Common use of Limitation on Enrollment Clause in Contracts

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group Health’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Health Cooperative Benefits Booklet Group Health Cooperative 2017 Benefits Booklet CA-1888a17, Important Notice Under Federal Health Care Reform Group Health recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-000-000-0000. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: • All stages of reconstruction of the breast on which the mastectomy has been performed. • Surgery and reconstruction of the other breast to produce a symmetrical appearance. • Prostheses. • Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health will provide the information regarding the types of plans offered by Group Health to Members on request. Please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-000-000-0000. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group Health’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Health Cooperative Benefits Booklet Group Health Cooperative 2017 Benefits Booklet CA-1888a17, Important Notice Under Federal Health Care Reform Group Health recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: •  All stages of reconstruction of the breast on which the mastectomy has been performed. •  Surgery and reconstruction of the other breast to produce a symmetrical appearance. •  Prostheses. •  Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health will provide the information regarding the types of plans offered by Group Health to Members on request. Please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health KFHPWA may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group HealthKFHPWA’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Xxxxxx Foundation Health Cooperative Plan of Washington Benefits Booklet Group Xxxxxx Foundation Health Cooperative Plan of Washington A nonprofit health maintenance organization 2017 Benefits Booklet CA-1888a17CA-1888a17r, Important Notice Under Federal Health Care Reform Group Xxxxxx Foundation Health Plan of Washington (“KFHPWA”) recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health KFHPWA networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000888-000901-00004636. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health KFHPWA or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health KFHPWA network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: •  All stages of reconstruction of the breast on which the mastectomy has been performed. •  Surgery and reconstruction of the other breast to produce a symmetrical appearance. •  Prostheses. •  Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health KFHPWA will provide the information regarding the types of plans offered by Group Health KFHPWA to Members on request. Please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01- 888-000901-000-00004636. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group Health’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Health Cooperative Options, Inc. 2016 Access PPO Benefits Booklet Group Health Cooperative 2017 Benefits Booklet CA-1888a17CA-3962a16, Important Notice Under Federal Health Care Reform Group Health recommends each Member choose a Network Personal Physicianpersonal physician. This decision is important since the designated Network Personal Physician personal physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician personal physician who participates in one of the Group Health networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physicianpersonal physician, and for a list of the participating Network Personal Physicianspersonal physicians, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health or from any other person (including a Network Personal Physicianpersonal physician) to access obstetrical or gynecological care from a health care professional in the Group Health network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-000- 0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: •  All stages of reconstruction of the breast on which the mastectomy has been performed. •  Surgery and reconstruction of the other breast to produce a symmetrical appearance. •  Prostheses. •  Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health will provide the information regarding the types of plans offered by Group Health to Members on request. Please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health KFHPWA may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group HealthKFHPWA’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Xxxxxx Foundation Health Cooperative Plan of Washington Benefits Booklet Group Xxxxxx Foundation Health Cooperative 2017 Plan of Washington A nonprofit health maintenance organization 2018 Benefits Booklet CA-1888a17CA-1888a18, Important Notice Under Federal Health Care Reform Group Xxxxxx Foundation Health Plan of Washington (“KFHPWA”) recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health KFHPWA networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000888-000901-00004636. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health KFHPWA or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health KFHPWA network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: • All stages of reconstruction of the breast on which the mastectomy has been performed. • Surgery and reconstruction of the other breast to produce a symmetrical appearance. • Prostheses. • Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health KFHPWA will provide the information regarding the types of plans offered by Group Health KFHPWA to Members on request. Please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01- 888-000901-000-00004636. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health KFHPWA may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group HealthKFHPWA’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Xxxxxx Foundation Health Cooperative Plan of Washington Benefits Booklet Group Xxxxxx Foundation Health Cooperative Plan of Washington A nonprofit health maintenance organization 2017 Benefits Booklet CA-1888a17, 1258EID2017c Important Notice Under Federal Health Care Reform Group Xxxxxx Foundation Health Plan of Washington (“KFHPWA”) recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health KFHPWA networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000888-000901-00004636. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health KFHPWA or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health KFHPWA network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: •  All stages of reconstruction of the breast on which the mastectomy has been performed. •  Surgery and reconstruction of the other breast to produce a symmetrical appearance. •  Prostheses. •  Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health KFHPWA will provide the information regarding the types of plans offered by Group Health KFHPWA to Members on request. Please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01- 888-000901-000-00004636. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group Health’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Health Cooperative Options, Inc. Benefits Booklet Group Health Cooperative Options, Inc. 2017 Benefits Booklet CA-1888a17CA-2563a17, C427636512300 Important Notice Under Federal Health Care Reform Group Health recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: •  All stages of reconstruction of the breast on which the mastectomy has been performed. •  Surgery and reconstruction of the other breast to produce a symmetrical appearance. •  Prostheses. •  Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health will provide the information regarding the types of plans offered by Group Health to Members on request. Please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health KFHPWA may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group HealthKFHPWA’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Xxxxxx Foundation Health Cooperative Plan of Washington Benefits Booklet Group Kaiser Foundation Health Cooperative 2017 Plan of Washington A nonprofit health maintenance organization 2018 Benefits Booklet CA-1888a17CA-1888a18, Important Notice Under Federal Health Care Reform Group Xxxxxx Foundation Health Plan of Washington (“KFHPWA”) recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health KFHPWA networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-000-000-0000. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health KFHPWA or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health KFHPWA network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: • All stages of reconstruction of the breast on which the mastectomy has been performed. • Surgery and reconstruction of the other breast to produce a symmetrical appearance. • Prostheses. • Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health KFHPWA will provide the information regarding the types of plans offered by Group Health KFHPWA to Members on request. Please call the Group Health Customer Service Center Xxxxxx Permanente Member Services at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-0- 000-000-0000. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group Health’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Health Cooperative 2016 Benefits Booklet Group Health Cooperative 2017 Benefits Booklet CA-1888a17CA-1888a16, Important Notice Under Federal Health Care Reform Group Health recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: •  All stages of reconstruction of the breast on which the mastectomy has been performed. •  Surgery and reconstruction of the other breast to produce a symmetrical appearance. •  Prostheses. •  Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health will provide the information regarding the types of plans offered by Group Health to Members on request. Please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 01-000-000-0000. Table of Contents

Limitation on Enrollment. The Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, Group Health may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that Group Health’s capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. Your Group Health Cooperative Options, Inc. Benefits Booklet Group Health Cooperative Options, Inc. 2017 Benefits Booklet CA-1888a17CA-2563a17, C427626512200 Important Notice Under Federal Health Care Reform Group Health recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member’s health care. The Member has the right to designate any Network Personal Physician who participates in one of the Group Health networks and who is available to accept the Member or the Member’s family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-000-000-0000. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from Group Health or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the Group Health network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre-approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-000-000-0000. Women’s health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: • All stages of reconstruction of the breast on which the mastectomy has been performed. • Surgery and reconstruction of the other breast to produce a symmetrical appearance. • Prostheses. • Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Benefits Booklet. Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information Group Health will provide the information regarding the types of plans offered by Group Health to Members on request. Please call the Group Health Customer Service Center at (000) 000-0000 in the Seattle area, or toll-free in Washington, 0-000-000-0000. Table of Contents