Additional Provisions

Facility Of Payment

A payment made under another plan may include an amount that should have been paid under this Plan. If it does, the Claims Administrator may pay that amount to the organization that made the payment. That amount will then be treated as a benefit payable under this Plan, and the Claims Administrator will not have to pay that amount again. "Payment made" includes providing benefits in the form of services, in which case "payment made" means the reasonable cash value of the benefits provided in the form of services.

This provision only applies under the CIGNA Medical and MetLife-administered Dental Plans.

Right Of Reimbursement

This provision applies when you or your covered dependents receive or may receive reimbursement from a third party as the result of an injury or illness. The purpose of this provision is to ensure no benefit payments are duplicated under the FlexSolutions health care plans.

As used here, third party reimbursement means any direct or indirect payments you may receive (as a result of an injury or illness) from any source by way of settlement, judgment or any other manner, including but not limited to, reimbursement from uninsured or underinsured motorist and no-fault insurance coverage.

If third party reimbursement is or may be due to you or your covered dependents, but is not yet paid, the Claims Administrator may advance benefit payments to you or your dependents, whoever is the covered individual. The covered individual (or his or her legal guardian in the event the covered individual is a minor or is not legally competent) agrees to...

• Promptly notify the Claims Administrator of any recovery received from the third party, and

• Reimburse the Claims Administrator the benefits advanced under the FlexSolutions Plan, up to the amount of any reimbursement received from the third party.

Any benefit paid will be subject to all provisions that apply under the FlexSolutions Plan.

The covered individual must complete and return to the Claims Administrator any forms required by the Claims Administrator.

This provision will apply whether or not liability for payment is admitted by the third party. If a covered person refuses to reimburse the Claims Administrator in accordance with the terms of this provision, the Claims Administrator has the right to deduct the amount of benefits paid from any future benefits payable to the covered person or to any other covered family member. The Claims Administrator has the right to bring legal action against the covered person to recover any balance owed under the terms of this provision.

Right Of Recovery

Whenever payments have been made exceeding the amount necessary to satisfy the provisions of this Plan, the Plan has the right to recover these expenses from any individual (including yourself, or an Insurance Company or other organization receiving the excess payments). The Plan may also withhold payment, if necessary, on future benefits until the overpayment is recovered.

Further, whenever payments have been made based on fraudulent information provided by you, the Plan will exercise the right to withhold payment on future benefits until the overpayment is recovered.