13 Termination ................................ ................................ ................................ ................................ ................ 98 Removal of Members ................................ ................................ ................................ ................................ 98 Continuation of Coverage Under Federal Law (COBRA) ................................ ................................ .......... 98 Qualifying events for Continuation Coverage under Federal Law (COBRA) ................................ ......... 99 If Your Employer Offers Retirement Coverage ................................ ................................ .................... 100 Second qualifying event ................................ ................................ ................................ ....................... 100 Notification Requirements ................................ ................................ ................................ .................... 100 Disability extension of 18 - month period of continuation coverage ................................ ...................... 100 Trade Adjustment Act Eligible Individual ................................ ................................ ............................. 101 When COBRA Coverage Ends ................................ ................................ ................................ ............ 101 Other coverage options besides COBRA Continuation Coverage ................................ ...................... 101 If You Have Questions ................................ ................................ ................................ ......................... 101 Continuation of Coverage Due To Military Service ................................ ................................ ................. 101 Maximum Period of Coverage During a Military Leave ................................ ................................ ....... 102 Reinstatement of Coverage Following a Military Leave ................................ ................................ ...... 102 Family and Medical Leave Act of 1993 ................................ ................................ ................................ ... 103 General Provisions ................................ ................................ ................................ ................................ .. 104 Care Coordination ................................ ................................ ................................ ................................ ... 104 Clerical Error ................................ ................................ ................................ ................................ ............ 104 Confidentiality and Release of Information ................................ ................................ .............................. 104 Conformity with Law ................................ ................................ ................................ ................................ 104 Contract with Anthem ................................ ................................ ................................ .............................. 104 Employer’s Sole Discretion ................................ ................................ ................................ ...................... 105 Form or Content of Booklet ................................ ................................ ................................ ..................... 105 Government Programs ................................ ................................ ................................ ............................ 105 Medical Policy and Technology Assessment ................................ ................................ .......................... 105 Medicare ................................ ................................ ................................ ................................ .................. 106 Member Rights and Responsibilities ................................ ................................ ................................ ....... 106 Modifications ................................ ................................ ................................ ................................ ............ 106 Not Liable for Provider Acts or Omissions ................................ ................................ ............................... 106 Payment Innovation Programs ................................ ................................ ................................ ................ 106 Policies, Procedures and Pilot Programs ................................ ................................ ................................ 107 Program Incentives ................................ ................................ ................................ ................................ .. 107 Relationship of Parties (Employer - Member - Anthem) ................................ ................................ .............. 108 Relationship of Parties (Anthem and In - Network Providers) ................................ ................................ ... 108 Reservation of Discretionary Authority ................................ ................................ ................................ .... 108 Right of Recovery and Adjustment ................................ ................................ ................................ .......... 108 Unauthorized Use of Identification Card ................................ ................................ ................................ .. 109 Value - Added Programs ................................ ................................ ................................ ........................... 109 Value of Covered Services ................................ ................................ ................................ ...................... 109 Voluntary Clinical Quality Programs ................................ ................................ ................................ ........ 109 Voluntary Wellness Incentive Programs ................................ ................................ ................................ .. 109 Waiver ................................ ................................ ................................ ................................ ...................... 110 Workers’ Compensation ................................ ................................ ................................ .......................... 110 Definitions ................................ ................................ ................................ ................................ ................ 111

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