Common use of Statement of Rights Under the Newborns’ and Mothers Clause in Contracts

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000800-000639-0000 2227 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHD00222 R5001091 D0000550 VP000030 Plan 18a = On/Off Exchange – VantageBlue (Modified) DP 750.1500 - Pedi dental - Pedi vision - RX$10/25/50/75/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHD00218 R5001084 D0000554 VP000031 Plan 14a = Off Exchange - BlueSolutions DP 1700.3400 - Pedi dental - Pedi vision - Acu - RX$10/25/50/75/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02441 R5001109 VP000031 Plan 20b= BXO - BSHSA SG 4000.8000 100.60 - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHD00216 R5001074 D0000562 VP000033 Plan 10a = Off Exchange - BasicBlue DP 5500.11000 - Pedi dental - Pedi vision - Acu - RX$10/30/50/75/100 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00198 R5001102 VP000030 Plan 21b= BXO - NBNE SG 1000/2000 100/NC - Pedi vision - RX$10/25/35/60/100 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.MBD00042 R5001079 D0000566 VP000033

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00209 R5001113 VP000030 Plan 29b= BXO - NBNEO SG 2000/4000 100/NC - Pedi vision - RX$10/40/80/150/300 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02482 R5001119 D0000404 VP000030 Plan 7a = BXO Exchange - VantageBlue SG 2500.5000 100.80 - pedi dental - Pedi vision - RX$10/40/50/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02439 R5001106 VP000031 Plan 17b= OOE - BSHSA SG 1900.3800 - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00204 R5001100 VP000030 Plan 26b = BXO - BCNE SG 3000/6000 100/80 - Pedi vision - RX$10/30/50/75/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00196 R5001097 VP000031 Plan 33b= BXO - ABNE SG 1900/3800 100/NC - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.MNH00206 R5001112 D0000366 XX000000

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02431 R5001120 D0000405 VP000030 Plan 9a = BXO - VantageBlue SG 2000.4000 - pedi dental - Pedi vision - RX$10/40/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHD00215 R5001070 D0000560 VP000033 Plan 16a = Off Exchange - BasicBlue DP 2500.5000 - Pedi dental - Pedi vision - Acu - RX$10/30/50/75/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02642 R5001123 D0000035 XX000000 Xxxx 0x = XXX - XxxxxxxXxxx XX 750.1500 100.80 - Pedi dental - Pedi vision - Acu - RX$10/25/35/60/100 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & G Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sexsex (consistent with the scope of sex discrimination required under federal law). BCBSRI provides reasonable modifications and free appropriate auxiliary aids and services services, and language assistance services, to people with disabilities and to people whose primary language is not English when such services are necessary to ensure accessibility and to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance withwith us through the Corporate Compliance Officer: Director of • by mailing the Corporate Compliance Officer c/o Grievance and Appeals Department, Blue Cross & G Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or • by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051711). You can file a grievance in person, • by phone sending an email to XXX_Xxxxxxxxxx_Xxxxxxx@xxxxxx.xxx, or • by mail, fax at faxing 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsfxxxxx://xxxxxxxxx.xxx.xxx/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-10191016, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.. This notice is available at BCBSRI’s website: xxxxxx.xxx

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02481 R500116 D0000466 VP000030 Plan 4a = BXO - VantageBlue SG 2000.4000 100.80 - pedi dental - Pedi vision - RX$10/40/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MBD00040 R5001077 D0000384 VP000033 Plan 17a = Off Exchange - BlueCHiP DP 2300.4600 - Pedi dental - Pedi vision - Acu - RX$10/25/50/75/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.MNH00205 R5001099 D0000402 XX000000

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02440 R5001107 D0000610 XX000000 Xxxx 00x= XXX - XXXXX XX 2500.5000 100.60 - Pedi dental - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02439 R5001106 D0000607 XX000000 Xxxx 00x= XXX - XXXXX XX 1900.3800 - Pedi dental - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.MNH00198 R5001102 D0000616 XX000000

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02642 R5001123 D0000035 VP000030 Plan 6a = BXO - VantageBlue SG 750.1500 100.80 - Pedi dental - Pedi vision - Acu - RX$10/25/35/60/100 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02477 R5000918 D0000465 XX000000 Xxxx 0x = XXX - XxxxxxxXxxx XX 500.1000 100.80 - Pedi dental - Pedi vision - Acu - RX$10/25/35/60/100 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02442 R5001110 D0000396 VP000031 Plan 19a= BXO - BSHSA SG 5000/10000 100.60 - Pedi dental - Pedi vision - RX$10/50/75/95/150 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00210 R5001114 VP000030 Plan 30b = BXO - NBNEO SG 5000/10000 100/NC - Pedi vision - RX$15/50/100/200/400 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MBD00041 R5001079 D0000566 VP000033 Plan 11a = Off Exchange - BlueCHiP DP 4800.9600 - Pedi dental - Pedi vision - Acu - RX$7/35/50/75/100 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00197 R5001098 D0000611 VP000031 Plan 34a= BXO - ABNE SG 3400/6800 100/NC – Pedi dental - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00280 R5001103 D0000803 VP000031 Plan 35a= BXO- ABNE SG 7000/14000 – Pedi dental - Pedi vision - RX$0/0/0/0/0 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02485 R5001105 VP000031 Plan 15b= BXO - BSHSA SG 1500.3000 100.60 - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00206 R5001112 VP000030 Plan 22b= BXO - NBNE SG 3000/6000 - Pedi vision - RX$10/30/50/75/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02433 R5001127 D0000618 VP000030 Plan 27a = BXO - VantageBlue SG 8550.17100 - pedi dental - Pedi vision - RX$10/40/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00199 R5001102 VP000030 Plan 24b = BXO - BCNE SG 1000/2000 100/80 - Pedi vision - RX$10/25/35/60/100 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02440 R5001107 VP000031 Plan 32b= BXO - BSHSA SG 2500.5000 100.60 - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00281 R5001101 VP000030 Plan 38b = BXO - BCNE SG 500/1000 100/80 - Pedi vision - RX$10/25/35/60/100 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02437 R5001104 VP000031 Plan 16b= OOE - BSHSA SG 1500/3000 100.60 copay - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02485 R5001105 D0000546 XX000000 Xxxx 00x= XXX - XXXXX XX 1500.3000 100.60 - Pedi dental - Pedi vision - RX$10/45/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & G Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sexsex (consistent with the scope of sex discrimination required under federal law). BCBSRI provides reasonable modifications and free appropriate auxiliary aids and services services, and language assistance services, to people with disabilities and to people whose primary language is not English when such services are necessary to ensure accessibility and to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance withwith us through the Corporate Compliance Officer: Director of • by mailing the Corporate Compliance Officer c/o Grievance and Appeals Department, Blue Cross & G Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or • by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051711). You can file a grievance in person, • by phone sending an email to XXX_Xxxxxxxxxx_Xxxxxxx@xxxxxx.xxx, or • by mail, fax at faxing 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsfxxxxx://xxxxxxxxx.xxx.xxx/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-10191016, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.. This notice is available at BCBSRI’s website: xxxxxx.xxx

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.and

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00208 R5001100 VP000030 Plan 31b= BXO - NBNE SG 4000/8000 100/NC - Pedi vision - RX$10/30/50/75/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02640 R5001122 D0000805 VP000030 Plan 36a = BXO - VantageBlue SG 5000.10000 100.80 - pedi dental - Pedi vision - RX$10/40/70/90/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MHM02639 R5001103 VP000031 Plan 14b= OOE - BSHSA SG 7000.14000 - Pedi vision - RX$0/0/0/0/0 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.

Statement of Rights Under the Newborns’ and Mothers. Health Protection Act Under federal law, group health plans and health insurance issuers offering group healthcare coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than forty-eight forty -eight (48) hours following a vaginal delivery, or less than ninety-six (96) hours following a delivery by cesarean section. However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers 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. In addition, a plan or issuer may not, under federal law, require that a physician or other healthcare provider obtain authorization for prescribing a length of stay of up to 48 hours (or 96 hours). In accordance with R.I. General Law §27-20-17.1, this plan covers a minimum inpatient hospital stay of forty-eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • if the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • if the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn child is admitted to a hospital following childbirth. Decisions to shorten hospital stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your newborn child participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your newborn child, (any additional visits may be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge from the hospital. MNH00202 R5001100 D0000585 XX000000 Xxxx 00x= XXX - XXXX XX 4000/8000 100/80 – Pedi dental - Pedi vision - RX$10/30/50/75/125 - v1.22 Nondiscrimination and Language Assistance Blue Cross & Blue Shield of Rhode Island (BCBSRI) complies with applicable Federal civil rights laws and does not discriminate or treat people differently on the basis of race, color, national origin, age, disability, or sex. BCBSRI provides free aids and services to people with disabilities and to people whose primary language is not English when such services are necessary to communicate effectively with us. If you need these services, contact us at 000-000-0000. If you believe that BCBSRI has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Director of Grievance and Appeals Department, Blue Cross & Blue Shield of Rhode Island, 000 Xxxxxxxx Xxxxxx, Xxxxxxxxxx XX 00000, or by calling 000-000-0000 or 000-000-0000 (TTY/TDD: 888-252-5051). You can file a grievance in person, by phone or by mail, fax at 000-000-0000, or electronically through our member portal at xxxxxx.xxx. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at xxxxx://xxxxxxxxx.xxx.xxx/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 000 Xxxxxxxxxxxx Xxxxxx, XX Xxxx 000X, XXX Xxxxxxxx Xxxxxxxxxx, X.X. 00000 800-368-1019, 000-000-0000 (TDD). Complaint forms are available at xxxx://xxx.xxx.xxx/ocr/office/file/index.html.