Common use of SUMMARY PLAN DESCRIPTION BOOKLET AND ORIENTATION PROGRAMS MARKETING PROVISIONS Clause in Contracts

SUMMARY PLAN DESCRIPTION BOOKLET AND ORIENTATION PROGRAMS MARKETING PROVISIONS. 1. The INSURER shall be responsible for the preparation, printing and distribution, at its own cost, of booklets, in the Spanish language, that describe the plan and the benefits covered therein. The Insurer agrees to submit before the effective date of the contract a translated copy of the beneficiaries' booklet in the English language by the proper revision of federal authorities. These booklets will be delivered to each subscriber upon enrollment, along with the required identification card(s). 2. The booklets shall serve as guarantee of the benefits to be provided and shall contain the following information: a) Schedule of benefits covered, all services and items that are available and that are covered either directly or through methods of referral and/or prior authorization, a written description of how and where the services that have been available through the plan services may be obtained. b) Benefit's exclusions and limitations. For benefits that enrollees are entitled to but are not available through the MCO, a written description on how and where to obtain benefits; description of procedures for requesting disenrollments/changes. c) Beneficiary's rights and responsibilities, in accordance with specific rights and requirements to be afforded in accordance with Medicaid Program regulations as amended, the Puerto Rico Patient Bill of Rights Law 194 of August 25, 2000, the Puerto Xico Mental Health Code, of October 2, 2000, as amended and implemented by their regulations, and Law 11 creating the Office of Patients Solicitor General of April 11, 2001. d) Instructions on how to access benefits, including a list of (1) available HCO's and its participating providers, PCP or Specialists (its locations and qualifications), (2) providers from which to obtain benefits under the Special Coverage. Said list can be provided in a separate booklet. e) Official grievances and appeal filing procedures. f) In the event a Physician Incentive Plan affects the use of referral services and/or places physicians at substantial risk, the INSURER shall provide the following information upon beneficiaries' requests: the type of incentive arrangements, whether stop-loss insurance is provided and the survey results of any enrollee/disenrollee surveys that will have to be conducted by INSURER. g) Unless otherwise specified, subscription materials must be written at the 4th-6th grade reading comprehension level. h) Explanations of instances under which a beneficiary's disenrollment may be requested without his/her consent by a provider. i) Explanations of right of beneficiary to transfer from HCO at any time for cause and to transfer or change within first ninety (90) days of the date of enrollment or the later date of receipt of notice of enrollment, and at least every (12) months thereafter without cause. 3. The booklets shall be approved by the ADMINISTRATION prior to printing, distribution, and dissemination in compliance with provisions of Article IX. 4. The INSURER shall also be responsible for the preparation, printing and distribution, at its own cost, of an Informative Bulletin, in the Spanish language, that describes the plan, services and benefits covered therein as well as the managed care concept. This Informative Bulletin will be distributed among the HCO's, HCO's network of participating providers and the INSURER's participating providers. 5. The INSURER shall be responsible to conduct and assure the participation of all providers under this contract to diverse seminars to be held throughout the Health Area/Region in order to properly orient and familiarize said providers with all aspects and requirements related to the Preventive Medicine Program, Benefits and Coverage under this contract, and the Managed Care concept. Said seminars will be organized, scheduled, conducted and offered at the expense of the INSURER. The curriculum for said seminars will be coordinated with and approved by the ADMINISTRATION Healthcare Coordinators. 6. All participating providers are mandated required to receive yearly during the contract term at least fifteen (15) hours of orientation, education and familiarization with different aspects related to this contract on/or before the expiration of the first four and a half (4 1/2) months of the contract term. Failure to comply with this requirement will be sufficient grounds to exclude from the Health Insurance Program the participating provider. If, at the expiration of the first four and half (4 1/2 months) of the contract term, the participating provider has not fully complied with this requirement, it will be excluded as participating provider for subsequent periods of the contract or the contract term. At the discretion of the ADMINISTRATION, and for good cause the excluded provider may be authorized to be contracted as a participating provider if it subsequently complies with the requirement. 7. The ADMINISTRATION will monitor and evaluate all marketing activities by the INSURER, its contractor, sub-contractors or any provider of services under this contract. 8. Any marketing material addressed to enrollees can not contain false or misleading information. All oral, written or audiovisual information addressed to enrollees should be accurate and sufficient for beneficiaries to make an informed consent decision as to whether or not to enroll and will have to be pre-approved by the ADMINISTRATION. 9. The INSURER, contractor or subcontractor or any providers of services must distribute the material to its entire service area/region. In the event the INSURER or any of its contractors develop new and revised materials they shall submit them to the ADMINISTRATION for prior approval. 10. The ADMINISTRATION will appoint an Advisory Committee, with representation of at least: a board certified physician, a beneficiary of a consumer advocate organization that includes Medicaid recipients a health related professional related with the medical needs of low-income population and a Director of a Welfare Department that does not head a Medicaid agency. 11. The Advisory Committee will assist the ADMINISTRATION in the evaluation and the review of any marketing or informational material addressed to assist Medicaid recipients in the provision of health services under this contract. All the marketing activities and the information which shall be allowed will be limited to the following: a) Clear description of health care benefits coverage and exclusions to enrollees; b) Explain how, when, where benefits are available to enrollees; c) Explain how to access emergency, family-planning services, and services that do or do not require referrals and authorizations; d) Explain any benefits enrollees are entitled to, that are not available through the INSURER and how to obtain them; e) Enrollees rights and responsibilities;

SUMMARY PLAN DESCRIPTION BOOKLET AND ORIENTATION PROGRAMS MARKETING PROVISIONS. 1. The INSURER shall be responsible for the preparation, printing and distribution, at its own cost, of booklets, in the Spanish language, that describe the plan and the benefits covered therein. The Insurer agrees to submit before the effective date of the contract a translated copy of the beneficiaries' booklet in the English language by the proper revision of federal authorities. These booklets will be delivered to each subscriber upon enrollment, along with the required identification card(s). 2. The booklets shall serve as guarantee of the benefits to be provided and shall contain the following information: a) Schedule of benefits covered, all services and items that are available and that are covered either directly or through methods of referral and/or prior authorization, a written description of how and where the services that have been available through the plan services may be obtained. b) Benefit's exclusions and limitations. For benefits that enrollees are entitled to but are not available through the MCO, a written description on how and where to obtain benefits; description of procedures for requesting disenrollments/changes. c) Beneficiary's rights and responsibilities, in accordance with specific rights and requirements to be afforded in accordance with Medicaid Program regulations as amended, the Puerto Rico Patient Bill Xxxx of Rights Law 194 of August 25, 2000, the Puerto Xico Rico Mental Health Code, of October 2, 2000, as amended and implemented by their regulations, and Law 11 creating the Office of Patients Solicitor General of April 11, 2001. d) Instructions on how to access benefits, including a list of (1) available HCO's and its participating providers, PCP or Specialists (its locations and qualifications), (2) providers from which to obtain benefits under the Special Coverage. Said list can be provided in a separate booklet. e) Official grievances and appeal filing procedures. f) In the event a Physician Incentive Plan affects the use of referral services and/or places physicians at substantial risk, the INSURER shall provide the following information upon beneficiaries' requests: the type of incentive arrangements, whether stop-loss insurance is provided and the survey results of any enrollee/disenrollee surveys that will have to be conducted by INSURER. g) Unless otherwise specified, subscription materials must be written at the 4th-6th grade reading comprehension level. h) Explanations of instances under which a beneficiary's disenrollment may be requested without his/her consent by a provider. i) Explanations of right of beneficiary to transfer from HCO at any time for cause and to transfer or change within first ninety (90) days of the date of enrollment or the later date of receipt of notice of enrollment, and at least every (12) months thereafter without cause. 3. The booklets shall be approved by the ADMINISTRATION prior to printing, distribution, and dissemination in compliance with provisions of Article IX. 4. The INSURER shall also be responsible for the preparation, printing and distribution, at its own cost, of an Informative Bulletin, in the Spanish language, that describes the plan, services and benefits covered therein as well as the managed care concept. This Informative Bulletin will be distributed among the HCO's, HCO's network of participating providers and the INSURER's participating providers. 5. The INSURER shall be responsible to conduct and assure the participation of all providers under this contract to diverse seminars to be held throughout the Health Area/Region in order to properly orient and familiarize said providers with all aspects and requirements related to the Preventive Medicine Program, Benefits and Coverage under this contract, and the Managed Care concept. Said seminars will be organized, scheduled, conducted and offered at the expense of the INSURER. The curriculum for said seminars will be coordinated with and approved by the ADMINISTRATION Healthcare Coordinators. 6. All participating providers are mandated required to receive yearly during the contract term at least fifteen (15) hours of orientation, education and familiarization with different aspects related to this contract on/or before the expiration of the first four and a half (4 1/2) months of the contract term. Failure to comply with this requirement will be sufficient grounds to exclude from the Health Insurance Program the participating provider. If, at the expiration of the first four and half (4 1/2 months) of the contract term, the participating provider has not fully complied with this requirement, it will be excluded as participating provider for subsequent periods of the contract or the contract term. At the discretion of the ADMINISTRATION, and for good cause the excluded provider may be authorized to be contracted as a participating provider if it subsequently complies with the requirement. 7. The ADMINISTRATION will monitor and evaluate all marketing activities by the INSURER, its contractor, sub-contractors or any provider of services under this contract. 8. Any marketing material addressed to enrollees can not contain false or misleading information. All oral, written or audiovisual information addressed to enrollees should be accurate and sufficient for beneficiaries to make an informed consent decision as to whether or not to enroll and will have to be pre-approved by the ADMINISTRATION. 9. The INSURER, contractor or subcontractor or any providers of services must distribute the material to its entire service area/region. In the event the INSURER or any of its contractors develop new and revised materials they shall submit them to the ADMINISTRATION for prior approval. 10. The ADMINISTRATION will appoint an Advisory Committee, with representation of at least: a board certified physician, a beneficiary of a consumer advocate organization that includes Medicaid recipients a health related professional related with the medical needs of low-income population and a Director of a Welfare Department that does not head a Medicaid agency. 11. The Advisory Committee will assist the ADMINISTRATION in the evaluation and the review of any marketing or informational material addressed to assist Medicaid recipients in the provision of health services under this contract. All the marketing activities and the information which shall be allowed will be limited to the following: a) Clear description of health care benefits coverage and exclusions to enrollees; b) Explain how, when, where benefits are available to enrollees; c) Explain how to access emergency, family-planning services, and services that do or do not require referrals and authorizations; d) Explain any benefits enrollees are entitled to, that are not available through the INSURER and how to obtain them; e) Enrollees rights and responsibilities;

SUMMARY PLAN DESCRIPTION BOOKLET AND ORIENTATION PROGRAMS MARKETING PROVISIONS. 1. The INSURER shall be responsible for the preparation, printing and distribution, at its own cost, of booklets, in the Spanish language, that describe the plan and the benefits covered therein. The Insurer agrees to submit before the effective date of the contract a translated copy of the beneficiaries' beneficiaries booklet in the English language by the proper revision of federal authorities. These booklets will be delivered to each subscriber upon enrollment, along with the required identification card(s). 23. The booklets shall serve as guarantee of the benefits to be provided and shall contain the following information: a) Schedule of benefits covered, all services and items that are available and that are covered either directly or through methods of referral and/or prior authorization, a written description of how and where the services that have been available through the plan services may be obtained. b) Benefit's exclusions and limitations. For benefits that enrollees are entitled to but are not available through the MCO, a written description on how and where to obtain benefits; description of procedures for requesting disenrollments/changes. c) Beneficiary's rights and responsibilities, in accordance with specific rights and requirements to be afforded in accordance with Medicaid Medical Program regulations 42 CFR 438.100 as amended, the Puerto Rico Patient Bill of Rights Law 194 of 194, Puerto Rico Mental Health Cxxx, August 25, 2000, the Puerto Xico Mental Health Code, of October 2, 2000, as amended and implemented by their regulationsregulation, and Law 11 creating which creates the Office of Patients Solicitor General of April 11, 2001. d) Instructions on how to access benefits, including a list of (1) available HCO's and its participating providers, PCP or Specialists (its locations and qualifications), (2) providers from which to obtain benefits under the Special Coverage. Said list can be provided in a separate booklet. e) Official grievances and appeal filing procedures. f) In the event a Physician Incentive Plan affects the use of referral services and/or places physicians at substantial risk, the INSURER shall provide the following information upon beneficiaries' beneficiaries requests: the type of incentive arrangements, whether stop-loss insurance is provided and the survey results of any enrollee/disenrollee surveys that will have to be conducted by INSURER. g) Unless otherwise specified, subscription materials must be written at the 4th-6th grade reading comprehension level. h) Explanations of instances under which a beneficiary's disenrollment may be requested without his/her consent by a provider. i) Explanations of right of beneficiary to transfer from HCO at any time for cause and to transfer or change within first ninety (90) days of the date of enrollment or the later date of receipt of notice of enrollment, and at least every (12) months thereafter without cause. 34. The booklets shall be approved by the ADMINISTRATION prior to printing, distribution, and dissemination in compliance with provisions of Article IX. 45. The INSURER shall also be responsible for the preparation, printing and distribution, at its own cost, of an Informative Bulletin, in the Spanish language, that describes the plan, services and benefits covered therein as well as the managed care concept. This Informative Bulletin will be distributed among the HCO'sHCOs, HCO's network of participating providers and the INSURER's participating providers. 56. The INSURER shall be responsible to conduct and assure the participation of all providers under this contract to diverse seminars to be held throughout the Health Area/Region in order to properly orient and familiarize said providers with all aspects and requirements related to the Preventive Medicine Program, Benefits and Coverage under this contract, and the Managed Care concept. Said seminars will be organized, scheduled, conducted and offered at the expense of the INSURER. The curriculum for said seminars will be coordinated with and approved by the ADMINISTRATION Healthcare Coordinators. 67. All participating providers are mandated mandatorily required to receive yearly during the contract term at least fifteen four (154) hours of orientation, education and familiarization with different aspects related to this contract on/or before the expiration of the first four and a half (4 1/2) months of the contract term. Failure to comply with this requirement will be sufficient grounds to exclude from the Health Insurance Program the participating provider. If, at the expiration of the first four and half (4 1/2 months1/2) of the contract term, the participating provider has not fully complied with this requirement, it will be excluded as participating provider for subsequent periods of the contract or the contract term. At the discretion of the ADMINISTRATION, and for good cause the excluded provider may be authorized to be contracted as a participating provider if it subsequently complies with the requirement. 78. The ADMINISTRATION will monitor and evaluate all marketing activities by the INSURER, its contractor, sub-contractors or any provider of services under this contract. 89. Any marketing material addressed to enrollees can not contain false or misleading information. All oral, written or audiovisual information addressed to enrollees should be accurate and sufficient for beneficiaries to make an informed consent decision as to whether or not to enroll and will have to be pre-approved by the ADMINISTRATION. 910. The INSURER, contractor or subcontractor or any providers of services must distribute the material to its entire service area/region. In the event the INSURER or any of its contractors develop new and revised materials they shall submit them to the ADMINISTRATION for prior approval. 1011. The ADMINISTRATION will appoint an Advisory Committee, with representation of at least: a board certified physician, a beneficiary of a consumer advocate organization that includes Medicaid recipients a health related professional related with the medical needs of low-income population and a Director of a Welfare Department that does not head a Medicaid medicaid agency. 1112. The Advisory Committee will assist the ADMINISTRATION in the evaluation and the review of any marketing or informational material addressed to assist Medicaid medicaid recipients in the provision of health services under this contract. All the marketing activities and the information which shall be allowed will be limited to the following: a) Clear description of health care benefits coverage and exclusions to enrollees; b) Explain how, when, where benefits are available to enrollees; c) Explain how to access emergency, family-planning services, and services that do or do not require referrals and authorizations; d) Explain any benefits enrollees are entitled to, that are not available through the INSURER MCO and how to obtain them; e) Enrollees rights and responsibilities;

SUMMARY PLAN DESCRIPTION BOOKLET AND ORIENTATION PROGRAMS MARKETING PROVISIONS. 1. The INSURER shall be responsible for the preparation, printing and distribution, at its own cost, of booklets, in the Spanish language, that describe the plan and the benefits covered therein. The Insurer agrees to submit before the effective date of the contract a translated copy of the beneficiaries' booklet in the English language by the proper revision of federal authorities. These booklets will be delivered to each subscriber upon enrollment, along with the required identification card(s). 2. The booklets shall serve as guarantee of the benefits to be provided and shall contain the following information: a) Schedule of benefits covered, all services and items that are available and that are covered either directly or through methods of referral and/or prior authorization, a written description of how and where the services that have been available through the plan services may be obtained. b) Benefit's exclusions and limitations. For benefits that enrollees are entitled to but are not available through the MCO, a written description on how and where to obtain benefits; description of procedures for requesting disenrollments/changes. c) Beneficiary's rights and responsibilities, in accordance with specific rights and requirements to be afforded in accordance with Medicaid Program regulations as amended, the Puerto Rico Patient Bill of Rights Law 194 of August 25, 2000, the Puerto Xico Rico Mental Health Code, of October 2, 2000, as amended and implemented by their regulations, and Law 11 creating the Office of Patients Solicitor General of April 11, 2001. d) Instructions on how to access benefits, including a list of (1) available HCO's and its participating providers, PCP or Specialists (its locations and qualifications), (2) providers from which to obtain benefits under the Special Coverage. Said list can be provided in a separate booklet. e) Official grievances and appeal filing procedures. f) In the event a Physician Incentive Plan affects the use of referral services and/or places physicians at substantial risk, the INSURER shall provide the following information upon beneficiaries' requests: the type of incentive arrangements, whether stop-loss insurance is provided and the survey results of any enrollee/disenrollee surveys that will have to be conducted by INSURER. g) Unless otherwise specified, subscription materials must be written at the 4th-6th grade reading comprehension level. h) Explanations of instances under which a beneficiary's disenrollment may be requested without his/her consent by a provider. i) Explanations of right of beneficiary to transfer from HCO at any time for cause and to transfer or change within first ninety (90) days of the date of enrollment or the later date of receipt of notice of enrollment, and at least every (12) months thereafter without cause. 3. The booklets shall be approved by the ADMINISTRATION prior to printing, distribution, and dissemination in compliance with provisions of Article IX. 4. The INSURER shall also be responsible for the preparation, printing and distribution, at its own cost, of an Informative Bulletin, in the Spanish language, that describes the plan, services and benefits covered therein as well as the managed care concept. This Informative Bulletin will be distributed among the HCO's, HCO's network of participating providers and the INSURER's participating providers. 5. The INSURER shall be responsible to conduct and assure the participation of all providers under this contract to diverse seminars to be held throughout the Health Area/Region in order to properly orient and familiarize said providers with all aspects and requirements related to the Preventive Medicine Program, Benefits and Coverage under this contract, and the Managed Care concept. Said seminars will be organized, scheduled, conducted and offered at the expense of the INSURER. The curriculum for said seminars will be coordinated with and approved by the ADMINISTRATION Healthcare Coordinators. 6. All participating providers are mandated required to receive yearly during the contract term at least fifteen (15) hours of orientation, education and familiarization with different aspects related to this contract on/or before the expiration of the first four and a half (4 1/2) months of the contract term. Failure to comply with this requirement will be sufficient grounds to exclude from the Health Insurance Program the participating provider. If, at the expiration of the first four and half (4 1/2 months) of the contract term, the participating provider has not fully complied with this requirement, it will be excluded as participating provider for subsequent periods of the contract or the contract term. At the discretion of the ADMINISTRATION, and for good cause the excluded provider may be authorized to be contracted as a participating provider if it subsequently complies with the requirement. 7. The ADMINISTRATION will monitor and evaluate all marketing activities by the INSURER, its contractor, sub-contractors or any provider of services under this contract. 8. Any marketing material addressed to enrollees can not contain false or misleading information. All oral, written or audiovisual information addressed to enrollees should be accurate and sufficient for beneficiaries to make an informed consent decision as to whether or not to enroll and will have to be pre-approved by the ADMINISTRATION. 9. The INSURER, contractor or subcontractor or any providers of services must distribute the material to its entire service area/region. In the event the INSURER or any of its contractors develop new and revised materials they shall submit them to the ADMINISTRATION for prior approval. 10. The ADMINISTRATION will appoint an Advisory Committee, with representation of at least: a board certified physician, a beneficiary of a consumer advocate organization that includes Medicaid recipients a health related professional related with the medical needs of low-income population and a Director of a Welfare Department that does not head a Medicaid agency. 11. The Advisory Committee will assist the ADMINISTRATION in the evaluation and the review of any marketing or informational material addressed to assist Medicaid recipients in the provision of health services under this contract. All the marketing activities and the information which shall be allowed will be limited to the following: a) Clear description of health care benefits coverage and exclusions to enrollees; b) Explain how, when, where benefits are available to enrollees; c) Explain how to access emergency, family-planning services, and services that do or do not require referrals and authorizations; d) Explain any benefits enrollees are entitled to, that are not available through the INSURER and how to obtain them; e) Enrollees rights and responsibilities;

SUMMARY PLAN DESCRIPTION BOOKLET AND ORIENTATION PROGRAMS MARKETING PROVISIONS. 1. The INSURER shall be responsible for the preparation, printing and distribution, at its own cost, of booklets, in the Spanish language, that describe the plan and the benefits covered therein. The Insurer agrees to submit before the effective date of the contract a translated copy of the beneficiaries' beneficiaries booklet in the English language by the proper revision of federal authorities. These booklets will be delivered to each subscriber upon enrollment, along with the required identification card(s). 2. [DELETED] 3. The booklets shall serve as guarantee of the benefits to be provided and shall contain the following information: a) Schedule of benefits covered, all services and items that are available and that are covered either directly or through methods of referral and/or prior authorization, a written description of how and where the services that have been available through the plan services may be obtained. b) Benefit's exclusions and limitations. For benefits that enrollees are entitled to but are not available through the MCO, a written description on how and where to obtain benefits; description of procedures for requesting disenrollments/changes. c) Beneficiary's rights and responsibilities, in accordance with specific rights and requirements to be afforded in accordance with Medicaid Medical Program regulations 42 CFR 438.100 as amended, the Puerto Rico Patient Bill of Rights Law 194 of 194, Puerto Rico Mental Health Cxxx, August 25, 2000, the Puerto Xico Mental Health Code, of October 2, 2000, as amended and implemented by their regulationsregulation, and Law 11 creating which creates the Office of Patients Solicitor General of April 11, 2001. d) Instructions on how to access benefits, including a list of (1) available HCO's and its participating providers, PCP or Specialists (its locations and qualifications), (2) providers from which to obtain benefits under the Special Coverage. Said list can be provided in a separate booklet. e) Official grievances and appeal filing procedures. f) In the event a Physician Incentive Plan affects the use of referral services and/or places physicians at substantial risk, the INSURER shall provide the following information upon beneficiaries' beneficiaries requests: the type of incentive arrangements, whether stop-loss insurance is provided and the survey results of any enrollee/disenrollee surveys that will have to be conducted by INSURER. g) Unless otherwise specified, subscription materials must be written at the 4th-6th grade reading comprehension level. h) Explanations of instances under which a beneficiary's disenrollment may be requested without his/her consent by a provider. i) Explanations of right of beneficiary to transfer from HCO at any time for cause and to transfer or change within first ninety (90) days of the date of enrollment or the later date of receipt of notice of enrollment, and at least every (12) months thereafter without cause. 34. The booklets shall be approved by the ADMINISTRATION prior to printing, distribution, and dissemination in compliance with provisions of Article IX. 45. The INSURER shall also be responsible for the preparation, printing and distribution, at its own cost, of an Informative Bulletin, in the Spanish language, that describes the plan, services and benefits covered therein as well as the managed care concept. This Informative Bulletin will be distributed among the HCO'sHCOs, HCO's network of participating providers and the INSURER's participating providers. 56. The INSURER shall be responsible to conduct and assure the participation of all providers under this contract to diverse seminars to be held throughout the Health Area/Region in order to properly orient and familiarize said providers with all aspects and requirements related to the Preventive Medicine Program, Benefits and Coverage under this contract, and the Managed Care concept. Said seminars will be organized, scheduled, conducted and offered at the expense of the INSURER. The curriculum for said seminars will be coordinated with and approved by the ADMINISTRATION Healthcare Coordinators.the 67. All participating providers are mandated mandatorily required to receive yearly during the contract term at least fifteen four (154) hours of orientation, education and familiarization with different aspects related to this contract on/or before the expiration of the first four and a half (4 1/2) months of the contract term. Failure to comply with this requirement will be sufficient grounds to exclude from the Health Insurance Program the participating provider. If, at the expiration of the first four and half (4 1/2 months1/2) of the contract term, the participating provider has not fully complied with this requirement, it will be excluded as participating provider for subsequent periods of the contract or the contract term. At the discretion of the ADMINISTRATION, and for good cause the excluded provider may be authorized to be contracted as a participating provider if it subsequently complies with the requirement. 78. The ADMINISTRATION will monitor and evaluate all marketing activities by the INSURER, its contractor, sub-contractors or any provider of services under this contract. 89. Any marketing material addressed to enrollees can not contain false or misleading information. All oral, written or audiovisual information addressed to enrollees should be accurate and sufficient for beneficiaries to make an informed consent decision as to whether or not to enroll and will have to be pre-approved by the ADMINISTRATION. 910. The INSURER, contractor or subcontractor or any providers of services must distribute the material to its entire service area/region. In the event the INSURER or any of its contractors develop new and revised materials they shall submit them to the ADMINISTRATION for prior approval. 1011. The ADMINISTRATION will appoint an Advisory Committee, with representation of at least: a board certified physician, a beneficiary of a consumer advocate organization that includes Medicaid recipients a health related professional related with the medical needs of low-income population and a Director of a Welfare Department that does not head a Medicaid medicaid agency. 1112. The Advisory Committee will assist the ADMINISTRATION in the evaluation and the review of any marketing or informational material addressed to assist Medicaid medicaid recipients in the provision of health services under this contract. All the marketing activities and the information which shall be allowed will be limited to the following: a) Clear description of health care benefits coverage and exclusions to enrollees; b) Explain how, when, where benefits are available to enrollees; c) Explain how to access emergency, family-planning services, and services that do or do not require referrals and authorizations; d) Explain any benefits enrollees are entitled to, that are not available through the INSURER MCO and how to obtain them; e) Enrollees rights and responsibilities;