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HHRC-EOC 02.10.2017 5 Evidence of Coverage VII. FACILITIES The location of Providers is obtained by calling Plan at 1-800-342-8111. If you prefer, a customized list of providers will be provided upon request. This is arranged by zip code in the area specialty that you request. VIII. LIABILITY OF PLAN / MEMBERS A. Liability of Plan In the event Plan fails to pay EAP Providers for Benefits provided to you, you shall not be liable to EAP Providers for any sums owed by Plan. B. Liability of Members It is not contemplated that Members would make payment to Plan providers for benefits. If this has occurred, the Member may contact Plan at 1-800-342-8111 to be reimbursed. There is no restriction on assignment of sums payable to the Member by the health plan. C. Member Liability to Non-EAP Providers You may be liable to non-EAP Providers for the cost of services rendered when such services are not authorized or referred by Plan. IX. PROVIDER COMPENSATION Members may request information about Plan’s EAP Provider reimbursement policies and procedures by contacting Plan’s Manager, Provider Relations, at 1-800-342-8111 or the Member's EAP Provider. X. SECOND OPINION POLICY You may request a second opinion regarding both treatment recommended by the treating EAP Provider and treatment desired by you. Plan will authorize second opinions where the second opinion is consistent with professionally recognized standards of practice. The second opinion request will not result in a change in what is and is not a Benefit as described in the EAP Services Agreement and this Combined Evidence of Coverage and Disclosure Form. Plan may deny coverage for second opinion requests for services not listed as Benefits in the EAP Services Agreement and this Combined Evidence of Coverage and Disclosure Form. If Plan denies such a request, you will bear the financial responsibility for any self-directed second opinion. There will be no cost to you if the second opinion is received from an EAP Provider under contract with Plan. If you request a second opinion from a provider not under contract with Plan, you must provide an explanation as to why an EAP Provider cannot render such an opinion. Plan’s Medical Director shall review the request to determine whether there is an EAP Provider qualified to render a second opinion. REV: 03-10-23 MI ATTY/AGR.2023.039/Aetna (EAP Services Agreement) (Page 29 of 42)