11 Removal of Members ............................................................................................................................102 Continuation of Coverage Under Federal Law (COBRA)......................................................................103 Qualifying events for Continuation Coverage under Federal Law (COBRA).....................................103 If Your Employer Offers Retirement Coverage..................................................................................104 Second qualifying event.....................................................................................................................104 Notification Requirements..................................................................................................................104 Disability extension of 18-month period of continuation coverage ....................................................105 Trade Adjustment Act Eligible Individual ...........................................................................................105 When COBRA Coverage Ends..........................................................................................................105 Other coverage options besides COBRA Continuation Coverage ....................................................105 If You Have Questions.......................................................................................................................105 Continuation of Coverage Due To Military Service ...............................................................................106 Maximum Period of Coverage During a Military Leave .....................................................................106 Reinstatement of Coverage Following a Military Leave ....................................................................106 Family and Medical Leave Act of 1993 .................................................................................................108 General Provisions .................................................................................................................................109 Care Coordination .................................................................................................................................109 Clerical Error..........................................................................................................................................109 Confidentiality and Release of Information............................................................................................109 Conformity with Law ..............................................................................................................................109 Contract with Anthem ............................................................................................................................109 Employer’s Sole Discretion....................................................................................................................110 Form or Content of Booklet ...................................................................................................................110 Government Programs ..........................................................................................................................110 Medical Policy and Technology Assessment ........................................................................................110 Medicare................................................................................................................................................110 Member Rights and Responsibilities .....................................................................................................111 Modifications..........................................................................................................................................111 Not Liable for Provider Acts or Omissions.............................................................................................111 Payment Innovation Programs ..............................................................................................................111 Policies, Procedures and Pilot Programs ..............................................................................................112 Program Incentives................................................................................................................................112 Protected Health Information Under HIPAA..........................................................................................112 Relationship of Parties (Employer-Member-Anthem)............................................................................112 Relationship of Parties (Anthem and In-Network Providers).................................................................113 Reservation of Discretionary Authority ..................................................................................................113 Right of Recovery and Adjustment........................................................................................................113 Unauthorized Use of Identification Card................................................................................................113 Value-Added Programs .........................................................................................................................114 Value of Covered Services....................................................................................................................114 Voluntary Clinical Quality Programs......................................................................................................114 Voluntary Wellness Incentive Programs................................................................................................114 Waiver....................................................................................................................................................114 Workers’ Compensation ........................................................................................................................115 Definitions................................................................................................................................................116