11 Removal of Members ................................ ................................ ................................ .............................. 99 Continuation of Coverage Under Federal Law (COBRA) ................................ ................................ ...... 100 Qualifying events for Continuation Coverage under Federal Law (COBRA) ................................ ..... 100 If Your Employer Offers Retirement Coverage ................................ ................................ .................. 101 Second qualifying event ................................ ................................ ................................ ..................... 101 Notification Requirements ................................ ................................ ................................ .................. 101 Disability extension of 18 - month period of continuation coverage ................................ .................... 102 Trade Adjustment Act Eligible Individual ................................ ................................ ........................... 102 When COBRA Coverage Ends ................................ ................................ ................................ .......... 102 Other coverage options besides COBRA Continuation Coverage ................................ .................... 102 If You Have Questions ................................ ................................ ................................ ....................... 102 Continuation of Coverage Due To Military Service ................................ ................................ ............... 103 Maximum Period of Coverage During a Military Leave ................................ ................................ ..... 103 Reinstatement of Coverage Following a Military Leave ................................ ................................ .... 103 Family and Medical Leave Act of 1993 ................................ ................................ ................................ . 104 General Provisions ................................ ................................ ................................ ................................ . 105 Care Coordination ................................ ................................ ................................ ................................ . 105 Clerical Error ................................ ................................ ................................ ................................ .......... 105 Confidentiality and Release of Information ................................ ................................ ............................ 105 Conformity with Law ................................ ................................ ................................ .............................. 105 Contract with Anthem ................................ ................................ ................................ ............................ 105 Employer’s Sole Discretion ................................ ................................ ................................ .................... 106 Form or Content of Booklet ................................ ................................ ................................ ................... 106 Government Programs ................................ ................................ ................................ .......................... 106 Medical Policy and Technology Assessment ................................ ................................ ........................ 106 Medicare ................................ ................................ ................................ ................................ ................ 106 Member Rights and Responsibilities ................................ ................................ ................................ ..... 107 Modifications ................................ ................................ ................................ ................................ .......... 107 Not Liable for Provider Acts or Omissions ................................ ................................ ............................. 107 Payment Innovation Programs ................................ ................................ ................................ .............. 107 Policies, Procedures and Pilot Programs ................................ ................................ .............................. 108 Program Incentives ................................ ................................ ................................ ................................ 108 Protected Health Information Under HIPAA ................................ ................................ .......................... 108 Relationship of Parties (Employer - Member - Anthem) ................................ ................................ ............ 108 Relationship of Parties (Anthem and In - Network Providers) ................................ ................................ . 109 Reservation of Discretionary Authority ................................ ................................ ................................ .. 109 Right of Recovery and Adjustment ................................ ................................ ................................ ........ 109 Unauthorized Use of Identification Card ................................ ................................ ................................ 109 Value - Added Programs ................................ ................................ ................................ ......................... 110 Value of Covered Services ................................ ................................ ................................ .................... 110 Voluntary Clinical Quality Programs ................................ ................................ ................................ ...... 110 Voluntary Wellness Incentive Programs ................................ ................................ ................................ 110 Waiver ................................ ................................ ................................ ................................ .................... 110 Workers’ Compensation ................................ ................................ ................................ ........................ 111 Definitions ................................ ................................ ................................ ................................ ................ 112