95 Statements and Forms All Members must complete and submit applications or other forms or statements that the Employer may reasonably request. Any rights to benefits under this Plan are subject to the condition that all such information is true, correct, and complete. Any material misrepresentation by you may result in termination of coverage as provided in the "Termination and Continuation of Coverage" section. The Plan will not use a statement made by you to void your coverage after that coverage has been in effect for two years. This does not apply, however, to fraudulent misstatements.

Anthem Blue Access PPO HSA Option E6 IN PPO Large 96R6 01 01 2025 L12026MR02 L12026 English EOC CY - Page 96 Anthem Blue Access PPO HSA Option E6 IN PPO Large 96R6 01 01 2025 L12026MR02 L12026 English EOC CY Page 95 Page 97