 The Member receives the Service at a facility accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). 6. Services Provided in Connection with Clinical Trials We cover Services you receive in connection with a clinical trial if all of the following conditions are met:  We would have covered the Services if they were not related to a clinical trial.  You are eligible to participate in the clinical trial according to the trial protocol with respect to treatment of cancer or other life-threatening condition (a condition from which the likelihood of death is probable unless the course of the condition is interrupted), as determined in one of the following ways: • A Participating Provider makes this determination. • You provide us with medical and scientific information establishing this determination. • If any Participating Providers participate in the clinical trial and will accept you as a participant in the clinical trial, you must participate in the clinical trial through a Participating Provider unless the clinical trial is outside the state where you live.  The clinical trial is a phase I, phase II, phase III, or phase IV clinical trial related to the prevention, detection, or treatment of cancer or other life-threatening condition and it meets one of the following requirements: • The study or investigation is conducted under an investigational new drug application reviewed by the U.S. Food and Drug Administration (FDA). • The study or investigation is a drug trial that is exempt from having an investigational new drug application. • The study or investigation is approved or funded by at least one of the following: o The National Institutes of Health. o The Centers for Disease Control and Prevention. o The Agency for Health Care Research and Quality. o The Centers for Medicare & Medicaid Services. o A cooperative group or center of any of the above entities or of the Department of Defense or the Department of Veterans Affairs. o A qualified non-governmental research entity identified in the guidelines issued by the National Institutes of Health for center support grants. o The Department of Veterans Affairs or the Department of Defense or the Department of Energy, but only if the study or investigation has been reviewed and approved through a system of peer review that the U.S. Secretary of Health and Human Services determines meets all of the following requirements:  It is comparable to the National Institutes of Health system of peer review of studies and investigations.  It assures unbiased review of the highest scientific standards by qualified people who have no interest in the outcome of the review. For covered Services related to a clinical trial, you will pay the Cost Share you would pay if the Services were not related to a clinical trial. For example, see “Hospital Services” in the “Benefit Summary” for the Cost Share that applies to hospital inpatient care. EWCLGHDHP1983ACT0124 42 WAPEBB-CD-ACT