Common use of Plan Interpretation Clause in Contracts

Plan Interpretation. Blue Shield shall have the power and authority to construe and interpret the provisions of this Plan, to determine the Benefits of this Plan and deter- mine eligibility to receive Benefits under this Plan. Blue Shield shall exercise this authority for the benefit of all Members entitled to receive Benefits under this Plan. This procedure enables Members to participate in establishing the public policy of Blue Shield. It is not to be used as a substitute for the grievance pro- cedure, complaints, inquiries or requests for infor- mation. Public policy means acts performed by a plan or its employees and staff to assure the comfort, dignity, and convenience of patients who rely on the plan’s facilities to provide health care services to them, their families, and the public (California Health and Safety Code, §1369). At least one third of the Board of Directors of Blue Shield is comprised of Subscribers who are not employees, providers, subcontractors or group contract brokers and who do not have financial in- terests in Blue Shield. The names of the members of the Board of Directors may be obtained from: Sr. Manager, Regulatory Filings Blue Shield of California ▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ San Francisco, CA 94105 Phone: ▇-▇▇▇-▇▇▇-▇▇▇▇ Please follow the following procedure:

Plan Interpretation. Blue Shield shall have the power and discretionary authority to construe and interpret the provisions of this Plan, to determine the Benefits of this Plan and deter- mine determine eligibility to receive Benefits under this Plan. Blue Shield shall exercise this authority for the benefit of all Members entitled to receive Benefits Bene- fits under this Plan. This procedure enables Members to participate in establishing the public policy of Blue ShieldShield of Cal- ifornia. It is not to be used as a substitute for the grievance pro- cedureprocedure, complaints, inquiries or requests re- quests for infor- mationinformation. Public policy means acts performed by a plan or its employees and staff to assure the comfort, dignity, and convenience of patients Members who rely on the plan’s facilities to provide health care services to them, their families, and the public (California Health and Safety Code, §1369). At least one third of the Board of Directors of Blue Shield of California is comprised of Subscribers who are not employeesEmployees, providers, subcontractors or group contract brokers and who do not have financial in- terests fi- nancial interests in Blue Shield. The names of the members of the Board of Directors may be obtained from: Sr. Manager, Regulatory Filings Blue Shield of California ▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ San Francisco, CA 94105 Phone: ▇-▇▇▇-▇▇▇-▇▇▇▇ Please follow the following procedure:

Plan Interpretation. Blue Shield shall have the power and authority to construe and interpret the provisions of this Plan, to determine the Benefits of this Plan and deter- mine eligibility to receive Benefits under this Plan. Blue Shield shall exercise this authority for the benefit of all Members entitled to receive Benefits under this Plan. This procedure enables Members to participate in establishing the public policy of Blue Shield. It is not to be used as a substitute for the grievance pro- cedure, complaints, inquiries or requests for infor- mation. Public policy means acts performed by a plan or its employees and staff to assure the comfort, dignity, and convenience of patients who rely on the plan’s facilities to provide health care services to them, their families, and the public (California Health and Safety Code, §1369). At least one third of the Board of Directors of Blue Shield is comprised of Subscribers who are not employees, providers, subcontractors or group contract brokers and who do not have financial in- terests in Blue Shield. The names of the members of the Board of Directors may be obtained from: Sr. Manager, Regulatory Filings Blue Shield of California ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇, ▇▇ San Francisco, CA 94105 ▇▇▇▇▇ Phone: ▇-▇▇▇-▇▇▇-▇▇▇▇ Please follow the following procedure: