Page 19 - 2021 Marcolin Benefit Guide

WOMEN’S HEALTH AND CANCER RIGHTS (WHCRA)

Special Rights Following Mastectomy. A group health plan generally must, under federal law, make certain benefits
available to participants who have undergone a mastectomy. In particular, a plan must offer mastectomy patients
benefits for:

• Reconstruction of the breast on which the mastectomy has been performed
• Surgery and reconstruction of the other breast to produce a symmetrical appearance
• Prostheses
• Treatment of physical complications of mastectomy
Our Plan complies with these requirements. Benefits for these items generally are comparable to those provided
under our Plan for similar types of medical services and supplies. Of course, the extent to which any of these items is
appropriate following mastectomy is a matter to be determined by consultation between the attending physician and
the patient. Our Plan neither imposes penalties (for example, reducing or limiting reimbursements) nor provides
Incentives to induce attending providers to provide care inconsistent with these requirements.

GINA NOTICE TO AVOID PROVIDING GENETIC INFORMATION FOR WELLNESS PROGRAMS

The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA
from requesting or requiring genetic information of an individual or family member of the individual, except as
specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information
when responding to this request. “Genetic information” as defined by GINA, includes an individual’s family medical
history, the results of an individual’s or family member’s genetic tests, the fact that an individual or an individual’s
family member sought or received genetic services, and genetic information of a fetus carried by an individual or an
individual’s family member or an embryo lawfully held by an individual or family member receiving assistive
reproductive services. Please do not include any family medical history or any information related to genetic testing,
genetic services, genetic counseling, or genetic diseases for which an individual may be at risk.

MICHELLE’S LAW

Michelle’s Law permits seriously ill or injured college students to continue coverage under a group health plan when
they must leave school on a full-time basis due to their injury or illness and would otherwise lose coverage. The
continuation of coverage applies to a dependent child’s leave of absence from (or other change in enrollment) a
postsecondary educational institution (college or university) because of a serious illness or injury, while covered under
a health plan. This would otherwise cause the child to lose dependent status under the terms of the plan.

Coverage will be continued until:

1. One year from the start of the medically necessary leave of absence, or

2. The date on which the coverage would otherwise terminate under the terms of the health plan; whichever is
earlier.

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