109 General Provisions Care Coordination Anthem, as the Claims Administrator, pays In-Network Providers in various ways to provide Covered Services to you. For example, sometimes Anthem may pay In-Network Providers a separate amount for each Covered Service they provide. Anthem may also pay them one amount for all Covered Services related to treatment of a medical condition. Other times, Anthem may pay a periodic, fixed pre- determined amount to cover the costs of Covered Services. In addition, Anthem may pay In-Network Providers financial incentives or other amounts to help improve quality of care and/or promote the delivery of health care services in a cost-efficient manner, or compensate In-Network Providers for coordination of Member care. In some instances, In-Network Providers may be required to make payment to us because they did not meet certain standards. You do not share in any payments made by In-Network Providers to Anthem under these programs. Circumstances Beyond the Control of the Plan If circumstances arise that are beyond the control of the Plan, the Plan will make a good-faith effort to ensure Covered Services are available to you. Circumstances that may occur, but are not within the control of the Plan, include but are not limited to, a major disaster, epidemic, war, when health care services covered under this Certificate are delayed or rendered impractical, or other events beyond our control. Under such circumstances, We will not be responsible for any delay or failure to give services due to lack of available Facilities or staff. Clerical Error A clerical error will never disturb or affect your coverage, as long as your coverage is valid under the rules of the Plan. This rule applies to any clerical error, regardless of whether it was the fault of the Employer or us. Confidentiality and Release of Information Applicable state and federal law requires the Claims Administrator to undertake efforts to safeguard your medical information. For informational purposes only, please be advised that a statement describing the Claims Administrator’s policies and procedures regarding the protection, use and disclosure of your medical information is available on the Claims Administrator’s website and can be furnished to you upon request by contacting the Claims Administrator’s Member Services department. Obligations that arise under state and federal law and policies and procedures relating to privacy that are referenced but not included in this Booklet are not part of the contract between the parties and do not give rise to contractual obligations. Conformity with Law Any term of the Plan which is in conflict with federal law, will hereby be automatically amended to conform with the minimum requirements of such laws. Contract with Anthem