33 The Plan will make an initial payment or notice of denial of payment for Emergency Services, Non- Emergency Services at PPO Facilities by Non-PPO Providers, and Air Ambulance Services, within thirty (30) calendar days of receiving a Clean Claim from the Non-PPO Provider. The 30-day calendar period begins on the date the Plan receives the information necessary to decide a claim for payment for the services. If a claim is subject to the No Surprises Act, the participant cannot be required to pay more than the cost sharing under the Plan, and the provider or facility cannot bill the participant or dependent more than the required cost sharing. The Plan will pay a total plan payment directly to the Non-PPO Provider that is equal to the amount by which the Out-of-Network Rate for the services exceeds the cost sharing amount for the services, less than any initial payment amount. External Review In addition to the two (2) reasons for External Review listed in the Medical SPD, External Review is also available for a claim denial that is related to an Emergency Service, Non-Emergency Service provided by a Non-PPO Provider at a PPO facility, and/or Air Ambulance Service, as covered under the federal No Surprises Act. Please see the External Review Procedures in the Medical SPD for further information. Continuity of Coverage If you are a Continuing Care Patient, and the contract with your Network provider or facility terminates, or your benefits under a group health plan are terminated because of a change in terms of the providers’ and/or facilities’ participation in the Plan: 1. You will be notified in a timely manner of the contract termination and of your right to elect continued transitional care from the provider or facility; and 2. You will be allowed up to ninety (90) days from the date of notification of continued coverage at Network cost sharing to allow for a transition of care to a Network provider. Incorrect PPO Provider Information A list of PPO Providers is available to you without charge by visiting the CareFirst Administrators website or by calling the phone number on your ID card. The network consists of providers, including hospitals, of varied specialties as well as general practice, who are contracted with the Plan or an organization contracting on its behalf. If you obtain and rely upon incorrect information about whether a provider is a PPO Provider from the Plan or its administrators, the Plan will apply PPO cost sharing to your claim, even if the provider was a Non-PPO Provider. Complaint Process If you believe you have been wrongly billed, please contact Quantum Customer Service at 1-866-871- 0839 for assistance or the Employee Benefits Security Administration (“EBSA”) toll-free number at 1- 866-444-3272. Repeal of Emergency Room Payment Rules The Plan provision concerning payment for Emergency Room Services, as required by the Affordable Care Act, is repealed for services provided on or after January 1, 2022, and replaced with the No Surprises Act requirements.