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~ /{?- 6$ The Department of Managed Health Care MHN is a licensed California specialized health care service plan. The Department of Managed Health Care (the "Department") is responsible for regulating health care service plans in California. If you have a grievance against MHN, you should first telephone MHN at the same number you would use to access your EAP services, and use MHN's grievance process, as described above, before contacting the Department. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by MHN, or a grievance that has remained WITesolved for more than 30 days, you may call the Department. You may also be eligible for an Independent Medical Review ("IMR"). If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treattnent, coverage decisions for treattnents that are experimental or investigational in nature and payment disputes for emergency or urgent medical services. MHN's grievance process and the Department's complaint review process are in addition to any other dispute resolution procedures that may be available to you, and your failure to use these processes does not preclude your use of any other remedy provided by law. The Department has a toll-free telephone number (1-888-HMO-2219) to receive complaints and a TDD line (1-877-688-9891) for the hearing and speech impaired. The Department's Internet website (http://www.hmohelp.ca.gov) has grievance forms, IMR application forms and instructions online. Public Policy MHN pennits Members to participate in establishing its public policy through its Public Policy Committee - the findings and recommendations of which are regularly reported to MHN's governing Board of Directors. For the purposes of description, "public policy" means acts performed by MHN and its employees to assure the comfort, dignity and convenience of Members who rely on Pamcipating Practitioners to provide EAP services. If you would like to participate on MHN'sPublic Policy Committee please contact 1-800-227-1060. Principal Exclusions You and your eligible family members may be entitled to receive a specified number of counseling sessIOns each year. See section entitled "Principal Benefits and Coverages" for number of sessions covered, However, there are some exclusions. MHN's EAP services do not provide: . Inpatient treatment of any kind Prescription drugs Counseling required by law or a court Formal psychological evaluations and fitness-for-duty opinions Termination of Benefits Your eligibility ends upon your termination of employment, or when your Employer's contract with MHN is no longer in force as a result of nonpayment of premium or otherwise. If premiums are not paid according to the Agreement, termination is effective fifteen days after notice of tennination is mailed to your Employer, as of midnight of the last day of the month for which premiums were last received and accepted by MHN, The Employer may automatically reinstate the Agreement by remitting, within fifteen (15) days of the date of written notice of termination, all outstanding 10