13 Removal of Members ................................ ................................ ................................ ................................ 97 Continuation of Coverage Under Federal Law (COBRA) ................................ ................................ .......... 97 Qualifying events for Continuation Coverage under Federal Law (COBRA) ................................ ......... 98 If Your Employer Offers Retirement Coverage ................................ ................................ ...................... 99 Second qualifying event ................................ ................................ ................................ ......................... 99 Notification Requirements ................................ ................................ ................................ ...................... 99 Disability extension of 18 - month period of continuation coverage ................................ ........................ 99 Trade Adjustment Act Eligible Individual ................................ ................................ ............................. 100 When COBRA Coverage Ends ................................ ................................ ................................ ............ 100 Other coverage options besides COBRA Continuation Coverage ................................ ...................... 100 If You Have Questions ................................ ................................ ................................ ......................... 100 Continuation of Coverage Due To Military Service ................................ ................................ ................. 100 Maximum Period of Coverage During a Military Leave ................................ ................................ ....... 101 Reinstatement of Coverage Following a Military Leave ................................ ................................ ...... 101 Family and Medical Leave Act of 1993 ................................ ................................ ................................ ... 102 General Provisions ................................ ................................ ................................ ................................ .. 103 Care Coordination ................................ ................................ ................................ ................................ ... 103 Clerical Error ................................ ................................ ................................ ................................ ............ 103 Confidentiality and Release of Information ................................ ................................ .............................. 103 Conformity with Law ................................ ................................ ................................ ................................ 103 Contract with Anthem ................................ ................................ ................................ .............................. 103 Employer’s Sole Discretion ................................ ................................ ................................ ...................... 104 Form or Content of Booklet ................................ ................................ ................................ ..................... 104 Government Programs ................................ ................................ ................................ ............................ 104 Medical Policy and Technology Assessment ................................ ................................ .......................... 104 Medicare ................................ ................................ ................................ ................................ .................. 105 Member Rights and Responsibilities ................................ ................................ ................................ ....... 105 Modifications ................................ ................................ ................................ ................................ ............ 105 Not Liable for Provider Acts or Omissions ................................ ................................ ............................... 105 Payment Innovation Programs ................................ ................................ ................................ ................ 105 Policies, Procedures and Pilot Programs ................................ ................................ ................................ 106 Program Incentives ................................ ................................ ................................ ................................ .. 106 Relationship of Parties (Employer - Member - Anthem) ................................ ................................ .............. 107 Relationship of Parties (Anthem and In - Network Providers) ................................ ................................ ... 107 Reservation of Discretionary Authority ................................ ................................ ................................ .... 107 Right of Recovery and Adjustment ................................ ................................ ................................ .......... 107 Unauthorized Use of Identification Card ................................ ................................ ................................ .. 108 Value - Added Programs ................................ ................................ ................................ ........................... 108 Value of Covered Services ................................ ................................ ................................ ...................... 108 Voluntary Clinical Quality Programs ................................ ................................ ................................ ........ 108 Voluntary Wellness Incentive Programs ................................ ................................ ................................ .. 108 Waiver ................................ ................................ ................................ ................................ ...................... 109 Workers’ Compensation ................................ ................................ ................................ .......................... 109 Definitions ................................ ................................ ................................ ................................ ................ 110