11 Members Covered Under the Employer’s Prior Plan...........................................................................93 Enrolling Dependent Children .................................................................................................................93 Newborn Children ................................................................................................................................93 Adopted Children .................................................................................................................................94 Adding a Child due to Award of Legal Custody or Guardianship ........................................................94 Qualified Medical Child Support Order ................................................................................................94 Updating Coverage and/or Removing Dependents ................................................................................95 Nondiscrimination ....................................................................................................................................95 Statements and Forms ............................................................................................................................95 Termination and Continuation of Coverage ...........................................................................................96 Termination..............................................................................................................................................96 Removal of Members ..............................................................................................................................96 Continuation of Coverage Under Federal Law (COBRA)........................................................................97 Qualifying events for Continuation Coverage under Federal Law (COBRA).......................................97 If Your Employer Offers Retirement Coverage....................................................................................98 Second qualifying event.......................................................................................................................98 Notification Requirements....................................................................................................................98 Disability extension of 18-month period of continuation coverage ......................................................99 Trade Adjustment Act Eligible Individual .............................................................................................99 When COBRA Coverage Ends............................................................................................................99 Other coverage options besides COBRA Continuation Coverage ......................................................99 If You Have Questions.........................................................................................................................99 Indiana Public Employee Continuation of Coverage.............................................................................100 Continuation of Coverage Due To Military Service ...............................................................................100 Maximum Period of Coverage During a Military Leave .....................................................................100 Reinstatement of Coverage Following a Military Leave ....................................................................100 Family and Medical Leave Act of 1993 .................................................................................................101 General Provisions .................................................................................................................................102 Care Coordination .................................................................................................................................102 Clerical Error..........................................................................................................................................102 Confidentiality and Release of Information............................................................................................102 Conformity with Law ..............................................................................................................................102 Contract with Anthem ............................................................................................................................102 Employer’s Sole Discretion....................................................................................................................103 Form or Content of Booklet ...................................................................................................................103 Government Programs ..........................................................................................................................103 Medical Policy and Technology Assessment ........................................................................................103 Medicare................................................................................................................................................103 Member Rights and Responsibilities .....................................................................................................104 Modifications..........................................................................................................................................104 Not Liable for Provider Acts or Omissions.............................................................................................104 Payment Innovation Programs ..............................................................................................................104 Policies, Procedures and Pilot Programs ..............................................................................................105 Program Incentives................................................................................................................................105 Relationship of Parties (Employer-Member-Anthem)............................................................................105 Relationship of Parties (Anthem and Participating Providers) ..............................................................106 Reservation of Discretionary Authority ..................................................................................................106 Right of Recovery and Adjustment........................................................................................................106 Unauthorized Use of Identification Card................................................................................................107 Value-Added Programs .........................................................................................................................107 Value of Covered Services....................................................................................................................107 Voluntary Clinical Quality Programs......................................................................................................107 Voluntary Wellness Incentive Programs................................................................................................107 Waiver....................................................................................................................................................108 Workers’ Compensation ........................................................................................................................108