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CONTRACT NO. 0HS-573-89 <br /> <br />in its periodic reports recommended corrective actions to be taken <br />in light of the pattern of grievances received. <br /> <br /> I. Effectiveness of Coveraqe. Coverage for services <br />under this agreement becomes effective for an Enrollee immediately <br />after (1) this Agreement is executed by Contractor and Sponsor and <br />(2) Subscriber has the relationship with Sponsor that makes him or <br />her eligible for Program Services as set forth in Section I. (F.) of <br />this agreement. <br /> <br /> III. LIMITATIONS, EXCEPTIONS AND EXCLUSIONS <br /> <br /> A (1). Choice of Physicians and Providers. Enrollees must <br />obtain Program services only from Panel Providers if Contractor is <br />to pay for such Services. <br /> <br /> A (2). Liability of Subscriber or Enrollee for Payment. <br />If an Enrollee chooses to receive Program Services from a Provider <br />who is not a Panel Provider, Contractor has no obligation or <br />responsibility to compensate or reimburse such Non-Panel Provider or <br />the Enrollee for any services rendered to such Enrollee, and <br />Enrollee has the responsibility for paying such Non-Panel Provider. <br />Therefore, Contractor will not pay Non-Panel Providers for services <br />rendered to Enrollees, and Enrollees may be liable to the Non-Panel <br />Provider for the cost of services. <br /> <br /> B. Costs to Enrollees for Additional Sessions. If an <br /> <br />Enrollee elects to receive counseling sessions in addition to the <br />sessions per contract period specified in Section IV (D) of this <br />Agreement, the Enrollee is responsible for paying the costs of such <br /> <br /> - 8 - <br /> <br /> <br />