Health and Welfare Summary Plan Description
8.4 No Surprises Act: Certain Out-of-Network Charges Cost-Sharing Same As In-Network / PPO
Certain out-of-network charges, including emergency, specific non-emergency services rendered in an in-network facility, and air ambulance services will be identified by the Plan as being subject to the No Surprises Act (�NSA�), a federal law intended to protect consumers from surprise bills by healthcare providers. For NSA charges, the Plan will calculate and, as appropriate, negotiate the payment amount with the out-of-network provider in an amount substantially similar to the Plan's contracted in-network rate for the same services.
Unless you affirmatively consent to waive the applicability of the NSA, you will be subject to the same cost-sharing requirements for these NSA charges as if the claim was provided by a PPO provider and will not be responsible for any charges in excess of the contracted amount, including any �balance bill� that might otherwise be required by an out-of-network provider.