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HHRC-EOC 02.10.2017 9 Evidence of Coverage The following conditions must be met to receive continuing care services from a licensed mental health provider who is not on Plan’s panel: a. Plan must authorize the continuing care. b. Requested treatment must be a covered benefit under Group’s EAP Services Agreement with Plan. c. The non-plan provider must agree in writing to the same contractual terms as a plan provider, which includes payment rates. d. Member must be new to Plan. B. Terminated EAP Providers Should Plan terminate an EAP Provider for reasons other than a disciplinary cause, fraud, or other criminal activity, you may be able to continue receiving Benefits from the terminated provider following the termination, if the provider agrees in writing to continue to provide Benefits under the terms and conditions of his/her agreement with Plan. To inquire about continued care, you should contact the Member Services Department. XIV. CONTINUATION OF GROUP COVERAGE A. COBRA Continuation of Coverage If Group is subject to the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, as amended, you may be entitled to continuation of Group coverage under that act (COBRA Coverage). You may qualify for COBRA Coverage if you lose Group coverage due to the occurrence of certain qualifying events. Such events include, but are not limited to: Termination or separation from employment for reasons other than gross misconduct. Reduction of work hours. Death of the Participant. Termination of eligibility of a spouse due to divorce or legal separation. Termination of eligibility of a dependent child. Covered dependent if Member becomes eligible for Medicare COBRA Coverage extends up to thirty-six (36) months, depending upon your qualifying event. COBRA Coverage may be terminated on the occurrence of certain events, including you becoming eligible for coverage under Medicare. In addition, COBRA Coverage is not available to certain Members, including those Members who have certain other coverage at the time of the qualifying event. You may obtain complete information on COBRA qualifying events, COBRA Coverage termination circumstances, and ineligibility for COBRA Coverage from Group. REV: 03-10-23 MI ATTY/AGR.2023.039/Aetna (EAP Services Agreement) (Page 33 of 42)