112 Definitions If a word or phrase in this Booklet has a special meaning, such as Medical Necessity or Experimental / Investigational, it will start with a capital letter, and be defined below. If you have questions on any of these definitions, please call Member Servic es at the number on the back of your Identification Card. Accidental Injury An unexpected Injury for which you need Covered Services while enrolled in this Plan. It does not include injuries that you get benefits for under any Workers’ Compensation, Employer’s liability or similar law. Ambulatory Surgery Center A facility licensed as an Ambulatory Surgery Center as required by law that must satisfy our accreditation requirements and be approved by us. Approved In - Network Provider Please see the “ Human Organ and Tissue Transplant (Bone Marrow / Stem Cell), Cellular and Gene Therapy Services” benefit in the “What’s Covered” section. Athletic Trainer Please see the “Athletic Trainer Services” benefit in the “ What’s Covered ” section for details. Administrative Services Agreement The agreement between the Claims Administrator and the Employer regarding the administration of certain elements of the health care benefits of the Employer's Group Health Plan. Authorized Service(s) A Covered Service you get from an Out - of - Network Provider that we, on behalf of the Employer, have agreed to cover at the In - Network level. You will have to pay any In - Network Deductible, Coinsurance, and/or Copayment(s) that apply, and may also have to pay the difference between the Maximum Allowed Amount and the Out - of - Network Provider’s charge unless your claim is a Surprise Billing Claim . Please see the “ Claims Payment ” section as well as the “Consolidated Appropriations Act of 2021 Notice” at the front of this Booklet for more details. Benefit Period The length of time the Plan will cover benefits for Covered Services. For Calendar Year plans, the Benefit Period starts on January 1 st and ends on December 31 st . For Plan Year plans, the Benefit Period starts on your Employer’s effective or renewal date and lasts for 12 months. (See your Employer for details.) The Schedule of Benefits shows if your Plan’s Benefit Period is a Calendar Year or a Plan Year. If y our coverage ends before the end of the year, then your Benefit Period also ends. Benefit Period Maximum The most the Plan will cover for a Covered Service during a Benefit Period. Biomarker A characteristic that is measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacologic responses to a specific therapeutic intervention, including but not limited to: