13 Termination ................................ ................................ ................................ ................................ .............. 100 Removal of Members ................................ ................................ ................................ .............................. 100 Continuation of Coverage Under Federal Law (COBRA) ................................ ................................ ........ 100 Qualifying events for Continuation Coverage under Federal Law (COBRA) ................................ ....... 101 If Your Employer Offers Retirement Coverage ................................ ................................ .................... 102 Second qualifying event ................................ ................................ ................................ ....................... 102 Notification Requirements ................................ ................................ ................................ .................... 102 Disability extension of 18 - month period of continuation coverage ................................ ...................... 102 Trade Adjustment Act Eligible Individual ................................ ................................ ............................. 103 When COBRA Coverage Ends ................................ ................................ ................................ ............ 103 Other coverage options besides COBRA Continuation Coverage ................................ ...................... 103 If You Have Questions ................................ ................................ ................................ ......................... 103 Continuation of Coverage Due To Military Service ................................ ................................ ................. 103 Maximum Period of Coverage During a Military Leave ................................ ................................ ....... 104 Reinstatement of Coverage Following a Military Leave ................................ ................................ ...... 104 Family and Medical Leave Act of 1993 ................................ ................................ ................................ ... 105 General Provisions ................................ ................................ ................................ ................................ .. 106 Care Coordination ................................ ................................ ................................ ................................ ... 106 Clerical Error ................................ ................................ ................................ ................................ ............ 106 Confidentiality and Release of Information ................................ ................................ .............................. 106 Conformity with Law ................................ ................................ ................................ ................................ 106 Contract with Anthem ................................ ................................ ................................ .............................. 106 Employer’s Sole Discretion ................................ ................................ ................................ ...................... 107 Form or Content of Booklet ................................ ................................ ................................ ..................... 107 Government Programs ................................ ................................ ................................ ............................ 107 Medical Policy and Technology Assessment ................................ ................................ .......................... 107 Medicare ................................ ................................ ................................ ................................ .................. 108 Member Rights and Responsibilities ................................ ................................ ................................ ....... 108 Modifications ................................ ................................ ................................ ................................ ............ 108 Not Liable for Provider Acts or Omissions ................................ ................................ ............................... 108 Payment Innovation Programs ................................ ................................ ................................ ................ 108 Policies, Procedures and Pilot Programs ................................ ................................ ................................ 109 Program Incentives ................................ ................................ ................................ ................................ .. 109 Relationship of Parties (Employer - Member - Anthem) ................................ ................................ .............. 110 Relationship of Parties (Anthem and In - Network Providers) ................................ ................................ ... 110 Reservation of Discretionary Authority ................................ ................................ ................................ .... 110 Right of Recovery and Adjustment ................................ ................................ ................................ .......... 110 Unauthorized Use of Identification Card ................................ ................................ ................................ .. 111 Value - Added Programs ................................ ................................ ................................ ........................... 111 Value of Covered Services ................................ ................................ ................................ ...................... 111 Voluntary Clinical Quality Programs ................................ ................................ ................................ ........ 111 Voluntary Wellness Incentive Programs ................................ ................................ ................................ .. 111 Waiver ................................ ................................ ................................ ................................ ...................... 112 Workers’ Compensation ................................ ................................ ................................ .......................... 112 Definitions ................................ ................................ ................................ ................................ ................ 113