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HomeMy WebLinkAbout921070.tiff RESOLUTION RE: APPROVE 1993 MASTER GROUP CONTRACT AND AUTHORIZE CHAIRMAN TO SIGN - TAKECARE OF COLORADO, INC. WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with the 1993 Master Group Contract Application with TakeCare of Colorado, Inc. , commencing January 1, 1993, and ending December 31, 1993, with the further terms and conditions being as stated in said contract, and WHEREAS, after review, the Board deems it advisable to approve said contract, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the 1993 Master Group Contract Application with TakeCare, Colorado, Inc. be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is, authorized to sign said contract. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 4th day of November, A.D. , 1992. } BOARD OF COUNTY COMMISSIONERS ATTEST: f i��� �tz " `� yS" WELD COUNTY, COLORADO /4C At14 6614 :::y4 Weld County Clerk to the Board Geoor e Keredy, Chairman BY: � = .A, k-te r...tcr-�, Deputy Cl≥ to the Board Constance L. Harbert, Pro-Tem APPROVED AS T FORM: C. W. Kir ) er0 / County Attorney Gor a W. H. e ster 921070 • MASTER GROUF 7NTRACT APPLICATION TAKECARE OF COLORADO, INC. The entirecont act,consisting of the attached Master Group Contract(MGC),Evidence of Coverage(EOC),applicable Addenda,if any,and this Master Group CcnvactAppllcaticn, has been entered into betweenTakeCare of Colorado,Inc.,and(name below).In consideration of the Health Services Fee to be paid toTakeCare of Colorado,Inc.,by Enrolling Unit on behalf of eligible Enrollees and Enrolled Family Dependents,TakeCare of Colorado,Inc.agrees to arrange Medically Necessary Health Services as specified herein,in accordance with the terms,conditions,limitations and exclusions of this contract 1) NAME AND ADDRESS OF GROUP: 2) GROUP NUMBER(S): Weld County HMO — Northern Colorado Spa 915 10th Street HMO — Denver 744 P.O. Box 758 HMO — Colorado Springs 1031 Greeley, CO 80632 PPO 50158 3)GROUP RENEWAL DATE January 1 Month Day 4) ELIGIBILITY: In addition to the requirements herein,employee eligibility will be as follows:Part—time employees (those working 20 or more hours per week, but less than 40) and full—time employees will be eligible for benefits. 5) NEWLY HIRED ELIGIBLE EMPLOYEES AND TERMINATED EMPLOYEES:In addition to the requirements herein,eligible employees will have coverage provided and Health Services Fees due as follows: Newly hired eligible employees will have coverage effective the first of the month following employment through a full pay—period (the 16th through the 15th) if application is made within 31 days. A full monthly fee will be charged. See attachment #2 for termination of coverage due to employment termination. 6)GROUP OPEN ENROLLMENT PERIOD:Membership applications,subject to the terms of the attached contract,shall be accepted as follows: In November for a January 1 effective date. 7)OTHER ATTACHMENTS: Attachment 1 and 2. 8)COVERAGE: EQQ. MGC Contract Tvoe(Medical) Monthly Fee Fmolover Contrib. U Design I 6729(10/91) 6755 (10/91) Emp.Only $ 136.25 $See Attach 1 ❑Design VA 6752 (10/91) 6756 (10/91) Emp. & 1 Fam. Dep. $ 376.05 $ II ❑Design VIA 6753(10/91) 6757(10/91) Emp. & Children $ 376.05 $ ,r 13 Design IXA 6754(10/91) 6758(10/91) Emp.,Spouse& Children $ '376.05 $ rt ❑Design X 6730(10/91) 6759(10/91) ta ID The foregoing rates shall remain effective subject to the terms and conditions of the attached contract and any attachment specified on this page through December 31, 1993 9)SUPPLEMENTAL ADDENDUM: Lei Prescription Drug Addendum Rx5 6826(10/91) ❑ ❑Prescription Drug Addendum Rx7 6649 (10/91) ❑ ❑Prescription Drug Addendum Rx10 6731(10/91) ❑ ❑Preventive Dental Addendum 6079 (5/90) ❑Basic 6640(12/88) Contract Tvoe(Dental) Monthly Fee Employer Contrib. ❑Comprehensive 6641 (12/88) Emp.Only $ $ ❑Comprehensive Orthodontic 6642 (12/89) Emp. & 1 Fam. Dep. $ $ ❑Medicare Supplement 6643 ( ) Emp. & Children $ $ ❑Durable Medical Equipment 6631 (12/88) Emp.,Spouse&Children $ $ 10) Minimum Number of Enrollees 10 (ten) a 11) Executed in Colorado effective as of: January 1, 1993 �. ENROLLING UNIT C a: iiiiitpip& 90, INC. p tst� u G ///O'�/(DD /0-.30 te7 uredAut bed epreeematbe) ///0�f/L/� (Date) (Signature of Authorized Representative) (Dale) George Kennedy Stephen T. O'Dell (Type or Print Above Name) (Type or Print Above Name) Chair of the Board of County Camissioners President (Tele) (Title) fie38(8/92) White:TakeCare Enrollment pepanmant •Yellow:TakeCare-Regbnal Marketing Dept. Pink:Employer 9 in ig 1 73 Attachment w1 WELD COUNTY For Contract Year January 1 through December 31, 1993 Employer contribution to the cost of TakeCare Colorado, Design Plan 9A, Rx5. For employees who work: 40 + hours: $130.25 30 — 40 hours: $ 97.69 20 — 30 hours: $ 65.13 921O7O Red'cine Rd. -9-0 R. Tufts Venue >T:5 Alark Dabling Bl d. -?U A'. Alain Street Suite 1:i Suite -00 Suite _00 Suite =00 Fort Collins. CO Denser, CO 50'_3- Colonist() Springs, CO 50019 Pueblo. CO SIlmi r 31131 .'_3`)59N (31131 -70-r-ni) ( 19) ii5-S-00 (-191 ;-1_-_os; lti.LL.; c ',eiI ;,r. .: Attachment *2 Contract Year January 1 - December 31, 1993 WELD COUNTY TERMINATION OF COVERAGE: Terminated employees will have coverage through the end of the month In which termination occurs if the termination date is the first through the fifteenth of the month, or through the end of the following month if the termination date Is the sixteenth through the last day of the month. A full monthly premium will be charged (through the employer) for the month coverage terminates. :(c: Redwing Rd. "9-9 [:. fufts :Avenue i;?5 \lark Dabling Blvd. -_(l N. Main Street Suite 120 Suite -0(1 Suite 2_00 Suite 22(10 Fart ( ollins. CO Denser. CO 5IC3- Colorado Springs. CO S((919 Pueblo, CO ~1011'7, L(i3) 3AY)5 (,Oil --9.4-1111 (]9) ',.-k.•C)0 ("19) G.}?.:6SS 9?-(4 7;3 are LINCOLN NATIONAL HEALTH PLAN OF COLORADO CT DESIGN IXw As of August 1, 1992 the name of our health MASTER GROUP CONTRA plan has changed to TakeCare of Colorado, (Herein called the Contract) Inc., from Lincoln National Health Plan. with the Enrolling Unit to provide the called PLAN)hereby agrees. and itio pros of this Lincoln National Health Plan n Colorado (herein subject to die terms.conditions.exclusions Health Services set forth herein to Covered Persons Contract. a em of the required Contras(]target on of the Enrolling Unit's application and payment ym . application is attached to and is made a part of this Contact. This Contract is made in cotisnderati Thas specified herein-A copy of the enforce by the timely payment on theAppli�on�willbecontinued provided herein of ihe Contract retCecc°sn whe en due,subject don of this Cook as of the required Contract Charges wbea due. to termination All Coverage under this Contract shall begin and end at. 12:01 a.m.Mountain Time. This Contract is delivered in and governed by the laws of the State of Colorado. As of August 1. ]992 the name of our heal plan has changed to TakeCare of Colorad CONTENTS Inc., from Lincoln National Health Play Section Definitions of Terms Used in this Contract.......... ................... .......... Section II Entailment and Effective Date of Individual Coverage...........................6 Section III 6 Procedures for Reimbursement of Eligible Expenses.............................. Section IV Coordination of Benefits and Subrogation............... ................... Section V Complaint and Grievance Ptocertes.......................................................11' Section VI 11 Termination of Individual Coverage......................................... Section VII ContractCharges.....................................................................................1 5 Section VIII GeneralProvisions..................................................................................1 6 • Section IX Health Services .............................................18 procedures for Obtaining Section X Schedule of Benefits and Exclusions............._....................................... 20 Section I DEFINITIONS "Acute Mental Disorder"means a condition determined by the Mental Health Provider o be psychological in gym'and a short duration. when such Addendum is signed by which A nas an immediate onset and if any,of Health Services coveted only mcans an attached description, Health Services Fees. "Addendum"dm" em of additional PLAN. and subject to PaYm bee 31 of any Y� this Conttacx for the diagnosis"Calendar Year" means the period froma January 1 through es caves Classification the of Diseases of Services"chemical means sg dependency a classified in the International "chemical Dependencyo and�ical or drug deQenr! ed the U.S. Depattmem of Health and Human Services. bouts a Hospital or Participattn8 Skilled stay of mom than eighteen (18) ".Confinement" means an tminset=nP� a Nursing Facility. means a defective development or formation of a part of the body which is determined by "Congenital Anomaly" at the time of birth. Physician w have been present the application of the Enrolling Unit.ther conditions betty ad Contract"means the Master Group Cent gig benefits.exclUst°°s andN and the by PLAN which constitrtte the agreem Enrolled Family Dep��• Enrolling nit the yam of the Health Serviaa Fee for all Enrollees and "Contract Charge mans the effective date of this Contracts t t "Contract Years" and"Contract Months" are determined Services Fee.worth�Coveted Person is em of at in addition to the HPerson t for the pay for eta certain Health metros the charge. under this Contract �e of service.The total CopaYm�Charge pay for Health to the provider of the aylnotex 2�of the totalUmt those caste Health Services e d PLAN Chatee is any behalf o fteat may through the Enro g aid o any Cotrtraa owhere tt paid bye Y Covered Person herring the same period Faonmily behalf pendents with the CovetedPerson total Copaymeac C th Services an Coln to PI-e byralllx Covered Persons in the family unit exceed Enrollee-is the totalannualthe recovery of Fees d to P1 A du all ring the setup period through the Enrolling Unit The Errro is responsible do not correct Charges. (See Section IlL) physical appearance, but which which improve pN sisal a . "Cosmetic temetic improve pnaph means those function,procedures am not Medically subject to materially a physiological provided under this Contact,���� a Covered Person to Health Services Health Services the following conditions:(a) ,any of termination condo "Coverage" means the entitlement by provided prior to the date tha- whenterms limitations, Health Services must be P ices d prior ust be provided that my the rminations a ndit and exclusions of this Connect and Covi two(2) Contract is in effect:(b) in Section II. Person, and meets l eligib of ility requirements rementdascdeesscnb d while Coverage of person, and all eligibility tech fled Family Dependent,but applies only "Covered Person"means either the Enrollee or an Enrolled is determined by the Menem Health provider person under this Contract is in effect. functioning of the individual. n-term care for a condition which normal daily "Crisis in nn" means a sudden onset and arts the oal in developing immediate of coping individual. psychological n r native,and which has assistance se Intervention services include evaluation and oes. ���oRm�,does e,,o�c�es-tL�n lled Health"Custodial Cate"means any skilled��wr.�or supportive.--...preventivef acme or protective health`'rite,_Af sr u . . __�l.n Alnr `^ _ current medical,condition is are stabilized and whose The absence of such not individual whose Health Service's requirementsrogre over a specified penod of time. e or progress erred throuBiiPenodic is provided to improvemenctedt an mdt se upon improve may or objectively documented of a to significantly �objectively predictable medical oucco supervision participation imp m will be based Custoal Care . Ie include d the The mere participation anon ofof these roveme licensed use professionals and Plan- ar or desirable assessment by stored therapist ascnecessary m nature and if the nacuie the services can be safely an nurse. o test Furze of r.Custodial Care and land physician. preclude theson-med c being services ate custodial nt professionals does not non-medical person.,�on-medical Pe�°n' but not off those e performed not altered the availability provided by or under the dliecnon of a Dentist^including of services are altered by mouth Treatment or Care"means all services P or soft tissues of the ,Dental Surgery, procedure which involves the hardand qualified to provide Dental Surgery limited to my surgical ..DDS:', who is dulylicensed rcec�a. ,Dentist" means any d°r °ladental of jurisdiction in which treatment into an agseema' "Designated Treatment or Care under Hospital named as such by PLAN.whit ch entered i into anagr en an ••Designated elf of PLAN r Facility" Services for organ transplants which are with or on behalf of PLAN an withstand Rid�and is not disp°�e.is use which are covered under this Contractand is apPrpPna "Durable oserveMedicalEqupoS stn"means e ly not useful equipment.to in the absence of a Sickness or Injury,� generally not to serve a medical put'Pox• covered under this Contra for use in the home. d specific to the service area for Health Services G "Eligible Expenses"are�fees established who ce meets the eligibility �P�'�et°her lling Unit or other personer we specified pegibed in theca"application � Yahis m °�the who t Sees who work or am er work lessPLAN han p� d at in eligible a prior approved in wr tin g by PLAN Enrolled Eligible Persons w g�resi Area. id mn�mems.Part _ writing bS��PLAN.Enrolled Participator re the Service bAreashaRlyd��°�y for Health �,PLAN, xi of an Emergm'ay,or upon prior written approval or Mental Illness which arises sudd in the event from Injury.Sickness, whit nonresulimg to �life or health of a Covered "Emergency"require •means a serious andme treatment to avoid jeopardy annrson. an Emery and requites Healthimmediate Le caretrzaServices and supplies tied for the tie meat of to the wadi those Health sery �terrjieotrsetof an for thericy. ..Emerge er Services" four(24)hours whicharegenerallYPt�dddn°laterthaniwe CY-"tract- this Contract Copayment Charles as described in this for Coverage under who is enrolled ,•mss a Family Dependent Contract- "Enrolled Family Dependent" Enrollee"means an Eligible Person who is enrolled for Coverage under this Contract or other entity with whom this Contract is made. ..Enrolling Unit"meamis the employer psychiatric pris eRs'rreamtents,devices ar Procedures"me �s medical.surgical fir incd by the medical comm., therapies) as detemi ht to change, mm "Experimental regimes roveuPrce investigational drugs and drug the rig ., large, including ingibut o(including Administration.PLAN reserves the righ if a particularP but not limited to the Food and Drug Unproven. Contact PLAN Unproven. large, includingExperimental or Unp Ex erimental or pharmacological regime is considered to be Pr dependentct»ld(° time,the procedures considered to be P✓ and w "Family arm device,or p Enrollee's legal spouse or(2)an unmarried depende , llee has e01( )anu red gi'a s astep stepchild, legally adopted ed a child, or who is(1)f the Enrollee or the Enrollee for child,aa child fwhom ryyanco trot)of either utter a Enrol a stepchild,legally tit paten Enrollee unless PLAN approves for g arrangements.Services spc Enrollee has legal a place residence is with the the Se a shall be covered only rio Health ngPP�ree (3)Pa whose principaltempo y reside outside of Sthe oruponprior . �enmof an Emergency,Dependents who tempo SetviceArea.ubjecttothe conditions and limitationsf:� Participating Providers tnilx..Y.Yient. is subject to the following J"-- 70 1. The term"Family Dependent" shall not include any unmarried dependent child 19 years of age or older. ed dependent child 19 years of age or older but less 2. The term"Family Dependent'shall not include any unmarri titan 23 years of age unless: a. The child is not regularly employed on a full-time basis: and b. The child is a Full-time Student and evidence satisfactory to PLAN is furnished upon request: and c. The child is primarily dependent upon the Enrollee for support and maintenance and evidence satisfactory to PLAN is furnished upon request and 3. The Enrollee shall be responsible reimbursement from the not for any Health Services s providedP to the child obtaining at a time when the child did not satisfy these conditions.The Enrolling Unit agrees for such Health Services. course of study or training "Full-time Student" means a person who is enrolled and attending full-time in a recognized at 1. an accredited high school or vocational school: 2. an accredited college or university: or school. 3. a licensed technical school.beautician school, automotive school. or similar training school. or at the end of the Contract Month during wwhic rson ce ontinues n aes or oA person ceases to be a Full-time Student therwise ceases ttibe tiro��inaawd3aat the instinuiononaful eb ad nni� uebeaFull- established by the institution.unless Full- time Student during periods of vacation of vacation. Full- time Student immediately following the periodto the extent that such lies covered under this Contract except "Health Services"means the are �or �under this Contract health care services and supplies Enrollee and each Enrolled Family Dependent in for each "Health Services Fee means the monthly requiredfee accordance with the terms of this Contract. in providing Health Services on an to law which is primarily engaged . tic and surgical on an or sick individuals through medical.dia@ans "Hospital means an institution operated pursuantcontract or with an accredited hospital i- Inpatient(including basis for the i al facility and treatment wcha of a injured arrangement,bywhich has twenty-four(gal tiesefrmsuch a surgical which has a bona fideuper sion of,a staff of Physicians [rha of Healthcare (2 ) to perform sac ser tea►procedures)accred t d as a r Hospital o supervision b the Joi Commission are of the aged.Accreditation s not na of Hea home, hour izatiog red as ore by Organizations. A Hospital is not primarily a place for rest or Custodial convalescent home or similar institution. PLAN and theEnrolling Unit during which Eligib'• "Initial Eligibility Period"means the period of time determined by Persons may enroll themselves and Family Dependents under this Contract."Injury"means bodily damage other than Sickness(excluding medical malpractice),including all related conditions an recurrent symptoms, not otherwise excluded under this Contract "Medical Director" means the Physician so named by PLAN as the Medical Director, or his or her designee. meet tl PLAN to be necessary Necessity t done on a case-by-case to be necessary fact that "Medically needs an iv means those on Services which are i deistermined by Necess. �a that procedure or treatment does not mean that it is Medically dent's 'Itdadon. itic basic health needs of individual.Determination of Medical bed course of treatment �for the pa solely I the has performed be ed o prescribed h thea iagosis of.and prescribed or not at requited c� the service must ea nsconsistent than convenience of the patient or his or her Physicianof 8 appropriate: be required for reasons other n reasons and(3)be performed in most cost efficient type s �, ti 70 "Medicate" means Pats A and Pan B of the insurance program established by Title XVIII.United States Social Security Act. as later amended. 42 U.S.C. Sections 1394. et seq. into a service agreement with or individual who has entered "Mental Health Provider" meens the Health organization. entity es Dependency Services covered under this Contract. supplies coveted under this Contract for the diagnosis and treatment PLAN to arrange er ices" the Mental Health Services and Chemical of Health oMe ent Health Services"means shose in the and of Mental Illnesses which are classified in the International Classification of Diseases of the U.S. Department and Human Services. s chologicai ongin or effect including "Mental Illness" means a physical or mental condition having an emotional or psychological Y alcoholism and chemical or drug dependency. "Open Enrollment Period"means an annual period thirty-one(31)days in duration.subsequent to the Initial Eligibility Period.determined by PLAN and the Enrolling Unit during which Eligible Persons may enroll themselves and Family Dependents under this Contract. facility designated as such by a Hos- meansanon-Hospitalhealthcarefacility,oradjtmct , reschegnes surgical services. "Participating l (1) provides or services on an outpatient basis: p or diagnostic e services.and Eml which Health provides one or more of care the following secvi uled rehabilitative.laboratory. Em has Services.service urgent are en wiserth PLANes,or topr provide has entered into a agreement with to provide Health Services to Covered Persons. i"Participating dug ua Healththe Agency" means a program which is(1)engaged in providing home health care services and is authorized pursuant to the law of jurisdiction in whichueamtentis received,and(2)has entered into a service agreement with PLAN to provide Health Services to Covered Persons. with PLAN to provide Health Serv- ices"Participating Hospital"means a Hospital which has entered into a service agreement ices to Covered Persons. with PLAN to provide Health "Participating Physician"means any Physician who has entered into a service agreement Services to Covered Persons. pr>�mitiacely includes pediatrics.internal Physician whose practice into a Primary Care Physician serv- ice a Primary Care o y,or means any medicine.obstetrics/gynecology.or family or general medicine,and who has entered agreement with PLAN to provide Health Services to Covered Persons' any other Health Service provider "Participating Provide?'means a Participating Hospital.Participating Physician.and who/which has entered into a service agreement with PLAN to provide Health Services to Covered Persons. home facility which is(1)licensed and operated in means a Hospital or nursing is Medicare ap is(1) aan t pera intc "Participating w Skilled Nursing Faction which treatment accordance Teem n law o P uAN to p�ide Health S races to Covered Persons. a service agreement with PLAN to p who is duly licensed and qualifies "physician"means any doctor of medicine."M.D.",or doctor of osteopathy, "D.O:•, under the law of jurisdiction in which treatment is received. "Reasonable and Customary Chargcs"means fees for covered Health Services and supplies which do not exceed the fec that the provider would charge any oit,cr payer for the same services. u Sickness.orCongzn "Reconstructive Surgery"means any Medically Necessary surgery which is incidental to an Injury tal Anomaly and whose purpose is to restore normal physiological functioning to the involved part of the body. "Semi-private Accommodations" means a room with two or more beds in a Hospital or Participating Skilled Nursi' Facility. agencies. Contact PLAN "Service Area" means the geographic area served by PLAN. as approved by regulatory determine the precise geographic area served by PLAN. "c:,.,.,,PcC" means nhvsical illness or disease. or pregnancy, but does not include Mental Mn „D' Section 11 ENROLLMENT AND EFFECTIVE DATE OF INDIVIDUAL COVERAGE A. Enrollment Eligible Persons may enroll themselves and their Family Dependents in PLAN during the Initial Eligibility Period or during an Open Enrollment Period specified by PLAN by submitting application on a form provided or approved by PLAN. In addition,new Eligible Persons may be enrolled in PLAN within 31 LAN daysof te date toon which.they first which become Eligible Persons.and new Family Dependents may be enrolled in newborn 1 days o are covered at the they first become Family Dependents,except that Family DependEligible l Persons and/or Family moment of birth. Except during the time periods set forth in this paragraph. Dependents may not enroll in PLAN without the express written authorization of PLAN and evidence of insurability. The Enrolling Unit shall notify PLAN in writing within sixty (60) days of the effective date of enrollments. terminations or other changes:provided.however.that the Enrolling Unit shall notify PLAN in writing each month of any changes in the Coverage classification of any Enrollee. B. Effective Date of Coverage Coverage for an Eligible Person and his or her Family Dependents. if any, is effective on the date specified by Enrolling Unit and PLAN.provided that PLAN receives a property completed individual enrollment application that was submitted to PLAN according to the enrollment provisions of Section II.A of this Contract: and provided. however, that 1. No Coverage shall be effective until this Contract takes effect 2. No Family Dependent shall be covered under this Contract until the Eligible Person is coveted. anew Family Dependent by reason of adoption or marriage.then Coverage forthat Family 3. If an Enrollee d acquiresent is adopted or married, if PLAN and Dependent shall take effect on the date that the new Family Dependent .one(31)days of occurrence; Enrolling Unit is notified by the Enrollee of the adoption or marriage within thirty and any necessary adjustments to Health Services Fees have been made. 4. If an Enrollee acquires anew Family Dependent who is a newborn child.then Coverage for t�oDependent shall take effect at the moment of birth and remain in effect for thirty-one(31)days bey continue Coverage for that Family Dependent.the Enrollee shall notify PLAN and Enrolling Unit of the newborn child's birth and the name: and make any necessary changes in the Coverage classification and Health Services Fees. 5. Health Services for medical conditions arising prior to the effective date of Coverage and resulting in Confinement are covered as of the effective date only if the Covered Person notifies PLAN of Cand ifHealth m wi forty-eight(48)hours of the effective date,or as soon thereafter as is reasonably possible, Services are received in accordance with the terms, conditions. exclusions and limitations of this Contract. Section III PROCEDURES FOR REIMBURSEMENT OF ELIGIBLE EXPENSES Reimbursement of Eligible Expenses PLAN shall reimburse for Eligible Expenses incurred with non-participating providers only for MEDICALLY NECES- SARY EMERGENCY SERVICES OR SERVICES AUTHORIZED OR APPROVED BY PLAN in accordance with the terms of this Contract 0na 0170 directly to PLAN N an the Participating Providers are i 3 u1eible for submitting written proof of loss for Eligible Expenses o the _ _ r Dorrenn cc hided by a Participating Provider for Eligible Expenses. Written proof of loss for services rendered by non-participating providers. satisfactory to PLAN, shall be furnished at PLAN's office within ninety(90)days after the date of such loss.Failure to furnish proof within the time required shall invalidate or reduce Coverage unless it was not reasonably possible to have given proof within ninety(90)days or.in the absence of legal capacity of the Covered Person.later than one(1)year from the time in which proof is otherwise required. All Eligible Expenses shall be paid within sixty(60)days of receipt by PLAN of proof of loss.Where applicable.Eligible Expenses shall be paid to the Enrollee. Subject to written authorization from an Enrollee. all or a portion of any Eligible Expenses due may be paid directly to the provider of the Health Services. Copayment Reimbursement PLAN shall reimburse for amounts of Copayment Charges paid by any Enrollee in any Contract Year that exceed 200% of the total annual Health Services Fees paid to PLAN during the same period on behalf of the Enrollee through the Dependents with PLAN. PLAN shall Enrolling Unit In those cases where the Enrollee has enrolled his or her Family that reimburse for amounts of Copayment Charges paid by all Coveted Persons in the family unit in any Contract Year exceed 200%of the total annual Health Services Fees paid to PLAN through the Enrolling Unit during the same period. Written notice that excess amounts of Copayment Charges have been paid by the Enrollee or by all Covered Persons in the same family unit must be sent to PLAN. Such notice must(1) include proof satisfactory to PLAN of the payment of Copayment Charges,and(2)be provided to PLAN not later than ninety(90)days after the end of the Contract Year.The amount of any excess Copayment Charges will be paid within sixty(60)days of receipt of written notice by PLAN that excess Copayment Charges have been paid by Covered Persons. Limitation of Actions No action at law or in equity shall be brought to recover on the Contract by a Covered Person prior to the expiration of sixty(60)days after proof of loss has been filed in accordance withthe requicemems of the Contract.nor shall such action be brought at all unless brought within three(3) years after the time written proof of loss is required by the Contract Section IV COORDINATION OF BENEFITS AND SUBROGATION Coordination of Benefits A. Applicability 1. This coordination of benefits("COB")provision applies to This Plan when an Enrollee or the Enrollee's Enrolled Family Dependents have health care coverage under more than one coverage plan. "Coverage plan" and"This Plan" are defined below. nation rules ould be ose rules 2. If determine s w etaarproviston applies,the benefits of This Plan are determinede order of benefit rbefore or after those of looked r coverage plan.The benefits of This Plan: (a) Shall not be reduced when,under the order of benefit determination rules,This Plan determines its benefits before another coverage plan: but (b) May be reduced when,under the order of benefits determination rules,another coverage plan determines its benefits first.The above reduction is described in subsection D"Effect on the Benefits of This Plan." B. Definitions 1. "Coverage plan"is any of these which provides benefits or services for,or because of,medical or dental care or treatment JSv�.i, £7 (a\ nmun insurance or ttroup-rytx coverage. whether insured or uninsured. This includes prepayment. group __s...,.I .,.-.-:,ienr_rvne coverage. (b) Coverage under a governmental plan,or coverage required or provided by law.This does not include a state plan uoder Medicaid Mee XDC.Grants to States for MedicalAssistance Programs,of the United States Social Security act. as amended from time to time). Each contract or other arrangement for coverage under (a) or (b) is a separate coverage plan. Also, if an arrangement has two parts and COB rules apply only to one of the two, each of the parts is a separate cov- erage plan. 2. "This Plan" is the part of this group Contract that provides benefits for health care expenses. 3. "Primary Plan/Secondary Plan": The order of benefit determination rules state whether This Plan is a Primary Plan or Secondary Plan as to another coverage plan covering the person. When This Plan is a Primary Plan,its benefits are determined before those of the other coverage plan and without considering the other coverage plan's benefits. When This Plan is a Secondary Plan,its benefits are determined after those of the other coverage plan and may be reduced because of the other coverage plan's benefits. When there are more than two coverage plans covering the person.This Plan may be a Primary Plan as to one or more other coverage plans, and may be a Secondary Plan as to a different coverage plan or plans. 4. "Allowable Expense"means a necessary. reasonable and item of customary item of expense for health care: when the expense is covered at least in part by one or mote coverage plans covering the person for whom the claim is made. The difference between the cost of private accommodations in a Hospital and the cost of Semi-private Accom- modations in a Hospital is not considered an Allowable Expense under the above definition unless the patient's stay in a private Hospital room is Medically Necessary either in terms of generally accepted medical practice,or as specifically defined in the coverage plan. taco C18geplanprovides benefits in the form of services,the reasonable cash value of each service rendered will be considered both an Allowable Expense and a benefit paid. 5. "Claim Determination Period"means a Calendar Year. However, it does not include any part of a year during which ich<person has no Coverage under This Plan,or any pan of a year before the date this COB provision or a provision takes effect. C. Order of Benefit Determination Rules 1. General. When there is a basis for a claim under This Plan and another coverage plan.This Plan is a Secondary Plan which has its benefits determined after those of the other coverage plan, unless; (a) The other coverage plan has rules coordinating its benefits with those of This Plan; and (b) Both those rules and This Plan's rules,in subsection 2 below,require that This Plan's benefits be determined before those of the other coverage plan. 2. Rules. This Plan determines its order of benefits using the first of the following rules which applies: (a) Non-DepEndent/Dependent The benefits of the coverage plan which covers the person as an employee, member or subscriber(that is,other than as a dependent)are determined before those of the coverage plan which covers the person as a dependent (b) Dependent Child/Parents not Separated or Divorced.Except as stated in Paragraph(2)(c)below,when This Plan and another coverage plan cover the same child as a dependent of different persons,called"gtrAts"• G) The benefits of the coverage e--70 plan of the parent whose birthday falls earlier in a year are determined be- fore those of the coverage nian of♦/.a ____— (ii) If both parents have the same birthday,the benefits of the coverage plan which covered one parent longer are determined before those of the coverage plan which covered the other parent for a shorter period of time. However.if the other coverage plan does not have the rule described in(i)immediately above,but instead has a rule based upon the gender of the parent,and if.as a result,the coverage plans do not agree on the order of benefits, the rule in the other coverage plan will determine the order of benefits. (c) Dependent Child/Separated or Divorced.If two or more coverage plans cover a person as a dependent child of divorced or separated parents, benefits for the child are determined in this order. (i) First, the coverage plan of the parent with custody of the child: (ii) Then, the coverage plan of the spouse of the parent with the custody of the child: and (iii)Finally, the coverage plan of the parent not having custody of the child. However,if the specific terms of a court decree state that one of the parents is responsible for the health care expense of the child,and the entity obligated to pay or provide the benefits of the plan of that parent has actual knowledge of those terms,the benefits of that coverage plan are determined first The coverage plan of the other parent shall be the Secondary Plan. This paragraph does not apply with ieapcc.t to any Claim Determination Period or plan year during which any benefits are actually paid or provided before the entity has that actual knowledge. (d) Active/Inactive Employee. The benefits of a coverage plan which covers a person as an employee who is neither laid off nor retired(or as that employee's dependent)are determined before those of a coverage plan which covers that person as a laid off or retired employee(or as that employee's dependent). If the other coverage plan does not have this rule, and if, as a result, the coverage plans do not agree on the order of benefits, this rule(d) is ignored. (e) Longer/Shorter Length of Coverage.If none of the above rules determines the order of benefits,the benefits of the coverage plan which covered an employee,member or subscriber longer are determined before those of the coverage plan which covered that person for the shorter term. (f) No-Fault Automobile Insurance.Your benefits wide this PLAN will be coordinated with minimum coverages required under the Colorado Auto Accident Reparations Act(No-Fault). WHAT IF YOU FAIL TO PURCHASE THE REQUIRED NO-FAULT COVERAGE ON YOUR AUTO- MOBILE The benefits of this PLAN will not be available to you to the extent of minimum benefits required by the"No- Fault" Law for injuries suffered by you while operating or riding in a motor vehicle owned by you if said vehicle is in operation on the public highways of this State and such vehicle is not covered by No-Fault Auto- mobile Insurance as required by Law.This denial of benefits does not apply to any other person injured in a motor vehicle accident if the injured person is a non-owner operator, passenger or a pedestrian and such other person is not covered by No-Fault Automobile Insurance. D. Effect on the Benefits of This Plan 1. When This Subsection Applies. This subsection D applies when, in accordance with subsection C "Order of Benefit Determination Rules,"This Plan is a Secondary Plan as to one or more other coverage plans.In that event the benefits of This Plan may be reduced under this subsection. Such other coverage plan or plans are referred to as "the other coverage plans"in subsection 2 immediately below. 2. Reduction in This Plan's Benefits.The benefits of This Plan will be reduced when the sum of: (a) The benefits that would be payable for the Allowable Expense under This Plan in the absence of this COB provision: and As of August 1, 1992 the name of our health plan has changed to TakeCare of Colorado, Inc., from Lincoln National Health Plan. :RIPTION MEDICATION ADDENDUM RX 5 In consideration of the Health Services Fees to be paid, the Master Group Contract and Evidence of Coverage are hereby amended by the attachment thereto of this Addendum. Section I of this Contract, entitled "Definitions" shall be modified by the following additions: "Drug Formulary", if enacted, is a listing of Prescription Medications approved for use by PLAN which may be dispensed through Participating Pharmacies to a Covered Person. When Designated by PLAN, a generic equivalent shall be dispensed. This list shall be subject to periodic review and modification by PLAN. "Participating Pharmacy" means a pharmacy which has entered into a service agreement with PLAN to provide Prescription Drug services to Covered Persons. "Participating Provider" means a Participating Hospital, Participating Pharmacy, Participating Physician, and any other Health Services provider who/which has entered into a service agreement with PLAN to provide Health Services to Covered Persons. "Prescription Medication" means a drug or medication which bears the federal legend "Federal law prohibits dispensing without prescription", which can under federal or state law be dispensed only pursuant to a prescription order. This definition includes insulin, compounded prescriptions or formulas which must be prepared by a pharmacist subject to a prescription order. "Prescription Order or Refill" means the authorization for a Prescription Medication issued by a Participating Physician who is duly licensed to make such an authorization in the ordinary course of his or her professional practice. The "Relationships Between Parties" subsection of Section VIII shall be modified by the following addition: "The Participating Pharmacy is solely responsible for the pharmacy services provided to any Covered Person." Section X.B.2.a. of this Contract, entitled "Hospital and Related Services" shall be modified by the following addition: 3) Outpatient Prescription Medications provided by a Participating Hospital or Participating Alternate Facility in conjunction with emergency services for the same condition, not to exceed a consecutive seven (7) day supply. COPAYMENT CHARGE: $5.00 per Prescription Order or Refill 6826(1/92) (over) Section X.E. of this Contract, entitled "Miscellaneous Health Services", shall be modified by the following addition: 8. Prescription Medications Prescription Medications which have been prescribed under the direction of the Participating Primary Care Physician and obtained through a Participating Pharmacy. Prescription Medications shall, in all cases, be dispensed in generic equivalent form, or in accordance with the PLAN Drug Formulary, if enacted, and as amended from time to time, or upon PLAN approval. COPAYMENT CHARGE: $5.00 per Prescription Order or Refill, or the average retail price, whichever is less: For a single Copayment Charge, a Covered Person may obtain one of the following: • up to a consecutive thirty-four (34) day supply of medication; ' up to one (1) cycle supply of oral contraceptives. A COVERED PERSON SHALL PAY TO A PARTICIPATING PHARMACY 100% OF THE ADDITIONAL COST OF ANY PRESCRIPTION MEDICATION WHICH, AT THE REQUEST OF THE COVERED PERSON OR PHYSICIAN, IS NOT DISPENSED ACCORDING TO THE CURRENT PLAN DRUG FORMULARY,OR ITS GENERIC EQUIVALENT, UNLESS APPROVED IN ADVANCE BY PLAN. The "Exclusions" subsection of Section X shall be modified by the following addition: The following are excluded: 27. Contraceptive supplies or devices (except diaphrams and birth control pills), drug and supplies not requiring a prescription order(including but not limited to aspirin, antacids, oxygen, benzoyl peroxide preparations, medicated soaps, syringes other than insulin syringes and bandages), food supplements, antabuse, methodone, nicotine gum, minoxidil topical preparations, experimental drugs, drugs determined by PLAN to be ineffective and prescription medications related to health services which are not covered under the contract. As of August 1, 1992 the name of our health coin National Health Plat. of Colorado plan has changed to TakeCare of Colorado, Inc., from Lincoln National Health Plan. Prescription Medication Added= Amendment I (Effective 1/1/92) Rx 3 - 6825, Rx 5 - 6826, Rx 7 - 6649, Rx 10 - 6731 • This amendment contains language that is to be added to your Prescription Medication Addendum. Section I of this Contract, entitled "Definitions"shall be modified by the following additions: "Drug Formulary", if enacted, is a listing of Prescription Medications approved for use by PLAN which may be dispensed through Participating Pharmacies to a Covered Person. When designated by PLAN, a generic equivalent shall be dispensed. This list shall be subject to periodic review and modification by PLAN. Section X.E. of this Contract, entitled "Miscellaneous Health Services", shall he modiEed by the following addition: Prescription Medications shall, in all cases, be dispensed in generic equivalent for or in • accordance with the PLAN Drag Formulary, if enacted, and as amended from time to time, or upon PLAN approval. A COVERED PERSON SHALL PAY TO A PARTICIPATING PHARMACY 100% OF THE ADDITIONAL COST OF ANY PRESCRIPTION MEDICATION WHICH,AT THE REQUEST OF THE COVERED PERSON OR PHYSICIAN, IS NOT DISPENSED ACCORDING TO THE CURRENT PLAN DRUG FORMULARY, OR ITS GENERIC EQUIVALENT, UNLESS APPROVED IN ADVANCE BY PLAN. "ATIONAL HEALTH PLAN OF COLORADO As of August 1, 1992 the name of our health plan has changed to TakeCare of Colorado, EVIDENCE OF COVERAGE DESIGN IXA Inc., from Lincoln National Health Plan. Lincoln National Health Plan of Colorado (herein called PLAN)hereby agrees to provide the Health Services set forth in this Evidence of Coverage,which details your rights and obligations as a PLAN Covered Person. It is important that you READ YOUR EVIDENCE OF COVERAGE CAREFULLY and familiarize yourself with its terms and conditions. CONTENTS Section I Definitions of Terms Used in this Evidence of Coverage 2 Section II Enrollment and Effective Date of Individual Coverage 6 Section III Procedures for Reimbursement of Eligible Expenses 7 Section IV Coordination of Benefits and Subrogation 8 Section V Complaint and Grievance Processes 11 Section VI Termination of Individual Coverage 12 Section VII Contract Charges 15 Section VIII General Provisions 15 Section IX Procedures for Obtaining Health Services 17 Section X Schedule of Benefits and Exclusions 19 INTRODUCTION PLAN hereby certifies that the Enrollee and the Enrollee's Enrolled Family Dependents,if any, for whom the required Health Services Fee has been paid are entitled to Coverage under the Master Group Contract(referred to in this Evidence of Coverage as the"Contract") designated on the identification card. Coverage under PLAN is subject to the teens,conditions,exclusions,and limitations of the Contract. As an Evidence of Coverage,this document summarizes the provisions of the Contract but does not constitute the Contract of Coverage.The Contract may be examined by any Enrollee at the office of the Enrolling Unit during regular business hours. This Evidence of Coverage replaces and supersedes any Evidence of Coverage which may have been previously issued to the Enrollee by PLAN. 32" 070 6754 (10/91) How to Use this Evidence of Coverage This Evidence of Coverage should be read and re-read in its entirety. Many of the provisions of this Evidence of Cov- erage are interrelated; therefore, reading just one or two provisions may give a misleading impression to the reader. Many words used in this Evidence of Coverage have special meanings. These words will appear in capitals, and are defined for you. By using these definitions, you will get the clearest picture of what is being said. From time to time,the Contract may be amended.When that happens,a new Evidence of Coverage or Amendment pages for this Evidence of Coverage will be sent to you.Your Evidence of Coverage should be kept in a safe place for your future reference. In order to avoid being faced with responsibility for payment of bills for non-covered services,you must always 1)make certain that your Participating Primary Care Physician provides or arranges all of your Health Services,and 2)verify that Health Services are rendered by Participating Providers or that a referral to a non-participating provider has been authorized in writing by PLAN.This verification may be accomplished by asking the health care provider at the time an appointment is scheduled, or by calling PLAN or the Participating Primary Care Physician. Identification Card Show your PLAN identification card every time you request health care services.If you do not,you may be responsible for payment of bills sent by the health care provider. If your Family Dependents are covered,you have received additional PLAN identification cards.Your identification card is needed for your PLAN provider to bill PLAN and not you. Section I DEFINITIONS "Acute Mental Disorder'means a condition determined by the Mental Health Provider to be psychological in nature,and which has an immediate onset and a short duration. "Addendum"means an attached description,if any,of Health Services covered only when such Addendum is signed by PLAN, and subject to payment of additional Health Services Fees. "Calendar Year"means the period from January 1 through December 31 of any year. "Chemical Dependency Services"means services and supplies covered under the Contract for the diagnosis and treatment of alcoholism and chemical or drug dependency as classified in the International Classification of Diseases of the U.S. Department of Health and Human Services. "Confinement" means an uninterrupted stay of more than eighteen (18) hours in a Hospital or Participating Skilled Nursing Facility. "Congenital Anomaly" means a defective development or formation of a part of the body which is determined by a Physician to have been present at the time of birth. "Contract"means the Master Group Contract, the application of the Enrolling Unit,Addenda, and amendments signed by PLAN which constitute the agreement regarding the benefits,exclusions and other conditions between PLAN and the Enrolling Unit. "Contract Charge"means the sum of the Health Services Fee for all Enrollees and Enrolled Family Dependents. "Contract Years" and"Contract Months"are determined from the effective date of the Contract. "Copayment Charge"means the charge,in addition to the Health Services Fee,which the Covered Person is required to pay for certain Health Services provided under the Contract.The Covered Person is responsible for the payment of any -2 - Copayment Charge directly to the provider of the Health Services at the time of service.The total Copayment Charges paid by any Covered Person in any Contract Year may not exceed 200%of the total annual Health Services Fees paid to PLAN during the same period on behalf of the Covered Person through the Enrolling Unit. In those cases where the Enrollee has enrolled his or her Family Dependents with PLAN,the total Copayment Charges paid in any Contract Year by all Covered Persons in the family unit shall not exceed 200%of the total annual Health Services Fees paid to PLAN during the same period through the Enrolling Unit. The Enrollee is responsible for the recovery of excess Copayment Charges. (See Section III.) "Cosmetic Procedures" means those procedures which improve physical appearance, but which do not correct or materially improve a physiological function, and are not Medically Necessary. "Coverage"means the entitlement by a Covered Person to Health Services provided under the Contract, subject to the terms, limitations, and exclusions of the Contract, and the following conditions: (a) Health Services must be provided when the Contract is in effect; (b) Health Services must be provided prior to the date that any of termination conditions two(2)through ten(10)of Section VI occur,and(c)Health Services must be provided only when the recipient is a Covered Person, and meets all eligibility requirements as described in Section II. "Covered Person"means either the Enrollee or an Enrolled Family Dependent,but applies only while Coverage of such person under the Contract is in effect. "Crisis Intervention" means short-term care for a condition which is determined by the Mental Health Provider to be psychological in nature,and which has a sudden onset and inhibits the normal daily functioning of the individual.Crisis Intervention services include evaluation and assistance to the individual in developing immediate coping skills. "Custodial Care"means any skilled or non-skilled Health Services,or personal comfort or convenience-related services which provide general maintenance,supportive,preventive and/or protective care. Custodial Care does not seek to cure, is provided in any setting,and may be provided between periods of acute or intercurrent health care needs.Custodial Care is provided to an individual whose Health Service's requirements are stabilized and whose current medical condition is not expected to significantly and objectively improve or progress over a specified period of time. The absence of such improvement and progress will be based upon predictable medical outcome or objectively documented through periodic assessment by licensed health professionals and Plan. Custodial Care may include the supervision or participation of a Physician, licensed nurse, or registered therapist as necessary or desirable services. The mere participation of these professionals does not preclude the services as being custodial in nature and if the nature of the services can be safely and effectively performed by a trained non-medical person,the services are custodial.Further,Custodial Care and the nature of those services are not altered by the availability of the non-medical person. "Dental Surgery,Treatment or Care"means all services provided by or under the direction of a Dentist,including but not limited to any surgical procedure which involves the hand or soft tissues of the mouth. "Dentist"means any doctor of dental surgery, "D.D.S.",who is duly licensed and qualified to provide Dental Surgery, Treatment or Care under the law of jurisdiction in which treatment is received. "Designated Organ Transplant Facility"means a Hospital named as such by PLAN,which has entered into an agreement with or on behalf of PLAN to render Health Services for organ transplants which are not Experimental or Unproven and which are covered under the Contract. "Durable Medical Equipment"means medical equipment which can withstand repeated use and is not disposable,is used to serve a medical purpose, is generally not useful to a person in the absence of a Sickness or Injury,and is appropriate for use in the home. "Eligible Expenses"are the fees established specific to the service area for Health Services covered under this Contract. "Eligible Person" means an employee of the Enrolling Unit or other person who meets the eligibility requirements specified in the application and the Contract, and who resides within the Service Area unless PLAN approves other ar- rangements.Part-time employees(i.e.those employees who work or are scheduled to work less than 20 hours per week) are not eligible unless prior approved in writing by the PLAN.Enrolled Eligible Persons who temporarily reside outside of the Service Area shall be covered only for Health Services rendered by Participating Providers in the Service Area, except in the event of an Emergency, or upon prior written approval by PLAN. 3 3ri3 "Emergency"means a serious medical condition resulting from Injury,Sickness,or Mental Illness which arises suddenly and requires immediate care and treatment to avoid jeopardy to the life or health of a Covered Person. "Emergency Health Services" means those Health Services and supplies necessary for the treatment of an Emergency, which are generally provided no later than twenty-four (24) hours after the onset of an Emergency, subject to the conditions and Copayment Charges as described in the Contract. "Enrolled Family Dependent"means a Family Dependent who is enrolled for Coverage under the Contract. "Enrollee"means an Eligible Person who is enrolled for Coverage under the Contract. "Enrolling Unit" means the employer or other entity with whom the Contract is made. "Experimental or Unproven Procedures" means medical, surgical or psychiatric procedures, treatments, devices and pharmacological regimes(including investigational drugs and drug therapies)as determined by the medical community at large, including but not limited to the Food and Drug Administration. PLAN reserves the right to change,from time to time,the procedures considered to be Experimental or Unproven.Contact PLAN to determine if a particular procedure, treatment, device, or pharmacological regime is considered to be Experimental or Unproven. "Family Dependent"means a person who is(1)the Enrollee's legal spouse or(2)an unmarried dependent child(including a stepchild,legally adopted child,or a child for whom the Enrollee has court-appointed guardianship and for whom the Enrollee has legal or permanent parental responsibility and control)of either the Enrollee or the Enrollee's spouse,and (3)whose principal place of residence is with the Enrollee unless PLAN approves other arrangements.Enrolled Family Dependents who temporarily reside outside of the Service Area shall be covered only for Health Services rendered by Participating Providers in the Service Area,except in the event of an Emergency,or upon prior written approval by PLAN. The definition of"Family Dependent" is subject to the following conditions and limitations: 1. The term"Family Dependent" shall not include any unmarried dependent child 19 years of age or older, 2. The term"Family Dependent"shall not include any unmarried dependent child 19 years of age or older but less than 23 years of age unless: a. The child is not regularly employed on a full-time basis; and b. The child is a Full-time Student and evidence satisfactory to PLAN is furnished upon request; and c. The child is primarily dependent upon the Enrollee for support and maintenance and evidence satisfactory to PLAN is furnished upon request; and 3. The Enrollee shall be responsible for any Health Services provided to the child at a time when the child did not satisfy these conditions.The Enrolling Unit agrees to assist PLAN in obtaining reimbursement from the Enrollee for such Health Services. "Full-time Student"means a person who is enrolled and attending full-time in a recognized course of study or training at: 1. an accredited high school or vocational school; 2. an accredited college or university; or 3. a licensed technical school,beautician school, automotive school, or similar training school. A person ceases to be a Full-time Student at the end of the Contract Month during which the person graduates or otherwise ceases to be enrolled and in attendance at the institution on a full-time basis. A person continues to be a Full-time Student during periods of vacation established by the institution,unless the person does not continue as a Full-time Student immediately following the period of vacation. "Health Services"means the health care services and supplies covered under the Contract,except to the extent that such health care services and supplies are limited or excluded under the Contract. -4 - r e.270 "Health Services Fee" means the monthly fee required for each Enrollee and each Enrolled Family Dependent in accordance with the terms of the Contract. "Hospital means an institution operated pursuant to law which is primarily engaged in providing Health Services on an Inpatient basis for the care and treatment of injured or sick individuals through medical,diagnostic and surgical facili- ties(including a surgical facility which has a bona fide arrangement,by contract or otherwise,with an accredited hospital to perform such surgical procedures)by,or under the supervision of,a staff of Physicians and which has twenty-four(24) hour nursing services, and is accredited as a Hospital by the Joint Commission on Accreditation of Healthcare Organizations. A Hospital is not primarily a place for rest or Custodial Care of the aged, and is not a nursing home, convalescent home or similar institution. "Initial Eligibility Period"means the period of time determined by PLAN and the Enrolling Unit during which Eligible Persons may enroll themselves and Family Dependents under the Contract. "Injury"means bodily damage other than Sickness(excluding medical malpractice),including all related conditions and =current symptoms, not otherwise excluded under the Contract. "Medical Director"means the Physician so named by PLAN as the Medical Director, or his or her designee. "Medically Necessary"services means those Health Services which are determined by PLAN to be necessary to meet the basic health needs of an individual. Determination of Medical Necessity is done on a case-by-case basis.The fact that a Physician has performed or prescribed a procedure or treatment does not mean that it is Medically Necessary.In addition, the service must(1) be consistent with the diagnosis of, and prescribed course of treatment for the patient's condition, (2)be required for reasons other than the convenience of the patient or his or her Physician,or not be required solely for custodial,comfort or maintenance reasons,and(3)be performed in the most cost efficient type of setting appropriate for the condition. "Medicare"means Part A and Part B of the insurance program established by Title XVIII,United States Social Security Act, as later amended, 42 U.S.C. Sections 1394, et seq. "Mental Health Provider"means the organization, entity or individual who has entered into a service agreement with PLAN to arrange or provide the Mental Health Services and Chemical Dependency Services covered under the Contract. "Mental Health Services"means those services and supplies covered under the Contract for the diagnosis and treatment of Mental Illnesses which are classified in the International Classification of Diseases of the U.S. Department of Health and Human Services. "Mental Illness"means a physical or mental condition having an emotional or psychological origin or effect,including alcoholism and chemical or drug dependency. "Open Enrollment Period"means an annual period thirty-one(31) days in duration,subsequent to the Initial Eligibility Period,determined by PLAN and the Enrolling Unit,during which Eligible Persons may enroll themselves and Family Dependents under the Contract. "Participating Alternate Facility"means a non-Hospital health care facility, or adjunct facility designated as such by a Hospital which(1)provides one or more of the following services on an outpatient basis:prescheduled surgical services, Emergency Health Services,urgent care services,or prescheduled rehabilitative,laboratory,or diagnostic services,and (2) has entered into a service agreement with PLAN to provide Health Services to Covered Persons. "Participating Home Health Agency"means a program which is(1)engaged in providing home health care services and is authorized pursuant to the law of jurisdiction in which treatment is received,and(2)has entered into a service agreement with PLAN to provide Health Services to Covered Persons. "Participating Hospital" means a Hospital which has entered into a service agreement with PLAN to provide Health Services to Covered Persons. "Participating Physician"means any Physician who has entered into a service agreement with PLAN to provide Health Services to Covered Persons. e "participating Primary Care Physician"means any Physician whose practice predominately includes pediatrics,internal medicine, obstetrics/gynecology, or family or general medicine, and who has entered into a Primary Care Physician service agreement with PLAN to provide Health Services to Covered Persons. "Participating Provider"means a Participating Hospital,Participating Physician, and any other Health Service provider who/which has entered into a service agreement with PLAN to provide Health Services to Covered Persons. "Participating Skilled Nursing Facility"means a Hospital or nursing home facility which is(1)licensed and operated in accordance with the law of jurisdiction in which treatment is received,(2)is Medicare approved,and(3)has entered into a service agreement with PLAN to provide Health Services to Covered Persons. "Physician"means any doctor of medicine,"M.D.",or doctor of osteopathy,"D.O.",who is duly licensed and qualified under the law of jurisdiction in which treatment is received. "Reasonable and Customary Charges"means fees for covered Health Services and supplies which do not exceed the fees that the provider would charge any other payor for the same services. "Reconstructive Surgery"means any Medically Necessary surgery which is incidental to an Injury,Sickness,or Congeni- tal Anomaly and whose purpose is to restore normal physiological functioning to the involved part of the body. "Semi-private Accommodations"means a room with two or more beds in a Hospital or Participating Skilled Nursing Facility. "Service Area" means the geographic area served by PLAN, as approved by regulatory agencies. Contact PLAN to determine the precise geographic area served by PLAN. "Sickness"means physical illness or disease, or pregnancy,but does not include Mental Illness. Section II ENROLLMENT AND Et rECTIVE DATE OF INDIVIDUAL COVERAGE A. Enrollment Eligible Persons may enroll themselves and their Family Dependents in PLAN during the Initial Eligibility Period or during an Open Enrollment Period specified by LNHP by submitting application on a form provided or approved by LNHP.In addition,new Eligible Persons may be enrolled in PLAN within 31 days of the date on which they first become Eligible Persons,and new Family Dependents may be enrolled in PLAN within 31 days of the date on which they first become Family Dependents,except that Family Dependents who are newborn children are covered at the moment of birth. Except during the time periods set forth in this paragraph, Eligible Persons and/or Family Dependents may not enroll in PLAN without the express written authorization of LNHP and evidence of insurability. The Plan Sponsor shall notify PLAN in writing within sixty(60)days of the effective date of enrollments,terminations or other changes;provided,however,that the Plan Sponsor shall notify LNHP in writing each month of any changes in the Coverage classification of any Enrollee. B. Effective Date of Coverage Coverage for an Eligible Person and his or her Family Dependents,if any,is effective on the date specified by Plan Sponsor and LNHP,provided that LNHP receives a properly completed individual enrollment application that was submitted to LNHP according to the enrollment provisions of Section ILA of this booklet; and provided,however, that: 1. No Coverage shall be effective until the PLAN takes effect; 2. No Family Dependent shall be covered under the PLAN until the Eligible Person is covered. - 6 - ran., ^'a! tifrfi1...A1 O ti 3. If an Enrollee acquires a new Family Dependent by reason of adoption or marriage,then Coverage for that Family Dependent shall take effect on the date that the new Family Dependent is adopted or married,if LNHP and Plan Sponsor is notified by the Enrollee of the adoption or marriage within thirty-one(31)days of occurrence;and any necessary adjustments to Health Services Fees have been made. 4. If anEnrollee acquires anew Family Dependent who is a newborn child,then Coverage for that Family Dependent shall take effect at the moment of birth and remain in effect for thirty-one(31)days beyond the date of birth.To continue Coverage for that Family Dependent,the Enrollee shall notify LNHP and Plan Sponsor of the newborn child's birth and the name; and make any necessary changes in the Coverage classification and Health Services Fees. 5. Health Services for medical conditions arising prior to the effective date of Coverage and resulting in Confinement are covered as of the effective date only if the Covered Person notifies LNHP of Confinement within forty-eight(48)hours of the effective date,or as soon thereafter as is reasonably possible,and if Health Services are received in accordance with the terms,conditions, exclusions and limitations of the PLAN. Section III PROCEDURES FOR REIMBURSEMENT OF ELIGIBLE EXPENSES Reimbursement of Eligible Expenses Plan Sponsor shall reimburse for Eligible Expenses incurred with non-participating providers only for MEDICALLY NECESSARY EMERGENCY SERVICES OR SERVICES AUTHORIZED OR APPROVED BY LNHP in accordance with the terms of the PLAN. Participating Providers are responsible for submitting written proof of loss for Eligible Expenses directly to LNHP on the Covered Person's behalf. In the event a Covered Person is billed by a Participating Provider for Eligible Expenses, the Covered Person should contact LNHP. Written proof of loss for services rendered by non-participating providers, satisfactory to LNHP, shall be furnished at PLAN's office within ninety(90)days after the date of such loss.Failure to furnish proof within the time required shall invalidate or reduce Coverage unless it was not reasonably possible to have given proof within ninety(90)days or,in the absence of legal capacity of the Covered Person,later than one(1)year from the time in which proof is otherwise required. All Eligible Expenses shall be paid within sixty(60)days of receipt by LNHP of proof of loss.Where applicable,Eligible Expenses shall be paid to the Enrollee. Subject to written authorization from an Enrollee,all or a portion of any Eligible Expenses due may be paid directly to the provider of the Health Services. Copayment Reimbursement The Plan Sponsor shall reimburse for amounts of Copayment Charges paid by any Enrollee in any Contract Year that exceed 200%of the total annual Health Services Fees paid during the same period on behalf of the Enrollee.In those cases where the Enrollee has enrolled his or her Family Dependents with LNHP,the Plan Sponsor shall reimburse for amounts of Copayment Charges paid by all Covered Persons in the family unit in any Contract Year that exceed 200%of the total annual Health Services Fees paid during the same period. Written notice that excess amounts of Copayment Charges have been paid by the Enrollee or by all Covered Persons in the same family unit must be sent to LNHP. Such notice must(1)include proof satisfactory to LNHP of the payment of Copayment Charges,and(2)be provided to LNHP not later than ninety(90)days after the end of the Contract Year.The amount of any excess Copayment Charges will be paid within sixty(60)days of receipt of written notice by Plan Sponsor that excess Copayment Charges have been paid by Covered Persons. Limitation of Actions No action at law or in equity shall be brought to recover on the Contract by a Covered Person prior to the expiration of sixty(60)days after proof of loss has been filed in accordance with the requirements of the Contract,nor shall such action be brought at all unless brought within three (3) years after the time written proof of loss is required by the Contract Section IV COORDINATION OF BENEFITS AND SUBROGATION Coordination of Benefits A. Applicability 1. This coordination of benefits("COB")provision applies to This Plan when an Enrollee or the Enrollee's Enrolled Family Dependents have health care coverage under more than one coverage plan. "Coverage plan"and"This Plan" are defined below. 2. If this COB provision applies,the order of benefit determination rules should be looked at first.Those rules de- termine whether the benefits of This Plan are determined before or after those of another coverage plan. The benefits of This Plan: (a) Shall not be reduced when,under the order of benefit determination rules,This Plan determines its benefits before another coverage plan; but (b) May be reduced when,under the order of benefits determination rules,another coverage plan determines its benefits first. The above reduction is described in subsection D"Effect on the Benefits of This Plan." B. Definitions 1. "Coverage plan"is any of these which provides benefits or services for,or because of,medical or dental cam or treatment: (a) Group insurance or group-type coverage, whether insured or uninsured. This includes prepayment, group practice or individual practice coverage.It also includes coverage other than school accident-type coverage. (b) Coverage under a governmental plan,or coverage required or provided by law.This does not include a state plan under Medicaid (Tide XIX, Grants to States for Medical Assistance Programs, of the United States Social Security act, as amended from time to time). Each contract or other arrangement for coverage under(a) or(b) is a separate coverage plan. Also, if an arrangement has two parts and COB rules apply only to one of the two,each of the parts is a separate coverage plan. 2. 'This Plan"is the part of this group Contract that provides benefits for health care expenses. 3. "Primary Plan/Secondary Plan": The order of benefit determination rules state whether This Plan is a Primary Plan or Secondary Plan as to another coverage plan covering the person. When This Plan is a Primary Plan,its benefits are determined before those of the othercoverage plan and without considering the other coverage plan's benefits. When This Plan is a Secondary Plan,its benefits are determined after those of the other coverage plan and may be reduced because of the other coverage plan's benefits. When there are more than two coverage plans covering the person,This Plan may be a Primary Plan as to one or more other coverage plans, and may be a Secondary Plan as to a different coverage plan or plans. 4. "Allowable Expense"means a necessary,reasonable and customary item of expense for health care; when the item of expense is covered at least in part by one or more coverage plans covering the person for whom the claim is made. The difference between the cost of private accommodations in a Hospital and the cost of Semi-private Accom- modations in a Hospital is not considered an Allowable Expense under the above definition unless the patient's stay in a private Hospital room is Medically Necessary either in terms of generally accepted medical practice,or _ g n1 ^i as specifically defined in the coverage plan. When a coverage plan provides benefits in the form of services,the reasonable cash value of each service ren- dered will be considered both an Allowable Expense and a benefit paid. 5. "Claim Determination Period"means a Calendar Year. However, it does not include any part of a year during which a person has no Coverage under This Plan, or any part of a year before the date this COB provision or a similar provision takes effect. C. Order of Benefit Determination Rules 1. General. When there is a basis for a claim under This Plan and another coverage plan,This Plan is a Secondary Plan which has its benefits determined after those of the other coverage plan, unless; (a) The other coverage plan has rules coordinating its benefits with those of This Plan; and (b) Both those rules and This Plan's rules,in subsection 2 below,require that This Plan's benefits be determined before those of the other coverage plan. 2. Rules. This Plan determines its order of benefits using the first of the following rules which applies: (a) Non-Dependent/Dependent. The benefits of the coverage plan which covers the person as an employee, member or subscriber(that is,other than as a dependent) are determined before those of the coverage plan which covers the person as a dependent. (b) Dependent Child/Parents not Separated or Divorced.Except as stated in Paragraph(2)(c)below,when This Plan and another coverage plan cover the same child as a dependent of different persons, called"parents": (i) The benefits of the coverage plan of the parent whose birthday falls earlier in a year are determined before those of the coverage plan of the parent whose birthday falls later in that year; but (ii) If both parents have the same birthday,the benefits of the coverage plan which covered one parent longer are determined before those of the coverage plan which covered the other parent for a shorter period of time. However,if the other coverage plan does not have the rule described in(i)immediately above,but instead has a rule based upon the gender of the parent,and if,as a result,the coverage plans do not agree on the order of benefits, the rule in the other coverage plan will determine the order of benefits. (c) Dependent Child/Separated or Divorced.If two or more coverage plans cover a person as a dependent child of divorced or separated parents, benefits for the child are determined in this order. (i) First, the coverage plan of the parent with custody of the child; (ii) Then, the coverage plan of the spouse of the parent with the custody of the child; and (iii)Finally, the coverage plan of the parent not having custody of the child. However,if the specific terms of a court decree state that one of the parents is responsible for the health care expense of the child,and the entity obligated to pay or provide the benefits of the plan of that parent has actual knowledge of those terms,the benefits of that coverage plan are determined first. The coverage plan of the other parent shall be the Secondary Plan. This paragraph does not apply with respect to any Claim Determination Period or plan year during which any benefits are actually paid or provided before the entity has that actual knowledge. (d) Active/Inactive Employee. The benefits of a coverage plan which covers a person as an employee who is neither laid off nor retired(or as that employee's dependent)are determined before those of a coverage plan which covers that person as a laid off or retired employee(or as that employee's dependent).If the other cov- erage plan does not have this rule,and if,as a result,the coverage plans do not agree on the order of benefits, this rule (d) is ignored. (e) Longer/Shorter Length of Coverage.If none of the above rules determines the order of benefits,the benefits of the coverage plan which covered an employee,member or subscriber longer are determined before those of the coverage plan which covered that person for the shorter term. (f) No-Fault Automobile Insurance. Your benefits under this PLAN will be coordinated with minimum coverages required under the Colorado Auto Accident Reparations Act (No-Fault). WHAT IF YOU FAIL TO PURCHASE THE REQUIRED NO-FAULT COVERAGE ON YOUR AUTO- MOBILE The benefits of this PLAN will not be available to you to the extent of minimum benefits required by the"No- Fault"Law for injuries suffered by you while operating or riding in a motor vehicle owned by you if said vehicle is in operation on the public highways of this State and such vehicle is not covered by No-Fault Automobile Insurance as required by Law.This denial of benefits does not apply to any other person injured in a motor vehicle accident if the injured person is a non-owner operator,passenger or a pedestrian and such other person is not covered by No-Fault Automobile Insurance. D. Effect on the Benefits of This Plan 1. When This Subsection Applies. This subsection D applies when, in accordance with subsection C "Order of Benefit Detennination Rules,"This Plan is a Secondary Plan as to one or more other coverage plans.In that event the benefits of This Plan may be reduced under this subsection. Such other coverage plan or plans are referred to as "the other coverage plans" in subsection 2 immediately below. 2. Reduction in This Plan's Benefits. The benefits of This Plan will be reduced when the sum of: (a) The benefits that would be payable for the Allowable Expense under This Plan in the absence of this COB provision; and (b) The benefits that would be payable for the Allowable Expenses under the other coverage plans,in the absence of provisions with a purpose like that of this COB provision, whether or not claim is made; exceeds those Allowable Expenses in a Claim Determination Period.In that case,the benefits of This Plan will be reduced so that they and the benefits payable under the other coverage plans do not total more than those Allowable Expenses. When the benefits of This Plan are reduced as described above,each benefit is reduced in proportion. It is then charged against any applicable benefit limit of This Plan. E. Right to Receive and Release Needed Information Certain facts are needed to apply these COB rules.PLAN has the right to decide which facts it needs. It may get needed facts from or give them to any other organization or person.PLAN need not tell,or get the consent of,any person to do this. Each person claiming benefits under This Plan must give PLAN any facts it needs to pay the claim. F. Payments Made A payment made under another coverage plan may include an amount which should have been paid under This Plan. If it does,PLAN may pay that amount to the organization which made that payment.That amount will then be treated as though it were a benefit paid under This Plan.PLAN will not have to pay that amount again.The term"payment made" includes providing benefits in the form of services, in which case"payment made"means reasonable cash value of the benefits provided in the form of services. G. Right of Recovery If the amount of the payment made by PLAN is more than it should have been paid under this COB provision, it may recover the excess from one or more of: - 10- 32:_07:3 (b) The benefits that would be payable for the Allowable Expenses under the other coverage plans.in the absence of provisions with a purpose like that of this COB provision, whether or not claim is made: exceeds those Allowable Expenses in a Claim Determination Period.In that case.the benefits of This Plan will be reduced so that they and the benefits payable under the other coverage plans do not total more than those Allowable Expenses. When the benefits of This Plan are reduced as described above,each benefit is reduced in proportion. It is then charged against any applicable benefit limit of This Plan. E. Right to Receive and Release Needed Information Certain facts are needed to apply these COB rules.PLAN has the right to decide which facts it needs.It may get needed facts from or give them to any other organization or person.PLAN need not tell,or get the consent of,any person to do this. Each person claiming benefits under This Plan must give PLAN any facts it needs to pay the claim. F. Payments Made A payment made under another coverage plan may include an amount which should have been paid under This Plan. If it does, PLAN may pay that amount to the organization which made that payment.That amount will then be treated as though it were a benefit paid under This Plan.PLAN will not have to pay that amount again.The term"payment made" includes providing benefits in the form of services, in which case"payment made"means reasonable cash value of the benefits provided in the form of services. G. Right of Recovery If the amount of the payment made by PLAN is more than it should have been paid under this COB provision,it may re- cover the excess front one or more of: 1. The persons it has paid or for whom it has paid: 2. Insurance companies: or 3. Other organizations. The"amount of the payments made"includes the reasonable cash value of any benefits provided in the form of services. Subrogation PLAN shall be subrogated to,and shall succeed to all rights of recovery of any Covered Person from a third party,includ- ing his or her employer,for the reasonable value of services provided under this Contract PLAN may require assignment of the rights of recovery from the Covered Person,to the extent of the reasonable value of services and benefits provided by it plus reasonable costs of collection. The Covered Person shall cooperate with PLAN in protecting the PLAN's legal rights under these subrogation provisions and acknowledges that PLAN's subrogation rights shall be considered as the first priority claim against any third parry, to be paid before any other claims which may exist are paid,including claims for general damages by the Covered Person. The Covered Person shall do nothing to prejudice PLAN's rights under this provision,either before or after the need for services or benefits under this Contract.PLAN may, at its option. take necessary and appropriate action to preserve its rights under these subrogation provisions,including the right to bring suit in the name of the Covered Person.PLAN may collect, at its option, amounts from the proceeds of any settlement or judgment that may be recovered by the Covered Person or his or her legal representative, regardless of whether or not the Covered Person has been fully compensated. Any proceeds of settlement or judgment shall be held in trust by the Covered Person for the benefit of PLAN under these subrogation provisions,and PLAN shall be entitled to recover reasonable attorney fees from the Covered Person incurred in collecting proceeds held by the Covered Person. a W, .d Section V COMPLAINT AND GRIEVANCE PROCESSES the provision of Health Services or benefits under this Contract.a written If complaint concerning P the affected Coveted Person's legal guardian,or a verbal co Person mayhas a the affected Covered Person or by complaint be made by PLAN's Member Services Department. and attempt to resolve the verbal complaint ant shall contact the complainant taint erbaltom the complainant of the resolution of the verbal comp 1�,thirty-owhe or The PLAN's Member Services Deparim with the resolution of the wed au��h infor- mation informal discussions.itrce and shall Person is not satisfied m resew the t complaint ofth she days equewing its writing, the Member Services Department P she may request. in PLAN's consideration to the Member Relations Committee for further are researched and reviewed by the Member Relations Commir- the complainant f he resolution mmit- tainand unresolved m to shall l complaints ipninant ofiheed the resolutn ion Written compreview this information and notify through the PLAN's siCommit- tee.The Member Relations aetwritten Committee laintwas first received.lf a C to overed levels of appeal by tt ems)days of rRel dotethewritten�eecomplainanthastheright the Member Relations Committer. formal grievance process. Section VI TERMINATION OF INDIVIDUAL COVERAGE Termination Conditions including Coverage of the Covered Person under this Contract. Coverage for any Health Services rendered after the date eons arising prior to the date of termination shall automatically terminate on the earliest of termination.formedicalcoPdi of the following dates: 1. The date this Contract is terminated• been paid. 2. The last day of the last Contact Month that the required Health Services Fee has required Copayme°t Charge for Health Services rendered.the pay a notice to the a for Healing th Such notice be 3. date the casespecified a Covered or feronmi °ho an Cto erage in written provided byPLAN PLAN one(31) days in advance of such termination. by at least thirty notice to the Enrollee that all Coverage under this wi terminate 4. The date the Enrollee by PLAN in knowingly provided rovi�PLAN with false.material information ngnt t not limited to, because the aoherp Pt° eligibility for Coverage or status as aFamily Depew person's eligi rY Family Dependent. al informationrrelai n to another Enrollee's or that of any information relating the Enrollee's health status g• The date specified by PLAN or used in written notice to the Enrollee that all Coverage under this Contract will terminate Enrollee's identification card by any unauthorized person, because the Enrollee permitted the use of the another person's card. a The Enrolling Unit or Enrollee longer in the PLAN Service Are • under this 6. The date a pon ible for f residence PLA is a provided PLAN of a Covered Person's move from the Service Area.Coverage shall ra responsible terminate notify g e or the Contract will on the date of such move, even if such notice is not termination of Coverage,7. The date the Enrolling Unit receives written notice from the Enrollee requesting date requested by the Enrollee in such notice,if later. classification is specified for retired o. • 8. The date the Enrollee is retired or pensioned,unless[o this specific fiContracr-erage pensioned individuals in the application attached notice to the Fsiioller that all Coverage uncle cifiedby PLAN,aftezthitty-0er(31)dayspn°rwritten T^ this Contraa will terminate due to the failure of the Enrollee to establish and maintain a satisfactory provider- paw=relationship with any Participating Provider.Termination of Coverage under this condition shall not occur prior to the date that the Enrollee exercises his or her rights through the Complaint and Grievance Processes. should the Enrollee choose to do so. 10. The last day of the Contract Month in which the Covered Person ceases to be eligible as an Enrollee or Enrolled Family Dependent Under certain circumstances, Covered Persons who cease to be eligible for Coverage under this Contract am entitled to continue Coverage under this Contract. as described below in "Continuation Coverage." Continuation Coverage A Covered Person whose Coverage ends under this Contract is entitled to elect continuation of Coverage in accordance with either Part I (Federal continuation)or Pan II (State continuation)of this subsection.The Covered Person should contact the Enrolling Unit to determine whether Part I or Pan II is applicable. Pant I: Continuation of Coverage Under Federal Law A. Qualifying Events The Covered Person's Coverage must have terminated due to one of the following Qualifying Events: 1. Termination of the Enrollee from employment with the Enrolling Unit.or reduction of bows,for any reason other than gross misconduct 2. Death of the Enrollee; 3. Divorce or legal separation from the Enrollee: 4. Loss of eligibility by an Enrolled Family Dependent who is a child: 5. Entitlement of an Enrollee to Medicare benefits 6. The Enrolling Unit filing for bankruptcy.underTitle XI.United States Code.on or after July 1,1986.but only for a retired Enrollee and his or her Enrolled Family Dependents. A Covered Person who is totally disabled may extend continuation coverage it a. it has been determined that the Covered Person is totally disabled for Social Security purposes; and b. the Covered Person notifies the PLAN within 60 days of the date the determination is made by the Social Security Administration. The Covered Person must elect continuation during the election period,and payment of the Health Service Fees is required. If the Covered Person elects continuation of Health Services,it must be the same Coverage that the Covered Person had at the ante of the Qualifying Event B. Notification Requirements and Election Period The Covered Person must notify the Enrolling Unit's designated plan administrator within sixty(60)days when divorce, legal separation, or loss of eligibility as an Enrolled Family Dependent would end Coverage. NOTE: PLAN is not the Enrolling Unit's designated plan administrator.The Covered Person should consult his or her Enrolling Unit. In the case of an Enrollee's reduction of hours,termination of employment,death,or entitlement to Medicare. the Enrolling Unit will notify its designated plan adtmmstator. Within fourteen(14)days upon receiving such notification,the Enrolling Unit's designated plan administrator will notify the eligible Covered Persons) of the right to elect continuation. and of the Health Service Fees re- quired. Continuation must be elected by the later of: 1. Sixty (60) days after the Covered Person's Coverage ends; or 2. Sixty(60)days after the Covered Person receives notice of the continuation right from the Enrolling Unit's designated plan administrator. the initial Health Service A Covered Person whose Coverage was terminated due to a Qualifying Event must pay Fees due within forty-five (45) days after electing continuation.All other Health Service Fees after the initial payment are due within the applicable grace period. C. Terminating Events dates: Continuation under this Contract will end on the earliest of the following a Covered Person whose Coverage ended because of 1. Eighteen(18)months from the date continuation began for Qualifying Event 1. whose coverage was extended2. Twenty-nine(29)months from the date continuation began for Covered Persons due to total disability. lied Family Dependent whose Coverage 3. Thirty-six (36) months from the date continuation began for an Enrolled ended because of Qualifying Events 2.3.4 and 5. 4. The date Coverage terminates under the Contract for failure to make timely payment of the Health Services n with a pre-existing is obtainedunnderanyothergrouphealthp»•Ex�t ,a C vered SPerso plan may LLg 5. The date coverage other employer sponsored condition which is limited or excluded under any coverage• (except that this shall not apply in the event Covered care.6. The tin's the Coverage ag wasd teonin d because of Qualifntitled to ying Eve ). Person's was terminated 7. The date the Contract ends. If a second qualifying event occurs.the following rules apply of continuation.and a second qualifying event occurs may contind ti to. a maximum of (36) occurs 1. Ifduring a Covered Person is Covered dd ato eighteen Co e a)monthsup that time.the Person's Coverage from the date of Qualifying Event 1. dies during tali eer thirty-six the 2. If a Covered Person is entitled to continuation due to Qualifying Event 6.and the retired Enrollee the 36) continuation period.the Enrolled Family Dependents shall be entitled to continue Coverage months from the date of death.Terminating Events 2 - 6 shall apply during the extended continuation period. Part II: Continuation of Coverage Under State Law under state law iremtrac of may be entitled lo to an alternative continuation COBRA when bow ale lat An Enrollee whose Coverage ends under this Contract be entitled elect Coverage if the Enrolling Unit is not subject to the requirements and COBRA apply. The Enrollee shall not be entitled to cot The Enrollee's Coverage must have ended due to tennination of employment Urination Coverage under state law if: 7 a. Health Services Fees for Coverage up to the termination date have not been paid by or on behalf of the Enrollee: or b. the Enrollee has not been continuously covered under this Contract or under any coverage plan providing similar coverage which this Contract replaced.for at least six(6)months immediately pnor to termination from employ- ment: or c. the Enrollee is covered by Medicate or Medicaid: or d. the entire Contract is discontinued. The Enrollee must elect continuation Coverage and pay Health Services Fees due within twenty(20)days from the date of termination from employment Coverage may be continued for enrollees working 40 hours or more when the working hours are reduced to less than 30 hours because of economic conditions.Coverage may also be continued for such enrollees enrolled family dependents. Coverage may be continued provided: 1. the enrollee has been continuously covered under the Contract or under any coverage plan providing similar coverage which the Contract replaced.for at least six(6)months immediately prior to the reduction in working hours: 2. the enrolling unit has imposed the reduction in hours due to economic conditions: 3. the enrolling unit intends to restore the enrollee to a full 40 hour work schedule as soon as economic conditions improve; and 4. the applicable Health services Fees are paid. Continuation of Coverage under state law will aid after a period of ninety(90)days after the date Coverage would have ended,or until the Enrollee is reemployed.whichever occurs first.At the end of the ninety(90))c aye continuationeun under state law,the Enrollee or the Enrolled Family Dependents are entitled to conversion privileges Conversion A Covered Person who ceases to be eligible for PLAN Coverage for the reasons stated n r termination oondit rosy or 10 above, or upon termination of continuation Coverage, and who continues evidence of insurability.ServiArema make application to PLAN for coverage under a conversion contract without furnishing evidence s after e e of Coverage and payment of the initial Health Services Fees must be made within thirty under this Contract.A conversion contract shall be issued in accordance with the terms and conditions in effect at the time of application. Out of Area Conversion PLAN may designate a carrier to provide conversion membership to any Covered Person who ceases to be eligible for PLAN Coverage for the reasons stated in termination conditions 6or10 above,and who nolonlgier resides ►within c Service Area.Application to convert membership effective on the date of termina) tion, aft wr ithout furnishing of shCoverage evidence of insurability,must be made to the PLAN designated carrier within thirty this Contract.A conversion contact may be issued in accordance with the terms and conditions the designated carrier may have in effect at the time of application. Section VII CONTRACT CHARGES Computation of Contract Charges Each monthly Contract Charge shall be calculated on the basis of PLAN's record as to the number of Enrollees in each Coverage classification at the time of calculation. at Addenda.S e. Fees then in effect The initial Health Services and/ r any Fees are shown in the Master Group Application. Adjustments to Contract Charges s in classifi- cation or terminations of EnrolleesanPd�Howe Coverage e etclassiv- ca Retroactive reflected i adjustments P may S recordsbe made for any a is calculated Y credtnotrbegrantd oranyc angecaurt rine nmotheConranCharg credicshallbegantedforanychangeoccun'�gmorethansixty(60)days prior to the date PLAN was notified of the change by the Enrolling Unit. th Services Fees(1)on the due dateafteamend t Contract PLAN reserves the right tod change the saher.or(2)on any datethat the provisions of thus Contract are nor d. tori the monthl due date shall be • llin Unit at least thirty-one(31)days p n Year or on any monthly given by PLAN to the Enrolling notice of any such change in rates shall be effective date of the change. Payment of Contract Charges All Contract Charges are payable monthly in advance by the Enrolling Unit to PLAN at its offices or at an address specified by PLAN. Contract Charges are due The first Contract Charge is due and payable on the effective date of this Contract.Subsequent� nffact and payable no later than the first day of each.Contract Month thereafter shon Contract is in h Service Fee is due and often re He thno Health Service Feefor ir I a month. If a Person's ed o is effective the 1st through the th 15th of the the month, that month If a Covered Person's coverage is effective the 16th through due until the following month He the Covered Person:If a Covered Person's coverage terminates the 1st through u are of the the 15th of the month no month HeHe the Service Fee is due for that month. If a Covered Person's coverage terminates the 16th through gh entire Health Service Fee is due for that month. Grace Period during which time this Contract A grace period of ten(10)days will be granted for the payment of any Contract Charga shall continue in force. In no event shall any grace period extend beyond the date this Contract terminates. Contract Termination- follow- ing date of Coverage at 12:01 a.m.on the i paid date of Charge. Should such day This the grace gr shall if the Enrolling oy terminateretroactivefails once i to the quiwithin PLAN'd su h Contract o toCharge reinstate the e e y the period PL if the afterhc Unit period to remit the above.it will be totally received by PLAN the grace outlined nittand terminate the group. coverage or return the Contract Charge to the Enrolling PLAN or Enrolling Unit may terminate this Contract for other than non-payment of Contract charge by giving the other party written notice of termination thirty-one(31) days prior to the effective date of termination•revised in Section III Termination of this Contract shall be without prejudice to any written proof of loss furnished as p for Eligible Expenses for Health Services rendered prior to the effective date of termination. Upon termination of this Contras. the Enrolling Unit shall be liable to PLAN for the payment of any and all Health Services Fees which are accrued and unpaid at the time of termination. 1— 4- Section VIII GENERAL PROVISIONS Entire Contract The Master Group Contract. the application of the Enrolling Unit, any individual Enrollee applications.Addenda and amendments shall constitute the entire Contract of Coverage between parties.All statements made by the Enrolling Unit or by an Enrollee shall.in the absence of fraud, be deemed representations and not warranties.No such statement shall void or reduce Coverage under this Contract or be used in defense of a legal action unless it is contained in a written application. Limitation of Actions No action in law or equity may be brought against PLAN,or any officer,director,or employee of PLAN,by any Covered Person with respect m any matter arising under this Contract or the relationship between that Covered Pelson and PLAN without full and complete compliance with the complaint procedure set forth in Section V of this Contract nor shall such action be brought at all unless brought within one(1)year from the date when the cause of action first arose.Written proofs of loss furnished under Section III of this Contract are subject to the provisions regarding limitation of actions set forth in that Section. Time Limit on Certain Defenses No statement,except a fraudulent statement.made by the Enrolling Unit shall ire used to void this Contact after it has been in forte for a period of two(2) years. Alterations No alteration of this Contract and no waiver of any of its provisions shall be valid unless evidenced by an Addendum or an amendment attached to this Contract which is signed by an executive officer of PLAN.No agent has authority w change this Contact or to waive any of its provisions. Minimum Number of Enrollees For initial coverage.the minimum number of Eligible Persons selecting Health Services the mpsticatihe number at PLAN's on the Application.The Enrolling Unit must maintain at least the number specified will A plbe caowed or te the individua. N' option this Contact may be terminated and conversion to an individual direct-pay plan meets the conversion requirements outlined in this Contract and under applicable state law. Relationships Between Panics The relationships between PLAN and Participating Providers(except for the position of Medical Director),and betwee PLAN and Enrolling Units are contractual relationships between independent contractors. Participating Providers an Enrolling Units are not agents or employees of PLAN nor is PLAN or any employee of PLAN an agent or employee c Participating Providers or Enrolling Units. The relationship between a Participating Provider and any Covered Person is that of provider and patient.Tin Panic ic paring Physician is solely responsible for the medical services provided to any Covered Person.The Participating l '"P is solely responsible for the Hospital services provided to any Covered Person. The relationship between any Enrolling Unit and any Covered Person is that of employer and employee,Family Depen ent,or other Coverage classification as defined in this Contract. The Enrolling Unit is solely responsible for providing written notice to PLAN of the enrollment and Coverage changr including termination of a Covered Person's Coverage through PLAN, and the timely payment of Contract Charges PLAN. n.,._7 Assossissmanisw Records documentation PLAN The Enrolling Unit shall furnish PLAN with all information.authorization,and supporting nhed to the which PL Enrolling may reasonably require with regard to any matters pertaining to this Contract.All documents furor Unit by an individual in connection with the Coverage, and the Enrolling Unit's payroll and any other records pertinent to the Coverage under this Contract shall be open for inspection by PLAN at any reasonable time. Each Covered Person authorizes and directs any person or institution that has attended.examined or treated the Covered Person,to furnish PLAN at any reasonable time.upon its request.any and all information and records or copies of records relating to attendance.examination or treatment rendered to the Covered Person.PLAN agrees that such information and records will be considered confidential.PLAN shall have the right to submit any and all records concerning episodes of health care for Covered Persons to appropriate medical or other review bodies or individuals and/or Physicians. Examination of Covered Persons payment for such services under this In rvices or C nther event f a may or dispute y require equir that e a Coverion of Health ed Person be examined.at L 's expense.by a Participating Contract.PLAN may also reasonably require Physician acceptable to PLAN. Clerical Error on of the date it is scheduled to terminate according to the terms of this Contract. Clerical error shall not deprive any individual of Coverage under this Contract Failure to report the termination Cov- erage shall not discovery continue such Coverage beyond adjustment in Health Services Fees shall be made.However,no such Upon s mnt in Health a Services ericcl Fees e•an appropriate by PLAN to the Enrolling Unit for more than sixty(60) adjustment in or Coverage shall be granted days of Coverage prior to the date PLAN was notified of such clerical error. Notice notice to allaffected e of the Enrolling Unit shall be deemed termination f this Notice given PLAN to an authorized rev stration of this Contract. irritating Enrollees and their Enrolled Family Dependents in the admini Contract or the termination of individual Coverage. Covered Benefits with this Contract except In no event shall any Covered Person be responsible to pay for benefits received in accordance as otherwise provided in this Contract. Workers' Compensation Not Affected ants for coverage by Wolters'ct any ho provided under e. B Contract is not in lieu of s will not be denied toand does not a member hose employer has not complied with law and Compensation goveminance• that such member has sought and received services regulations governing-Workers Compensation Insurance,provided under the provisions of this Contract. Conformity with Statutes Any provision of this Contract which,on its effective date.is in conflict with the statutes of the jurisdiction in which it is delivered is hereby amended to conform to the minimum requirements of such statutes. Non Discrimination In compliance with federal and state law, PLAN shall not discriminate on the basis of age, sex, color, race, disability. marital status, sexual preference. religious affiliation or public assistance status. Section IX PROCEDURES FOR OBTAINING HEALTH SERVICES A. HEALTH SERVICES RENDERED BY PARTICIPATING PROVIDERS Subject to the terms.conditions.exclusions.and limitations of this Contract.a Covered Person is entitled to age described in Section X if such services (1) are authorized and determined to be Medically Necessary by LAN a (2) are provided by or referred by the Participating Primary Care Physician. Each Covered Person shall select a Participating Primary Care Physician who shall be responsible for the coordination of all Health Services rendered to the Covered Person and for ensuring continuity of care.Covered Persons who have not selected a Participating Primary Care Physician within 31 days of enrollment may be assigned one by the PLAN. The Participating Primary Care Physician shall refer the Covered Person only to Participating Providers.except as provided in Section IX.B. All Health Services rendered to the Covered Person must be provided or referred by the Participating Primary Care Physician. Health Services obtained by the Covered Person without referral by the Participating Primary Care Physician are not covered.The fact that a Physician may prescribe.order. recommend. approve or provide a service or supply does not,in and of itself.make the service or supply a covered Health Service. Each Covered Person is responsible for verifying the participation status of the provider prior to receiving HealrequirHe forth Services.These Health Services are subject to(1)payment by the Enrollee of the Health Services Fees for under this Contract and(2) payment by the Covered Person of the Copayment Charge specified any service. LIMITATION ON SELECTION OF PROVIDER In the case of a medical condition which significantly endangers either a Covered Person's health or the public health the Covered Person may be required to receive all covered Health Services through a single PLAN Participatirr Physician or network of Participating Providers designated by PLAN. B. REFERRAL HEALTH SERVICES RENDERED BY NON-PARTICIPATING PROVIDERS In the event that specific Health Services cannot be provided by or through a Participating Provider,a Covered Perso shall be entitled to Coverage for Eligible Expenses for Medically Necessary Health Services obtained through nor. participating providers. All such Health Services. including but not limited to Miscellaneous Health Service identified in this Contract.must be authorized in writing in advance by PLAN. and are subject to all of the term,: conditions.exclusions. and limitations of this Contract IT IS THE COVERED PERSON'S RESPONSIBILITY TO VERIFY THAT THE REQUIRED WRTCTE- APPROVAL FROM PLAN HAS BEEN GRANTED. PRIOR TO RECEIVING SERVICES FROM NO? PARTICIPATING PROVIDER SHOULD THE COVERED PERSON RECEIVE CARE FROM A NON-PAT TICIPATING PROVIDER,INCLUDING HOSPITALIZATION, WITHOUT THE REQUIRED APPROVAL B PLAN, THE COVERED PERSON WILL BE RESPONSIBLE FOR ALL COSTS ASSOCIATED WITH THA CARE. FAILURE OF PARTICIPATING PRIMARY CARE PHYSICIAN TO OBTAIN NECESSARY PRI( APPROVAL FROM PLAN DOES NOT EXCUSE THE COVERED PERSON'S NSIBILITY TO VERT' APPROVAL FROM PLAN BEFORE RECEIVING SERVICES FROM OR THROUGH NON-PARTICIPATE PROVIDERS. C. EMERGENCY HEALTH SERVICES Covered Persons are directed to telephone their Participating Primary Care Physician whenever possible prior p r. receiving Emergency Health Services.PLAN will payEligible Expenses for Medically Necessary Emergency He Services rendered to a Covered Person.subject to the terms,conditions,exclusions,and limitations of this achMeieontr Emergency Health Services rendered by Participating Providers are subject to a Copayment Charge for In order for Emergency Health Services rendered by non-participating providers to be covered under this Contr the required Emergency Health Services must be(1)of such immediate nature that the Covered Person's life or he: would be jeopardized if taken to a facility where the services of a Participating Physician would be available,or(2) provided under circumstances in which the Covered Person is unable,due to unconsciousness n ss r e inability ould be available. Inthis to be rational.to request treatment at a location where the services of a Participating Necessary Emergency Health case, Coverage is subject to a Copayment Chargefor each incident of Medically Services rendered by a non-participating Pro r. The above Copayment Charges for Emergency Health Services rendered by either Participating Providers or by non- participating providers are in addition to any other Copayment Charges which may apply to the Health Service. If, however, a Covered Person is confined. the above Copayment Charge is waived, but the Copayment Charges described in Section X.B.1. and X.E.2. shall apply. The Covered Person must notify PLAN within forty-eight(48) hours after Emergency Health Services are initially provided,or as soon thereafter as is reasonably possible.Full details of the Emergency Health Services received shall be made available by the Covered Person at the request and PLAN.e pnor Continuation written an�o care the of after shy require coordination by the Participating PrimaryC Physician ng If the Covered Person is hospitalized,the PLAN may elect to transfer the Covered Emergency t Health a Sepaatii ng Hospred ospital as soon as it is medically appropriate in the opinion of the attending Physician. remain in non-participating o paz pating facility after P providers or in LAN has notified the ating facilities Co Covered Person of the intent to transfnot covered if the Covered feerthe Covered Person to a Participating Provider facility. ELIGIBLE EXPENSES FOR EMERGENCY HEALTH SERVICES Eligible Expenses for Emergency Health Services are the Reasonable and Customary Charges for the Health Services described in Section X of this Contract,provided during b course medical case of the Emergency,and d when ica Medically NCCessary y for stabilization y r The n of lSment until smustbepro dedbyorunderthedirearonofaPhysicianandaresubject to Primary he Care Physician.n The Health ovisi Services of n a Services rendered on an Emergency basis are not to the d i f,in pi other n PLAN. of this islater Contract. Health to be non-emergency.This determination shall covered if.in the opinion of PLAN.the situation is later determined be based on generally accepted medical criteria. D. SECOND OPINION POLICY econd Participating Coverage of certain Health Services requires that the Covered Person obtain a cotn>lt�ith �e Co eied Persog Physician prior to the scheduling of the Health Service.The Participating Physician PLAN policy.ofThe Covered Person that second opinions are implemented at the PLAN's discretion in accordance vines who authorizedon r render is then responsible for contacting PLAN to obtain a list of Participating are i with PLAN second opinion and verify that the procedure or treatment referred for a second opinion with the AN policy.The Enrollee will arrange a consultation with the second Participating Physician.not affiliated first Participating Physician.The consultation for the second opinion must occur within thirty-one(31)days of the first opinion, or as soon thereafter as is reasonably possible. In the event that the second opinion differs from the first opinion, the Covered Person may arrange for a third opinion. Coverage is provided for second and third opinions if arranged through PLAN as described above. Failure to comply with this procedure for obtaining a second opinion shall result in a total Copayment Charge of 40% of Eligible Expenses. E. COPAYMENT CHARGES In the event that two (2) or more Copayment Charges apply to a single Health Service, all applicable Copayment Charges shall apply,provided,however,that the total of all applicable Copayment Charges shall not exceed 40%of Eligible Expenses for the single Health Service. (PLAN Enrollees who wish to ascertain the total dollar amount of combined Copayment Charges may obtain such information from PLAN.) n= • �. $ .7:t...:0t . Section X SCHEDULE OF BENEFITS The amount paid by the Enrollee for Coverage under this Contract exclusive of Copayment Charges or charges for non- covered services, is described in the Appendix. A. PHYSICIAN SERVICES (except for those identified in Sections X.C and X.D of this Contract). when provided or referred by the Participating Primary Care Physician. authorized by PLAN, and rendered through a Participating Providerunless alternative arrangements have been authorized in advance by PLAN,or in the event of an Emergency: 1. Services and supplies provided in a Physician's office, including diagnostic ueatmem and preventive medical care such as x-rays, electrocardiograms, electroencephalograms, and other clinical laboratory tests.well-baby cart. physical examinations. voluntary family planning, application and removal of casts and dressings. immunizations, and Medically Necessary therapeutic injections. COPAYMENT CHARGE: $10.00 per visit during scheduled office hours or$25.00 after scheduled office hours except for Copayment Charges required for specific services and supplies set forth below. 2. Eye exams,excluding refraction,provided in the Physician's office. (No limitation applies to Covered Persons through the age of seventeen(17).) COPAYMENT CHARGE: $10.00 per visit Eye exams for refraction provided in a Participating Provider's office,limited to one(1)exam per Covered Person per Calendar Year. COPAYMENT CHARGE: $10.00 per visit 3. Physician surgical services and other medical care. including anesthesia. consultation with and treatment by specialists, and services by surgical assistants only when authorized in advance by PLAN,when provided in a Participating Physician's office. COPAYMENT CHARGE:$10.00 per visit except for Copayment Charges for specific services and supplies set forth in this contract 4. Allergy Testing and Treatment Services. No Coverage is provided for RAST testing,except when skin testing is medically impossible. COPAYMENT CHARGE: $10.00 per visit 5. Dermatology Services. COPAYMENT CHARGE: $10.00 per visit B. HOSPITAL AND RELATED SERVICES,when provided or referred by the Participating Primary Care Physician, and authorized by PLAN: 1. Inpatient Services Some Health Services rendered while confined are subject to separate benefit limitations, restrictions and/or Copayment Charges, as described elsewhere in this Contract. a. Room and Board Unlimited Confinement.when Medically Necessary and approved by PLAN prior to admission in a Partici- pating Hospital on a Semi-Private Accommodations basis.The difference in cost between Semi-private and private mom accommodations will not be considered an Eligible Expense unless private accommodations are Medically Ner nary, or unless Semi-private Accommodations are not available. - 20- .52....ir `.3 Sar COPAYMENT CHARGE: $100 per admission for non-surgical or surgical Health Services. Copay- menu are limited to two(2)admissions per person per Calendar year.except copayments for transplant services. In addition to the Copayment Charges listed elsewhere in this Contract, the following shall apply when Health Services are rendered for organ transplants provided, however, that the total of all applicable Copayment Charges shall not exceed 40%of Eligible Expenses for the Health Service. 5%of Eligible Expenses for kidney and corneal transplants in children and adults.liver transplants in chil- dren with biliary atresia or children with other end stage liver disease.bone marrow transplants in chil- dren and adults for the following diseases: • Aplastic anemia • Leukemia • Severe combined immunodeficiency disease and • Wiskott-Aldrich syndrome and any other transplants required by Federal or State Statutes and Regulations when Health Services are rendered in a Designated Transplant Facility. b. Other Inpatient Services and Supplies Services and supplies provided while confined in a Participating Hospital as described in Section X.B.1.a of this Contract. Services and supplies include nursing care.Medically Nei-nary meals and special diets.use of operating morn and related facilities. use of intensive care unit and services,x-ray,laboratory and other diagnostic tests, thugs, medications, biologicals. anesthesia and oxygen services. internal prosthetics. Medically Necessary special duty nursing,radiation therapy,inhalation therapy,and administration of blood and blood plasma,except that such services are subject to the terms,conditions,exclusions,and limitations of this Contract COPAYMENT CHARGE: $100 per admission for non-surgical or surgical Health Services. Copay- mans are limited to two(2)adm1Csions per person per Calendar year.except copayments for transplant services.In addition to the Copayment charges listed elsewhere in this Contract.the following shall apply when Health Services are rendered for organ transplants provided.however,that the total of all applicable Copayment Charges shall not exceed 40%of Eligible Expenses for the Health Service. 5%of Eligible Expenses for kidney and comeal transplants in children and adults,liver transplants in chil- dren with biliary anesia or children with other end stage liver disease,bone marrow transplants in chil- dren and adults for the following diseases: • Aplastic anemia • Leukemia • Severe combined immunodeficiency disease and • Wiskott-Aldrich syndrome and any other transplants required by Federal or State Statutes and Regulations when Health Services arc rendered in a Designated Transplant Facility. 2. Outpatient Services and Supplies, at either Participating Hospital or Participating Alternate Facility and when provided or referred by the Participating Primary Care Physician and authorized by PLAN.except in the event of an Emergency. Emergency Health Services provided at or by nonparticipating facilities or providers are covered subject to the terms, conditions. exclusions and limitations of this Contract. and when PLAN later determines these Emergency Health Services to be Medically Necessary: a. Emergency Services 1) Services and supplies for stabilization or initiation of treatment of Emergency conditions•rendered on an outpatient basis in an emergency mom of a HospitaL - 21 - 3 21J7 COPAYMENT CHARGE:$50.00 per visit except the the Copayment Charge described in Section X.B.1.a or X.E.2 will apply when the Emergency condition directly results in Confinement. 2) Services and supplies for stabilization or initiation of treatment of Emergency conditions, rendered on an outpatient basis in a physician's office or urgent care facility. COPAYMENT CHARGE: $25.00 per visit, except the Copayment Charge described in Section X.A.1 will apply when services are rendered by a Primary Care Physician during regularly scheduled office hours. b. Non-Emergency Services 1) Physician surgical services,supplies and other medical can:,including anesthesia,consultation with and treatment by specialists,and services by surgical assistants only when authorized in advance by PLAN, for prescheduled outpatient surgery provided at a Participating Hospital or Participating Alternate Facility. COPAYMENT CHARGE: $50.00 per outpatient surgery 2) Prescheduled diagnostic and therapeutic services,including x-ray,radiation therapy and laboratory tests and services, provided at a Participating Hospital or Participating Alternate Facility. COPAYMENT CHARGE: $10.00 per visit C. MATERNITY, FAMILY PLANNING AND INFERTILITY SERVICES For the purposes of this subsection, maternity and obstetrical care shall mean pre- and post-partum care during pregnancy, childbirth.early termination of pregnancy, or any associated complications. 1. Services,equipment and supplies provided on an inpatient or outpatient basis for obstetrical care of the mother before and during delivery and during the post-parwm period. including Physician services. operations and special procedures such as Caesarean sections,Hospital services,including use of the delivery room.x-ray and laboratory, injectable substances and anesthesia. Unless authorized in writing and in advance, obstetrical and neonatal care provided outside of the Service Area will not be covered if such care is rendered during the normal delivery period.The normal delivery period is the three to five week period prior to the expected delivery date. COPAYMENT CHARGE: $10.00 per outpatient visit,and inpatient services- same as X.B.1. 2. Services and supplies provided on an inpatient or outpatient basis for family planning counseling and treatment. including infertility evaluation,birth control counseling and treatment,certain intrauterine devices,measurement for contraceptive diaphragms,voluntary male or female surgical sterilization,and up to two(2)elective abortions per lifetime if performed within ten(10)weeks of conception.(Donor semen for artificial insemination,in vitro fertilization,embryo transport procedures,surrogate parenting,and outpatient injectable substances and supplies related to infertility are not covered.) COPAYMENT CHARGE: $10.00 per outpatient visit, and inpatient services same as X.B.1. D. MENTAL HEALTH SERVICES AND CHEMICAL DEPENDENCY SERVICES The following Health Services are covered only when provided or referred by PLAN's Mental Health Provider. 1. Inpatient and outpatient Health Services for detoxification of chemical dependency, without limitation. Health Services otherwise covered under this Contract for the treatment of medical complications of chemical dependency are described in Sections X.A. and X.B. of this Contract. 2. Inpatient Mental Health. Coverage,up to a maximum of forty-five(45)full days or ninety(90)partial days per Calendar Year,for inpatient Semi-private Accommodations,or private when Medically Necessary, for Mental Health Services when provided by the Mental Health Provider in a Participating Hospital or Participating - 22 - 5v_.✓-I ;3 Alternate Facility."Partial Days"means neamtem for at least three(3)hours but not mote than twelve(12)hours in a 24-hour period. COPAYMENT CHARGE:The first day's Copayment Charge is the same as specified in Section X.B.l.a plus S25.00 per day thereafter. 3. Inpatient Chemical Dependency. Coverage for Semi-private accommodations, or private when Medically Necessary, for a maximum of twenty-one (21) days per Calendar Year and two (2) Confinements per lifetime, for treatment of alcoholism or chemical dependency when authorized in writing in advance by the Mental Health Provider, and provided in an inpatient treatment facility designated by PLAN. Covered Person must complete prescribed and approved course of treatment of PLAN to be responsible for payment. COPAYMENT CHARGE:The first day's Copayment Charge is the same as specified in Section X.B.1.aplus $25.00 per day thereafter. 4. Outpatient Mental Health and Chemical Dependency Services are provided when furnished by the Mental Health Provider. COPAYMENT CHARGE: No charge per visit. The full Reasonable and Customary Charge for each appointment broken less than twenty-four(24) hours prior to the time of scheduled visit. E. MISCELLANEOUS HEALTH SERVICES THE FOLLOWING HEALTH SERVICES ARE COVERED PROVIDED THAT SUCH HEALTH SERVICES (EXCEPT EMERGENCY SURFACE AMBULANCE SERVICE) ARE (A) ORDERED, PROVIDED, OR AR- RANGED BY OR UNDER THE DIRECTION OF THE PARTICIPATING PRIMARY CARE PHYSICIAN AND (B) APPROVED IN WRITING IN ADVANCE BY PLAN AND (C) OBTAINED THROUGH A VENDOR OR PROVIDER SELECau BY PLAN MANAGEMENT. I. Home Health Agency and Private Duty Nursing Services Intermittent Health Services of a Participating Home Health Agency,and private duty nursing care,by,or under the supervision of, a registered nurse, in a Covered Person's home, required for care and treatment which otherwise would require Confinement in a Participating Hospital or Participating Skilled Nursing Facility. Covered Health Services include diagnostic and therapeutic nursing services and Physician home visits within the Service Area. COPAYMENT CHARGE: No charge per visit 2. Skilled Nursing Facility Up to sixty-two(62)days of Medically Necessary Confinement(Semi-Private Accommodations unless private accommodations are Medically Necessary)and medical services and supplies and equipment ordinarily provided in a Participating Skilled Nursing Facility for the care and treatment of an acute Injury or Sickness,and which otherwise would require Confinement in a Participating Hospital.Some Health Services rendered while confined are subject to separate benefit limitations,restrictions and/or Copayment Charges,as described elsewhere in this Contract. COPAYMENT CHARGE: No charge per confinement 3. Ambulance Services Medically Necessary ambulance transportation is covered if approved in advance by PLAN or when PLAN determines after the transportation is provided that the transportation was Medically Necessary. Ambulance transportation provided due to the absence of other medically appropriate forms of transportation is not covered. a. Emergency surface ambulance transportation by a licensed ambulance service to the nearest Hospital where Emergency care and treatment can be rendered. -23 - 3 '.' :':`"n COPAYMENT CHARGE: $30.00 per trip b. Non-emergency surface ambulance transportation when referred by the Participating Primary Cam Physician and approved in writing in advance by PLAN. COPAYMENT CHARGE: $30.00 per trip c. Air ambulance transportation only when medically appropriate surface ambulance transportation is not available. COPAYMENT CHARGE: $30.00 per trip 4. Rehabilitation Services Short term inpatient or outpatient, whichever is Medically Necessary,rehabilitative services(physical therapy, occupational therapy,and speech therapy)performed at a Participating Hospital or Participating Skilled Nursing Facility, or through Participating Home Health Agency,or other Participating Provider. Rehabilitation services are limited to services which, in the judgment of the Participating Primary Cam Physician and PLAN, are Medically Necessary and will result in significant improvement of a Covered Person's condition through short term therapy. (Short term means that significant improvement is anticipated within two (2) months of start of treatment)All combined rehabilitation services are limited to a sixty-two(62)day period per Sickness episode, beginning with the first day of treatment. COPAYMENT CHARGE: $10.00 per outpatient visit and No Charge per Confinement 5. Blood and Blood Products The administration of prescribed blood transfusions,including supplies and equipment used in the administration of blood,and blood products and derivatives if such products and derivatives am replaced in accordance with the blood bank's requirements.Coverage is provided for the drawing and storing of the Covered Person's blood for use by the Covered Person only for blood units used as replacement therapy for Medically Necessary treatment of conditions while the Covered Person is covered under this Contract COPAYMENT CHARGE: No Charge 6. Tempommandibular Joint Syndrome Treatment of temporomardibular joint syndrome as a result of trauma: fracture of the jaw or laceration of the mouth,tongue,or gums is covered. Health Services and supplies provided for the treatment of temporomandi- bular joint syndrome are covered only when performed by a PLAN-designated Physician or oral surgeon. COPAYMENT CHARGE: 40% of Eligible Expenses 7. Hemodialysis Services and supplies, subject to approval by PLAN and a determination that the Covered Person meets PLAN medical criteria,when provided in a Participating Hospital or Participating Alternate Facility,for dialysis for end stage renal disease (ESRD), and services and supplies for renal conditions. COPAYMENT CHARGE: $10.00 per hemodialysis treatment '1 4 GENERAL EXCLUSIONS The following are not covered: 1. Dental Surgery, Treatment or Care (including such for overbite or underbite, maxillary and mandibulary osteotomies. and orthognathic conditions, whether or not related to temporomandibular joint dysfunction), or dental x-rays,supplies and appliances(including occlusal splints)and all associated expenses arising out of such Dental Surgery,Treatment or Care including hospitalizations. Hospital and Physician services and supplies and anesthesiology services referred by the Participating Primary Care Physician and approved in writing in advance by PLAN, for the correction of cleft lip or cleft palate which has been diagnosed as a Congenital Anomaly in newborn children,or as are necessary to safeguard the health of a Covered Person because of a specific non-dental physiological impairment are covered. Dental Services required due to trauma are limited to functional restoration of structures other than teeth.Treatment of trauma resulting in fracture of the jaw or laceration of the mouth, tongue, or gums is covered. 2. Health Services and associated expenses for temporomandibular joint syndrome.except as described in X.E.6. 3. Custodial Care, domiciliary care, respite care or rest cures. 4. Health Services and associated expenses for Cosmetic Procedures including,but not limited to.pharmaceutical regimes, nutritional procedures or treatments. plastic surgery, including reduction mammoplasty, and recon- structive mammoplasty,except when the original mastectomy was performed while the person was covered under this Contract. (Medically Necessary reconstructive surgery is not excluded.) 5. Health Services and associated expenses for Experimental or Unproven Procedures.treatments,devices or phar- macological regimes. 6. Health Services and associated expenses for organ transplants, except for those transplants stated as covered under Section X,B,1.,a.and b.unless covered through an addendum to this Contract.Liver transplants in adults are NOT covered. Bone marrow transplants are NOT covered for conditions other than those listed in Section X,B,I. a. and b. 7. Health Services and associated expenses for in vitro fertilization, embryo transport. Gamete Intra-Fallopian Transfer, surrogate parenting, donor semen,outpatient injectable substances and supplies related to infertility, elective abortions when performed beyond the tenth week of pregnancy,or elective abortions in excess of two (2) per lifetime, home childbirth, and non-Medically N- ecsary amniocentesis. 8. Health Services not authorized by PLAN or not Medically Necessary, or not provided or referred by the Participating Primary Care Physician,except in Emergency situations (described in Section IX.C.) 9. Hearing aids,cochlear implant devices and implant procedures.eye glasses,contact lenses and the fitting thereof. unless covered through an Addendum to this contract. 10. Personal comfort and convenience items or services obtained or rendered in or out of the Hospital or any facility, such as television,telephone,barber or beauty service,guest service and similar incidental services and supplies which are not Medically Necessary. 11. Mental Health Services, which are (a) rendered in connection with Mental Illnesses not classified in the International Classification of Diseases of the U.S.Department of Health and Human Services,or(b)for any of the following: learning, behavioral or developmental disabilities, mental retardation or autism. marriage counseling, counseling or therapy for weight reduction, behavioral training, personal growth, lifestyle or vocational counseling, biofeedback,pain control,hypnosis, sexual dysfunction or inadequacy, transsexualism, early infant stimulation,or psychotherapy credited toward earning a degree or required for educational purposes. 12. Services rendered by a provider with the same legal residence as a Covered Person, or who is a member of a Covered Person's family, including spouse. brother,sister, parent, or child. - 25 - 13. Physical.psychiatric,or psychological examinations or testing,or vaccinations.immunizations,or treatments not otherwise covered under this Contract,when such services are for purposes of obtaining,maintaining orothetwise relating to employment or insurance,marriage or adoption,or relating to judicial or administrative proceedings or orders,or which are conducted for purposes of medical research,or to obtain or maintain a license of any type. 14. Travel or transportation expenses (except ambulance service as specifically provided in this Contract) even though prescribed by a Physician. 15. Health Services and associated expenses for outpatient Hospital and Hospital emergency room or Participating Alternative Facility services obtained during normal Physician office hours (unless necessary because of an Emergency),except as specified in Section X.B.2.b,or when authorized in advance in writing by the Participating Primary Care Physician or PLAN. 16. Prosthetic devices.Durable Medical Equipment,and appliances,and personal comfort items.including air con- ditioners,even though prescribed by a Physician,unless covered through an Addendum to this Contract or when such devices,equipment or appliances are medically necessary for outpatient care in lieu of hospitalization or an integral part of a case management plan. 17. Health Services and associated expenses for surgical procedures and associated Health Services intended primarily for the treatment of morbid obesity, including gastric bypasses, gastric balloons, stomach stapling, wiring of the jaw,jejunal bypasses. and Health Services of a similar nature. unless Medically Necessary. 18. Health Services and associated expenses for sex transformation operations and for reversal of voluntary sterilization. 19. Health Services otherwise covered under this Connact related to a specific condition or treatment when a Covered Person has terminated the specific scheduled service or treatment against the advice of a Physician,or has left a Hospital or inpatient facility against medical advice. 20. Health Services for military service connected disabilities for which the Covered Person is legally entitled to services and for which facilities are reasonably available to the Covered Person. 21. Health Services and associated expenses for megavitamin therapy,psychosurgery,radial keratotomy,nutritional based therapy for alcoholism or other chemical dependency. salabrasion, chemosurgery or other such skin abrasion procedures associated with the removal of scars,tattoos.actinic changes and/or which are performed as a treatment for acne,RAST testing,except with skin testing is medically impossible.acupuncture,services or treatment for sleep apnea,or chelation therapy,unless Medically Necessary for the treatment of metal poisoning. 22. Health Services provided by a chemical dependency neatment or rehabilitation ro 'except as described in Section X.D.,or unless covered through an Addendum to this Contract. p 23. Prescription Medications for outpatient treatment.unless covered through an Addendum, to this.Contract. 24. Health Services otherwise covered under this Contract,but rendered after the date individual Coverage under this Contract terminates, including Health Services for medical conditions arising prior to the date individual Coverage under this Contract terminates. 25. Medical supplies,oxygen,blood, blood derivatives and fees for blood replacement,and penile implant devices and procedures,except as described in Section X.E.5.,or unless covered through an Addendum to this Contract. 26. Outpatient nutritional and dietary services in the absence of a physiological disease condition. - 26- 3n'070 1. The persons it has paid or for whom it has paid; 2. Insurance companies; or 3. Other organizations. The"amount of the payments made"includes the reasonable cash value of any benefits provided in the form of services. Subrogation PLAN shall be subrogated to,and shall succeed to all rights of recovery of any Covered Person from a third party,including his or her employer, for the reasonable value of services provided under the Contract. PLAN may require assignment of the rights of recovery from the Covered Person, to the extent of the reasonable value of services and benefits provided by it plus reasonable costs of collection. The Covered Person shall cooperate with PLAN in protecting the PLAN's legal rights under these subrogation provisions and acknowledges that PLAN's subrogation rights shall be considered as the first priority claim against any third party, to be paid before any other claims which may exist are paid,including claims for general damages by the Covered Person. The Covered Person shall do nothing to prejudice PLAN's rights under this provision,either before or after the need for services or benefits under the Contract. PLAN may, at its option,take necessary and appropriate action to preserve its rights under these subrogation provisions,including the right to bring suit in the name of the Covered Person.PLAN may collect, at its option, amounts from the proceeds of any settlement or judgment that may be recovered by the Covered Person or his or her legal representative, regardless of whether or not the Covered Person has been fully compensated. Any proceeds of settlement or judgment shall be held in trust by the Covered Person for the benefit of PLAN under these subrogation provisions,and PLAN shall be entitled to recover reasonable attorney fees from the Covered Person incurred in collecting proceeds held by the Covered Person. Section V COMPLAINT AND GRIEVANCE PROCESSES If a Covered Person has a complaint concerning the provision of Health Services or benefits under the Contract,a written or verbal complaint may be made by the affected Covered Person or by the affected Covered Person's legal guardian,to PLAN's Member Services Department. The PLAN's Member Services Department shall contact the complainant and attempt to resolve the verbal complaint through informal discussions,and shall notify the complainant of the resolution of the verbal complaint within thirty-one (31) days following its receipt. If the Covered Person is not satisfied with the resolution of the verbal complaint, he or she may request, in writing,the PLAN's Member Services Department to present the complaint and all research infor- mation to the Member Relations Committee for further consideration. Written complaints and unresolved verbal complaints are researched and reviewed by the Member Relations Committee. The Member Relations Committee shall review this information and notify the complainant of the resolution within sixty (60) days of the date the written complaint was first received. If the Covered Person is not satisfied with the resolution by the Member Relations Committee, the complainant has the right to successive levels of appeal through the PLAN's formal grievance process. 2'1 Section VI TERMINATION OF INDIVIDUAL COVERAGE Termination Conditions Coverage of the Covered Person under the Contract,including Coverage for any Health Services rendered after the date of termination,for medical conditions arising prior to the date of termination,shall automatically terminate on the earliest of the following dates: . The date the Contract is terminated. 2. The last day of the last Contract Month that the required Health Services Fee has been paid. 3. In the case of a Covered Person who fails to pay a required Copayment Charge for Health Services rendered,the date specified by PLAN for termination of Coverage in written notice to the Enrolling Unit.Such notice shall be provided by PLAN at least thirty-one (31) days in advance of such termination. 4. The date specified by PLAN in written notice to the Enrollee that all Coverage under the Contract will terminate because the Enrollee knowingly provided PLAN with false,material information,including,but not limited to, information relating to another person's eligibility for Coverage or status as a Family Dependent;or false,ma- terial information relating to the Enrollee's health status or that of any Family Dependent. 5. The date specified by PLAN in written notice to the Enrollee that all Coverage under the Contract will terminate because the Enrollee permitted the use of the Enrollee's identification card by any unauthorized person,or used another person's card. 6. The date a Covered Person's residence is no longer in the PLAN Service Area.The Enrolling Unit or Enrollee snail be responsible for notifying PLAN of a Covered Person's move from the Service Area.Coverage under the Contract will terminate on the date of such move, even if such notice is not provided to PLAN. 7. The date the Enrolling Unit receives written notice from the Enrollee requesting termination of Coverage,or the date requested by the Enrollee in such notice, if later. 8. The date the Enrollee is retired or pensioned,unless a specific Coverage classification is specified for retired or pensioned individuals in the application attached to the Contract. 9. The date specified by PLAN,after thirty-one(31)days prior written notice to the Enrollee,that all Coverage under the Contract will terminate due to the failure of the Enrollee to establish and maintain a satisfactory provider- patient relationship with any Participating Provider.Termination of Coverage under this condition shall not occur prior to the date that the Enrollee exercises his or her rights through the Complaint and Grievance Processes, should the Enrollee choose to do so. 10. The last day of the Contract Month in which the Covered Person ceases to be eligible as an Enrollee or Enrolled Family Dependent. Under certain circumstances, Covered Persons who cease to be eligible for Coverage under the Contract are entitled to continue Coverage under the Contract, as described below in "Continuation Coverage." Continuation Coverage A Covered Person whose Coverage ends under the Contract is entitled to elect continuation of Coverage in accordance with either Part I (Federal continuation) or Part II (State continuation) of this subsection. The Covered Person should contact the Enrolling Unit to determine whether Part I or Part II is applicable. Part I: Continuation of Coverage Under Federal Law A. Qualifying Events The Covered Person's Coverage must have terminated due to one of the following Qualifying Events: ,n `van - 12 - '•i 1. Termination of the Enrollee from employment with the Enrolling Unit,or reduction of hours,for any mason other than gross misconduct; 2. Death of the Enrollee; 3. Divorce or legal separation from the Enrollee; 4. Loss of eligibility by an Enrolled Family Dependent who is a child; 5. Entitlement of an Enrollee to Medicare benefits; 6. The Enrolling Unit filing for bankruptcy, under Tide XI, United States Code,on or after July 1, 1986, but only for a retired Enrollee and his or her Enrolled Family Dependents. A Covered Person who is totally disabled may extend continuation coverage if: a. it has been determined that the Covered Person is totally disabled for Social Security purposes; and b. the Covered Person notifies the PLAN within 60 days of the date the determination is made by the Social Security Administration. The Covered Person must elect continuation during the election period,and payment of the Health Service Fees is required. If the Covered Person elects continuation of Health Services,it must be the same Coverage that the Covered Person had at the time of the Qualifying Event. B. Notification Requirements and Election Period The Covered Person must notify the Enrolling Unit's designated plan administrator within sixty(60)days when divorce, legal separation,or loss of eligibility as an Enrolled Family Dependent would end Coverage. NOTE: PLAN is not the Enrolling Unit's designated plan administrator.The Covered Person should consult his or her Enrolling Unit. In the case of an Enrollee's reduction of hours,termination of employment,death,or entitlement to Medicare, the Enrolling Unit will notify its designated plan administrator. Within fourteen(14)days upon receiving such notification, the Enrolling Unit's designated plan administrator will notify the eligible Covered Person(s) of the right to elect continuation, and of the Health Service Fees required. Continuation must be elected by the later of: 1. Sixty (60) days after the Covered Person's Coverage ends; or 2. Sixty (60) days after the Covered Person receives notice of the continuation right from the Enrolling Unit's designated plan administrator. A Covered Person whose Coverage was terminated due to a Qualifying Event must pay the initial Health Service Fees due within forty-five(45) days after electing continuation. All other Health Service Fees after the initial payment am due within the applicable grace period. C. Terminating Events Continuation under the Contract will end on the earliest of the following dates: 1. Eighteen(18)months from the date continuation began for a Covered Person whose Coverage ended because of Qualifying Event 1. 2. Twenty-nine (29) months from the date continuation began for Covered Persons whose coverage was extended due to total disability. 13 - Jr, Ai I 3. Thirty-six(36)months from the date continuation began for an Enrolled Family Dependent whose Coverage ended because of Qualifying Events 2, 3,4 and 5. 4. The date Coverage terminates under the Contract for failure to make timely payment of the Health Services Fee. 5. The date coverage is obtained under any other group health plan. Except that,a Covered Person with a pre- existing condition which is limited or excluded under any other employer sponsored group health plan may continue coverage. 6. The date the Covered Person becomes entitled to Medicare, (except that this shall not apply in the event Covered Person's Coverage was terminated because of Qualifying Event 6). 7. The date the Contract ends. If a second qualifying event occurs, the following rules apply: 1. If a Covered Person is entitled to eighteen(18)months of continuation,and a second qualifying event occurs during that time,the Covered Person's Coverage may be extended up to a maximum of thirty-six(36)months from the date of Qualifying Event 1. 2. If a Covered Person is entitled to continuation due to Qualifying Event 6,and the retired Enrollee dies during the continuation period, the Enrolled Family Dependents shall be entitled to continue Coverage for thirty- six (36)months from the date of death. Terminating Events 2 - 6 shall apply during the extended continuation period. Part II: Continuation of Coverage Under State Law An Enrollee whose Coverage ends under the Contract may be entitled to elect continuation Coverage under state law,if the Enrolling Unit is not subject to the requirements of COBRA,or as an alternative to COBRA when both state law and COBRA apply. The Enrollee's Coverage must have ended due to termination of employment. The Enrollee shall not be entitled to continuation Coverage under state law if: a. Health Services Fees for Coverage up to the termination date have not been paid by or on behalf of the Enrollee; or b. the Enrollee has not been continuously covered under the Contract,or under any coverage plan providing similar coverage which the Contract replaced,for at least six(6)months immediately prior to termination from employ- ment; or c. the Enrollee is covered by Medicare or Medicaid; or d. the entire Contract is discontinued. The Enrollee must elect continuation Coverage and pay Health Services Fees due within twenty(20)days from the date of termination from employment. Coverage may be continued for enrollees working 40 hours or more when the working hours are reduced to less than 30 hours because of economic conditions. Coverage may also be continued for such enrollees enrolled family dependents. Coverage may be continued provided: 1. the enrollee has been continuously covered under the Contract, or under any coverage plan providing similar coverage which the Contract replaced, for at least six(6)months immediately prior to the reduction in working hours; - 14 - ate-_ 3i. 2. the enrolling unit has imposed the reduction in hours due to economic conditions; 3. the enrolling unit intends to restore the enrollee to a full 40 hour work schedule as soon as economic conditions improve; and 4. the applicable Health services Fees are paid. Continuation of Coverage under state law will end after a period of ninety(90)days after the date Coverage would have ended,or until the Enrollee is reemployed,whichever occurs first. At the end of the ninety(90)day continuation period under state law,the Enrollee or the Enrolled Family Dependents are entitled to conversion privileges as described below. Conversion A Covered Person who ceases to be eligible for PLAN Coverage for the reasons stated in termination conditions 8 or 10 above, or upon termination of continuation Coverage, and who continues to reside in the Service Area, may make application to PLAN for coverage under a conversion contract without furnishing evidence of insurability. Application and payment of the initial Health Services Fees must be made within thirty-one(31)days after termination of Coverage under the Contract.A conversion contract shall be issued in accordance with the terms and conditions in effect at the time of application. Out of Area Conversion PLAN may designate a carrier to provide conversion membership to any Covered Person who ceases to be eligible for PLAN Coverage for the reasons stated in termination conditions 6 or 10 above,and who no longer resides within the PLAN Service Area. Application to convert membership effective on the date of termination, without furnishing evidence of insurability,must be made to the PLAN designated carrier within thirty-one(31)days after termination of Coverage under the Contract.A conversion contract may be issued in accordance with the terms and conditions the designated carrier may have in effect at the time of application. Section VII CONTRACT CHARGES Your employer is responsible for making all monthly payments due under the Contract.For other than copayments,you should speak with your employer regarding any amount due for payment for health services under this Contract. If your employer fails to make the required payment within ten(10)days of when it is due,coverage terminates effective on the last day for which payment was made.Please consult your employer and review the Contract if you have further questions regarding Contract payments. Section VIII GENERAL PROVISIONS Entire Contract The Master Group Contract, the application of the Enrolling Unit, any individual Enrollee applications, Addenda and amendments shall constitute the entire Contract of Coverage between parties.All statements made by the Enrolling Unit or by an Enrollee shall,in the absence of fraud,be deemed representations and not warranties. No such statement shall void or reduce Coverage under the Contract or be used in defense of a legal action unless it is contained in a written application. Limitation of Actions No action in law or equity may be brought against PLAN,or any officer,director,or employee of PLAN,by any Covered Person with respect to any matter arising under the Contract or the relationship between that Covered Person and PLAN without full and complete compliance with the complaint procedure set forth in Section V of the Contract,nor shall such - 15 - 9 W.373 action be brought at all unless brought within one(I)year from the date when the cause of action first arose.Written proofs of loss furnished under Section III of the Contract are subject to the provisions regarding limitation of actions set forth in that Section. Time Limit on Certain Defenses No statement,except a fraudulent statement,made by the Enrolling Unit shall be used to void the Contract after it has been in force for a period of two (2) years. Alterations No alteration of the Contract and no waiver of any of its provisions shall be valid unless evidenced by an Addendum or an amendment attached to the Contract which is signed by an executive officer of PLAN.No agent has authority to change the Contract or to waive any of its provisions. Relationships Between Parties The relationships between PLAN and Participating Providers(except for the position of Medical Director),and between PLAN and Enrolling Units are contractual relationships between independent contractors. Participating Providers and Enrolling Units are not agents or employees of PLAN nor is PLAN or any employee of PLAN an agent or employee of Participating Providers or Enrolling Units. The relationship between a Participating Provider and any Covered Person is that of provider and patient. The Participating Physician is solely responsible for the medical services provided to any Covered Person.The Participating Hospital is solely responsible for the Hospital services provided to any Covered Person. The relationship between any Enrolling Unit and any Covered Person is that of employer and employee, Family Dependent, or other Coverage classification as defined in the Contract. The Enrolling Unit is solely responsible for providing written notice to PLAN of the enrollment and Coverage changes, including termination of a Covered Person's Coverage through PLAN, and the timely payment of Contract Charges to PLAN. Records The Enrolling Unit shall furnish PLAN with all information,authorization,and supporting documentation which PLAN may reasonably require with regard to any matters pertaining to the Contract.All documents furnished to the Enrolling Unit by an individual in connection with the Coverage,and the Enrolling Unit's payroll and any other records pertinent to the Coverage under the Contract shall be open for inspection by PLAN at any reasonable time. Each Covered Person authorizes and directs any person or institution that has attended,examined or treated the Covered Person,to furnish PLAN at any reasonable time,upon its request,any and all information and records or copies of records relating to attendance,examination or treatment rendered to the Covered Person.PLAN agrees that such information and records will be considered confidential.PLAN shall have the right to submit any and all records concerning episodes of health care for Covered Persons to appropriate medical or other review bodies or individuals and/or Physicians. Examination of Covered Persons In the event of a question or dispute concerning the provision of Health Services or payment for such services under the Contract,PLAN may also reasonably require that a Covered Person be examined,at PLAN's expense,by a Participating Physician acceptable to PLAN. Clerical Error Clerical error shall not deprive any individual of Coverage under the Contract. Failure to report the termination of Coverage shall not continue such Coverage beyond the date it is scheduled to terminate according to the terms of the Contract. Upon discovery of a clerical error,an appropriate adjustment in Health Services Fees shall be made.However, no such adjustment in Health Services Fees or Coverage shall be granted by PLAN to the Enrolling Unit for more than sixty (60)days of Coverage prior to the date PLAN was notified of such clerical error. - 16 - ' )014 Notice Notice given by PLAN to an authorized representative of the Enrolling Unit shall be deemed notice to all affected Enrollees and their Enrolled Family Dependents in the administration of the Contract, including termination of the Contract or the termination of individual Coverage. Covered Benefits In no event shall any Covered Person be responsible to pay for benefits received in accordance with the Contract except as otherwise provided in the Contract. Workers' Compensation Not Affected The Coverage provided under the Contract is not in lieu of and does not affect any requirements for coverage by Workers' Compensation Insurance. Benefits will not be denied to a member whose employer has not complied with law and regulations governing Workers' Compensation Insurance,provided that such member has sought and received services under the provisions of this Contract. Conformity with Statutes Any provision of the Contract which,on its effective date,is in conflict with the statutes of the jurisdiction in which it is delivered is hereby amended to conform to the minimum requirements of such statutes. Non Discrimination In compliance with federal and state law, PLAN shall not discriminate on the basis of age, sex, color, race, disability, marital status, sexual preference, religious affiliation or public assistance status. Section IX PROCEDURES FOR OBTAINING HEALTH SERVICES A. HEALTH SERVICES RENDERED BY PARTICIPATING PROVIDERS Subject to the terms,conditions,exclusions,and limitations of this Contract,a Covered Person is entitled to Coverage described in Section X if such services(1)are authorized and determined to be Medically Necessary by PLAN and (2) are provided by or referred by the Participating Primary Care Physician. Each Covered Person shall select a Participating Primary Care Physician who shall be responsible for the coordination of all Health Services rendered to the Covered Person and for ensuring continuity of care.Covered Persons who have not selected a Participating Primary Care Physician within 31 days of enrollment may be assigned one by the PLAN. The Participating Primary Care Physician shall refer the Covered Person only to Participating Providers,except as provided in Section IX.B. All Health Services rendered to the Covered Person must be provided or referred by the Participating Primary Care Physician. Health Services obtained by the Covered Person without referral by the Participating Primary Care Physician are not covered.The fact that a Physician may prescribe,order, recommend, approve or provide a service or supply does not,in and of itself,make the service or supply a covered Health Service. Each Covered Person is responsible for verifying the participation status of the provider prior to receiving Health Services.These Health Services are subject to (1)payment by the Enrollee of the Health Services Fees required for Coverage under this Contract and (2)payment by the Covered Person of the Copayment Charge specified for any service. LIMITATION ON SELECTION OF PROVIDER In the case of a medical condition which significantly endangers either a Covered Person's health or the public health, the Covered Person may be required to receive all covered Health Services through a single PLAN Participating Physician or network of Participating Providers designated by PLAN. 17 rt...rns J Gay....OJ 1 B. REFERRAL HEALTH SERVICES RENDERED BY NON-PARTICIPATING PROVIDERS In the event that specific Health Services cannot be provided by or through a Participating Provider,a Covered Person shall be entitled to Coverage for Eligible Expenses for Medically Necessary Health Services obtained through non- participating providers. All such Health Services, including but not limited to Miscellaneous Health Services identified in this Contract, must be authorized in writing in advance by PLAN, and are subject to all of the terms, conditions, exclusions, and limitations of this Contract. IT IS THE COVERED PERSON'S RESPONSIBILITY TO VERIFY THAT THE REQUIRED WRI11"hN APPROVAL FROM PLAN HAS BEEN GRANTED, PRIOR TO RECEIVING SERVICES FROM NON- PARTICIPATING PROVIDER. SHOULD THE COVERED PERSON RECEIVE CARE FROM A NONPAR- TICIPATING PROVIDER, INCLUDING HOSPITALIZATION, WITHOUT THE REQUIRED APPROVAL BY PLAN, THE COVERED PERSON WILL BE RESPONSIBLE FOR ALL COSTS ASSOCIATED WITH THAT CARE. FAILURE OF PARTICIPATING PRIMARY CARE PHYSICIAN TO OBTAIN NECESSARY PRIOR APPROVAL FROM PLAN DOES NOT EXCUSE THE COVERED PERSON'S RESPONSIBILITY TO VERIFY APPROVAL FROM PLAN BEFORE RECEIVING SERVICES FROM OR THROUGH NON-PARTICIPATING PROVIDERS. C. EMERGENCY HEALTH SERVICES Covered Persons are directed to telephone their Participating Primary Care Physician whenever possible prior to receiving Emergency Health Services.PLAN will pay Eligible Expenses for Medically Necessary Emergency Health Services rendered to a Covered Person,subject to the terms,conditions,exclusions,and limitations of this Contract. Emergency Health Services rendered by Participating Providers are subject to a Copayment Charge for each incident. In order for Emergency Health Services rendered by non-participating providers to be covered under this Contract, the required Emergency Health Services must be(1)of such immediate nature that the Covered Person's life or health would be jeopardized if taken to a facility where the services of a Participating Physician would be available,or(2) provided under circumstances in which the Covered Person is unable,due to unconsciousness or the inability to be rational,to request treatment at a location where the services of a Participating Physician would be available.In this case, Coverage is subject to a Copayment Charge for each incident of Medically Necessary Emergency Health Services rendered by a non-participating provider. The above Copayment Charges for Emergency Health Services rendered by either Participating Providers or by non- participating providers are in addition to any other Copayment Charges which may apply to the Health Service. If, however, a Covered Person is confined, the above Copayment Charge is waived, but the Copayment Charges described in Section X.B.I. and X.E.2. shall apply. The Covered Person must notify PLAN within forty-eight(48)hours after Emergency Health Services are initially provided,or as soon thereafter as is reasonably possible.Full details of the Emergency Health Services received shall be made available by the Covered Person at the request of PLAN. Continuation of care thereafter shall require coordination by the Participating Primary Care Physician and the prior written authorization of PLAN. If the Covered Person is hospitalized,the PLAN may elect to transfer the Covered Person to a Participating Hospital as soon as it is medically appropriate in the opinion of the attending Physician.Emergency Health Services rendered by non-participating providers or in non-participating facilities are not covered if the Covered Person chooses to remain in a non-participating facility after PLAN has notified the Covered Person of the intent to transfer the Covered Person to a Participating Provider facility. ELIGIBLE EXPENSES FOR EMERGENCY HEALTH SERVICES Eligible Expenses for Emergency Health Services are the Reasonable and Customary Charges for the Health Services described in Section X of this Contract,provided during the course of the Emergency,and when Medically Necessary for stabilization and initiation of treatment until responsibility for medical care can be assumed by the Participating Primary Care Physician.The Health Services must be provided by or under the direction of a Physician and are subject to the exclusions and other provisions of this Contract. Health Services rendered on an Emergency basis are not covered if,in the opinion of PLAN, the situation is later determined to be non-emergency.This determination shall be based on generally accepted medical criteria. 18 :I u e�:� D. SECOND OPINION POLICY Coverage of certain Health Services requires that the Covered Person obtain a consultation with a second Participating Physician prior to the scheduling of the Health Service.The Participating Physician shall notify the Covered Person that second opinions are implemented at the PLAN's discretion in accordance with PLAN policy.The Covered Person is then responsible for contacting PLAN to obtain a list of Participating Physicians who are authorized to render a second opinion and verify that the procedure or treatment referred for a second opinion is consistent with PLAN policy.The Enrollee will arrange a consultation with the second Participating Physician,not affiliated with the first Participating Physician. The consultation for the second opinion must occur within thirty-one(31) days of the first opinion, or as soon thereafter as is reasonably possible. In the event that the second opinion differs from the first opinion, the Covered Person may arrange for a third opinion. Coverage is provided for second and third opinions if arranged through PLAN as described above. Failure to comply with this procedure for obtaining a second opinion shall result in a total Copayment Charge of 40% of Eligible Expenses. E. COPAYMENT CHARGES In the event that two (2) or more Copayment Charges apply to a single Health Service, all applicable Copayment Charges shall apply,provided,however,that the total of all applicable Copayment Charges shall not exceed 40%of Eligible Expenses for the single Health Service. (PLAN Enrollees who wish to ascertain the total dollar amount of combined Copayment Charges may obtain such information from PLAN.) Section X SCHEDULE OF BENEFITS The amount paid by the Enrollee for Coverage under this Contract,exclusive of Copayment Charges or charges for non- covered services, is described in the Appendix. A. PHYSICIAN SERVICES (except for those identified in Sections X.C and X.D of this Contract), when provided or referred by the Participating Primary Care Physician, authorized by PLAN, and rendered through a Participating Provider unless alternative arrangements have been authorized in advance by PLAN,or in the event of an Emergency: 1. Services and supplies provided in a Physician's office, including diagnostic treatment and preventive medical care such as x-rays, electrocardiograms, electroencephalograms, and other clinical laboratory tests, well-baby care, physical examinations, voluntary family planning, application and removal of casts and dressings, immunizations, and Medically Necessary therapeutic injections. COPAYMENT CHARGE: $10.00 per visit during scheduled office hours or$25.00 after scheduled office hours except for Copayment Charges required for specific services and supplies set forth below. 2. Eye exams,excluding refraction,provided in the Physician's office. (No limitation applies to Covered Persons through the age of seventeen(17).) COPAYMENT CHARGE: $10.00 per visit Eye exams for refraction provided in a Participating Provider's office,limited to one(1)exam per Covered Person per Calendar Year. COPAYMENT CHARGE: $10.00 per visit 3. Physician surgical services and other medical care, including anesthesia, consultation with and treatment by specialists, and services by surgical assistants only when authorized in advance by PLAN, when provided in a Participating Physician's office. - 19 - .� Ø. srt� COPAYMENT CHARGE:$10.00 per visit,except for Copayment Charges for specific services and supplies set forth in this contract. 4. Allergy Testing and Treatment Services. No Coverage is provided for RAST testing, except when skin testing is medically impossible. COPAYMENT CHARGE: $10.00 per visit 5. Dermatology Services. COPAYMENT CHARGE: $10.00 per visit B. HOSPITAL AND RELATED SERVICES,when provided or referred by the Participating Primary Cate Physician, and authorized by PLAN: 1. Inpatient Services Some Health Services rendered while confined are subject to separate benefit limitations, restrictions and/or Copayment Charges, as described elsewhere in this Contract. a. Room and Board Unlimited Confinement,when Medically Necessary and approved by PLAN prior to admission in a Partici- pating Hospital on a Semi-Private Accommodations basis.The difference in cost between Semi-private and private mom accommodations will not be considered an Eligible Expense unless private accommodations are Medically Necessary, or unless Semi-private Accommodations are not available. COPAYMENT CHARGE: $100 per admission for non-surgical or surgical Health Services. Copay- ments are limited to two(2)admissions per person per Calendar year,except copayments for transplant services. In addition to the Copayment Charges listed elsewhere in this Contract, the following shall apply when Health Services are rendered for organ transplants provided, however, that the total of all applicable Copayment Charges shall not exceed 40% of Eligible Expenses for the Health Service. 5%of Eligible Expenses for kidney and corneal transplants inch children and adults,liver transplants in chil- dren with biliary atresia or children with other end stage liver disease,bone marrow transplants in chil- dren and adults for the following diseases: • Aplastic anemia • Leukemia • Severe combined immunodeficiency disease and • Wiskott-Aldrich syndrome and any other transplants required by Federal or State Statutes and Regulations when Health Services are rendered in a Designated Transplant Facility. b. Other Inpatient Services and Supplies Services and supplies provided while confined in a Participating Hospital as described in Section X.B.l.a of this Contract. Services and supplies include nursing care,Medically Necessary meals and special diets,use of operating room and related facilities, use of intensive care unit and services,x-ray,laboratory and other diagnostic tests, drugs, medications, biologicals, anesthesia and oxygen services, internal prosthetics, Medically Necessary special duty nursing,radiation therapy,inhalation therapy,and administration of blood and blood plasma,except that such services are subject to the terms,conditions,exclusions, and limitations of this Contract. COPAYMENT CHARGE: $100 per admission for non-surgical or surgical Health Services. Copay- ments are limited to two(2)admissions per person per Calendar year,except copayments for transplant services.In addition to the Copayment charges listed elsewhere in this Contract,the following shall apply - 20 - W , when Health Services are rendered for organ transplants provided,however,that the total of all applicable Copayment Charges shall not exceed 40% of Eligible Expenses for the Health Service. 5%of Eligible Expenses for kidney and corneal transplants in children and adults,liver transplants inchil- dren with biliary atresia or children with other end stage liver disease,bone marrow transplants in chil- dren and adults for the following diseases: • Aplastic anemia • Leukemia • Severe combined immunodeficiency disease and - Wiskott-Aldrich syndrome and any other transplants required by Federal or State Statutes and Regulations when Health Services are rendered in a Designated Transplant Facility. 2. Outpatient Services and Supplies, at either Participating Hospital or Participating Alternate Facility and when provided or referred by the Participating Primary Care Physician and authorized by PLAN,except in the event of an Emergency. Emergency Health Services provided at or by nonparticipating facilities or providers are covered subject to the terms, conditions, exclusions and limitations of this Contract, and when PLAN later determines these Emergency Health Services to be Medically Necessary: a. Emergency Services 1) Services and supplies for stabilization or initiation of treatment of Emergency conditions, rendered on an outpatient basis in an emergency room of a Hospital. COPAYMENT CHARGE: $50.00 per visit except the the Copayment Charge described in Section X.B.1.a or X.E.2 will apply when the Emergency condition directly results in Confinement. 2) Services and supplies for stabilization or initiation of treatment of Emergency conditions,rendered on an outpatient basis in a physician's office or urgent care facility. COPAYMENT CHARGE: $25.00 per visit, except the Copayment Charge described in Section X.A.1 will apply when services are rendered by a Primary Care Physician during regularly scheduled office hours. b. Non-Emergency Services 1) Physician surgical services,supplies and other medical care,including anesthesia,consultation with and treatment by specialists,and services by surgical assistants only when authorized in advance by PLAN, for prescheduled outpatient surgery provided at a Participating Hospital or Participating Alternate Facility. COPAYMENT CHARGE: $50.00 per outpatient surgery 2) Prescheduled diagnostic and therapeutic services,including x-ray,radiation therapy and laboratory tests and services,provided at a Participating Hospital or Participating Alternate Facility. COPAYMENT CHARGE: $10.00 per visit C. MATERNITY, FAMILY PLANNING AND INFERTILITY SERVICES For the purposes of this subsection, maternity and obstetrical care shall mean pre- and post-partum care during pregnancy, childbirth, early termination of pregnancy, or any associated complications. 1. Services,equipment and supplies provided on an inpatient or outpatient basis for obstetrical care of the mother before and during delivery and during the post-partum period, including Physician services, operations and special procedures such as Caesarean sections,Hospital services,including use of the delivery room,x-ray and laboratory, injectable substances and anesthesia. Unless authorized in writing and in advance, obstetrical and neonatal care provided outside of the Service Area will not be covered if such care is rendered during the normal delivery period. The normal delivery period is the three to five week period prior to the expected delivery date. COPAYMENT CHARGE: $10.00 per outpatient visit, and inpatient services - same as X.B.1. 2. Services and supplies provided on an inpatient or outpatient basis for family planning counseling and treatment, including infertility evaluation,birth control counseling and treatment,certain intrauterine devices,measurement for contraceptive diaphragms,voluntary male or female surgical sterilization,and up to two(2)elective abortions per lifetime if performed within ten(10)weeks of conception.(Donor semen for artificial insemination,in vitro fertilization,embryo transport procedures,surrogate parenting,and outpatient injectable substances and supplies related to infertility are not covered.) COPAYMENT CHARGE: $10.00 per outpatient visit, and inpatient services same as X.B.1. D. MENTAL HEALTH SERVICES AND CHEMICAL DEPENDENCY SERVICES The following Health Services are covered only when provided or referred by PLAN's Mental Health Provider. 1. Inpatient and outpatient Health Services for detoxification of chemical dependency, without limitation. Health Services otherwise covered under this Contract for the treatment of medical complications of chemical dependency are described in Sections X.A. and X.B. of this Contract. 2. Inpatient Mental Health. Coverage,up to a maximum of forty-five(45)full days or ninety(90)partial days per Calendar Year,for inpatient Semi-private Accommodations, or private when Medically Necessary, for Mental Health Services when provided by the Mental Health Provider in a Participating Hospital or Participating Alternate Facility."Partial Days"means treatment for at least three(3)hours but not more than twelve(12)hours in a 24-hour period. COPAYMENT CHARGE:The first day's Copayment Charge is the same as specified in Section X.B.1.aplus $25.00 per day thereafter. 3. Inpatient Chemical Dependency. Coverage for Semi-private accommodations, or private when Medically Necessary, for a maximum of twenty-one(21)days per Calendar Year and two (2) Confinements per lifetime, for treatment of alcoholism or chemical dependency when authorized in writing in advance by the Mental Health Provider, and provided in an inpatient treatment facility designated by PLAN. Covered Person must complete prescribed and approved course of treatment of PLAN to be responsible for payment. COPAYMENT CHARGE:The first day's Copayment Charge is the same as specified in Section X.B.l.a plus $25.00 per day thereafter. 4. Outpatient Mental Health and Chemical Dependency Services are provided when furnished by the Mental Health Provider. COPAYMENT CHARGE: No charge per visit. The full Reasonable and Customary Charge for each appointment broken less than twenty-four(24) hours prior to the time of scheduled visit. E. MISCELLANEOUS HEALTH SERVICES THE FOLLOWING HEALTH SERVICES ARE COVERED PROVIDED THAT SUCH HEALTH SERVICES (EXCEPT EMERGENCY SURFACE AMBULANCE SERVICE) ARE (A) ORDERED, PROVIDED, OR AR- RANGED BY OR UNDER THE DIRECTION OF THE PARTICIPATING PRIMARY CARE PHYSICIAN AND (B) APPROVED IN WRITING IN ADVANCE BY PLAN AND (C) OBTAINED THROUGH A VENDOR OR PROVIDER SELECTED BY PLAN MANAGEMENT. 1. Home Health Agency and Private Duty Nursing Services Intermittent Health Services of a Participating Home Health Agency,and private duty nursing care,by,-or under the supervision of, a registered nurse, in a Covered Person's home, required for care and treatment which - 22 - i* r • otherwise would require Confinement in a Participating Hospital or Participating Skilled Nursing Facility. Covered Health Services include diagnostic and therapeutic nursing services and Physician home visits within the Service Area. COPAYMENT CHARGE: No charge per visit 2. Skilled Nursing Facility Up to sixty-two(62)days of Medically Necessary Confinement(Semi-Private Accommodations unless private accommodations are Medically Necessary)and medical services and supplies and equipment ordinarily provided in a Participating Skilled Nursing Facility for the care and treatment of an acute Injury or Sickness, and which otherwise would require Confinement in a Participating Hospital.Some Health Services rendered while confined are subject to separate benefit limitations,restrictions and/or Copayment Charges,as described elsewhere in this Contract. COPAYMENT CHARGE: No charge per confinement 3. Ambulance Services Medically Necessary ambulance transportation is covered if approved in advance by PLAN or when PLAN determines after the transportation is provided that the transportation was Medically Necessary. Ambulance transportation provided due to the absence of other medically appropriate forms of transportation is not covered. a. Emergency surface ambulance transportation by a licensed ambulance service to the nearest Hospital where Emergency care and treatment can be rendered. COPAYMENT CHARGE: $30.00 per trip b. Non-emergency surface ambulance transportation when referred by the Participating Primary Care Physician and approved in writing in advance by PLAN. COPAYMENT CHARGE: $30.00 per trip c. Air ambulance transportation only when medically appropriate surface ambulance transportation is not available. COPAYMENT CHARGE: $30.00 per trip 4. Rehabilitation Services Short term inpatient or outpatient,whichever is Medically Necessary,rehabilitative services(physical therapy, occupational therapy,and speech therapy)performed at a Participating Hospital or Participating Skilled Nursing Facility,or through Participating Home Health Agency,or other Participating Provider.Rehabilitation services are limited to services which, in the judgment of the Participating Primary Care Physician and PLAN, are Medically Necessary and will result in significant improvement of a Covered Person's condition through short term therapy. (Short term means that significant improvement is anticipated within two (2)months of start of treatment.)All combined rehabilitation services are limited to a sixty-two(62)day period per Sickness episode, beginning with the first day of treatment. COPAYMENT CHARGE: $10.00 per outpatient visit, and No Charge per Confinement 5. Blood and Blood Products The administration of prescribed blood transfusions,including supplies and equipment used in the administration of blood,and blood products and derivatives if such products and derivatives are replaced in accordance with the blood bank's requirements.Coverage is provided for the drawing and storing of the Covered Person's blood for use by the Covered Person only for blood units used as replacement therapy for Medically Necessary treatment of conditions while the Covered Person is covered under this Contract. -23 - 3st'�,.t70 COPAYMENT CHARGE: No Charge 6. Temporomandibular Joint Syndrome Treatment of temporomandibular joint syndrome as a result of trauma: fracture of the jaw or laceration of the mouth, tongue,or gums is covered. Health Services and supplies provided for the treatment of temporomandi- bular joint syndrome are covered only when performed by a PLAN-designated Physician or oral surgeon. COPAYMENT CHARGE: 40% of Eligible Expenses 7. Hemodialysis Services and supplies, subject to approval by PLAN and a determination that the Covered Person meets PLAN medical criteria,when provided in a Participating Hospital or Participating Alternate Facility,for dialysis for end stage renal disease (ESRD), and services and supplies for renal conditions. COPAYMENT CHARGE: $10.00 per hemodialysis treatment GENERAL EXCLUSIONS The following are not covered: 1. Dental Surgery, Treatment or Care (including such for overbite or underbite, maxillary and mandibulary osteotomies, and orthognathic conditions, whether or not related to temporomandibular joint dysfunction), or dental x-rays,supplies and appliances(including occlusal splints)and all associated expenses arising out of such Dental Surgery,Treatment or Care including hospitalizations. Hospital and Physician services and supplies and anesthesiology services referred by the Participating Primary Care Physician and approved in writing in advance by PLAN, for the correction of cleft lip or cleft palate which has been diagnosed as a Congenital Anomaly in newborn children,or as are necessary to safeguard the health of a Covered Person because of a specific non-dental physiological impairment are covered. Dental Services required due to trauma are limited to functional restoration of structures other than teeth.Treatment ofsrauma resulting in fracture of the jaw or laceration of the mouth, tongue,or gums is covered. 2. Health Services and associated expenses for temporomandibular joint syndrome, except as described in X.E.6. 3. Custodial Care, domiciliary care, respite care or rest cures. 4. Health Services and associated expenses for Cosmetic Procedures including,but not limited to,pharmaceutical regimes, nutritional procedures or treatments, plastic surgery, including reduction mammoplasty, and recon- structive mammoplasty,except when the original mastectomy was performed while the person was covered under this Contract. (Medically Necessary reconstructive surgery is not excluded.) 5. Health Services and associated expenses for Experimental or Unproven Procedures,treatments,devices or phar- macological regimes. 6. Health Services and associated expenses for organ transplants, except for those transplants stated as covered under Section X,B,1.,a. and b.unless covered through an addendum to this Contract.Liver transplants in adults are NOT covered. Bone marrow transplants are NOT covered for conditions other than those listed in Section X,B,I. a. and b. 7. Health Services and associated expenses for in vitro fertilization, embryo transport, Gamete Intra-Fallopian Transfer, surrogate parenting, donor semen, outpatient injectable substances and supplies related to infertility, elective abortions when performed beyond the tenth week of pregnancy, or elective abortions in excess of two (2)per lifetime, home childbirth, and non-Medically Necessary amniocentesis. 8. Health Services not authorized by PLAN or not Medically Necessary, or not provided or referred by the Participating Primary Care Physician, except in Emergency situations (described in Section IX.C.) - 24 - 9. Hearing aids,cochlear implant devices and implant procedures,eye glasses,contact lenses and the fitting thereof, unless covered through an Addendum to this contract. 10. Personal comfort and convenience items or services obtained or rendered in or out of the Hospital or any facility, such as television,telephone,barber or beauty service,guest service and similar incidental services and supplies which are not Medically Necessary. 11. Mental Health Services, which are (a) rendered in connection with Mental Illnesses not classified in the International Classification of Diseases of the U.S. Department of Health and Human Services,or(b)for any of the following: learning, behavioral or developmental disabilities, mental retardation or autism, marriage counseling, counseling or therapy for weight reduction, behavioral training, personal growth, lifestyle or vocational counseling,biofeedback,pain control,hypnosis, sexual dysfunction or inadequacy, transsexualism, early infant stimulation,or psychotherapy credited toward earning a degree or required for educational purposes. 12. Services rendered by a provider with the same legal residence as a Covered Person, or who is a member of a Covered Person's family, including spouse, brother, sister, parent, or child. 13. Physical,psychiatric,orpsychological examinations or testing,orvaccinations,immunizations,or treatments not otherwise covered under this Contract,when such services are for purposes of obtaining,maintaining or otherwise relating to employment or insurance,marriage or adoption,or relating to judicial or administrative proceedings or orders,or which are conducted for purposes of medical research,or to obtain or maintain a license of any type. 14. Travel or transportation expenses (except ambulance service as specifically provided in this Contract) even though prescribed by a Physician. 15. Health Services and associated expenses for outpatient Hospital and Hospital emergency room or Participating Alternative Facility services obtained during normal Physician office hours (unless necessary because of an Emergency),except as specified in Section X.B.2.b,or when authorized in advance in writing by the Participating Primary Care Physician or PLAN. 16. Prosthetic devices,Durable Medical Equipment,and appliances,and personal comfort items,including air con- ditioners,even though prescribed by a Physician,unless covered through an Addendum to this Contract or when such devices,equipment or appliances are medically necessary for outpatient care in lieu of hospitalization or an integral part of a case management plan. 17. Health Services and associated expenses for surgical procedures and associated Health Services intended primarily for the treatment of morbid obesity, including gastric bypasses, gastric balloons, stomach stapling, wiring of the jaw,jejunal bypasses, and Health Services of a similar nature, unless Medically Necessary. 18. Health Services and associated expenses for sex transformation operations and for reversal of voluntary sterilization. 19. Health Services otherwise covered under this Contract related to a specific condition or treatment when a Covered Person has terminated the specific scheduled service or treatment against the advice of a Physician, or has left a Hospital or inpatient facility against medical advice. 20. Health Services for military service connected disabilities for which the Covered Person is legally entitled to services and for which facilities are reasonably available to the Covered Person. 21. Health Services and associated expenses for megavitamin therapy,psychosurgery,radial keratotomy,nutritional based therapy for alcoholism or other chemical dependency, salabrasion, chemosurgery or other such skin abrasion procedures associated with the removal of scan,tattoos, actinic changes and/or which are performed as a treatment for acne,RAST testing,except with skin testing is medically impossible,acupuncture,services or treatment for sleep apnea,or chelation therapy,unless Medically Necessary for the treatment of metal poisoning. 22. Health Services provided by a chemical dependency treatment or rehabilitation program,except as described in Section X.D., or unless covered through an Addendum to this Contract. - 25 _ 23. Prescription Medications tut outpatient treatment, unless covered through an Addendum, to this Contract. 24. Health Services otherwise covered under this Contract,but rendered after the date individual Coverage under this Contract terminates, including Health Services for medical conditions arising prior to the date individual Coverage under this Contract terminates. 25. Medical supplies,oxygen, blood, blood derivatives and fees for blood replacement, and penile implant devices and procedures,except as described in Section X.E.5.,or unless covered through an Addendum to this Contract. 26. Outpatient nutritional and dietary services in the absence of a physiological disease condition. - 26 - >„ ;,,.t I i INDEX How to use this index: The Definitions are found in Section I.Specific topics are cross Rendered by Non-Participating Providers Section IX referenced for your convenience. Please refer to Section I, Rendered by Participating Providers Section IX Definitions (DEF) for specific information as related to the Skilled Nursing Facility Section X E. topic. (Example: Adoption; See Section I,Definition-Family Temporomandibular Joint Syndrome Section X E. Dependent.) Adoption Section II Indentification Card E.O.C. Def:Family Dependent • Limitation on Selection Provider Section IX Benefit Determination Rules Section IV Marriage Section II Clerical Error Section VIII Def:Family Dependent Complaint Process Section V Newborn Coverage , Section II Def:Family Dependent Conformity with Statutes Section VIII No Fault Coverage Section IV Continuation of Individual Coverage Section VI Non Discrimination Section VIII Contract Alterations Section VIII Notice to Contract Charges Section VII Enrolling Unit Section VIII Enrollees Section VIII Conversion Section VI Records Section VII Coordination of Benefits Section IV Reimbursement of Copayment Def:Copyament Eligible Expenses Section II Section II Copayment Section II Section III Section IX Relationship Between Parties Section VIII Section X-See Specific Health Services Right of Recovery Section IV Effective Date of Coverage Section II Second Opinion Policy Section IX Eligible Expenses Section II-Def. Subrogation Section IV Emergency Health Services Section IX Termination of Enrollment Section II Individual Coverage Section VI Contract Section VII Examination of Covered Person Section VIII Verbal Complaint Section V Grievance Section V Worker's Compensation Section VIII Health Services Ambulance Services Section X E. Written Complaint Section V Blood&Blood Products Section X E. Family Planning Section X C. Hemodialysis Section X E. Home Health Services Section X E. Hospital Services Section X B. Infertility Planning Section X C. Maternity Services Section X C. Mental Health Services Section X D. Obtaining Services Section IX Physician Services Section X A. Private Duty Nursing Section X E. Rehabilitation Services Section X E. - 27 - era", -),, As of August 1, 1992 the name of our health Lincoln National Health Plan of Color plan has changed to TakeCare of Colorado, Evidence of Coverage Inc., from Lincoln National Health Plan. Amendment I (Effective 01/01/92) Design I - 6729(10/91) Design III - 6910(10/91) Design IV - 6928(12/91) Design Va - 6752(10/91) Design VIa - 6753(10/91) Design IXa - 6754(10/91) Design X - 6730(10/91) This amendment replaces Sections II and III entirely and Section VI,Continuation Coverage,Part H: Continuation of Coverage Under State Law. Section II ENROLLMENT AND EFFECTIVE DATE OF INDIVIDUAL COVERAGE A. Enrollment Eligible Persons may enroll themselves and their Family Dependents in PLAN during the Initial Eligibility Period or during an Open Enrollment Period specified by PLAN by submitting application on a form provided or approved by PLAN. In addition, new Eligible Persons may be enrolled in PLAN within 31 days of the date on which they first become Eligible Persons, and new Family Dependents may be enrolled in PLAN within 31 days of the date on which they first become Family Dependents, except that Family Dependents who are newborn children are covered at the moment of birth. Except during the time periods set forth in this paragraph, Eligible Persons and/or Family Dependents may not enroll in PLAN without the express written authorization of PLAN and evidence of insurability. The Enrolling Unit shall notify PLAN in writing within sixty (60) days of the effective date of enrollments, terminations or other changes; provided, however,that the Enrolling Unit shall notify PLAN in writing each month of any changes in the Coverage classification of any Enrollee. B. Effective Date of Coverage Coverage for an Eligible Person and his or her Family Dependents, if any, is effective on the date specified by Enrolling Unit and PLAN, provided that PLAN receives a properly completed individual enrollment application that was submitted to PLAN according to the enrollment provisions of Section HA of the Contract; and provided, however, that: 1. No Coverage shall be effective until the Contract takes effect; 2. No Family Dependent shall be covered under the Contract until the Eligible Person is covered. 3. If an Enrollee acquires a new Family Dependent by reason of adoption or marriage, then Coverage for that Family Dependent shall take effect on the date that the new Family Dependent is adopted or married, if PLAN and Enrolling Unit is notified by the Enrollee of the adoption or marriage within thirty-one (31) days of occurrence; and any necessary adjustments to Health Services Fees have been made. 4. If an Enrollee acquires a new Family Dependent who is a newborn child,then Coverage for that Family Dependent shall take effect at the moment of birth and remain in effect for thirty-one (31) days beyond the date of birth. To continue Coverage for that Family Dependent,the Enrollee shall notify PLAN and Enrolling Unit of the newborn child's birth and the name; and make any necessary changes in the Coverage classification and Health Services Fees. 5. Health Services for medical conditions arising prior to the effective date of Coverage and resulting in Confinement are covered as of the effective date only if the Covered Person notifies PLAN of Confinement within forty-eight(48)hours of the effective date,or as soon thereafter as is reasonably possible, and if Health Services are received in accordance with the terms, conditions, exclusions and limitations of the Contract. in; -u, as Section III PROCEDURES FOR REIMBURSEMENT OF ELIGIBLE EXPENSES Reimbursement of Eligible Expenses PLAN shall reimburse for Eligible Expenses incurred with non-participating providers only for MEDICALLY NECESSARY EMERGENCY SERVICES OR SERVICES AUTHORIZED OR APPROVED BY PLAN in accordance with the terms of the Contract. Participating Providers are responsible for submitting written proof of loss for Eligible Expenses directly to PLAN on the Covered Person's behalf. In the event a Covered Person is billed by a Participating Provider for Eligible Expenses, the Covered Person should contact PLAN. Written proof of loss for services rendered by non-participating providers,satisfactory to PLAN,shall be furnished at PLAN's office within ninety(90) days after the date of such loss. Failure to furnish proof within the time required shall invalidate or reduce Coverage unless it was not reasonably possible to have given proof within ninety (90) days or, in the absence of legal capacity of the Covered Person, later than one (1) year from the time in which proof is otherwise required. All Eligible Expenses shall be paid within sixty (60) days of receipt by PLAN of proof of loss. Where applicable, Eligible Expenses shall be paid to the Enrollee. Subject to written authorization from an Enrollee, all or a portion of any Eligible Expenses due may be paid directly to the provider of the Health Services. Copayment Reimbursement PLAN shall reimburse for amounts of Copayment Charges paid by an Enrollee in any Contract Year that erread 200%of the total annual Health Services Fees paid to PLAN during the same period on behalf of the Enrollee through the Enrolling Unit. In those cases where the Enrollee has enrolled his or her Family Dependents with PLAN,PLAN shall reimburse for amounts of Copayment Charges paid by all Covered Persons in the family unit in any Contract Year that exceed 200% of the total annual Health Services Fees paid to PLAN through the Enrolling Unit during the same period. Written notice that excess amounts of Copayment Charges have been paid by the Enrollee or by all Covered Persons in the same family unit must be sent to PLAN. Such notice must (1) include proof satisfactory to PLAN of the payment of Copayment Charges, and (2) be provided to PLAN not later than ninety (90) days after the end of the Contract Year. The amount of any excess Copayment Charges will be paid within sixty(60) days of receipt of written notice by PLAN that excess Copayment Charges have been paid by Covered Persons. Limitation of Actions No action at law or in equity shall be brought to recover on the Contract by a Covered Person prior to the expiration of sixty (60) days after proof of loss has been filed in accordance with the requirements of the Contract, nor shall such action be brought at all unless brought within three (3) years after the time written proof of loss is required by the Contract. Section VI Part II: Continuation of Coverage Under State Law An Enrollee whose Coverage ends under the Contract may be entitled to elect continuation Coverage under state law, if the Enrolling Unit is not subject to the requirements of COBRA, or as an alternative to COBRA when both state law and COBRA apply. The Enrollee's Coverage must have ended due to termination of employment. The Enrollee shall not be entitled to continuation Coverage under state law if: a. Health Services Fees for Coverage up to the termination date have not been paid by or on behalf of the Enrollee; or b. the Enrollee has not been continuously covered under the Contract, or under any coverage plan providing similar coverage which the contract replaced, for at least six (6) months immediately prior to termination from employment; or c. the Enrollee is covered by Medicare of Medicaid; or d. the entire Contract is discontinued. The Enrollee must elect continuation Coverage and pay Health Services Fees due within twenty (20) days from the date of termination from employment. Continuation of Coverage under state law will end after a period of ninety(90)days after the date Coverage would have ended, or until the Enrollee is reemployed,whichever occurs first. At the end of the ninety(90) day continuation period under state law, the Enrollee or the Enrolled Family Dependents are entitled to conversion privileges as described below. Coverage may be continued for enrollees working 40 hours or more when the working hours are reduced to less than 30 hours because of economic conditions. Coverage may also be continued for such enrollees enrolled family dependents. Coverage may be continued provided: 1. the enrollee has been continuously covered under the Contract,or under any coverage plan providing similar coverage which the Contract replaced, for at least six (6) months immediately prior to the reduction in working hours; 2. the enrolling unit has imposed the reduction in hours due to economic conditions; 3. the enrolling unit intends to restore the enrollee to a full 40 hour work schedule as soon as economic conditions improve; and 4. the applicable Health services Fees are paid. INDEX How to use this index: The Definitions are found in Section I.Specific topics are cross Rendered by Non-Participating Providers Section IX referenced for your convenience. Please refer to Section I. Rendered by Participating Providers Section IX Definitions (DEF) for specific information as related to the Skilled Nursing Facility Section X E. topic. (Example: Adoption:See Section I,Definition-Family Temporomardibular Joint Syndrome Section X E. Dependent) Adoption Section II Indentification Card E.O.C. Dee Family Dependent Limitation on Selection Provider Section IX Benefit Determination Rules Section IV Marriage Section II Clerical Error Section VIII Del:Family Dependent Complaint Process Section V Newborn Coverage Section II Deft Family Dependent Conformity with Statutes Section VIII No Fault Coverage Section IV Continuation of Individual Coverage Section VI Non Discrimination Section VIII Contract Alterations Section VIII Notice to Contract Charges Section VII Enrolling Unit Section VIII Enrollees Section VIII Conversion Section VI Section ection Coordination of Benefits Section IV Reimbursement of Section II Copayment Oct Copyament figible Espana Section II Section II ��t Section III Section VIII Section IX Relationship Between Parties Section X-See Specific Section IV Health Services Right of Recovery Effective Date of Coverage Section II Second Opinion Policy Section DC Eligible Expenses Section II-Def. Section IV Subrogation Emergency Health Services Section DC Termination of Section VI Enrollment Section II Individual Coverage Section VII Contract Examination of Covered-Person Section VIII Verbal Complaint Section V Grievance Section V Section VIII Worker's Compensation Health Services Ambulance Services Section X E. Written Complaint Section V Blood&Blood Products Section X E. Family Planning Section X C. Hemodialysis Section X E. Home Health Services Section X E. Hospital Services Section X B. Infertility Planning Section X C. Maternity Services Section X C. Mental Health Services Section X D. Obtaining Services Section IX Physician Services Sedan X A. Private Duty Nursing Section X E. Rehabilitation Services Section X E. Sil, , -27 - is of August 1, 1992 the name of our healt plan has changed to TakeCare of Colorado, Inc., from Lincoln National Health Plan. Lincoin iNattonal health Plan of Colorado Master Group Contract Amendment I (Effective 01/01/92) Design I - 6729(10/91) Design III - 6910(10/91) Design IV - 6928(12/91) Design Va - 6752(10/91) Design VIa - 6753(10/91) Design IXa - 6754(10/91) Design X - 6730(10/91) This amendment replaces Section VI, Continuation Coverage, Part II: Continuation of Coverage Under State Law. Part II: Continuation of Coverage Under State Law An Enrollee whose Coverage ends under the Contract may be entitled to elect continuation Coverage under state law, if the Enrolling Unit is not subject to the requirements of COBRA, or as an alternative to COBRA when both state law and COBRA apply. The Enrollee's Coverage must have ended due to termination of employment. The Enrollee shall not be entitled to continuation Coverage under state law if: a. Health Services Fees for Coverage up to the termination date have not been paid by or on behalf of the Enrollee; or b. the Enrollee has not been continuously covered under the Contract, or under any coverage plan providing similar coverage which the contract replaced, for at least six (6) months immediately prior to termination from employment; or c. the Enrollee is covered by Medicare of Medicaid; or d. the entire Contract is discontinued. The Enrollee must elect continuation Coverage and pay Health Services Fees due within twenty (20) days from the date of termination from employment. Continuation of Coverage under state law will end after a period of ninety(90)days after the date Coverage would have ended, or until the Enrollee is reemployed,whichever occurs first. At the end of the ninety(90) day continuation period under state law, the Enrollee or the Enrolled Family Dependents are entitled to conversion privileges as described below. Coverage may be continued for enrollees working 40 hours or more when the working hours are reduced to less than 30 hours because of economic conditions. Coverage may also be continued for such enrollees enrolled family dependents. Coverage may be continued provided: 1. the enrollee has been continuously covered under the Contract,or under any coverage plan providing similar coverage which the Contract replaced, for at least six (6) months immediately prior to the reduction in working hours; 2. the enrolling unit has imposed the reduction in hours due to economic conditions; 3. the enrolling unit intends to restore the enrollee to a full 40 hour work schedule as soon as economic conditions improve; and 4. the applicable Health services Fees are paid. Hello