R95-141 AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGE

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• XVII. DEFINITIONS A. "Claim" means notification in a form acceptable to the Claim Administrator that service has been rendered or furnished to a Covered Person. This notification must set forth in full the de- tails of such service including, but not limited to,the Covered Person's name,age,sex and iden- tification number, the name and address of the Provider, a specific itemized statement of the service rendered or furnished, the date of service, applicable diagnosis and the Claim Charge for such service. B. "Claim Charge"means the amount which appears on a Claim as the Provider's regular charge for service rendered to a patient,without further adjustment or reduction and irrespective of any separate financial arrangement between the Claim Administrator and the particular Provider. (See provisions of this Agreement regarding"CLAIM ADMINISTRATOR'S SEPARATE FINAN- CIAL ARRANGEMENTS WITH PROVIDERS.") C. "Claim Payment" means the benefit provided by the Claim Administrator, upon submission of a Claim, in accordance with the benefits specified in the Plan. All Claim Payments shall be calculated on the basis of the Provider's Eligible Charge for Covered Services rendered to the Covered Person, irrespective of any separate financial arrangement between the Claim Admin- istrator and the particular Provider. (See provisions of this Agreement regarding "CLAIM AD- MINISTRATOR'S SEPARATE FINANCIAL ARRANGEMENTS WITH PROVIDERS.") D. "Coinsurance"means a percentage of an eligible expense that you are required to pay toward a Covered Service. E. "Covered Employee" means the person to whom coverage under the Plan has been ex- tended by the Employer and to whom the Claim Administrator has directly or indirectly issued � an identification card bearing the number of the Employer. For purposes of providing benefits under the Plan, Covered Employee does not mean any person who has selected Medicare as his/her primary coverage. F. "Covered Person" means the Covered Employee and such employee's legal spouse and/or unmarried dependent children as specified in the Plan. G. "Covered Service" means a service or supply specified in the Plan for which benefits will be provided. H. "Inpatient" means the Covered Person is a registered bed patient and treated as such in a health care facility. I. "Provider"means any health care facility,person or entity duly licensed to render Covered Ser- vices to a Covered Person. J. "Provider's Eligible Charge" means (a) in the case of a Provider which has a written agree- ment with the Claim Administrator to provide care to Covered Persons at the time Covered Ser- vices are rendered, such Provider's Claim Charge for Covered Services and (b) in the case of a Provider which does not have a written agreement with the Claim Administrator to provide care to Covered Persons at the time Covered Services are rendered, such Provider's Claim Charge for Covered Services, not to exceed the reasonable charge therefor as reasonably de- termined by the Claim Administrator. XVIII. NOTICE OF ANNUAL MEETING The Employer is hereby notified that it is a Member of Health Care Service Corporation, a Mutual Legal Reserve Company, and is entitled to vote either in person, by its designated representative, � or by proxy at all meetings of said Company. The annual meeting is held at its principal office at 233 North Michigan Avenue, Chicago, Illinois each year on the last Tuesday in October at 12:30 p.m. - 10 -