AGREEMENT TO TERMS
These Terms of Service (these "Terms") constitute a legally binding agreement between you ("you" or "Participant") and Toothsome, Inc. ("Toothsome," "we," "us," or "our") governing your access to and use of the Toothsome platform, including our website, mobile applications, and related services (collectively, the "Platform").
By creating an account, accessing, or using the Platform, you acknowledge that you have read, understood, and agree to be bound by these Terms. If you do not agree to these Terms, you may not access or use the Platform.
1. ELIGIBILITY AND ENROLLMENT
Section 1.1 Eligibility. The Platform is available only to individuals who: (a) are employed by an employer that sponsors a dental benefit program through Toothsome; (b) meet their employer's eligibility requirements for the dental benefit program; and (c) are at least eighteen (18) years of age.
Section 1.2 Enrollment. To use the Platform, you must complete the enrollment process, which includes: (a) receiving an invitation from your employer; (b) creating an account with accurate information; and (c) acknowledging these Terms and the Privacy Policy.
Section 1.3 Account Information. You agree to provide accurate, current, and complete information during enrollment and to update such information as necessary. You are responsible for maintaining the confidentiality of your account credentials and for all activities that occur under your account.
Section 1.4 Toothsome ID. Upon enrollment, you will be assigned a unique Toothsome ID (format: TSM-XXXXXX). This ID is used to identify you within the Platform and to verify your eligibility with dental providers.
2. YOUR DENTAL BENEFIT
Section 2.1 Employer-Sponsored Benefit. Your dental benefit is an employer-funded health reimbursement arrangement under Sections 105 and 106 of the Internal Revenue Code. It is sponsored and funded entirely by your employer, and your employer is the plan sponsor and plan administrator of the benefit program. Toothsome provides technology services to facilitate your employer's self-administration of the benefit program. Toothsome does not fund your benefit or make decisions about your benefit amount or eligibility. Your benefit is not an insurance policy: no insurance company underwrites or guarantees your benefit, and reimbursements are limited to the balance your employer allocates to you.
Section 2.2 Benefit Amount. Your employer sets your annual benefit amount, which is displayed in your account. Your employer also chooses whether the full annual amount is available at the start of each plan year or becomes available in monthly installments. Your account shows the amount available to you.
Section 2.3 Carryover. Unused available benefit amounts carry over from year to year, up to a maximum accumulated available benefit amount of Ten Thousand Dollars ($10,000).
Section 2.4 Use of Benefits. To use your benefit, visit any licensed dental provider, pay for your visit out of pocket, and submit your itemized receipt through the Platform. Approved receipts are reimbursed through your employer's payroll system in accordance with Section 4. Only qualified dental expenses under Section 213(d) of the Internal Revenue Code are reimbursed (see Section 4.2).
Section 2.5 Toothsome Direct Providers. Toothsome Direct providers are dental providers who participate directly with Toothsome and have agreed to bill services under a reference fee schedule. You are not required to use a Toothsome Direct provider; your benefit is open access, and you may receive services from any licensed dental provider, who bills you the provider's own fees. You pay no membership, access, or platform fee of any kind to use your benefit at a Toothsome Direct provider or at any other licensed dental provider.
3. SUBMITTING RECEIPTS
Section 3.1 Receipt Submission. Receipt submission is required for all reimbursements. Submitted receipts must include: (a) provider name and address; (b) date of service; (c) CDT procedure codes and descriptions of services; (d) amount charged; and (e) proof of payment.
Section 3.2 Review Process. Submitted receipts are reviewed to verify that they meet the requirements for reimbursement. This review is an administrative verification, not a clinical evaluation.
Section 3.3 Approval and Denial. You will receive notification of whether your receipt is approved or denied. If denied, you may submit additional information or a corrected receipt.
Section 3.4 Submission Deadline. Receipts must be submitted within ninety (90) days of the date of service, unless a shorter period is specified by your employer.
4. REIMBURSEMENT
Section 4.1 Reimbursement Process. Approved reimbursements are processed through your employer's payroll system. The timing of reimbursements depends on your employer's payroll schedule.
Section 4.2 Tax Treatment. The tax treatment of your benefit depends on the applicable plan, recipient and expense requirements, not only the type of dental procedure:
(a) Qualified Dental Expenses. Reimbursements of substantiated qualified dental expenses are generally tax-free when the plan, recipient and expense satisfy the applicable tax requirements. Those requirements include eligibility, coverage, no duplicate reimbursement and applicable nondiscrimination rules. A procedure code or Platform approval alone does not guarantee tax treatment. Your employer is responsible for any legally required payroll treatment and reporting. Non-qualified expenses are not reimbursed; this is not an alternative taxable-cosmetic benefit.
(b) Non-Qualified Expenses (Not Reimbursed). Procedures that are not Section 213(d) qualified, such as teeth whitening, cosmetic veneers for appearance only, or other elective cosmetic procedures, are not reimbursed under your benefit. If a receipt includes both qualified and non-qualified services, only the qualified portion is reimbursed. Because non-qualified expenses are not reimbursed, no amount is added to your taxable wages.
(c) Classification. Toothsome's classification of CDT codes is based on IRS guidance and may be updated as IRS interpretations change. If you have questions about whether a specific procedure qualifies, contact support@toothsome.io before submitting your receipt.
(d) Classification Questions. If you believe a procedure on your receipt was classified incorrectly, contact support@toothsome.io within thirty (30) days of the decision on your receipt.
Section 4.3 Balance Limitations. Reimbursements are limited to your available balance. If a submitted receipt exceeds your available balance, you may be offered a multi-month reimbursement schedule or partial reimbursement.
Section 4.4 No Cash Withdrawal. Your benefit balance may only be used for reimbursement of eligible dental expenses. You may not withdraw your balance as cash or use it for non-dental purposes.
Section 4.5 Correction of Improper Payments. If you receive a reimbursement for an expense that is later determined to be ineligible, unsubstantiated, or otherwise improperly paid, the correction sequence described in IRS Revenue Ruling 2003-43 applies, in the following order: (a) you must repay the improper amount to your employer's benefit program; (b) if you do not repay it, your employer may withhold the amount from your wages or other compensation to the extent consistent with applicable law; and (c) any amount that remains outstanding may be offset against your future substantiated reimbursements.
5. TERMINATION OF EMPLOYMENT
Section 5.1 Submission Period. If your employment with your employer terminates, you have thirty (30) days from your termination date to submit receipts for dental services received before your termination date.
Section 5.2 Forfeiture. Any unused benefit balance remaining after the thirty (30) day submission period is forfeited and returned to your employer. You will not receive any payment for forfeited balances.
Section 5.3 Account Deactivation. Your account will be deactivated following the thirty (30) day submission period after your employment ends.
6. ACCEPTABLE USE
Section 6.1 Permitted Use. You may use the Platform only for its intended purpose: to manage and submit receipts for your employer-sponsored dental benefit.
Section 6.2 Prohibited Conduct. You agree not to:
(a) Submit false, fraudulent, or misleading receipts or information;
(b) Attempt to obtain reimbursement for services not actually received or expenses not actually incurred;
(c) Share your account credentials with any other person;
(d) Use another person's account without authorization;
(e) Attempt to circumvent any security measures or access controls;
(f) Interfere with the operation of the Platform;
(g) Use the Platform for any unlawful purpose.
Section 6.3 Consequences of Violation. If you violate these Terms, we may: (a) suspend or terminate your account; (b) deny pending reimbursement requests; (c) require repayment of improperly obtained reimbursements and apply the correction sequence described in Section 4.5; and (d) report suspected fraud to your employer and appropriate authorities.
7. PRIVACY AND DATA
Section 7.1 Privacy Policy. Our collection, use, and disclosure of your information is governed by our Privacy Policy, which is incorporated into these Terms by reference.
Section 7.2 Information Sharing. We share your transaction information with your employer for payroll processing and benefit administration. We do not share clinical details or specific procedure information with your employer.
Section 7.3 HIPAA. We handle your health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and our Business Associate Agreement with your employer.
8. INTELLECTUAL PROPERTY
Section 8.1 Ownership. The Platform and all content, features, and functionality are owned by Toothsome and are protected by intellectual property laws.
Section 8.2 License. Subject to these Terms, we grant you a limited, non-exclusive, non-transferable license to access and use the Platform for your personal, non-commercial use.
Section 8.3 Restrictions. You may not: (a) copy, modify, or distribute any portion of the Platform; (b) reverse engineer or attempt to extract source code; (c) use the Platform to develop a competing product; or (d) remove any proprietary notices.
9. DISCLAIMERS
Section 9.1 No Medical Advice. The Platform does not provide medical or dental advice. We do not recommend or endorse any specific dental providers, treatments, or procedures. All decisions about your dental care should be made in consultation with qualified dental professionals.
Section 9.2 No Guarantee of Reimbursement. Submission of a receipt does not guarantee reimbursement. Reimbursement is subject to review, your available balance, and the terms of your employer's benefit program.
Section 9.3 Provider Relationships. We do not employ dental providers or control the quality of services they provide. Your relationship with any dental provider is between you and that provider.
Section 9.4 Platform Availability. We do not guarantee that the Platform will be available at all times or free from errors. We may modify, suspend, or discontinue any part of the Platform at any time.
Section 9.5 Warranty Disclaimer. THE PLATFORM IS PROVIDED "AS IS" AND "AS AVAILABLE" WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT.
10. LIMITATION OF LIABILITY
Section 10.1 Limitation. TO THE MAXIMUM EXTENT PERMITTED BY LAW, TOOTHSOME'S TOTAL LIABILITY TO YOU FOR ANY CLAIMS ARISING FROM OR RELATED TO THESE TERMS OR THE PLATFORM SHALL NOT EXCEED ONE HUNDRED DOLLARS ($100).
Section 10.2 Exclusion. IN NO EVENT SHALL TOOTHSOME BE LIABLE FOR ANY INDIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, OR PUNITIVE DAMAGES, INCLUDING LOST PROFITS OR LOST DATA, REGARDLESS OF WHETHER SUCH DAMAGES WERE FORESEEABLE.
Section 10.3 Basis of Bargain. THE LIMITATIONS IN THIS SECTION REFLECT A REASONABLE ALLOCATION OF RISK AND ARE A FUNDAMENTAL BASIS OF THE AGREEMENT BETWEEN YOU AND TOOTHSOME.
11. DISPUTE RESOLUTION
Section 11.1 Informal Resolution. Before initiating any formal dispute resolution proceeding, you agree to first contact us at support@toothsome.io to attempt to resolve the dispute informally.
Section 11.2 Arbitration. Any dispute arising out of or relating to these Terms or the Platform shall be resolved by binding arbitration administered by the American Arbitration Association in accordance with its Consumer Arbitration Rules. The arbitration shall be conducted in Travis County, Texas.
Section 11.3 Class Action Waiver. YOU AGREE THAT ANY DISPUTE RESOLUTION PROCEEDINGS WILL BE CONDUCTED ONLY ON AN INDIVIDUAL BASIS AND NOT IN A CLASS, CONSOLIDATED, OR REPRESENTATIVE ACTION.
Section 11.4 Exceptions. Notwithstanding the foregoing, either party may seek injunctive relief in any court of competent jurisdiction.
12. GENERAL PROVISIONS
Section 12.1 Governing Law. These Terms are governed by the laws of the State of Texas, without regard to conflicts of law principles.
Section 12.2 Entire Agreement. These Terms, together with the Privacy Policy, constitute the entire agreement between you and Toothsome regarding the Platform.
Section 12.3 Modifications. We may modify these Terms at any time by posting the revised Terms on the Platform. Your continued use of the Platform after any modification constitutes your acceptance of the modified Terms.
Section 12.4 Severability. If any provision of these Terms is held invalid, the remaining provisions shall continue in full force and effect.
Section 12.5 Waiver. Our failure to enforce any provision of these Terms shall not constitute a waiver of that provision.
Section 12.6 Assignment. You may not assign these Terms without our prior written consent. We may assign these Terms without restriction.
Section 12.7 Contact. If you have questions about these Terms, please contact us at:
Toothsome, Inc. 3550 N Lakeline Blvd, Unit 170, PMB 1022 Leander, TX 78641 Email: legal@toothsome.io
Document Version: 2.5 · Last Updated: September 27, 2026