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Release of information The plan or HCA may require you to give information when needed to determine eligibility, administer benefits, or process claims. This could include medical and other records. The plan could deny coverage if you do not provide the information when requested. Relationship to Blue Cross and Blue Shield Association HCA, on behalf of itself and its members, hereby expressly acknowledges that this contract constitutes an agreement solely between HCA and Regence BlueShield, an independent corporation operating under a license from the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans (the “Association”), permitting the contractor Regence BlueShield to use the Washington license for those counties designated in its service area. Right to receive and release needed information Regence BlueShield may need certain facts about your health care coverage or services provided to process your claims correctly. Regence may get these facts from or give them to other organizations or persons without your consent. You must give Regence any facts necessary for processing of claims to get benefits under this plan. See page 136 for more information about the confidentiality of your health information. Right of recovery The plan has the right to a refund of incorrect payments. The plan may recover excess payment from any: • Person that received an excess payment. • Person on whose behalf an excess payment was made. • Other issuers of payment. • Other plans involved. Limitations on liability In all cases, you have the exclusive right to choose a health care provider. Since neither UMP nor Regence BlueShield provides any health care services, neither may be held liable for any claim or damages connected with injuries you may suffer while receiving health services or supplies provided by professionals who are neither employees nor agents of either UMP or Regence BlueShield. Neither Regence BlueShield nor UMP is responsible for the quality of health care you receive, except as provided by law. In addition, UMP will not be liable to any person or entity for the inability or failure to procure or provide the benefits of the plan by reason of epidemic, disaster, or other cause or condition beyond UMP’s control. Governing law The plan is governed by and construed in accordance with the laws of the United States of America and by applicable laws of Washington State without regard to its conflict of law rules. Anti-assignment Members may not assign this COC, or any rights, interests or obligations contained in this COC, in whole or in part, to a third party (including, but not limited to, providers of medical services), without the plan’s 2024 UMP CDHP (PEBB) Certificate of Coverage 137

UMP Consumer-Directed Health Plan (CDHP) COC (2024) - Page 138 UMP Consumer-Directed Health Plan (CDHP) COC (2024) Page 137 Page 139