AMERICAN SPECIALTY HEALTH PLANS GROUP SUBSCRIBER AGMT 1998

., 1.22 Open Enrollment Period. Open Enrollment Period is the period agreed upon by ASHP and Group during which all eligible group employees and their eligible Dependents may enroll in this ASHP Plan. 1.23 Participating Chiropractor. Participating Chiropractor is a Chiropractor who has contracted with ASHP to provide Chiropractic Services to Members at an agreed upon compensation plus any applicable Copayments, as the total charge. 1.24 Ouality Assurance Program. Quality Assurance Program are the procedures and standards established and administered by ASHP to ensure that Chiropractic Services rendered by a Participating Chiropractor comply with the standards of chiropractic care acceptable to the community in which the care is rendered. 1.25 Schedule of Benefits is the schedule of Chiropractic Services which are provided to a Member under this Health Plan. The Schedule of Benefits is incorporated herein and attached as Attachment A. 1.26 Service Area is the geographic area in which ASHP is licensed to arrange for Chiropractic Services in the State of California by the California Department of Corporations. 1.27 Subscriber is the person whose employment or other status is the basis for eligibility for Membership in this Health Plan. A Subscriber must meet all the applicable eligibility requirements of this Agreement and applicable Health Plan Premiums must have been received by ASHP on behalf of Subscriber. 1.28 Utilization Management Program. Utilization Management Program is an ASHP program to promote the efficient use of resources and maintain the quality of health care and includes, but is not limited to, the prospective, concurrent and retrospective review of Chiropractic Services. 2. ELIGIBILITY AND ENROLLMENT 2.01 Enrollment Procedure. ASHP provides Chiropractic Services to Members who meet the eligibility requirements stated in this Agreement, who are properly enrolled in the Health Plan pursuant to this Agreement and who are listed on the Eligibility Tape provided by Group. No services or benefits under this Agreement shall be available to any person not specifically enrolled. 2.01.01 Application Form. A properly completed application for Enrollment on a form provided by ASHP or other documentation as determined by ASHP must be submitted to ASHP by Group for each Subscriber, on behalf of the Subscriber and any Dependents. 2.01.02 Time of Enrollment. All applications for Enrollment shall be submitted by the applicant to Group during Open Enrollment Periods, except Group employees and their eligible Dependents who are not eligible during the previous Open Enrollment Period may apply for Enrollment within thirty (30) days after becoming eligible. All applications for Enrollment which are not received timely as described above by Group may be rejected by ASHP. Group shall provide notice to Members of the applicable Open Enrollment Periods. 2.02 Subscriber Eligibility. Only Subscribers who meet the eligibility requirements stated in this Agreement may be enrolled in the Health Plan. Loss of eligibility shall terminate Subscriber's membership in this Health Plan. Subscriber must meet each of the following eligibility requirements: a. Subscriber must permanently reside within the Service Area. b. Subscriber must meet all eligibility requirements of Group for Membership in this Health Plan.