership fee: $249 per month, unless otherwise stated at enrollment.
Wellness reimbursement limit: up to $500 per month after any applicable ramp period.
Wearable engagement bonus: up to $100 per month if requirements are met, plus additional engagement bonuses Gabriel may offer from time to time.
Credits expire monthly and do not roll over.
Full schedule in Exhibit A.
Sapphire
Membership fee: $399 per month, unless otherwise stated at enrollment.
Wellness reimbursement limit: up to $750 base per month after any applicable ramp period, up to $900 per month with the full wearable engagement bonus earned.
Wearable engagement bonus: up to $150 per month if requirements are met, plus additional engagement bonuses Gabriel may offer from time to time.
Credits expire monthly and do not roll over.
Full schedule in Exhibit A.
Onyx
Membership fee: $799 per month, unless otherwise stated at enrollment.
Positioning: concierge-managed private household health support.
Wellness reimbursement allowance: concierge-managed, with a default target up to $1,500 per month subject to the accepted Benefits Schedule. Wearable engagement bonus up to $200 per month if requirements are met, plus additional engagement bonuses Gabriel may offer from time to time.
Credits expire monthly and do not roll over unless the Benefits Schedule expressly says otherwise.
Full schedule in Exhibit A.
Teams
Teams is an employer-paid or sponsor-paid group wellness membership. Current standard Teams tiers are listed below, unless the sponsor agreement or accepted Benefits Schedule states otherwise. These are maximum possible draw amounts under the accepted Benefits Schedule, not cash, wages, stored value, or guaranteed monthly reimbursement.
| Tier | Monthly price | Base monthly draw | With wearable bonus |
|---|---|---|---|
| Core | $149 / eligible employee / mo | Up to $500 | Up to $600 |
| Plus | $199 / eligible employee / mo | Up to $700 | Up to $800 |
| Elite | $299 / eligible employee / mo | Up to $1,000 | Up to $1,200 |
Unused monthly Teams surplus is not paid to employees as cash and is not a member-owned account. Subject to the sponsor agreement, Benefits Schedule, eligibility rules, documentation, and approval, unused monthly surplus may reconcile into the sponsor group's Care Reserve at face value for larger approved care needs such as at-home birth, stem-cell or regenerative therapy, biological dentistry, and longevity care.
Care Reserve dollars hold face value. On partnered or in-network high-ticket services, Gabriel may negotiate preferred pricing that can create up to approximately 1.2x effective purchasing power, subject to provider availability and negotiated rates. This is not a guaranteed multiplier, cash value, or entitlement.
Undrawn Care Reserve credits older than 36 months may return to the employer as renewal credit. If a sponsor group cancels, the undrawn Care Reserve balance returns to the employer net of any pre-authorized high-ticket draws already in flight, unless the sponsor agreement or applicable law requires a different treatment.
Employees may also enroll voluntarily at individual Gabriel Care pricing outside the sponsor-paid Teams model. Standalone individual pricing starts at $279 per month for Emerald, $429 per month for Sapphire, and $829 per month for Onyx, with lower pricing available when bundled with a Gabriel-managed ACA plan.
Employer payment does not make Gabriel the employer's health plan, plan fiduciary, insurer, or benefits administrator unless a separate written agreement expressly says so.
Family Memberships
Family memberships layer a Primary Member with optional Adult Dependents and Child Dependents under a single shared monthly Wellness Pool. Pricing, pool composition, and ramp rules are set forth in Section 15 and Exhibit A.
Plan Changes
Gabriel may update, replace, reduce, increase, pause, or discontinue a membership tier, Benefits Schedule, reimbursement limit, covered category, deductible assistance feature, catastrophic assistance feature, or other benefit with notice when legally required or when Gabriel determines notice is appropriate. Gabriel may make immediate changes without advance notice when needed for fraud prevention, safety, plan integrity, regulatory concerns, provider availability, payment risk, pool health, reserve protection, financial sustainability, or operational reasons.
Changes do not retroactively alter an already approved reimbursement request for a service date before the effective change date, unless required by law, fraud prevention, safety, mistake correction, payment reversal, member ineligibility, sponsor ineligibility, or plan integrity rules. Pending, future, incomplete, unapproved, or not-yet-submitted requests remain subject to the Benefits Schedule and program rules in effect when Gabriel reviews them.
7. Wellness Reimbursement Rules
Gabriel may reimburse eligible expenses up to the limits in your Benefits Schedule. Reimbursements are not cash entitlements and do not create a member-owned account. Unused amounts expire at the end of each Monthly Benefit Period (as defined in Section 2), which is aligned to your membership billing date rather than the calendar month, and do not roll over.
Reimbursement limits are maximum review limits, not guaranteed payments. Gabriel may approve less than the requested amount or less than the stated maximum based on eligibility, documentation, category rules, fair market value, pool health, reserve protection, fraud controls, member history, provider pricing, legal restrictions, or other plan-integrity factors.
Wellness Credits and other benefit limits are internal program limits only. They are not cash, stored value, wages, compensation, insurance proceeds, HSA/FSA funds, trust assets, escrowed funds, or balances payable to you. You may not transfer, sell, assign, borrow against, redeem, cash out, roll over, or demand payment of unused benefits.
Reimbursement timing. Showing a wellness credit balance in your account does not mean funds are immediately payable. Wellness credits represent an internal monthly reimbursement limit, not cash. After you submit a complete reimbursement request, Gabriel typically processes approved payouts within 48 to 72 hours, though timing varies by reimbursement category, documentation completeness, and fraud and plan-integrity review. Gabriel may take additional time when a request requires further review, additional documentation, or audit.
To be eligible for reimbursement, an expense must:
Be for you or another covered member on your account.
Occur while your membership is active and paid.
Fit an eligible category in your Benefits Schedule.
Be supported by a dated, itemized receipt or invoice.
Include provider, merchant, product, or service details sufficient for review.
Be legal in the jurisdiction where purchased or received.
Be medically, wellness, or prevention related, not primarily cosmetic, recreational, or personal convenience, unless your Benefits Schedule expressly allows it.
Comply with pre-approval, waiting period, fair market price, and documentation rules.
Gabriel has final discretionary authority, subject to applicable law, to interpret the Benefits Schedule and determine whether a request is eligible, partially eligible, ineligible, requires more information, requires pre-approval, should be capped at fair market value, or should be denied for plan-integrity reasons. Gabriel may approve, deny, reduce, delay, audit, reverse, recoup, or request more information for any reimbursement request.
Gabriel may cap reimbursement at a fair market amount, exclude taxes, shipping, memberships, subscriptions, tips, late fees, financing charges, or bundled items that are not eligible. If a receipt, invoice, provider package, product bundle, or service charge appears inflated, excessive, unusual, bundled, duplicative, or above typical market pricing, Gabriel may reimburse only the amount Gabriel determines is reasonable or may deny the request.
Gabriel does not provide tax advice. Reimbursements, sponsor-paid memberships, stipends, or wellness benefits may have tax consequences depending on the member, sponsor, benefit design, and applicable law. Members and sponsors should consult their own tax advisors.
Date of service; prospective changes. Whether an expense is eligible, and the reimbursement limits that apply to it, are determined under the Benefits Schedule and program rules in effect on the date the expense was incurred (the date of service), not the date the request happens to be reviewed. If Gabriel changes a Benefits Schedule, reimbursement limit, or program rule, the change applies prospectively to expenses incurred on or after the effective date of the change and does not reduce eligibility for expenses already incurred while your membership was active and paid. Reconsideration. If Gabriel denies or reduces a reimbursement request, you may request a written reconsideration within sixty (60) days of the decision by submitting additional documentation or explanation through the available account process. Gabriel will review the request in good faith and provide a written response. This reconsideration process does not convert any discretionary benefit into a guaranteed benefit, and Gabriel's good-faith determination on reconsideration is final.
7A. Single Expenses, Monthly Caps, and Payment Over Time
A single expense is reviewed under the monthly reimbursement limit and program rules in effect for the month in which it was incurred (its date of service). A single expense, invoice, receipt, or service may not be divided, split, re-dated, or resubmitted across multiple Monthly Benefit Periods in order to draw from more than one month's pool or exceed the monthly limit that applies to its date of service. Any amount above the applicable monthly limit is not carried forward, banked, or reimbursed in a later month.
Genuinely recurring or ongoing care is treated differently from a single expense. Where a member receives care on an ongoing basis, or pays for care under a structured payment plan in which each monthly charge is a separate, real charge supported by its own dated, itemized invoice, each month's actual charge is reviewed against that month's pool in the ordinary way. Eligibility still depends on category rules, documentation, pre-approval, fair market pricing, pool health, and the other discretionary standards in this Agreement, and Gabriel may decline to treat artificially structured or re-dated charges as recurring care.
Large, high-cost, deductible, emergency, or catastrophic bills may be eligible for assistance under Section 9 rather than ordinary monthly wellness reimbursement. Under Section 9, and entirely at Gabriel's discretion, Gabriel may choose to help with such a bill over time, negotiate the bill, require insurance or other benefits to be used first, apply a member cost-share, pay a provider directly, or approve all, part, or none of the request. Nothing in this Section creates any obligation to reimburse any amount above the applicable monthly limit, and all reimbursement and assistance remains discretionary as described in this Agreement.
Episodes of Care. Where care is furnished as a bundled program, package, or global fee covering a course of care that spans multiple Monthly Benefit Periods, for example pregnancy, birth, and postpartum care; surgical preparation and recovery; fertility treatment; or an extended treatment series, Gabriel may treat the package as a single Episode of Care. An Episode of Care requires pre-approval before services begin. In the written pre-approval, Gabriel may establish a total allowed amount for the episode based on fair market value and allocate that amount across the Monthly Benefit Periods in which care is furnished, beginning no earlier than membership activation. Each period's allocated amount is reviewed against that period's available Wellness Pool and reimbursed at the applicable network reimbursement rate. Deposits, installments, prepayments, and financing schedules for a single package do not create separate expenses and do not change the allocation. Care furnished before membership activation is not allocated and is not reimbursed.
Episode maximum. Unless the active Benefits Schedule or a written pre-approval expressly states otherwise, the amount Gabriel reimburses for an Episode of Care in any Monthly Benefit Period is the lowest of: (a) the applicable network reimbursement rate applied to that period's allocated amount; (b) that period's available Wellness Pool; (c) the amount remaining under the episode maximum, which is three (3) times the membership's base monthly Wellness Pool per episode, using the shared household pool for family memberships and excluding wearable and other engagement bonuses, measured after the reimbursement rate is applied; and (d) the amount remaining under the fees-paid ceiling, under which cumulative Episode of Care reimbursements across a membership will not exceed cumulative Membership Fees actually paid to date. "Membership Fees" means all recurring fees actually paid for the membership, including the household base fee, added-life adders, and standalone surcharges, and excluding promotional credits and one-time discounts. Episode allocations are payable only for Monthly Benefit Periods in which the membership is active and paid. If the membership ends, unallocated and future episode amounts are forfeited; amounts already reimbursed are not recouped for cancellation alone; and expenses for care furnished while the membership was active and paid may be submitted during the run-out period under Section 21.
8. Eligible Categories
Gabriel Care focuses on integrative, functional, naturopathic, and holistic health and wellness: the practitioners, services, diagnostics, and protocols that conventional insurance typically does not cover. Reimbursement categories are:
Body Care: chiropractor visits, massage, acupuncture, stretching, and other bodywork.
Fitness & Movement: gym memberships, fitness and studio memberships, personal training, and recurring movement or exercise programs, subject to the monthly proof-of-payment and recurring-charge documentation requirements in Section 8.
Diagnostics & Doctors: lab testing, panels, imaging and scans, and other diagnostics; integrative, functional, naturopathic, and holistic medicine practitioners (including naturopathic doctors, functional medicine providers, and integrative or holistic physicians), and nurse practitioners and physician assistants practicing in these areas; biological and holistic dentistry; and urgent, specialist, and other care and treatments eligible under your Benefits Schedule.
Pregnancy, Birth & Postpartum Care: prenatal, childbirth, postpartum, and lactation care furnished by licensed midwives, certified nurse-midwives, and other licensed maternity practitioners; by licensed or accredited birth centers; and by doulas and midwife assistants holding certification or training recognized under applicable state requirements or otherwise approved by Gabriel; and related maternity wellness services eligible under your Benefits Schedule. Eligible pregnancy, birth, and postpartum expenses are ordinary wellness reimbursements, are ordinarily handled as an Episode of Care under Section 7A, and remain subject to provider verification, scope of practice, documentation, fair market value review, network reimbursement rates, pre-approval, and all other program rules. Planned childbirth remains outside deductible, emergency, and catastrophic assistance under Section 9.
Supplements: vitamins, supplements, prescription and compounded peptides where legally prescribed and dispensed, prescriptions, and other wellness, longevity, and biohacking consumables lawfully obtained by the Member. Gabriel may require an Apotheca-first or Gabriel-marketplace-first pathway when an eligible item is available through Apotheca or another Gabriel-designated marketplace. If an eligible item is not yet listed through Apotheca or a Gabriel-designated marketplace but is ordered, dispensed, or recommended through a Gabriel-approved in-network practitioner, provider, or partner pathway, Gabriel may reimburse up to 100% of the eligible cost within the applicable Supplements cap. If an eligible item is purchased off-Apotheca, outside a Gabriel-designated marketplace, or outside Gabriel's in-network/provider pathway, Gabriel may limit reimbursement to up to 50% of the eligible cost within the applicable Supplements cap. Eligibility for reimbursement of any item in this category is determined by Gabriel in its discretion under the applicable Benefits Schedule.
Mind Care: therapy, coaching, psychiatry, breathwork, and similar mental and emotional health support.
Eligible practitioners and services are those licensed or certified in their field and approved under your then-current Benefits Schedule. Gabriel may determine practitioner and service eligibility based on licensure, scope of practice, applicable law, and program rules. Reimbursement of a service does not constitute medical advice or a determination that any practitioner is your primary care physician.
These categories are administrative reimbursement categories, not guarantees that any specific modality, provider, product, treatment, protocol, or service will be covered. Gabriel may classify, reclassify, approve, deny, limit, or require pre-approval for any request based on the Benefits Schedule, documentation, legality, provider type, safety, medical or wellness relevance, fair market value, pool health, member history, and Gabriel's assessment of whether the request is likely to support the member's physical, mental, emotional, spiritual, or overall wellness.
No modality or treatment is guaranteed by Gabriel Care, even if similar modalities are mentioned in marketing, examples, coverage lists, category descriptions, sales materials, or prior reimbursement decisions. Coverage is always subject to Gabriel review and discretion under the then-current Benefits Schedule.
Eligibility may vary by state, provider type, prescription status, medical necessity, documentation, and partner availability. Gabriel may require additional review for controlled substances, peptides, psychedelics, cannabis, hormone therapies, dental biologics, stem cell services, off-label therapies, and high-cost protocols.
Recurring and Auto-Billed Expenses. For eligible expenses paid by automatic bank draft or recurring card charge, such as gym or fitness memberships, Gabriel requires (a) one-time documentation at first reimbursement establishing the membership and its recurring rate, for example a membership agreement or enrollment confirmation, and (b) monthly verification that the charge actually occurred. Acceptable monthly verification includes a provider-issued billing statement, a connected financial-account transaction record, or a dated statement line clearly identifying the merchant, date, and amount of the charge. Gabriel may reimburse only the verified recurring amount, may cap reimbursement at fair market value, and may request additional documentation.
Financial-Account Verification. To streamline verification of recurring and reimbursable expenses and to protect the program against fraud, Gabriel may offer or, on prospective notice, require members to securely connect a bank or payment account through a third-party financial-data provider. A connected account allows Gabriel to confirm that eligible recurring charges occurred without requiring monthly document uploads. Gabriel accesses only the transaction information reasonably necessary to verify eligible expenses and program integrity, as described in the Privacy Policy. Members who do not connect a financial account remain responsible for submitting acceptable monthly documentation.
9. Deductible, Emergency, and Catastrophic Assistance
Gabriel may, where allowed by the applicable Benefits Schedule, use available wellness pool resources to help members with high deductibles, emergency bills, catastrophic medical events, major accidents, surgeries, hospitalizations, serious diagnoses, or other high-cost health situations. Gabriel intends to make reasonable, good-faith efforts to support members in these situations whenever it can responsibly do so.
However, deductible assistance, emergency assistance, catastrophic assistance, medical bill assistance, or similar support is never guaranteed. Gabriel does not promise that any emergency, deductible, hospital bill, surgery, medical expense, catastrophic event, or out-of-pocket cost will be paid, reimbursed, shared, reduced, or covered. Any assistance depends on the member's Benefits Schedule, active membership status, documentation, available pool resources, reserve levels, pool health, fraud and plan-integrity review, legal and regulatory constraints, insurance-first requirements, bill review, provider pricing, timing, and Gabriel's discretionary approval.
Deductible, emergency, and catastrophic assistance is intended only for sudden, unforeseen emergency and catastrophic medical events that arise after the waiting period, such as an unexpected accident, emergency room visit, unplanned surgery, or acute serious diagnosis. It is not available for, and Gabriel does not intend to provide assistance toward, elective, planned, scheduled, routine, or foreseeable procedures or care, including any procedure, condition, treatment, or course of care that was known, recommended, scheduled, or reasonably foreseeable at or before enrollment or during the waiting period. This includes, by way of example, planned surgeries, elective procedures, and planned childbirth. Gabriel retains the full discretion described in this Section and may decline assistance for any request; nothing in this paragraph creates any obligation to provide assistance even for a qualifying unforeseen event.
Gabriel may approve all, part, or none of a high-cost request. Gabriel may also negotiate bills, require insurance or other benefits to be used first, request additional documentation, impose caps, apply waiting periods, apply member cost-share requirements, delay payment, pay providers directly where appropriate, reimburse members after review, or deny assistance.
A ninety (90) day continuous-membership waiting period applies before a member becomes eligible for deductible, emergency, or catastrophic assistance, except where a shorter period is required by law or expressly stated in the active Benefits Schedule.
Gabriel Care is not a substitute for emergency services or comprehensive health insurance. In an emergency, members should call 911 or seek emergency medical care immediately.
10. Waiting Periods, Pre-Approval, and Fraud Controls
Your Benefits Schedule may include waiting periods before some categories become eligible. Gabriel may require pre-approval before reimbursing expenses above a threshold, categories with higher regulatory risk, or services that are unusual, bundled, recurring, experimental, or high cost.
High-risk categories may require extra review, documentation, licensed-provider involvement, legal-status verification, prescription verification, medical necessity support, or pre-approval. High-risk categories may include peptides, cannabis, ketamine, psychedelic-assisted services, hormones, testosterone, compounded medications, controlled substances, stem cell services, regenerative medicine, dental biologics, off-label therapies, imported products, and other categories Gabriel identifies as high-risk.
Gabriel may use AI review, human review, third-party data, pricing databases, provider verification, and fraud controls to assess a request. You agree not to submit false, altered, duplicate, misleading, backdated, inflated, or non-member expenses.
Knowing and material fraud or intentional misuse will result in denial of the request, recoupment of any amounts already paid, suspension or termination of membership, a ban from Gabriel Care and other Gabriel products and services, forfeiture of any prepaid membership fees, and referral to law enforcement, state regulators, or other authorities where Gabriel determines reporting is appropriate or required. These consequences apply to conduct that is knowing, intentional, and material. An honest, good-faith mistake, a typographical or clerical error, or an incomplete submission is not fraud; Gabriel will treat such matters as a correctable documentation issue and, before imposing termination, recoupment, or a ban for alleged fraud, will provide the member written notice describing the concern and a reasonable opportunity (no less than ten (10) days) to respond, correct, or provide additional documentation, except where Gabriel reasonably believes immediate action is required to prevent ongoing harm, comply with law, or respond to clearly intentional fraud. Recoupment and denial of the specific request at issue may occur pending that response. Examples of fraud include submitting fake, altered, duplicated, inflated, backdated, or misleading receipts, invoices, prescriptions, or supporting documentation; submitting expenses that were not actually incurred by the member; submitting expenses for non-members; colluding with a provider, vendor, or third party to manipulate pricing or documentation; misrepresenting the nature, category, date, or purpose of an expense; or any other act intended to obtain reimbursement, deductible assistance, or catastrophic assistance the member is not entitled to receive.
11. Pre-Existing Conditions and Eligible Use of Wellness Benefits
Gabriel Care does not exclude members, deny membership, or restrict wellness benefits based on pre-existing health conditions, current diagnoses, prior diagnoses, family history, disability status, or expected future care needs. Members living with cancer, autoimmune conditions, chronic illness, mental health conditions, neurological conditions, metabolic conditions, or any other pre-existing or active condition are eligible to join Gabriel Care and use their full monthly wellness benefits on the same terms as any other member.
Wellness benefits may be used toward any service, product, or modality that falls within an eligible category in the active Benefits Schedule, regardless of the underlying condition the member is using the benefit to support. For example, a member may apply wellness benefits toward IV therapy, supplements, integrative consultations, acupuncture, bodywork, peptide protocols where legal, or other eligible categories, whether they are using the benefit for general wellness, complementary support during cancer treatment, autoimmune management, mental health support, or any other personal health goal.
Gabriel does not determine which conditions a member is allowed to address with their wellness benefits, and does not require members to disclose a diagnosis to use their benefits. Reimbursement decisions are based on category eligibility, documentation, pre-approval rules, fair market pricing, plan-integrity review, and the discretionary standards in this Agreement, not on the member's underlying condition.
The pre-existing condition protections in this section apply to wellness reimbursement. They do not create any guaranteed right to deductible, emergency, or catastrophic assistance, which remain discretionary as described in Section 9 and the Benefits Schedule.
12. Age-Neutral Membership and Coordination with Medicare
Gabriel Care membership pricing and benefits are age-neutral for adults. Every adult, including members age 50 through 64 and members age 65 or older, may select Emerald, Sapphire, or Onyx at the standard price for that tier. Every adult in the same tier receives the same published Wellness Pool, wearable engagement bonus, Balance Build, and other tier benefits. Gabriel does not apply an age-based fee or pool multiplier and does not offer a separately priced Senior tier.
Members who are age 65 or older, or who are eligible for Medicare, may receive optional Senior and Medicare coordination as a service overlay. This overlay may include help understanding, selecting, enrolling in, and using Medicare-related coverage and coordinating Gabriel Care services with that coverage. It does not change the selected Emerald, Sapphire, or Onyx tier's price, pool, wearable bonus, Balance Build, or other published benefits.
Medicare-eligible members are invited, on a fully voluntary basis, to appoint Gabriel Labs LLC, acting through its licensed insurance agency operations, as Agent of Record on the member's Medicare Advantage, Medicare Supplement (Medigap), or other Medicare-related coverage. This appointment is optional, is not a condition of membership or of receiving any Gabriel Care benefit, and may be made or revoked at any time in accordance with applicable Medicare and carrier rules. If Gabriel is not Agent of Record, the standalone surcharge in Section 16 and Exhibit A applies regardless of the member's age.
Gabriel Care is not Medicare, Medicare Advantage, Medicare Supplement insurance, Medicare Part D, health insurance, or a substitute for any such coverage. Gabriel Care does not replace, satisfy, or eliminate a member's need for Medicare or other health coverage and does not guarantee payment of Medicare-covered or other medical expenses. Members remain responsible for enrolling in and maintaining the Medicare or other health coverage they choose to hold.
13. Insurance-First and Third-Party Benefits
Gabriel may help you understand, optimize, or use existing insurance, HSA/FSA, employer benefits, wellness benefits, or third-party programs. If an expense may be covered by insurance or another benefit, Gabriel may require you to use that coverage first or provide documentation showing coverage was denied, unavailable, or impractical.
If Gabriel helps you enroll in, compare, or use insurance or third-party products, those products are governed by separate contracts, carrier documents, policy terms, provider terms, and legal requirements. Gabriel is not responsible for carrier decisions, provider decisions, network status, plan exclusions, claim denials, premium changes, or third-party service failures.
15. Family Memberships
This section governs household and family memberships. Where this section conflicts with another section of the Agreement, this section controls for family memberships.
Eligibility and Composition
A family membership covers a Primary Member, an optional Adult Dependent (spouse, domestic partner, or other adult listed at enrollment), and any Child Dependents under age 21 listed at enrollment. Child Dependents who reach age 21 transition to Adult Dependent status at the next renewal anniversary. Only persons listed on the active Enrollment Record and accepted by Gabriel are eligible for benefits under a family membership. Gabriel may decline to enroll any proposed dependent for eligibility, documentation, fraud, plan-integrity, or operational reasons. Child Dependents who are age 18, 19, or 20 are legal adults. Each such dependent must individually accept this Agreement and provide his or her own privacy, HIPAA, communications, and data-processing authorizations before receiving benefits, and the Primary Member represents that he or she has the authority to list that dependent and to facilitate those authorizations. Gabriel communicates with and shares the individual health information of an adult dependent (including any dependent age 18 or over) directly with that dependent, and not with the Primary Member, except to the extent the adult dependent has authorized otherwise in writing.
Pricing Structure
Family pricing is composed of a Household Base fee for the Primary Member and an Added-Life Adder for an Adult Dependent or each of the first two Child Dependents under age 21. Additional Child Dependents beyond the first two are added at no premium. Pricing scales by tier per the Family Pricing and Pool Schedule in Exhibit A and does not change based on the age of the Primary Member or any Adult Dependent.
Shared Wellness Pool
The family membership includes one shared monthly wellness reimbursement pool. The pool consists of the tier's Pool Base plus a Pool Adder for each paid Added-Life Adder, including each enrolled Adult Dependent and each of the first two enrolled Child Dependents under age 21. Additional Child Dependents do not increase the pool but may receive eligible reimbursements from the existing family pool, subject to all program rules.
The shared pool is a single discretionary review limit accessible by enrolled household members for eligible expenses incurred on their behalf, subject to pre-approval rules, documentation requirements, and all other terms of this Agreement. The shared pool is not a cash account, member-owned balance, escrow, trust, insurance benefit, stored value, or vested right.
Per-Person Services
Each enrolled household member receives, subject to all program rules and the applicable Benefits Schedule: the ability to submit personal eligible expenses against the shared pool; a personal Gabriel account and login; personal scheduling priority where applicable; and personalized protocols where included by the Benefits Schedule. A Family Membership includes one wearable engagement bonus tied to the paid household membership account. Added dependents do not receive separate wearable engagement bonuses unless they separately purchase their own Individual Membership.
Family Flex Balance Build and Full Access
A family membership selecting Flex receives the additive Balance Build described in Exhibit A-3 on the full shared household pool. Unused Balance Build amounts carry only through Period 3 and expire when the ordinary monthly full-pool reset begins in Period 4. A family membership selecting Full Access prepays three monthly membership fees and receives the full shared household pool in each of the first three monthly periods, with no Balance Build and no carryover.
A new Adult Dependent or Child Dependent added to an existing Flex family membership receives the Balance Build for that dependent's incremental pool contribution; the existing household pool remains unchanged. Members who cancel and re-enroll within twelve months restart the selected enrollment arrangement on the entire family pool. Renewing memberships in continuous good standing are not subject to a new Balance Build. Tier upgrades or downgrades mid-term apply the new tier's pool at the current period stage.
Adding and Removing Dependents
Dependents may be added or removed at qualifying events defined by Gabriel from time to time, which may include enrollment, annual renewal, marriage, divorce, birth, adoption, legal separation, death, loss of qualifying status, age-out at twenty-one, or other events Gabriel designates. Mid-term additions take effect on a billing date determined by Gabriel and are subject to the selected membership option's dependent Balance Build or Full Access terms. Mid-term removals take effect at the end of the then-current billing period and Gabriel does not refund any premium for removed dependents except as required by law or expressly stated in this Agreement.
Spending and Allocation
There is no fixed per-person or per-category dollar limit within the shared family pool. All eligible spending draws from and is bound by the single shared household pool ceiling. Gabriel may apply pre-approval thresholds, anti-abuse limits, fair-market-value review, and other plan-integrity controls. Gabriel reserves the right to introduce prospective, published per-person or per-category limits for a tier, sponsor group, geography, family structure, or other objectively defined eligibility class under this Agreement's notice provisions. Reimbursement requests must be incurred by an enrolled household member during the active benefit period.
Termination and Lapse Effects on the Family
Cancellation or non-payment by the Primary Member terminates the entire family membership. Death, divorce, or legal separation of the Primary Member does not automatically terminate the family membership; surviving enrolled members may elect to continue at a recalculated tier and pool consistent with the remaining household composition, subject to Gabriel's reasonable processes.
Family Standalone Memberships
A family that elects a Standalone Wellness Membership pays a surcharge of thirty dollars ($30) per month for each covered life age eighteen (18) or older enrolled under the family membership, including Adult Dependents and Child Dependents age 18, 19, or 20, whether or not that life carries a premium, as set forth in Exhibit A. Covered lives under age eighteen (18) are not surcharged. The surcharge does not change pool amounts. Standalone family memberships are subject to the same family eligibility, composition, pool, and ramp rules in this section, the same hard exclusions applicable to Standalone Wellness Memberships, and the additional acknowledgments and processes required at Standalone Wellness enrollment.
16. Standalone Wellness Memberships
A Standalone Wellness Membership is a Gabriel Care membership elected by a Member who does not also receive insurance enrollment, plan brokerage, or Agent of Record services through Gabriel. Standalone Wellness Memberships are available subject to the surcharge, acknowledgments, eligibility limits, and intake processes described in this Section and in Exhibit A. The Standalone surcharge is thirty dollars ($30) per month for each covered life age eighteen (18) or older enrolled under the membership, including Adult Dependents and Child Dependents age 18, 19, or 20, whether or not that life carries a premium. Covered lives under age eighteen (18) are not surcharged. The Monthly Wellness Cap, pool amounts, and Clinical Care Component are unchanged; the surcharge is allocated entirely to the Wellness & Concierge Component to offset the broker servicing and Agent of Record functions that would otherwise apply.
Standalone Wellness Memberships are available to adults regardless of age, including Medicare-eligible members. They are not available to prospective members who are currently uninsured and have a known major active medical condition for which they have not enrolled in qualifying coverage. Gabriel may require evidence of insurance coverage or a documented refusal of insurance enrollment before activating a Standalone Wellness Membership.
By electing a Standalone Wellness Membership, the Member acknowledges that Gabriel Care is not insurance, Medicare, Medicare Advantage, Medicare Supplement insurance, or Medicare Part D; does not replace Medicare or other health coverage; will not cover catastrophic medical expenses except as expressly provided in the Benefits Schedule and Section 9; and that the Member is solely responsible for arranging and maintaining any Medicare or other health insurance coverage they wish to hold. Gabriel may require an annual re-acknowledgment of the Standalone Wellness Membership status at renewal.
16A. Clinical Care Component; Direct-Care-Style Services; Tax Treatment
(a) Two components of your fee. Your monthly Gabriel Care fee consists of two parts, identified separately on your Benefits Schedule and on your monthly member statement: (1) the "Clinical Care Component," a fixed recurring amount that purchases ongoing access to clinical and medical-care services furnished by licensed Third-Party Providers arranged through Gabriel, which may include telehealth consultations, clinical visits, ordering and clinical review of laboratory tests and diagnostics, health screenings (including biometric and optical blood screening where offered), and prescription management and coordination with licensed clinicians; and (2) the "Wellness & Concierge Component," the remaining amount, which covers non-clinical health navigation, concierge coordination, wellness reimbursement administration, member support, and technology and application access.
(b) Direct-care-style arrangement; not insurance. The Clinical Care Component is structured as a recurring, periodic fee paid in exchange for access to defined clinical and medical-care services, similar to a direct primary care or direct-care arrangement. The Clinical Care Component is not insurance, is not a health plan, does not indemnify you against or pay your medical claims, and does not assume financial risk for the cost of your care. It purchases access to services, not coverage of expenses. As described in Section 5, Gabriel itself does not practice medicine; clinical services are furnished by independent licensed providers.
(c) Intended characterization as medical care. Gabriel intends and represents that the Clinical Care Component is paid for medical care within the meaning of Section 213(d) of the Internal Revenue Code (amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting a structure or function of the body). The Wellness & Concierge Component is not represented as medical care under Section 213(d) and is not intended to be reimbursable as a qualified medical expense.
(d) Statements and substantiation. On request, and as a standard monthly practice for members who need it, Gabriel will provide an itemized statement that separately states the Clinical Care Component and the Wellness & Concierge Component and reflects the period of service. You may use this statement to support reimbursement of the Clinical Care Component through an individual coverage health reimbursement arrangement (ICHRA), qualified small employer health reimbursement arrangement (QSEHRA), other health reimbursement arrangement, or other account, subject to the rules of that arrangement and applicable law.
(e) HRA and ICHRA reimbursement is determined by your plan and your advisors, not by Gabriel. Whether any portion of your fee is actually reimbursable, deductible, or eligible under any HRA, ICHRA, QSEHRA, HSA, FSA, employer arrangement, or tax filing is determined by the terms of that arrangement, the plan administrator, and applicable law, and not by this Agreement and not by Gabriel. Gabriel does not administer your HRA or ICHRA, does not guarantee any tax treatment or reimbursement outcome, and is not your plan administrator, CPA, tax advisor, or benefits attorney. Eligibility rules, substantiation requirements, owner-versus-employee eligibility, and affordability and subsidy interactions are your responsibility and your advisors' responsibility.
(f) No tax advice; consult a professional. Consistent with Sections 7 and 22, Gabriel does not provide tax, legal, or accounting advice. The information Gabriel provides regarding Section 213(d) and the Clinical Care Component is general information based on publicly available sources and is not tax or legal advice. You and any sponsor should consult your own qualified certified public accountant (CPA), tax advisor, and/or ERISA or employee-benefits attorney to confirm eligibility before treating any portion of the fee as a qualified medical expense, before reimbursing it through an HRA or ICHRA, or before claiming any deduction. Gabriel assumes no liability for the tax treatment of any payment.
(g) Allocation may change. The dollar allocation between the Clinical Care Component and the Wellness & Concierge Component is set in your then-current Benefits Schedule and may be updated under Section 23. Gabriel will reflect the current allocation on your statements.
17. Employer-Sponsored Memberships
If your employer or sponsor pays for or subsidizes your membership, Gabriel may share limited eligibility, enrollment, utilization, billing, and operational information with the sponsor as allowed by law and our Privacy Policy. Gabriel will not share individual health details with a sponsor unless authorized by you, required for plan administration under an applicable legal framework, or otherwise permitted by law.
Your employer or sponsor may set eligibility rules, contribution amounts, termination dates, or sponsor-specific benefit rules. If sponsor coverage ends, you may lose access or may be offered an individual continuation option where available.
Sponsor-specific benefits may differ from individual membership benefits or from benefits offered to other sponsor groups. Gabriel may adjust, reduce, expand, pause, or discontinue sponsor-specific benefits based on the sponsor agreement, group utilization, pool health, payment status, eligibility files, regulatory concerns, operational constraints, or financial sustainability. A sponsor's payment for membership does not guarantee that any specific reimbursement request will be approved.
18. Privacy, Health Information, and Communications
Gabriel collects and uses personal information, health information, payment information, communications, device data, wearable data, receipts, claims documents, insurance documents, provider information, and other information as described in the Privacy Policy and any additional authorizations you sign.
You authorize Gabriel to contact you by email, SMS, phone, in-app messages, push notification, and other channels for account, benefits, care coordination, reimbursement, security, and support purposes. You may opt out of marketing communications where legally required, but operational messages may still be necessary to provide services.
Phone calls with Gabriel or Gabriel's voice agents may be recorded, transcribed, analyzed, and stored for quality, compliance, booking, reimbursement, and operational purposes, subject to applicable law and consent requirements.
19. Member Responsibilities
You agree to:
Provide accurate, complete, and current information.
Keep your login credentials secure.
Use Gabriel Care only for lawful purposes.
Review AI outputs and Gabriel recommendations before acting.
Confirm provider instructions and medical decisions with licensed professionals.
Submit only truthful, accurate, and complete reimbursement requests.
Promptly respond to requests for documentation or clarification.
Tell Gabriel if you receive third-party payment, insurance reimbursement, refund, reversal, discount, or credit for an expense Gabriel reimbursed.
Repay any reimbursement made in error, by fraud, or for an expense later refunded or covered elsewhere.
20. Exclusions
Unless expressly included in your Benefits Schedule or approved by Gabriel in writing, Gabriel Care does not cover or reimburse:
Emergency services, hospital bills, surgery, inpatient care, or catastrophic claims.
Expenses incurred before membership activation or after termination.
Expenses for non-members.
Illegal products or services.
Fraudulent, duplicate, altered, backdated, inflated, or misleading receipts, invoices, prescriptions, or supporting documentation. Submission of any such item is grounds for immediate termination, permanent ban from Gabriel Care and all current and future Gabriel Labs products and services, recoupment, forfeiture of prepaid fees, and referral to law enforcement or regulators as described in Section 10.
General food, groceries, alcohol, tobacco, recreational drugs, entertainment, clothing, cosmetics, travel, lodging, missed appointment fees, tips, taxes, shipping, and subscriptions, unless expressly included. Gym and fitness memberships and other recurring or auto-billed memberships are reimbursable only when expressly included as an eligible category (for example, Fitness & Movement) and supported by the recurring-charge documentation described in Section 8.
Services primarily for aesthetic, recreational, or non-health purposes.
Provider charges above fair market value, unless pre-approved.
Expenses already paid, reimbursed, refunded, credited, or covered by another source.
Products or services Gabriel determines present unacceptable legal, safety, fraud, or quality risk.
For members enrolled in Medicare, expenses that are covered, or that would be covered if properly submitted, by the member's Medicare Advantage, Medicare Supplement (Medigap), Medicare Part A, Part B, or Part D plan, except where Gabriel Care wellness benefits are used to supplement an out-of-pocket expense the member has chosen to pursue outside of Medicare (such as integrative care, IV therapy, peptide protocols where legal, supplements, advanced diagnostics, or other eligible wellness categories not covered by Medicare).
21. Payments, Billing, Cancellation, and Nonpayment
Membership fees are billed monthly in advance unless your enrollment or sponsor agreement says otherwise. By enrolling, you authorize Gabriel or its payment processor to charge your selected payment method for membership fees and other authorized charges.
You may cancel your membership through the available account process or by contacting support. Unless a different cancellation policy is shown at enrollment, cancellation takes effect at the end of the current billing period and partial-month refunds are not provided.
If payment fails, Gabriel may suspend benefits, pause reimbursement processing, downgrade access, or terminate membership after reasonable notice where required. Reimbursement eligibility generally requires an active, paid membership on the date of service and date of submission unless Gabriel approves otherwise in writing.
Cancellation, suspension, nonpayment, sponsor termination, chargeback, refund, payment dispute, suspected fraud, or account review may pause or end eligibility for pending and future reimbursement requests. Gabriel may offset approved or future reimbursement amounts against unpaid membership fees, chargebacks, reversed payments, duplicate reimbursements, mistaken payments, or amounts owed to Gabriel where permitted by law.
Claim run-out period. If your membership ends for any reason other than termination for knowing and material fraud, you will have sixty (60) days after your membership end date (the "run-out period") to submit otherwise-eligible expenses that were incurred while your membership was active and paid. Expenses properly submitted during the run-out period will be reviewed under the same rules that applied on the date of service. Expenses incurred after your membership end date are not eligible, and expenses not submitted within the run-out period are waived.
22. Suspension, Termination, and Disclaimers
Gabriel may suspend or terminate your membership or benefits if you violate this Agreement, fail to pay, misuse benefits, submit fraudulent requests, threaten staff or members, create legal or safety risk, or use the service in a way that harms Gabriel, other members, providers, sponsors, or partners.
Gabriel may modify services, features, benefits, providers, categories, limits, and review rules as the program evolves, subject to notice obligations required by law or this Agreement.
Gabriel may also pause, limit, or terminate a category, benefit, provider pathway, reimbursement method, deductible assistance feature, catastrophic assistance feature, sponsor benefit, geography, or program feature when Gabriel determines that doing so is necessary or appropriate for pool health, reserve protection, fraud control, safety, legal compliance, regulatory risk, payment risk, provider availability, operational feasibility, or financial sustainability.
Gabriel Care is provided on an "as is" and "as available" basis. Gabriel does not guarantee uninterrupted access, reimbursement approval, provider availability, medical outcomes, insurance outcomes, claim outcomes, tax treatment, HSA/FSA eligibility, or third-party performance. The Clinical Care Component described in Section 16A is intended to be paid for medical care, but Gabriel does not guarantee its treatment under any HRA, ICHRA, HSA, FSA, employer arrangement, or tax provision; confirm any tax treatment with your own qualified tax professional.
Gabriel does not guarantee that any specific expense will be reimbursed unless Gabriel has issued a written pre-approval that expressly identifies the expense, amount, date, member, and conditions.
Gabriel does not guarantee that any benefit, reimbursement limit, provider pathway, deductible assistance feature, catastrophic assistance feature, or reimbursement speed will remain available, unchanged, or available at a particular amount. Program features may change as described in this Agreement and the Benefits Schedule.
To the maximum extent permitted by law, Gabriel and its officers, employees, contractors, affiliates, partners, and agents are not liable for indirect, incidental, consequential, special, exemplary, punitive, lost profit, lost data, lost opportunity, personal injury, medical outcome, provider, insurer, carrier, employer, sponsor, or third-party damages arising out of or relating to Gabriel Care.
To the maximum extent permitted by law, Gabriel's total liability for any claim arising out of this Agreement or Gabriel Care will not exceed the membership fees you personally paid to Gabriel during the twelve (12) months before the event giving rise to the claim, or $500 if you did not personally pay membership fees.
Nothing in this Agreement limits or excludes Gabriel's liability for: (a) gross negligence, willful misconduct, or fraud by Gabriel; (b) death or bodily injury to the extent directly caused by Gabriel's own acts or omissions; (c) violations of privacy or data-security obligations to the extent caused by Gabriel; or (d) any liability that cannot be limited or excluded under applicable law. The limitations in this section apply only to the maximum extent permitted by law and do not affect non-waivable statutory rights you may have.
Some jurisdictions do not allow certain limitations, so some limitations may not apply to you.
23. Dispute Resolution, Governing Law, and Updates
Informal Resolution
Before filing any claim, you agree to contact Gabriel at support@askgabriel.com and attempt to resolve the dispute informally. If the dispute is not resolved within thirty (30) days, either party may proceed as allowed by this Agreement.
Binding Individual Arbitration; Class Action Waiver
Any dispute arising out of or relating to this Agreement or Gabriel Care will be resolved by binding individual arbitration administered by the American Arbitration Association under its Consumer Arbitration Rules. The seat of arbitration will be Las Vegas, Nevada, and arbitration may be conducted by video conference, telephone, or in person at the arbitrator's discretion. The arbitrator's decision is final and binding except as required by applicable law.
Class actions, class arbitrations, collective actions, and representative actions are waived to the maximum extent permitted by law. You and Gabriel each agree to bring any dispute only in an individual capacity and not as a class member, named plaintiff, or representative of any other person.
This arbitration agreement does not prevent either party from seeking injunctive or equitable relief in court for intellectual property infringement, misuse of confidential information, or violations of fraud or unauthorized-access laws, or from bringing a claim in small claims court if eligible.
Governing Law
This Agreement is governed by the laws of the State of Nevada, without regard to its conflict of law rules, except where applicable consumer protection law of your state requires a different law.
Updates to this Agreement
Gabriel may update this Agreement, the Benefits Schedule, the Terms of Service, the Privacy Policy, and any related policies, consents, or exhibits from time to time. Updates may be made to reflect new features, pricing changes, benefit changes, legal or regulatory requirements, fraud or safety controls, dispute resolution mechanics, pool health, operational realities, or any other business reason Gabriel determines appropriate.
Gabriel distinguishes between non-material and material updates. Non-material updates, including typographical corrections, formatting changes, contact information updates, internal references, and clarifications that do not reduce member rights or increase member obligations, may take effect immediately on posting without individual notice. Material updates, including changes to pricing, monthly reimbursement limits, eligible categories, fraud and termination rules, dispute resolution, arbitration or class action terms, governing law, privacy or data use, or any change that meaningfully reduces member rights or increases member obligations, will be communicated at least thirty (30) days before the effective date, except where a shorter period is required by law, fraud prevention, safety, regulatory compliance, payment risk, or plan integrity. The minimum thirty (30) day notice period does not apply to Benefits Schedule adjustments made under Gabriel's pool-health, reserve, fraud, safety, regulatory, or sustainability rights described in Sections 6, 8, 9, and 22, which may take effect on the schedule stated in those sections.
Gabriel will provide notice of material updates by one or more of the following methods: email to the member's account email address, in-product notice or banner, dashboard notification, account portal posting, or other reasonable method. For material updates, Gabriel may require members to re-accept the updated Agreement before continuing to use Gabriel Care. Re-acceptance may be required by checkbox, button click, or other electronic acceptance method at next login, next reimbursement request, next renewal, or other reasonable trigger point.
If a member does not accept a material update during the notice period or at the required re-acceptance trigger, the member may cancel their membership without penalty before the effective date of the update and will receive a pro-rated refund of any prepaid membership fees covering periods after cancellation. Continued use of Gabriel Care after the effective date of a posted update, or affirmative re-acceptance of the updated Agreement, constitutes acceptance of the updated terms.
Updates do not retroactively alter an already approved reimbursement request for a service date before the effective change date, except where required by law, fraud prevention, safety, mistake correction, payment reversal, member ineligibility, sponsor ineligibility, or plan integrity rules. Pending, future, incomplete, unapproved, or not-yet-submitted requests remain subject to the Agreement and Benefits Schedule in effect when Gabriel reviews them.
Gabriel will maintain an archive of prior versions of this Agreement. Members may request a copy of the version of the Agreement they accepted at any time by emailing support@askgabriel.com.
24. General Legal Terms
If any part of this Agreement is found unenforceable, the remaining parts will remain in effect to the maximum extent permitted by law.
Gabriel's failure to enforce any part of this Agreement is not a waiver of Gabriel's right to enforce it later.
You may not assign or transfer this Agreement or your membership without Gabriel's written consent. Gabriel may assign this Agreement in connection with a merger, acquisition, financing, sale of assets, reorganization, or transfer of the Gabriel Care business.
This Agreement, the applicable Benefits Schedule, the Terms of Service, Privacy Policy, and signed consents form the complete agreement governing your Gabriel Care membership. In the event of conflict, the order of precedence is: signed Benefits Schedule first for benefit-specific terms, then this Agreement, then the Terms of Service, then general website or marketing copy.
25. Contact
Gabriel Care LLC Email: support@askgabriel.com Address: Las Vegas, Nevada
26. Electronic Acceptance
By accepting this Agreement electronically, you agree that your electronic signature has the same legal effect as a handwritten signature under the federal E-SIGN Act, the Uniform Electronic Transactions Act as adopted in your state, and any other applicable electronic signature law.
For each acceptance event, including initial signup, re-acceptance of material updates, Benefits Schedule sign-off, and any standalone consent, Gabriel will record and retain: account ID, member name, account email, timestamp in UTC, IP address, user agent and device or browser metadata, Agreement version identifier and content hash, Benefits Schedule version identifier and content hash, related consent identifiers (such as HIPAA, SMS, AI processing, marketplace, broker, or limited power of attorney), the acceptance method used, and a unique acceptance event ID.
At the time of acceptance, Gabriel will email the member a confirmation that includes a link to the version of the Agreement, Benefits Schedule, and consents the member accepted, a PDF or downloadable copy of that version, and the acceptance event ID. Members may at any time request, download, or re-email a copy of any version of the Agreement they previously accepted by logging into their Gabriel account or emailing support@askgabriel.com.
Gabriel will retain electronic acceptance records for the longer of seven (7) years after the membership ends or any period required by applicable law. These records may be used as evidence of the member's agreement to the version of the Agreement, Benefits Schedule, and consents in effect at the time of acceptance.
Acceptance Confirmation
I have read and agree to the Gabriel Care Membership and Benefits Agreement, the applicable Benefits Schedule, the Terms of Service, the Privacy Policy, and applicable consents. I understand that Gabriel Care is not health insurance, is not emergency care, does not guarantee reimbursement, and does not provide medical advice.
Exhibit A: Benefits Schedule and Fee Allocation
Version: 2026-08-23a (private beta). This Exhibit A is the Benefits Schedule referenced throughout the Agreement, including Sections 6, 15, and 16A. The dollar amounts below are the then-current amounts and may be updated under the Agreement's change provisions. Where this Exhibit conflicts with a sponsor-specific Benefits Schedule or another Benefits Schedule applying to an objectively defined eligibility class, that schedule controls for members in that sponsor group or eligibility class.
A-1. Individual Membership Tiers (all adult ages)
For each tier: the Monthly Fee is divided into a Clinical Care Component (CCC) and a Wellness & Concierge Component (WCC) as defined in Section 16A. The CCC is the portion Gabriel intends as payment for medical care under IRC Section 213(d); the WCC is non-clinical and is not represented as a qualified medical expense. The Monthly Wellness Cap is the maximum monthly wellness reimbursement amount (the "up to" pool), not a promised or guaranteed amount.
| Tier | Monthly fee | CCC | WCC | Monthly wellness cap | Wearable bonus |
|---|---|---|---|---|---|
| Emerald | $249 | $99 | $150 | Up to $500 base; up to $600 with full bonus | Up to $100 / mo |
| Sapphire | $399 | $159 | $240 | Up to $750 base; up to $900 with full bonus | Up to $150 / mo |
| Onyx | $799 | $299 | $500 | Up to $1,500 base; up to $1,700 with full bonus | Up to $200 / mo |
Deductible, emergency, and catastrophic assistance may be available across Emerald, Sapphire, and Onyx, subject to Section 9, the active Benefits Schedule, waiting periods, documentation, insurance-first requirements, plan-integrity review, pool health, reserve levels, legal limits, and Gabriel's discretionary approval. Eligibility is not conditioned on Gabriel or Gabriel Labs being the member's Agent of Record unless a member-specific or sponsor-specific Benefits Schedule expressly states otherwise.
A-1a. Wearable Engagement Bonus Amounts
The wearable engagement bonus is the discretionary Connection Bonus and Activity Bonus described in Section 6. Neither bonus is available during Periods 1 and 2. A member may first receive a wearable engagement bonus in Period 3, whether enrolled in Flex or Full Access, and only if all connection, activity, and other eligibility requirements are met. Data collected earlier may count toward qualification, but it does not create a bonus before Period 3. The current maximum bonus amounts are Emerald up to $100 per month, Sapphire up to $150 per month, and Onyx up to $200 per month. The current Connection Bonus is 30 percent of the maximum bonus: Emerald $30, Sapphire $45, and Onyx $60. The current Activity Bonus is 70 percent of the maximum bonus: Emerald up to $70, Sapphire up to $105, and Onyx up to $140. The Activity Bonus is tiered by trailing 30-day goal-days: 20 or more goal-days earns the full Activity Bonus; 10 through 19 goal-days earns one-half of the Activity Bonus; fewer than 10 goal-days earns no Activity Bonus. A goal-day currently means either 10,000 or more steps or 7 or more hours of sleep recorded through an eligible connected wearable. All amounts, breakpoints, metrics, and connection rules are subject to change prospectively under the Agreement.
A-2. Fee Allocation Method
The Clinical Care Component for each tier is a fixed dollar amount stated above, set with reference to the fair-market value of the clinical and medical-care services made available under that tier (telehealth and clinical consultations, ordering and clinical review of laboratory tests and diagnostics, health and biometric screenings including optical blood screening where offered, and prescription management and coordination with licensed clinicians). The Wellness & Concierge Component is the remaining balance of the Monthly Fee. The same per-tier allocation is reflected on each member's monthly statement under Section 16A(d). Gabriel may update the allocation under the Agreement's change provisions and will reflect the current allocation on member statements.
A-3. Flex Balance Build and Full Access
Flex uses a three-period Balance Build. In Period 1, Gabriel grants thirty-three percent (33%) of the full monthly Wellness Pool. In Period 2, Gabriel adds sixty-six percent (66%) of the full monthly pool to any unused Period 1 balance. In Period 3, Gabriel adds one hundred percent (100%) of the full monthly pool to any unused balance from Periods 1 and 2. Unused Balance Build amounts may carry only through the end of Period 3; at the start of Period 4, any remaining Balance Build amount expires and the membership begins the ordinary monthly full-pool reset. The per-single-expense pre-approval threshold applies from the first day of membership. Wearable engagement bonuses are unavailable in Periods 1 and 2 and may first increase the pool in Period 3, subject to all requirements. The Balance Build applies to all new household members on signup, to a new dependent's pool addition, and to members who cancel and re-enroll within 12 months. It applies only to the Wellness Pool and does not change the Clinical Care Component or Monthly Fee.
Full Access is available for Emerald, Sapphire, and Onyx individual and household memberships. It requires payment of the first three monthly membership fees in full at enrollment. Full Access provides the full tier- and household-specific monthly Wellness Pool in each of the first three Monthly Benefit Periods, with no Balance Build and no aggregation of three months of pool value at once. Each monthly pool resets at the next Monthly Benefit Period. After the prepaid term, the membership renews monthly at the enrollment-page renewal price unless canceled before renewal. The Full Access enrollment addendum shown at checkout controls the prepaid term.
A-4. Family Membership Pricing (bundled, all adult ages)
A Family Membership is one shared household wellness pool plus shared services (the Gabriel application, navigator, claims help, member advocacy), with a per-person adder that makes each added person an individual member able to draw from the pool. The Household Base fee includes the same Clinical Care Component and Wellness & Concierge Component split as the individual tier of the same name in Section A-1. Added-Life Adders (spouse or child) are allocated 100 percent to the Wellness & Concierge Component; no portion of an adder is represented as a Clinical Care Component or as a qualified medical expense under Section 16A.
| Tier | Household base | Household pool base | Added-life adder | Pool add | Additional children |
|---|---|---|---|---|---|
| Emerald | $249 | Up to $500 | $187 each | Up to $330 each | Children 3+ free; no pool add |
| Sapphire | $399 | Up to $750 | $299 each | Up to $525 each | Children 3+ free; no pool add |
| Onyx | $799 | Up to $1,500 | $599 each | Up to $1,050 each | Children 3+ free; no pool add |
Each enrolled person (primary or added dependent) receives their own login and Gabriel account and the ability to draw from the shared pool directly. A Family Membership receives one wearable engagement bonus at the tier maximum for the paid household membership account (Emerald up to $100, Sapphire up to $150, Onyx up to $200). Added dependents do not receive separate wearable engagement bonuses. Separately purchased Individual Memberships each have their own wearable engagement bonus. Children over age 21 are treated as adults (full Added-Life Adder). Free children (the third and beyond) may draw from the existing household pool but do not increase the pool.
No per-person or per-category dollar caps currently apply to an individual or household membership. Every enrolled person may submit eligible expenses, and all approved spending draws from the single shared household Wellness Pool subject to the shared pool ceiling, reimbursement rate, pre-approval, documentation, fair-market-value, eligibility, and other program rules.
Gabriel OS access differs by enrollment type. Each Individual Membership includes a full Gabriel OS seat with full or priority application access, including the member's own health vault, tracker, and the full or priority tier of AI-assisted support and messaging for that membership tier. On a shared household (Couple or Family) Membership, the Primary Member receives a full Gabriel OS seat and each added dependent receives a linked Gabriel OS seat with standard application access. Standard access includes the dependent's own login, the ability to draw from the shared pool, and standard tracker and support features, and may carry usage allowances (including messaging or AI-assisted support limits) set forth in the then-current Benefits Schedule or program documentation. Gabriel OS is in active development; access tiers, features, and any usage allowances are beta program features subject to change under this Agreement's change provisions.
A-5. Age-Neutral Pricing and Medicare Coordination
Emerald, Sapphire, and Onyx pricing and benefits apply equally to adults of every age. There is no age-based adjustment to the individual Monthly Fee, Household Base, Added-Life Adder, Monthly Wellness Cap, shared family pool, wearable engagement bonus, or Balance Build. Members age 65 or older and other Medicare-eligible members select Emerald, Sapphire, or Onyx at the standard tier price. Optional Senior and Medicare coordination is a service overlay, not a separately priced tier, and does not change the selected tier's pricing or benefits.
A-6. Standalone Family Pricing (no insurance bundle)
For any member or family for whom Gabriel is not the Agent of Record on an individual ACA or Medicare plan, the monthly premium is increased by thirty dollars ($30) for each covered life age eighteen (18) or older enrolled under the membership, including Adult Dependents and Child Dependents age 18, 19, or 20, whether or not that life carries a premium. Covered lives under age eighteen (18) are not surcharged. The Monthly Wellness Cap and pool amounts stay the same. The Clinical Care Component for a standalone member is the same fixed dollar amount as the corresponding bundled tier, and the standalone surcharge is allocated entirely to the Wellness & Concierge Component. The selected Flex Balance Build or Full Access arrangement, intake requirements, and exclusions apply identically.
A-7. Worked Examples (bundled, all adult ages)
These examples apply regardless of the adult members' ages.
| Example | Tier | Premium | Shared pool after ramp | Full-bonus ceiling / note |
|---|---|---|---|---|
| Couple | Emerald | $436 / mo | Up to $830 | Up to $930 with full wearable bonus |
| Couple | Sapphire | $698 / mo | Up to $1,275 | Up to $1,425 with full wearable bonus |
| Couple | Onyx | $1,398 / mo | Up to $2,550 | Up to $2,750 with full wearable bonus |
| Couple plus two children | Emerald | $810 / mo | Up to $1,490 | — |
| Couple plus two children | Sapphire | $1,296 / mo | Up to $2,325 | — |
| Couple plus four children | Sapphire | $1,296 / mo | Up to $2,325 | Children 3 and 4 have no premium |
| Couple plus three children | Onyx | $2,596 / mo | Up to $4,650 | — |
| Single adult plus two children | Emerald | $623 / mo | Up to $1,160 | — |
Standalone Wellness couple examples: Emerald couple $496 per month, Sapphire couple $758 per month, Onyx couple $1,458 per month. Pools are unchanged. The $30 per-life surcharge is removed when Gabriel becomes Agent of Record.
Surcharge comparison example: while waiting for Open Enrollment or before Gabriel becomes Agent of Record, two Sapphire Individual Memberships are $858 per month with the standalone surcharge, then $798 per month once the surcharge is removed. A shared Sapphire couple membership is $758 per month with the standalone surcharge, then $698 per month once Gabriel becomes Agent of Record.
A-8. Final Number Table (reference)
| Tier | Individual price | Individual pool | Full-bonus ceiling | Added-life adder | Pool add | Couple price | Couple pool | Couple full-bonus ceiling |
|---|---|---|---|---|---|---|---|---|
| Emerald | $249 | $500 | $600 | $187 | $330 | $436 | $830 | $930 |
| Sapphire | $399 | $750 | $900 | $299 | $525 | $698 | $1,275 | $1,425 |
| Onyx | $799 | $1,500 | $1,700 | $599 | $1,050 | $1,398 | $2,550 | $2,750 |
Exhibit B: State-Specific Notices
Gabriel will provide any state-specific disclosures required for your state of residence at enrollment and at renewal. Where a state-specific notice requires different language than this Agreement, the state-specific notice controls for residents of that state.
Exhibit D: Benefit Schedule Rules and Tier Templates
This Exhibit D sets out the operational rules and illustrative tier templates that supplement the pricing and fee allocation in Exhibit A. Where a dollar amount in a tier template differs from Exhibit A, Exhibit A controls.
Global Rules
These rules apply to all Benefits Schedules unless a tier schedule or sponsor-specific schedule says otherwise:
Benefits are available only while membership is active, paid, and in good standing.
Expenses must occur during the member's active benefit period.
Expenses must be submitted with dated, itemized documentation.
Gabriel may request additional documentation, deny ineligible requests, cap reimbursement at fair market value, or require pre-approval.
Monthly limits expire at the end of each Monthly Benefit Period and do not roll over.
Gabriel may require members to use insurance or other available third-party benefits first.
Reimbursement timing is a target, not a guarantee.
Gabriel may reimburse or assist with emergency services, hospital bills, surgery, inpatient care, catastrophic claims, or deductible-like expenses only when the applicable Benefits Schedule expressly includes that benefit and the request satisfies all eligibility, documentation, pre-approval, waiting period, and plan-integrity rules.
Gabriel does not provide tax, medical, legal, insurance, or financial advice.
State-specific limits may apply.
All benefits are subject to change based on utilization, pool health, reserve levels, fraud or abuse risk, member behavior, regulatory concerns, provider availability, pricing changes, financial sustainability, operational constraints, and other business reasons.
Gabriel Network providers and Preferred Partners receive 100% reimbursement of eligible expenses, subject to the available pool and program rules. Out-of-network providers receive 50% reimbursement of eligible expenses, subject to the available pool and program rules. Gabriel may add, remove, or update Gabriel Network providers and Preferred Partners at any time, with or without notice, based on availability, pricing, quality, member feedback, geography, regulatory considerations, or business reasons. Members may view the current list through their Gabriel account or by contacting member support.
Benefit balances are not cash, stored value, wages, compensation, insurance proceeds, HSA/FSA funds, trust assets, escrowed funds, or balances payable to the member.
Eligible Reimbursement Categories
Body Care: chiropractor visits, massage, acupuncture, stretching, bodywork, red light, sauna, and recovery modalities where eligible.
Diagnostics & Doctors: lab testing, panels, imaging and scans, and other diagnostics; integrative, functional, naturopathic, and holistic medicine practitioners (including naturopathic doctors, functional medicine providers, and integrative or holistic physicians), and nurse practitioners and physician assistants practicing in these areas; biological and holistic dentistry; and urgent, specialist, and other care and treatments eligible under your Benefits Schedule.
Pregnancy, Birth & Postpartum Care: prenatal, childbirth, postpartum, and lactation care furnished by licensed midwives, certified nurse-midwives, and other licensed maternity practitioners; by licensed or accredited birth centers; and by doulas and midwife assistants holding certification or training recognized under applicable state requirements or otherwise approved by Gabriel; and related maternity wellness services eligible under your Benefits Schedule. Eligible pregnancy, birth, and postpartum expenses are ordinary wellness reimbursements, are ordinarily handled as an Episode of Care under Section 7A, and remain subject to provider verification, scope of practice, documentation, fair market value review, network reimbursement rates, pre-approval, and all other program rules. Planned childbirth remains outside deductible, emergency, and catastrophic assistance under Section 9.
Supplements: vitamins, supplements, prescription and compounded peptides where legally prescribed and dispensed, prescriptions where eligible, other wellness, longevity, and biohacking consumables lawfully obtained by the Member, and cannabis medicine where legal and eligible. Gabriel may require an Apotheca-first or Gabriel-marketplace-first pathway when an eligible item is available through Apotheca or another Gabriel-designated marketplace. If an eligible item is not yet listed through Apotheca or a Gabriel-designated marketplace but is ordered, dispensed, or recommended through a Gabriel-approved in-network practitioner, provider, or partner pathway, Gabriel may reimburse up to 100% of the eligible cost within the applicable Supplements cap. If an eligible item is purchased off-Apotheca, outside a Gabriel-designated marketplace, or outside Gabriel's in-network/provider pathway, Gabriel may limit reimbursement to up to 50% of the eligible cost within the applicable Supplements cap. Eligibility for reimbursement of any item in this category is determined by Gabriel in its discretion under the applicable Benefits Schedule.
Mind Care: therapy, coaching, psychiatrist visits, breathwork, neurofeedback, and similar mental health support where eligible.
No modality or treatment is guaranteed by Gabriel Care, even if similar modalities are mentioned in marketing, examples, coverage lists, category descriptions, sales materials, or prior reimbursement decisions.
Emerald Benefits Schedule
Membership fee: $249 per month
Member type: individual or household per enrollment record
Monthly wellness reimbursement limit: up to $500 per month after ramp
Wearable engagement bonus: up to $100 per month if requirements are met, plus additional engagement bonuses Gabriel may offer from time to time.
Flex Balance Build
Period 1 grant: $165 (33% of the full monthly pool)
Period 2 additive grant: $330 (66% of the full monthly pool), with unused Period 1 balance retained
Period 3 additive grant: $500 (100% of the full monthly pool), with unused prior Balance Build amounts retained through Period 3
No per-category dollar caps currently apply. Approved spending remains subject to the available Wellness Pool and all program rules.
Support Level
AI-first member support
Human escalation where Gabriel determines appropriate
Reimbursement target: 48 hours after complete documentation and approval
Pre-Approval required for: any single expense of $300 or more, high-risk categories, recurring protocols, and unusual, bundled, experimental, or high-cost services.
Sapphire Benefits Schedule
Membership fee: $399 per month
Member type: individual or household per enrollment record
Monthly wellness reimbursement limit: up to $750 base per month after ramp, up to $900 per month with the full wearable engagement bonus earned
Wearable engagement bonus: up to $150 per month if requirements are met, plus additional engagement bonuses Gabriel may offer from time to time.
Flex Balance Build
Period 1 grant: $248 (33% of the full monthly pool, rounded)
Period 2 additive grant: $495 (66% of the full monthly pool), with unused Period 1 balance retained
Period 3 additive grant: $750 (100% of the full monthly pool), with unused prior Balance Build amounts retained through Period 3; up to $900 with the full wearable engagement bonus earned
No per-category dollar caps currently apply. Approved spending remains subject to the available Wellness Pool and all program rules.
Support Level
Priority AI support
Human escalation for insurance, reimbursement, claims, provider, and high-risk workflows
Reimbursement target: 24 hours after complete documentation and approval
Pre-Approval required for: any single expense of $300 or more, high-risk categories, recurring protocols, and unusual, bundled, experimental, or high-cost services.
Onyx Benefits Schedule
Membership fee: $799 per month
Member type: household or concierge per enrollment record
Positioning: private household health command center
Wellness Allowance Onyx includes a base monthly wellness reimbursement limit up to $1,500. A qualifying wearable engagement bonus may add up to $200 per month beginning in Period 3, producing a maximum ordinary monthly ceiling up to $1,700 if all requirements are met, plus additional engagement bonuses Gabriel may offer from time to time.
Flex Balance Build
Period 1 grant: $495 (33% of the full monthly pool)
Period 2 additive grant: $990 (66% of the full monthly pool), with unused Period 1 balance retained
Period 3 additive grant: $1,500 (100% of the full monthly pool), with unused prior Balance Build amounts retained through Period 3; up to $1,700 with the full wearable engagement bonus earned
No per-category dollar caps currently apply. Onyx follows the same defined Flex Balance Build or Full Access rules as Emerald and Sapphire; approved spending remains subject to the available Wellness Pool and all program rules.
Support Level
Dedicated or priority human coordinator
Household Health Vault support
Specialist routing, bill and EOB review, second opinion coordination, and executive diagnostics coordination where available
Reimbursement target: same-day or priority after complete documentation and approval, not guaranteed
Teams Benefits Schedule
| Tier | Monthly price | Base monthly draw | With wearable bonus |
|---|---|---|---|
| Core | $149 / eligible employee / mo | Up to $500 | Up to $600 |
| Plus | $199 / eligible employee / mo | Up to $700 | Up to $800 |
| Elite | $299 / eligible employee / mo | Up to $1,000 | Up to $1,200 |
Member type: employer-paid or sponsor-paid eligible employee. Teams benefits are defined by the sponsor-specific Benefits Schedule and are subject to group pool availability, plan rules, documentation, eligibility, and approval.
Care Reserve: unused monthly surplus may reconcile into the sponsor group's Care Reserve at face value for larger approved care needs above the monthly draw. Care Reserve credits are not cash, wages, stored value, insurance benefits, or a member-owned account.
Partner purchasing power: Care Reserve dollars hold face value; preferred partner pricing may create up to approximately 1.2x effective purchasing power on eligible partnered services, subject to availability and negotiated rates.
Care Reserve staleness and cancellation: undrawn Care Reserve credits older than 36 months may return to the employer as renewal credit, and a cancelled sponsor group receives the undrawn Care Reserve balance net of any pre-authorized high-ticket draws already in flight, unless the sponsor agreement or applicable law requires otherwise.
Reimbursement target: approximately 48 hours after complete documentation and approval, not guaranteed. Pre-approval may be required for high-cost, out-of-network, or Care Reserve expenses.
Sponsor Privacy Firewall Gabriel will not share individual health details, receipts, diagnoses, provider names, treatments, medications, or reimbursement details with the sponsor except as authorized by the member or permitted or required by law. Sponsor reporting is limited to eligibility, enrollment status, billing status, aggregate utilization where group size is sufficient, and operational data necessary to administer the sponsor account.
Family Memberships Pricing and Pool Schedule
Family pricing is composed of a Household Base and an Added-Life Adder for an Adult Dependent or each of the first two Child Dependents under age 21. Additional Child Dependents beyond the first two are added at no premium and do not increase the pool. Listed pool amounts are the ordinary full monthly review limits. Flex reaches the ordinary monthly reset after its three-period Balance Build; Full Access provides the full monthly pool beginning in Period 1.
Emerald Family
Household Base: $249 per month
Pool Base: up to $500 per month
Added-Life Adder (spouse or each of the first two children under 21): $187 per month each
Added-Life Pool Add: up to $330 per month each
Additional children: $0 premium, $0 pool add, eligible to spend from existing pool
Sapphire Family
Household Base: $399 per month
Pool Base: up to $750 per month
Added-Life Adder (spouse or each of the first two children under 21): $299 per month each
Added-Life Pool Add: up to $525 per month each
Additional children: $0 premium, $0 pool add, eligible to spend from existing pool
Onyx Family
Household Base: $799 per month
Pool Base: up to $1,500 per month
Added-Life Adder (spouse or each of the first two children under 21): $599 per month each
Added-Life Pool Add: up to $1,050 per month each
Additional children: $0 premium, $0 pool add, eligible to spend from existing pool
Shared-pool limits. No per-life or per-category dollar caps currently apply. Each enrolled person may submit eligible expenses, and all approved spending draws from the single shared household Wellness Pool subject to the shared pool ceiling and all other program rules.
Gabriel OS seat tiering. Gabriel OS access differs by enrollment type. Each Individual Membership includes a full Gabriel OS seat with full or priority application access, including the member's own health vault, tracker, and the full or priority tier of AI-assisted support and messaging for that membership tier. On a shared household (Couple or Family) Membership, the Primary Member receives a full Gabriel OS seat and each added dependent receives a linked Gabriel OS seat with standard application access. Standard access includes the dependent's own login, the ability to draw from the shared pool, and standard tracker and support features, and may carry usage allowances (including messaging or AI-assisted support limits) set forth in the then-current Benefits Schedule or program documentation. Gabriel OS is in active development; access tiers, features, and any usage allowances are beta program features subject to change under this Agreement's change provisions.
Onyx family memberships remain concierge-managed. Pool figures above are default targets and may be modified at enrollment by the accepted Benefits Schedule.
Age-Neutral Family Pricing
The Household Base, Pool Base, Added-Life Adders, pool additions, wearable engagement bonus, and Balance Build do not change based on the age of the Primary Member or any Adult Dependent. A Medicare-eligible household member may receive optional Senior and Medicare coordination as a service overlay without changing the household's selected tier or its pricing and benefits.
Standalone Family Surcharge
Memberships elected as Standalone Wellness Memberships pay a surcharge of thirty dollars ($30) per month for each covered life age eighteen (18) or older enrolled under the membership, including Adult Dependents and Child Dependents age 18, 19, or 20, whether or not that life carries a premium. Covered lives under age eighteen (18) are not surcharged. Pool Base and Pool Add amounts are unchanged. The Clinical Care Component is unchanged; the surcharge is allocated entirely to the Wellness & Concierge Component.
Family Flex Balance Build
Period 1 grant: thirty-three percent (33%) of the full monthly pool
Period 2 additive grant: sixty-six percent (66%) of the full monthly pool, with unused Period 1 balance retained
Period 3 additive grant: one hundred percent (100%) of the full monthly pool, with unused prior Balance Build amounts retained through Period 3
At the start of Period 4, unused Balance Build amounts expire and the ordinary monthly full-pool reset begins.
Balance Build controls. No per-category dollar caps apply during or after the Balance Build. The available pool, reimbursement rate, pre-approval threshold, documentation, fair-market-value review, eligibility, and other program rules continue to apply from the first day of membership.
Applies to new family memberships at enrollment, new dependents added to existing family memberships (for the incremental pool contribution only), and members who cancel and re-enroll within twelve (12) months.
Worked Examples (bundled, all adult ages)
Couple, Emerald: premium $436 per month, shared pool up to $830 per month after ramp (up to $930 with the full wearable engagement bonus earned)
Couple plus two children, Emerald: premium $810 per month, shared pool up to $1,490 per month after ramp
Couple, Sapphire: premium $698 per month, shared pool up to $1,275 per month after ramp (up to $1,425 with the full wearable engagement bonus earned)
Couple plus two children, Sapphire: premium $1,296 per month, shared pool up to $2,325 per month after ramp
Couple plus four children, Sapphire: premium $1,296 per month (children three and four at no premium), shared pool up to $2,325 per month after ramp (additional children do not add to pool)
Couple plus three children, Onyx: premium $2,596 per month, shared pool up to $4,650 per month after ramp
Single adult plus two children, Emerald: premium $623 per month, shared pool up to $1,160 per month after ramp
Standalone Wellness couple examples: Emerald couple $496 per month, Sapphire couple $758 per month, Onyx couple $1,458 per month. Pools are unchanged. The $30 per-life surcharge is removed when Gabriel becomes Agent of Record.
Surcharge comparison example: while waiting for Open Enrollment or before Gabriel becomes Agent of Record, two Sapphire Individual Memberships are $858 per month with the standalone surcharge, then $798 per month once the surcharge is removed. A shared Sapphire couple membership is $758 per month with the standalone surcharge, then $698 per month once Gabriel becomes Agent of Record.