Emergency Medical Condition. A medical, mental health, or Substance Use Disorder condition that manifests itself by acute symptoms of sufficient severity (including, but not limited to, severe pain or emotional distress) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical, mental health, or Substance Use Disorder treatment attention to result in any of the following:  Placing the person’s health (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy.  Serious impairment to bodily functions.  Serious dysfunction of any bodily organ or part. Emergency Services. All of the following with respect to an Emergency Medical Condition:  A medical screening examination (as required under the federal Emergency Medical Treatment and Active Labor Act, “EMTALA”) that is within the capability of the emergency department of a hospital, or of an Independent Freestanding Emergency Department, including Ancillary Services and patient observation routinely available to the emergency department to evaluate the Emergency Medical Condition.  A behavioral health screening examination that is within the capability of a Behavioral Health Emergency Services Provider, including Ancillary Services routinely available to the Behavioral Health Emergency Services Provider to evaluate the Emergency Medical Condition.  Further examination and treatment, within the capabilities of the staff and facilities available at the emergency department of a hospital, or Independent Freestanding Emergency Department, or Behavioral Health Emergency Services Provider to stabilize the patient, as required under EMTALA (or would be required under EMTALA if it applied to each of these settings).  Covered Services provided by a Non-Participating Provider (including staff or facilities at the emergency department of a hospital or Independent Freestanding Emergency Department, or Behavioral Health Emergency Services Provider) after you are Stabilized, and that are part of outpatient observation or an inpatient or outpatient stay with respect to the visit during which screening and Stabilization Services have been furnished, if the Non-Participating Provider determines that, taking into account your medical or behavioral health condition, you are not able to travel to an available Participating Provider within a reasonable travel distance, using non-medical transportation or non-emergency transportation. Employing Agency. A division, department, or separate agency of state government, including an institution of higher education; a county, municipality, or other political subdivision; and a tribal government covered by HCA statute. Enrollee. A person who is eligible and enrolled under this EOC, and for whom Kaiser has received applicable premium. This EOC sometimes refers to an Enrollee as “you” or “Member.” The term Enrollee may include the Subscriber, their Dependent, or other individual who is eligible for and enrolled under this EOC. Essential Health Benefits. Essential Health Benefits means benefits that the U.S. Department of Health and Human Services (HHS) Secretary defines as essential health benefits. Essential Health Benefits must be equal to the scope of benefits provided under a typical employer plan, except that they must include at least the following: ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and Substance Use Disorder services (including behavioral health treatment), prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services (including oral and vision care). External Prosthetic Devices. External prosthetic devices are rigid or semi-rigid external devices required to replace all or any part of a body organ or extremity, and designated by CMS in the “L codes” of the Healthcare Common Procedure Coding System. EWCLGHDHP1983ACT0124 10 WAPEBB-CD-ACT