109 Miscellaneous Provisions and Cost Savings Advice Misrepresentation and Fraud In the event you, your Spouse, or your Eligible Dependent Children receives benefits as a result of misleading representation or any type of false information or other fraudulent representations to the Fund, you, your Spouse, or your Eligible Dependent Child will be liable to repay all amounts paid by the Fund. Fraud includes a person’s failure to disclose any other group health coverage in which such person is entitled to receive reimbursement of a claim submitted to the Fund for payment or reimbursement from a third party (See the Section on Third Party Liability for more information). You, your Spouse, or your adult dependent children will be prosecuted for fraud and held liable for all costs of collection, including interest, court, and attorney’s fees. In addition, you may be subject to criminal penalties. Overpayments and Erroneous Payments If a claim payment is made to a participant or assigned to a provider and it is later determined that the payment is an overpayment or an erroneous payment, the Board of Trustees may offset future claim payments or take any other action it deems appropriate in order to recover the overpayment or erroneous payment. Notices Sent to Addresses of Participants The Board of Trustees and/or the Fund Office will give notice by mail to participants of actions taken with respect to eligibility, claims, and other important matters. All such notices will be sent to your address, as it appears in the Fund’s records. To protect yourself and your rights, you must be sure the Fund Office always has your current address. If you fail to notify the Fund Office of your current address, you may miss receiving an important notice and might lose valuable rights or benefits. You may even lose coverage. Any notice sent to you at the address in the Fund’s records will be deemed to have been received by you. The time in which you must reply to such a notice will not be extended, because you did not give the Fund Office your current address. Cost Savings Advice Physician’s Fees and Treatment Plans Whenever possible, you should use an in-network physician, hospital, laboratory or imaging provider. If you use an out-of-network provider, you should ask your physician about his/her treatment and medical fees, as it is important to know whether the Fund will recognize these fees as “reasonable and customary, Medically Necessary, or covered charges.” Remember that coverage under the Plan for out-of-network services is limited and subject to out-of- network deductibles and coinsurance. You are liable for charges billed by a physician or other provider that are in excess of the allowable covered charges under the Plan, and such amounts will not count towards your annual out-of-pocket maximum. You do not have this risk of being billed above the allowance recognized by the Fund if you utilize a provider from the CareFirst Administrators network.