2024 Evidence of Coverage for WA PEBB Kaiser Permanente Senior Advantage 101 Chapter 9: Legal notices Section 4 — Administration of this Evidence of Coverage We may adopt reasonable policies, procedures, and interpretations to promote orderly and efficient administration of this Evidence of Coverage. Section 5 — Amendment of Agreement Your group's Agreement with us will change periodically. If these changes affect this Evidence of Coverage, your group is required to inform you in accord with applicable law and your group's Agreement. Section 6 — Applications and statements You must complete any applications, forms, or statements that we request in our normal course of business or as specified in this Evidence of Coverage. Section 7 — Assignment You may not assign this Evidence of Coverage or any of the rights, interests, claims for money due, benefits, or obligations hereunder without our prior written consent. Section 8 — Attorney and advocate fees and expenses In any dispute between a member and Health Plan, Medical Group, or Kaiser Foundation Hospitals, each party will bear its own fees and expenses, including attorneys' fees, advocates' fees, and other expenses, except as otherwise required by law. Section 9 — Coordination of benefits As described in Chapter 1, Section 6, "How other insurance works with our plan," if you have other insurance, you are required to use your other coverage in combination with your coverage as a Senior Advantage plan member to pay for the care you receive. This is called "coordination of benefits" because it involves coordinating all of the health benefits that are available to you. You will get your covered care as usual from network providers, and the other coverage you have will simply help pay for the care you receive. If your other coverage is the primary payer, it will often settle its share of payment directly with us, and you will not have to be involved. However, if payment owed to us by a primary payer is sent directly to you, you are required by Medicare law to give this primary payment to us. For more information about primary payments in third party liability situations, see Section 17 in this 1-877-221-8221 (TTY 711), 7 days a week, 8 a.m. to 8 p.m.