113 Eligibility and Enrollment – Adding Members” section and who has enrolled in the Plan. Doctor See the definition of “Physician.” Effective Date The date your coverage begins under this Plan. Emergency (Emergency Medical Condition) Please see the "What’s Covered" section. Emergency Care Please see the "What’s Covered" section. Employee A person who is engaged in active employment with the Employer and is eligible for Plan coverage under the employment rules of the Employer. The Employee is also called the Subscriber. Employer An Employer who has allowed its Employees to participate in the Plan by acting as the Plan Sponsor or adopting the Plan as a participating Employer by executing a formal document that so provides. The Employer or other organization has an Administrative Services Agreement with the Claims Administrator to administer this Plan. Excluded Services (Exclusion) Health care services your Plan doesn’t cover. Experimental or Investigational (Experimental / Investigational) Any Drug, biologic, device, Diagnostic, product, equipment, procedure, treatment, service, or supply used in or directly related to the diagnosis, evaluation, or treatment of a disease, injury, illness, or other health condition which the Claims Administrator determines to be unproven. For how this is determined, see the “What’s Not Covered” section. Facility A facility including but not limited to, a Hospital, freestanding Ambulatory Surgery Center, Residential Treatment Center, Skilled Nursing Facility, as defined in this Booklet. The Facility must be licensed as required by law, satisfy our accreditation requirements, and be approved by us. Fee(s) The amount you must pay to be covered by this Plan. Home Health Care Agency