109 Definitions If a word or phrase in this Booklet has a special meaning, such as Medical Necessity or Experimental / Investigational, it will start with a capital letter, and be defined below. If you have questions on any of these definitions, please call Member Services at the number on the back of your Identification Card. Accidental Injury An unexpected Injury for which you need Covered Services while enrolled in this Plan. It does not include injuries that you get benefits for under any Workers’ Compensation, Employer’s liability or similar law. Ambulatory Surgery Center A facility licensed as an Ambulatory Surgery Center as required by law that must satisfy our accreditation requirements and be approved by us. Approved In-Network Provider Please see the “Human Organ and Tissue Transplant (Bone Marrow / Stem Cell), Cellular and Gene Therapy Services” benefit in the “What’s Covered” section. Athletic Trainer Please see the “Athletic Trainer Services” benefit in the “What’s Covered” section for details. Administrative Services Agreement The agreement between the Claims Administrator and the Employer regarding the administration of certain elements of the health care benefits of the Employer's Group Health Plan. Benefit Period The length of time the Plan will cover benefits for Covered Services. For Calendar Year plans, the Benefit Period starts on January 1st and ends on December 31st. For Plan Year plans, the Benefit Period starts on your Employer’s effective or renewal date and lasts for 12 months. (See your Employer for details.) The Schedule of Benefits shows if your Plan’s Benefit Period is a Calendar Year or a Plan Year. If your coverage ends before the end of the year, then your Benefit Period also ends. Benefit Period Maximum The most the Plan will cover for a Covered Service during a Benefit Period. Biomarker A characteristic that is measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention, including but not limited to: • Known gene-drug interaction for medications being considered for use or already being administered; and • Gene mutations and protein expression.