Common use of TERMS OF YOUR COVERAGE Clause in Contracts

TERMS OF YOUR COVERAGE. We provide the benefits described in this booklet only for eligible Members. The health care services are subject to the limitations, exclusions, Copayments, Deductibles and Coinsurance requirements specified in your Summary of Benefits and Coverage. This Certificate of Coverage supersedes any previously distributed Certificate of Coverage. Benefit payment for Covered Services or supplies will be made directly to whoever submits the claim. If the Provider submits the claim, we will make payment to the Provider. If you submit the claim, payment will be made directly to you and you are responsible for making payment to the Provider. We do not supply you with a Hospital or Physician. In addition, we are not responsible for any Injuries or damages you may suffer due to actions of any Hospital, Physician or other person. In order to process your claims, we may request additional information about the medical treatment you received and/or other health insurance you may have. This information will be treated confidentially. An oral explanation of your benefits by an Alliant employee is not legally binding. Any correspondence mailed to you will be sent to your most current address. You are responsible for notifying us of your new address.

TERMS OF YOUR COVERAGE. We provide the benefits described in this booklet only for eligible Members. The health care services are subject to the limitations, exclusions, Copayments, Deductibles and Coinsurance requirements specified in your Summary of Benefits and Coverage. This Certificate of Coverage supersedes any previously distributed Certificate of Coverage. Benefit payment for Covered Services or supplies will be made directly to whoever submits the claim. If the Provider submits the claim, we will make payment to the Provider. If you submit the claim, payment will be made directly to you and you are responsible for making payment to the Provider. We do not supply you with a Hospital or Physician. In addition, we are not responsible for any Injuries injuries or damages you may suffer due to actions of any Hospital, Physician or other person. In order to process your claims, we may request additional information about the medical treatment you received and/or other health insurance you may have. This information will be treated confidentially. An oral explanation of your benefits by an Alliant employee is not legally binding. Any correspondence mailed to you will be sent to your most current address. You are responsible for notifying us Alliant of your new address.

TERMS OF YOUR COVERAGE. We provide the benefits described in this booklet only for eligible Members. The health care services are subject to the limitations, exclusions, Copayments, Deductibles and Coinsurance requirements specified in your Your Summary of Benefits and Coverage. This Certificate of Coverage supersedes any previously distributed Certificate of Coverage. Benefit payment for Covered Services or supplies will be made directly to whoever submits the claim. If the Provider submits the submitsthe claim, we We will make payment to the Provider. If you You submit the claim, payment will be made directly to you You and you You are responsible for making payment to the Provider. We do not supply you You with a Hospital or Physician. In addition, we We are not responsible for any Injuries injuries or damages you You may suffer due to actions of any Hospital, Physician or other person. In order to process your Your claims, we We may request additional information about the medical treatment you You received and/or other health otherhealth insurance you You may have. This information will be treated confidentially. An oral explanation of your Your benefits by an Alliant employee is not legally binding. Any correspondence mailed to you You will be sent to your Your most current address. You are responsible for notifying us Us of your new addressYour newaddress.

TERMS OF YOUR COVERAGE. We provide the benefits described in this booklet only for eligible Members. The health care services are subject to the limitations, exclusions, Copayments, Deductibles and Coinsurance requirements specified in your Your Summary of Benefits and Coverage. This Certificate of Coverage supersedes any previously distributed Certificate of Coverage. Benefit payment for Covered Services or supplies will be made directly to whoever submits the claim. If the Provider submits the claim, we We will make payment to the Provider. If you You submit the claim, payment will be made directly to you You and you You are responsible for making payment to the Provider. We do not supply you You with a Hospital or Physician. In addition, we We are not responsible for any Injuries or damages you You may suffer due to actions of any Hospital, Physician or other person. In order to process your Your claims, we We may request additional information about the medical treatment you You received and/or other health insurance you You may have. This information will be treated confidentially. An oral explanation of your Your benefits by an Alliant employee is not legally binding. Any correspondence mailed to you You will be sent to your Your most current address. You are responsible for notifying us Us of your Your new address.

TERMS OF YOUR COVERAGE. We provide the benefits described in this booklet only for eligible Members. The health care services are subject to the limitations, exclusions, Copayments, Deductibles and Coinsurance requirements specified in your Your Summary of Benefits and Coverage. This Certificate of Coverage supersedes any previously distributed Certificate of Coverage. Benefit payment for Covered Services or supplies will be made directly to whoever submits the claim. If the Provider submits the claim, we We will make payment to the Provider. If you You submit the claim, payment will be made directly to you You and you You are responsible for making payment to the Provider. We do not supply you You with a Hospital or Physician. In addition, we We are not responsible for any Injuries injuries or damages you You may suffer due to actions of any Hospital, Physician or other person. In order to process your Your claims, we We may request additional information about the medical treatment you You received and/or other health insurance you You may have. This information will be treated confidentially. An oral explanation of your Your benefits by an Alliant employee is not legally binding. Any correspondence mailed to you You will be sent to your Your most current address. You are responsible for notifying us Alliant of your Your new address.