This continuity of care provision applies when our contract with a Participating Provider terminates or when a physician’s employment with Medical Group terminates, except when the termination is for cause (including quality of care issues) or because the Participating Provider:  Has retired.  Has died.  No longer holds an active license.  Has moved outside our Service Area.  Has gone on sabbatical.  Is prevented from continuing to care for patients because of other circumstances. If we directly or indirectly terminate the contract with Medical Group and/or any other primary care Participating Provider while your Plan is in effect and while you are under the care of the provider, we will notify you. We will retain financial responsibility for covered Services by that provider, in excess of any applicable Cost Share, for 90 days following the notice of termination to you. Additionally, if we directly or indirectly terminate the contract with Medical Group and/or any Participating Provider who is a Specialist, while your Plan is in effect and while you are under the care of the provider, we will notify you. We will retain financial responsibility for covered Services by that provider until we can make arrangements for the Services to be provided by another Participating Provider. Receiving Care in Another Kaiser Foundation Health Plan Service Area You may receive covered Services from another Kaiser Foundation Health Plan, if the Services are provided, prescribed, or directed by that other plan, and if the Services would have been covered under this EOC. Covered Services are subject to the terms and conditions of this EOC, including prior authorization requirements, the applicable Cost Share shown in the “Benefit Summary” and “Benefit Details,” and the exclusions, limitations and reductions described in this EOC. For more information about receiving care in other Kaiser Foundation Health Plan service areas, including availability of Services, and provider and facility locations, please call our Away from Home Travel Line at 951-268-3900. Information is also available online at kp.org/travel. POST SERVICE CLAIMS – SERVICES ALREADY RECEIVED In general, if you have a medical or pharmacy bill from a Non-Participating Provider, Non-Participating Facility, or non-participating pharmacy our Claims Administration Department will handle the claim. Member Services can assist you with questions about specific claims or about the claim procedures in general. If you receive Services from a Non-Participating Provider following an authorized referral from a Participating Provider, the Non-Participating Provider will send the bill to Claims Administration directly. You are not required to file a claim. If you receive Services from a Non-Participating Provider or Non-Participating Facility without an authorized , or from a pharmacy that is not a Participating Pharmacy, referral and you believe Kaiser should cover the Services, you need to send a completed medical claim form and the itemized bill to: Kaiser Permanente National Claims Administration - Northwest PO Box 370050 Denver, CO 80237-9998 EWCLGHDHP1983ACT0124 35 WAPEBB-CD-ACT