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HomeMy WebLinkAbout04-1473RICHARD F. MAFFETT, JR., ESQUIRE ID #3§539 2201 North Second Street Harrisburg, PA 17110 717-233-4160 Attorney for Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JAMES L. MILLER, Parent and Natural Guardian of SAMANTHA JO MILLER, a Minor, Plalntlffs 296 Old Stonahouse Road Carlisle, PA 17013 v JORDAN L. BRANDT, Defendant 161 Valley Drive Carlisle, PA 17013 NO. CIVIL ACTION - LAW JURY TRIAL DEMANDED PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue Writ of Summons in the above-captioned action. Writ of Summons Date: shall be issued and forwarded to Sheriff. R . Maffe~t', J~., Esq. WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANT: YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFFS HAVE CO~ENCED AN ACTION AGAINST YOU. P~otho~otary Deputy SHERIFF'S RETURN - REGULAR CASE NO: 2004-01473 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND MILLER JkMES L ET AL VS BR3kNDT JORDAN L CPL. MICHAEL BARRICK , Sheriff or Deputy Sheriff of Cumberland County, Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS was served upon BRANDT JORDAN L DEFENDANT , at 2020:00 HOURS, at 161 VALLEY DRIVE CARLISLE, PA 17013 DAVID BP~ANDT, FATHER a true and attested copy of WRIT OF SUMMONS on the 8th day of April by handing to the , 2004 together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 3.45 Affidavit .00 Surcharge 10.00 .00 31.45 Sworn and Subscribed to before me this /~ day of  ~W3~ A.D. Prothonotary / ~ So Answers: R. Thomas Kline 04/12/2004 RICFIARD MAFFETT JR RICHARD F. MAFFETT, JR., ESQUIRE ID #35§39 2201 North Second Street Harrisburg, PA 17110 717-233-4160 Attorneys for Petitioner JAMES L. MILLER, Parent and Natural Guardi&n of SAMANTHA JO MILLER, a minor, Petitioner v JORDAN L. BRANDT, ResDon~ent IN THE COURT OF COMMON PLEAS CUMBERLAND. COUNTY, PENNSYLVANIA NO. 04-1473 CIVIL ACTION - LAW PETITION FOR APPROVAL OF COMPROMISE SETTLEMENT INVOLVING A MINOR PETITION FOR APPROVAL OF MINOR'S SETTLEMENT AND NOW, this 22nd day of April, 2004, comes JAMES L. MILLER, Parent and Natural Guardian of SA~L~NTHA JO MILLER, their attorney, Richard F. Maffett, Jr., Esquire, this Petition For Approval of Minor's Settlement, thereof, by and submits and in support avers the following: COUNT I: JORDAN L. BRANDT AND ALLSTATE INS~ANCE COMPANY 1. Petitioner, JAMES L. MILLER, is guardian of SAMANTHA JO MILLER, a minor, August 1, 1986. 2. The minor, SAMANTHA JO MILLER, resides with her parents, Petitioner, JAMES L. MILLER, and STEPHANIE MILLER at 296 Old Stonehouse Road, Carlisle, Cumberland County, Pennsylvania, who have sole custody of said minor. the parent and natural age seventeen (17), born 3. Respondent, JORDAN L. BRANDT, is an adult individual, age eighteen (18), having a date of birth of February 26, 1986, who resides with her parents at 161 Valley Drive, Carlisle, Cumberland County, PA. 4. The above-captioned action involves a claim for damages as a result of injuries suffered by the minor, SAMANTHA JO MILLER, when she was involved in an automobile accident. 5. The aforesaid automobile accident occurred on January 26, 2003, at about 4:20 p.m. on Interstate Route 81, in Middlesex Township, Cumberland County, PA. 6. The minor, SAMANTHA JO MILLER, was a passenger in a vehicle driven by Respondent JORDAN L. BRANDT, which was headed southbound on Interstate Route 81 in the passing lane. 7. At the aforesaid time and place, Respondent JORDAN L. BRkNDT, lost control of her vehicle, which left the roadway, traveled across the median; and, entered the northbound lanes of Interstate Route 81 headed southeast, where the rear of Respondent BRAIqDT'S auto collided with the left side of a fully loaded tractor trailer. (See Police Report attached as Exhibit A.) 8. All of the injuries and damages suffered by the minor, SAMANTHA JO MILLER, are the direct result of the negligence of Respondent JORDAN L. BRANDT in: driving her automobile too fast 2 for conditions; and, her vehicle. 9. The minor, SAMANTHA JO MILLER, was ejected from the Respondent BRANDT'S vehicle and suffered multiple serious injuries. (See Discharge Summary attached as Exhibit B.) 10. The minor, SAMANTHA JO MILLER was an inpatient at the Milton S. Hershey Medical Center for sixteen (16) days from January 26, 2003 through February 10, 2003. (See Exhibit B attached.) 11. On January 26, 2003, surgery in the nature of a splenectomy and laporotomy was performed; and, SAMANTHA JO MILLER'S dislocated right hip was also put back into place. (See Exhibit B attached.) 12. The minor, SAMANTHA JO MILLER, suffered the following injuries: a. closed head injury; b. left frontal cephalohematoma; c. multiple lacerations, bruises & abrasions of the face, right shoulder, right hand & left knee; d. C4 facet fracture; e. fractured right clavical; f. comminuted fracture of the riglht scapula; g. bilateral pulmonary contusions; h. bilateral hemothorax; I. bilateral pneumothorax; failing to maintain adequate control over j. liver lacerations; k. splenic lacerations; 1. retroperitoneal hematoma; m. multiple rib fractures, including the posterior 10tn and 11th ribs; no compression fractures at T6,T9,T10,Tll, and T12; o. burst fractures at T10,T12, and L1; p. paraspinal hematoma; q. transverse process fracture of the L5 vertebrae on the right; r. complex bilateral sacral fractures involving both SI joints and the left sacrum; s. complex comminuted right superior pubic rami fracture; t. comminuted right pelvic acetabular fracture; and, u. fracture of the right femoral head. (See Exhibit B attached.) 13. On February 5, 2003, the minor, SAMANTHA JO MILLER was placed in a fiberglass full body cast in treatment of her spinal fractures which she remained in for seven (7) weeks, until March 19, 2003. (See Exhibit B attached.) 14. After her discharge from the hospital, the minor, SAMANTHA JO MILLER, has continued to receive outpatient treatment through the Milton S. Hershey Medical Center. 15. The minor, SAMANTHA JO MILLER bears a sixteen (16) inch scar down the middle of her abdomen; and, must take penicillin 4 daily for the rest of her life because of the loss of her spleen. She is more susceptible to infection and cannot play contact sports. 16. The minor, SAMANTHA JO MILLER also has a two (2) inch scar above her left eyebrow; and, a five (5) inch scar on her right leg. 17. The minor, SAMANTHA JO MILLER has made an excellent recovery, although she continues to have lower back pain. (See treatment notes of June 4, 2004 and July 24, 2003, attached as Exhibit C.) 18. The minor, SAMANTHA JO MILLER, has incurred medical bills for treatment of her injuries caused by the aforesaid auto accident in excess of $107,894.16. 19. Petitioner had first party medical bill coverage with Erie Insurance Group in the amount of $10,000.00, which has been exhausted. (See Exhibit D attached.) 20. Most of the remainder of the medical bills of the minor, SAMANTHA JO MILLER, have been paid by health insurance, Keystone Health Plan Central, which Petitioner, JAMES L. MILLER, makes partial payment for through his employment. 21. By letter dated April 5, 2003, Keystone Health Plan Central was given notice that the injuries of the minor, SAMANTHA JO MILLER, had been caused by an automobile accident and that first party automobile insurance benefits had been exhausted. (See Exhibit E attached.) 22. Petitioner has not received any notice of a subrogation claim from Keystone Health Plan Central for reimbursement of any health insurance benefits paid on behalf of the minor, SAMANTHA JO MILLER. 23. Undersigned counsel has reviewed the Subscriber Agreement of Keystone Health Plan Central; and, believes, and therefore avers, that there is no enforceable subrog'ation right under the Motor Vehicle Financial Responsibility Law. (See Subscriber Agreement attached as Exhibit F.) 24. At the time of the aforesaid accident, the minor, SAMANTHA JO MILLER, was in the eleventh (llth) grade at Cumberland Valley High School; and, as a result of her injuries, was unable to return to school for the balance of the 2002-2003 received home-bound instruction. (See Exhibit G school year, but attached.) 25. Because the minor, SA~4ANTHA JO MILLER was a high school student at the time of her injuries, she was not employed and suffered no wage loss. 26. Respondent, JORDAN L. BRANDT, was covered by two (2) policies of automobile insurance with Allstate Insurance Company as follows: 6 Pol£c~ No. 1554556561 B19 1554555480 B19 Patricia Coia, owner of auto Rebecca Brandt, Respondent's mother Policy Limit $15,000-30,000 $100,000-300,000 $109,125.00: a. $10,000.00 paid on 08/01/06 (age 20); b. $10,000.00 paid on 08/01/08 (age 22); c. $15,000.00 paid on 08/01/10 (age 24); d. $20,000.00 paid on 08/01/12 (age 26); e. $24,125.00 paid on 08/01/14 (age 28); f. $30,000.00 paid on 08/01/16 (age 30). (See Exhibit H Attached.) 27. Allstate Insurance Company has agreed, subject to the approval of Your Honorable Court, to pay their policy limits in settlement of this claim, which total $115,000. (See Exhibit I attached.) 28. In order to provide maximum recovery and security for his minor daughter, SAMAI~THA JO MILLER, Petitioner, JAMES L. MILLER, desires to enter into a structured settlement with Allstate Insurance Company, whereby $76,667.00 of the settlement proceeds would be used to purchase an Annuity Contract from Allstate Life Insurance Company. (See Exhibit J attached.) 29. As of March 25, 2004, the aforesaid Annuity Contract, would guarantee, the following tax-free payments to SAMANTHA JO MILLER on the following schedule, for a total payout of (See Exhibit J attached.) 30. Petitioner believes, and therefore avers, that there is no other liability insurance coverage available to Respondent BRANDT, nor does she own any significant unencumbered JORDAN L. assets. 31. Although the proposed settlement is not adequate to compensate the minor, SAMANTHA JO MILLER, for all of her injuries and damages caused by the aforesaid accident, it is unlikely that additional assets can be obtained from the tortfeasor, Respondent JORDAN L. BRANDT, the only negligent party, and the expense and delay of further litigation are not in the best interests of the minor, SAMANTHA JO MILLER. 32. Petitioner JAMES L. MILLER, and undersigned counsel, Richard F. Maffett, Jr., Esquire, believe and therefore aver that the proposed settlement is reasonable and in the best interests of the minor, SAMANTHA JO MILLER. 33. Petitioner also has underinsured motorist coverage for the injuries and damages suffered by his minor daughter, SAMANTHA JO MILLER, through his automobile insurance policy with Erie Insurance Group in the amount of $200,000. (See Exhibit K attached.) 34. Erie Insurance Group has also agreed to pay to the minor, SAMANTHA JO MILLER, the limits of the aforesaid underinsured motorist coverage, in the amount of $200,000, pursuant to a structured settlement, which is the subject of Count 2 herein. (See Exhibit L attached.) 35. Petitioner, JAMES L. MILLER is only aware of unpaid medical bills for treatment of the injuries of the minor, SAMANTHA JO MILLER, in the amount of $9,7213.26, which he proposes to pay out of the settlement funds pursuant to the aforesaid underinsured motorist coverage with Erie /insurance Group. (See Count II herein.) 36. STEPHANIE L. MILLER, mother of the minor, SAMANTHA JO MILLER, also agrees to the aforesaid settlement, believes it to be in the best interests of her daughter, and desires that the proposed settlement be accepted and approved. (See the Affidavit of STEPHANIE L. MILLER attached as Exhibit M.) 37. Should the Court deem it necessary to schedule a hearing to approve the settlement proposed herein, the minor, SAMANTHA JO MILLER, and her parents, Petitioner, JAMES L. MILLER, and STEPHANIE L. MILLER, are available to testify. 38. Undersigned counsel, Richard F. Maffett, Jr., Esquire, has an attorneys fee agreement with Petitioner in this matter in the amount of twenty-five (25%) percent of the amount recovered, resulting in attorneys fees on the recovery from Respondent JORDAN L. BRANDT, and Allstate Insurance Company, in the amount of $28,750.00, subject to the approval of Your Honorable Court. (See Exhibit N attached.) 9 39. Petitioner's attorney, Richard F. Maffett, Jr., Esquire, has incurred the sum of $266.74 for out-of-pocket expenses in prosecuting this claim; however, Petitioner proposes to make reimbursement of these litigation expenses out of the proceeds of the underinsured motorist settlement with Erie Insurance Group. (See Exhibit 0 attached.) W~ER~FOR~, Petitioner JAMES L. MILLER, Parent and Natural Guardian of SAMANTHA JO MILLER, a minor, respectfully requests that Your Honorable Court enter an order approving the foregoing compromise settlement, directing distribution of the proceeds thereof as set forth above, and authorizing Petitioner, upon payment of the aforesaid sums to discontinue the action brought to the above term and number, and to execute a good and sufficient release to Respondent, JORDAN L. BRANDT, and Allstate Insurance Company, of any and all claims by SAMANTHA JO MILLER, a minor, and JAMES L. MILLER, as Parent and Natural Guardian of the minor, and of all other persons, firms, or corporations arising from or as a result of the incident referred to above. COUNT II: ERIE INSURANCE GROUP 40. Petitioner incorporates by reference the averments of Paragraphs 1 through 39 above as fully as though set forth at length herein. 10 41. Petitioner's underinsured motorist coverage through his automobile insurance policy with Erie Insurance Group is in the aggregate amount of $200,000.00. (See Exhibit K attached.) 42. Erie Insurance Group has agreed to pay to Petitioner on behalf of the minor, SAMANTHA JO MILLER, the limits of their underinsured motorist coverage, in the amount of $200,000.00. (See Exhibit L attached.) 43. The only unpaid medical bills of which Petitioner, JAMES L. MILLER, is aware total $9,733.26, payment of which will be made out the settlement funds from Erie Insurance Group, subject to approval from Your Honorable Court. 44. In order to provide maximum recovery and security for his minor daughter, SAMANTHA JO MILLER, Petitioner JAMES L. MILLER, desires to accept the majority of the aforesaid underinsured motorist settlement funds by way of a structured settlement with Erie Insurance Group, whereby $130,912.00 of the settlement proceeds would be used to purchase an Annuity Contract from Erie Life Insurance Company. 45. As of March 18, 2004, the aforesaid Annuity Contract would guarantee the following tax free payments to SAMANTHA JO MILLER on the following schedule, for a total payout of $182,500.00: a. b. $10,500.00 paid on 08/01/06 (age 20); $10,500.00 paid on 08/01/08 (age 22); c. $10,500.00 paid on 08/01/10 (age 24); d. $10,500.00 paid on 08/01/12 ([age 26); e. $10,500.00 paid on 08/01/14 ([age 28); f. $130,000.00 paid on 08/01/16 (age 30). (See Exhibit P attached.) 46. Petitioner, JAMES L. believe, and therefore aver, MILLER, and undersigned counsel that other than the sums listed herein, there is no other insurance coverage applicable to the minor, SAMANTHA JO MILLER, nor are there any other collateral sources of recovery from which she would be likely to obtain reimbursement for her injuries and damages. 47. Although the settlement with Erie Insurance Group proposed herein is still insufficient to fully compensate the minor, SAMANTHA JO MILLER, for all of her injuries and damages, for all of the reasons set forth herein, Petitioner, JAMES L. MILLER, and undersigned counsel believe that this settlement is in the best interests of the minor, SAMANTHA JO MILLER. 48. STEPHANIE L. MILLER, mother of the minor, SAMANTHA JO MILLER, also agrees to the aforesaid settlement with Erie Insurance Group, believes it to be in the best interests of her daughter, and desires that the proposed settlement be accepted and approved. (See the Affidavit of STEPHANIE L. MILLER attached as Exhibit M.) 12 49. Undersigned counsel, Richard F. Maffett, Jr., Esquire, has an attorneys fee agreement with Petitioner in this matter in the amount of twenty-five (25%) percent of the amount recovered from Erie Insurance Group, resulting in attorneys fees of $50,000.00, subject to the approval of Your Honorable Court. (See Exhibit N attached.) 50. Petitioner, JAMES L. MILLER, has agreed, subject to approval from Your Honorable Court, to reimburse Richard F. Maffett, Jr., Esquire, the sum of $266.74 for out-of-pocket expenses in prosecuting this claim. (See Exhibit 0 attached.) W~I~R~FOR~, Petitioner, JAMES L. MILLER, Parent and Natural Guardian of SAMANTHA JO MILLER, a minor, respectfully requests that Your Honorable Court enter an order approving the foregoing compromise settlement with Erie Insurance Company, directing distribution of the proceeds thereof as set forth above, and authorizing Petitioner, upon payment of the aforesaid sums to execute a good and sufficient release to Erie Insurance Company, of all claims by SAMANTHA JO MILLER, a minor, and JAMES L. MILLER, as parent and natural guardian of the minor, and of all other persons, firms, or corporations arising from or as a result of the incident referred to above. Respectfully submitted, Attorney For Petitioner · Number Towea to Tewed ~y ~O~i~'-Y ' ----JJ---J ,,',, I ~'ZZZZZ] rowed PENNDOT COPY EXHIBIT "A" · --.,a " POLICE CRASH REPORTING FORM AA 4~ ~ ~ 00109'7 P0507258 'l'~ -- State __ thdlsad411 .... j~ ~Unkr,~ TMII~ Lille ~ ~h ltmTurning Left on l~l Cr, J~O ,. [,eft 06:Parked 12iTufnin(~ Left ~ 4~Sag/b of Hill ,,,, , ,,, PENNDOT CoPY .... AA45 3 1 00~098 FI MI l t fl I I'I"'IT'I-II~IIL1 cltf s~ Zip ..... __IL6-~_~_~ I1-~11 ~ I-~lol ~ I~1 0 Akoh~l and Drugs Akohol/Druq$ Suspected :'~3 No ~ Akohol State t Drinking ,.J Sltk ~._._, AsI~IIp J Urlkno~m t~en~ Num~, S~ ~ -::, ,,~o,~, 0 ~ Iii 0 ~J~ 0 ~.~ ' I~'~ ~ ~ tea~dbyPriver OS ~fl~W~ --WM~V~, ~ j- M~M ,~1 ~ ~ o~:e~v~te VehK~e NOt ~O~he~ - ~ eENNOOT _J COMMONWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM AA454 1 Change/ Continuation P0507258 Person Type: A ~:o,,,,,,D B F =Female U =Unknown Injury Seve~t~: C {)=Not In urea 11 =In Other E~,d Patsen~ Oe ~e~ Area 2=Ma~ Injury 3=M~e~ate (Ba~ Of Pickup, E~) Inju~ 13=Traillng Un~ 4=Minor Inju~ 14=RJdi~ On Vehl(~ Ex.riot 9=Unknown 15=8us Pas~ge~ 98=Othet gg~Unknown Seat Position: O~=Or,ver* AIl Veh~ 02=Front Seat Mille P~iflon Motorcycle 05=Seco~ Row. Midge ~on 06=S~ond Row- Right S~e 07=Third R~ Or Greater Le~ Side ~Th*~ R~Of G~. Rkl~ 10=Alt Bi( 11=Air Unk S I~w' ~,Unknowfl Name / Addres, / Phone Unit No Per~on No Date of B ~h (MM-DD-Yyyy) A B Dele e? c D E UmtNo Pet~on No Oelet e ? ,Date. of Birth (MM. DD.Yyyy) D EMSTMMlW/t, F 2 Oateofa!nh (M.M-DD-YYYy) A B C D E F G ' ' I --.-8".,;'; .,! ' ,v.,.u...A.,. u,,,.....v^.- P0507258 POLICE CRASH REPORTING FORM (~ ~w i~ ~,4s s, oo~oo,,. Ijf:;F'-FI o c~, I-]-F I '1 I'1 I I ' Interse(fion Type '--I -y- Intersection C~ Off Ramp $~alto~ation (c~4) Not Applicable 0 Bridge ~ M,dblo~k ~.. 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I~ve Unit NO blank ' (same P0507258 42=Hit ~now lank Unit 4~HIt O~mf ~ ~ I Kind Hdd ftloM From W,mng lane WlO POLICE CRASH REPORTING FORM AA457 I PENNDOT COPY , POLICE CRASH REPORTING FORM ~.~ New AA 458 ~ 00110,3 I' Pi ~'~ m:*!~ ;~"'; "lPsp~t, wdnes~, and other information here. It is not requiired to restate information from the form. PEtqNDOT COPY POLICE CRASH REPORTING FORM r~ New ~- ~ Cgange/ AA 45 8 1 eO~O~ ~e: ~ ~ ~- . ~ ~ Delete P,age F ~::,~c~ em~r'~anc¥ Iranspo~, witness, and other reformation here. It is not requi~r~ to r~s~te info~ation from ~l fo~. Witness I Add~'es$: Phone: : · //:m~ 2 Address: Phone: ' ~ ,~-I ', i~l .................... ~ ~ ' ._.:---._ - . _ ~.',JeflMUNWEALTH OF PENNSYLVANIA POLICE CRASH REPORTING FORM AA458 1 OOXXOS,a,,: P0507344 Place emergency transport, witness, and other information here, It is not required to restate information from the fo~m. i Addr~s: PENNDOT COPY AA45C 1 Unit Number Carrier I'~a me POLICE CRASH REPORTING FORM 001106 COMMONWEALTH OF PENNSYLVANIA Page: U~DOT# F_-j Cargo Tank (~, II ~_~ .......... (E~)~.~l i -'" '~'-' 3._.l I l_l,~l, I I I I I I ill" I~-'~,,~ i ~~ '*'--:' ;: ...... Fnl~ 4~i it h~ar~us mate~l c~ and ----' ENN~T COPY Surg D/C Summary MILLER, SAMANTHA J - 1265102 * Final Report * D'r S CI-I~R~E S ~,ARY PATIENT NAME= MILLER, SAMANTHAJ PATIENT NUMBER: 0365450 LOCATIONs 7254 SEX: F PRIMARY CARE PHYSICIAN: Denise F. Hart, DATE ADMITTED: 01/26/2003 DATE DISCIiARGED: 02/10/2003 DATE OF BIRTH: 08/01/1986 M.D. ADMISSION DIAGNOSIS: Multiple trauma. PRINCIPAL DIAGNOSIS: 1. Bilateral pulmonary contusions. 2. Bilateral hemothorax. 3. Bilateral pneumothorax. 4. Liver lacerations. 5. Splenic laceration. 6. Pubic rami fracture. 7. Acetabular fracture. 8. Multiple lacerations and abrasions. 9. L1 and T12 vertebral fractures. 10. Closed head injury. OPERATIONS OR PROCEDURES: 1. On January 26, 2003, exploratory laparotomy, splenectomy, and repair of multiple lacerations. 2. On February 5, 2003, hyperextension casting of the thoracolumbar spine. BRIEF COURSE: The patient is a 16-year-old white female who was brought into Hershey Medical Center at a level i trauma after a rollover motor vehicle accident with ejection. The patient was an unrestrained passenger in the car. She was found to have multiple injuries including bilateral pul~Dnary contusions, bilateral hemothoraces, bilateral pneumothoraces requiring chest tube insertions, liver and splenic lacerations, multiple vertebral body fractures, ]pubic rami fracture, acetabular fracture, multiple other lacerations, and a closed head injury. Both in the emergency room and in the pediatric ICU where the pa'=ient was admitted status post exploratory laparotomy and a splenectomy, the patient had profound hypotension and severe pulmonary failure, and ARDS requiring incremental increase in her respiratory support. Initially, the patient had approximately 700 cc of blood from both of her chest tubes and over 200 cc of blood mixed with pulmonary edema from her endotracheal tube with saturations varying between 8,9 and 92% despite changes in her ventilatory parameters. The patient received continuous vigorous fluid resuscitation due to ongoing losses prior to going to the operating room and Pdnted by: Shiner, Crystal L Page 1 of 3 Pdnted on: 4/16/2003 2:00 PM (Continued) EXHIBIT "B" Surg D/C Summary MILLER, SAMANTHA J - 1265102 ~hnderwent a tran~esoph~geal echocardiogram to look for an aortic injury. .The TEE showed an unrefilled heart despite aggressive volume resuscitation. The patient is also noted to have a mitral valve prolapse of a mild degree, but a qualitatively normal cardiac function. The patient's blood pressure was stabilized on dopamine drip. The patient received number of blood products as well as IV fluid boluses receiving a total of 8 units of packed red cells, 6 %lnits of fresh frozen plasma, 6 units of platelets, and more plasma, platelets, packed red cells, and cryoprecipitate in the operating room. In the operating room, she was found to have an intraabdominal hemorrhage from her spleen laceration. Her liver laceration was contained with signs of active bleeding and multiple retroperitoheal and mesenteric hematomas. The patient was found to have intact diaphragm and bladder. No other signs of active bleeding, status post her splenectomy where she was taken to the PICU status post operation. The patient was seen by orthopedics after her resuscitation for her clavicular, scapular, acetabular, and vertebral body fractures without significant cord compromise and as noted all fractures are likely be treated nonoperatively. The patient was placed on strict Tinel precautions. Upon further review of the patient's x-rays and CT scans, a C4 fracture was noted. The patient remained in an Aspen collar with good fit. The patient remains intubated; however, awake, alert, and following commands. She was extubated on postoperative day #5 and bilateral chest tubes were removed on postoperative day #4. The patient continued to do well and extubated with minimal requirements for additional oxygenation. The patient had some intermittent agitation. She was started on TPN for nutrition and had a couple of episodes of fevers. The patient continued to do well and was transferred from the PICU to the regular pediatrics floor progressing in physical and occupational therapy. The patient had some difficulties with pain control, but was comfortable when switched to OxyContin and OxyIR. The patient had a body cast placed by orthopedics on postoperative day #14. At this time, the patient was tolerating a regular diet, was having normal bowel and bladder motions, was afebrile with stable vital signs, and walking well with physical therapy and occupational therapy. The patient was discharged to home on postoperative day #15. DISCHARGE MEDICATIONS: 2. 3. 4. 5. 6. Penicillin 500 mg p.o.q.d. OxyContin 10 mg one p.o.b.i.d. OxyIR 5 mg one p.o.q.4-6h, p.r.n. Ambien 5 mg p.o.q.h.s. Colace while on 0xyContin and OxyIR. The patient may resume her usual home medications. DISCHARGE ORDERS/INSTRUCTIONS: 1. Diet regular as tolerated. 2. Activity as tolerated per physical therapy teaching and sling to right upper extremity for comfort. 3. The patient is to follow the orthopedic and status post concussion injury worksheet. 4. They are advised to call the pediatric surgery office for the pediatric surgery resident on call at 717-531-8521 with any questions or concerns. 5. Comfort Care will be assisting the patient with her home medical needs. Pdnted by: Shiner, Crystal L Page 2 of 3 Printed on: 4/16/2003 2:00 PM (Continued) PENNSTKFE W~Mi!,ton S.~¢rs,hgy Medical ~,..Oll~ge Ol meaic~ne Center Health Information Services HU24 P.O. Box 850 Hershey, PA 17033-0850 An Equal Opportunity University 'Surg D/C Summary MILLER, SAMANTHA J - 1265102 FOLLOW-UP APPOIATTMENTS: 1. With Dr. Segal in orthopedics on February 20, 2003. 2. Pediatric surgery clinic on March 5, 2003. #000933 DICTATING MD: Kimberli S. Cox, MD ATTENDING MD: Robert E. Cilley, MD KSC/dts D: 02/27/2003 c: WP Clerk DENISE F. F~RR, M.D. 1830 GOOD HOPE ROAD ENOLA, PA 17025 T: 02/28/2003 18:25 Pdnted by: Printed on: Shiner, Crystal L 4/16/2003 2:00 PM Page 3 of 3 (End of Report) PENNSTATE Milton S. Hershey Medical Center College of Medicine HU24 P.O. Box 850 Hershey, PA 17033-0850 An Equal Opportunity University PEDIATP C S RGEONS OF CENTRAL PENNSYLVANIA Robert E, Cllley, M.D. Kerr~ M. Fagalm~, M.D. Andr~l H. ~e~er, M.D. PENNSTATE Denise Hair, M.D. 1830 Good Hope Road Enola, PA 17025 Jtmc4,2003 RE: MILLER, S amantha MSHMC# 1265102 Dear Dr. Hart: we saw Samantha in our clinic ht follow t~p for her multi-tram accident earlier this year. She is now about five months out from h~r injuries. As you recall, she suffered multiple vertebral fractures as well as her hip fracture. She remains on penicillin for prophylaxis. She still has some back pain and until today was still taldng some Vicodin. About six weeks ago, she started to wean off ff~e back brace and has now perforiued physical therapy over the last three weeks. She is overall doing fairly well and her pain CUmlAaint is the Iow back pal~ She continues to follow with Dr. Scgal for the multiple fractures. On physical exam she is fairly pleasant and i[n no acute distress. Her head and neck exam is unremarkable. The previous scar over the upper fight back has healed nicely. Her lower back is straight and there js no significant tenderness noted. Her abdomen shows a well-healed midline scar. The abdomen is flat. Impression: Samantha is doing reasonably 'well after her severe injuries. She is currently still home-schooled. I talked to her and mentioned that the lower back pain is something she will most likely have for the foreseeable future. I strongly advised her not to continue the Vicodin ff at all possl%le as it is a habit-forming drug. I recotm~ended trying Tylenol and Motrin as a combination to see whether she can get relief for her back pain. I highly encouraged her to continue with physical therapy to gain some muscular strength which will support her lower back. She is also schednied to follow up with Dr. Segal in about four to six weeks. At this point, further follow up with us is not necessary. We will be available for her and the fa/ally in case they need l~-ther general trauma assistance. Ohce again, thank you for allowing us to participate in Samantha's care.- ~~Mci~, M.D. AHM/asap CC: Lee Segal, M.D. Hershey Medical Center Pediatric Hershey, PA 17033 Orthopedics EXHIBIT "C" Specializing in the Surgical Care of Infants, Children a nd Adolescents An Equal Opportunity University Ortho Outpt N'ote MILLFR, SAMANTH J - 1265102 * Final Report * PEDIATRIC ORTHOPAEDIC CLINIC PATIENT NAME= MILLER, SAMANTHA J PATIENT NUMBER= 1265102 SEX= F DATE OF SERVICE= 07/24/2003 DATE OF BIRTH: 08/01/1986 DATE OF BIRTH: 08/01/1986 HISTORY: The patient is a 17-year-old female who is 6 months status post multiple injuries from motor vehicle accident. She sustained right clavicle fracture and glenoid fracture, C4 spine fracture, right anterior hip dislocation, LC3 pelvic ring fracture as well as ~ltiple thoracolumbar spine fractures at the T6, T10, Tll, and L1 levels. She has had a posttraumatic kyphotic deformity. She did receive physical therapy, which she has completed. She has been out of brace. Denies any neck pain. Denies any specific right shoulder pain. She has some difficulty carrying a book bag on the right shoulder. Hip is okay. She is unable to sit for prolong periods of time and requires frequent stretching and also feels like her back needs to be stretched out. PHYSICAL EXAMINATION: On exam, she has excellent range of motion of the cervical spine and full range of motion of the right shoulder except for external rotation. There is a moderate posttraumatic kyphotic clinical deformity. No pain with palpation of thoracolumbar spine. No pain with range of motion of the right hip. RADIOGRAPHS: Repeat films today of the thoracolum~ar junction reveal no progression of her kyphosis, which measures 25 deg'rees from T9-Tll. It had measured 26 degrees at last visit. RECOMMENDATIONS: Return to clinic in 6 months. Additional physical therapy for hyperextension exercises, strengthening, and home PT program were prescribed. Return to clinic in 6 months to reevaluate at that time. Printed by: Shiner, Crystal L Page 1 of 2 Printed on: 9/26/2003 3:40 PM (Continued) PENNSTATE ~ Milton S. Hershey Medical Center College of Medicine Hea:th Information Services HU24 P.O. Box 850 Hershey, PA 17033-0850 An Equal Opportunity University Ortho Outpt N'ote MILLFR, SAMANTH/~ J - 1265102 DICTATING MD: ATTEA~DING MD: Lee S. Segal, MD Associate Professor, Orthopaedics & Rehabilitation & Pediatrics LSS/cbt D: 07/24/2003 DENISE HARR, MD* 1830 GOOD HOPE ROAD ENOLA, PA 17025 T: 07/26/2003 18:25 Printed by: Shiner, Crystal L Page 2 of 2 Printed on: 9/26/2003 3:40 PM (End of Report) PENNSTATE ~ Milton S. Hershey Medical Center College of Medicine Health Information Services HU24 P.O. Box 850 Hershey, PA 17033-0850 An Equal Opportunity University KERRY J. RITCHEY, CPCU, AIC Claims Manager ERIE INSURANCE GROUP Branch Office · 4901 Louise Dr. · Rossmoyne Business Center -'P.O. Box 2013 - Mechaniosburg, PA 17055-0710 (717) 795-8200 · Toll Free 1-800-382-1304 · Fax (717) 795-2315 · vcww.erieinsurance.com March 25, 2003 Richard F. Maffett, Jr. 2201 North Second Street Harrisburg, PA 17110 Erie Claim: 010170661624 Erie Insured: James L. Miller & Stephanie L. Miller Date of Loss: 1/26/03 Your Client: Samantha Miller Dear Mr. Maffett: I am in receipt of the letter of representation from your office dated March 24, 2003 and acknowledge same. Samantha Miller exhausted her First Party Benefits limit of $10,000.00 on March 5, 2003. Enclosed is a copy of her payout sheet. Should you have any questions, please feel free to contact me. $incerety, Lisa Maldonado Medical Mgmt Speciahst 717-79:[-2229 EXHIBIT "D" RECEIVED HAR 2 21)I)3 The ERIE Is Above All In sERvIcE~ · Since 1925 ~03/25/2003 13:46 Claims Management System Medical Management Print Medical Payments Req: CSPP060B 'Page: 1 MALDONADO ,L Claim: 010170661624 Ins: JAMES L MILLER & Claimant: 002 SAMANTHA MILLER Limit: 10000.00 Paid: 10000.00 CK F145193 F145194 F145195 F145197 F145200 F145202 F145203 F145205 F145207 F145208 F145211 F145212 F145213 F145214 F145217 Amount 76 00 94 00 96 00 295 00 310 00 327 00 354 00 444 00 804 00 1097.00 440.00 978.00 1162.50 1252.50 2270.00 Payee MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER MILTON S HERSHEY MEDICAL CENTER Service Date 20030205 20030129 20030130 20030126 20030126 20030126 20030128 20030127 20030201 20030126 20030126 20030126 20030126 20030126 20030126 to 20030205 to 20030130 to 20030131 to 20030127 to 20030201 to 20030126 to 20030128 to 20030129 to 20030205 to 20030126 to 20030126 to 20030126 to 20030126 to 20030126 to 20030126 April 5, 2003 Keystone Health Plan Central P.O. Box 898812 Camp Hill, PA 17001-9927 Re: Member: Samantha Jo Miller KHP Central ID# 168-48412703 Date of Accident: 01/26/03 Dear Sir or Madam: I am the attorney for Samantha Jo Miller, and her parents, James E~ Stephanie Miller, regarding the automobile accident of January 26, 2003. Enclosed is the authorization for release ot: information which has been completed and signed by Mr. Miller. Also enclosed is the February 28, 2003 request for information regarding exhaustion of automobile insurance benefits, which has been completed and signed by Mr. Miller. A copy of Erie Insurance Compan~/s letter of March 5, 2003 regarding exhaustion of benefits is enclosed. With best regards, RFM/cs Enclosure · cc: James E~ Stephanie Miller (w/enc) Richard F. Maffett, Jr. EXHIBIT "E" P.O, Box 898~12 Camp Hill, PA 17089-8812 www,khpc.com Dear Member: In order for us to properly determine eligibility benefits under your contract, please sign and date the form below. Please return this form in the euctosed postage paid envelope. This will enable us to obtain any document(s) relative ~to your claim. Thank you ~or your anticipated cooperation. Sincerely, COB Department Keystone Health Plan Central I, James L. Miller , hereby authorize the release of any information relative to the automobile accidenffinjm~ on Jan. 26. 2003 to Keystone Health Plan Central or their properly authorized agents and/or members. Signature ~ ~ ~ Parent &~5~ardian of Samantha Jo Miller Dat. e 03/26/03 P.O. Box 898812 Camp Hill, PA 17089-8812 www.khpc,com February 28, 2003 James Miller 296 Old Stonehouse Road Carlisle, PA 17013 Member: Samantha Miller KHP Central I.D. #: 16848412703 Dear KHP Subscriber: Keystone Health Plan has recently been advised that you were injured in what is reported as an "automobile accident related ....~njury. Your Keystone Health Plan contract has an automobile accident exclusion. If you were injured in some way relating to an automobile, then your automobile insurance carrier is responsible for your care until your benefit limit has been met. Keystone Health Plan must be reimbursed for money that KItP has paid for your doctor's bills, that have also been paid by your auto carrier. Date of Accident: January 26, 2003 Briefly describe Injury: Fractured cervical vertebra, fractured right collar bone & clavical, multiple fractured rib~, 2 collapsed lungs, ~. ~ed s~leen, bruised l~ver, ~ractured lumbar vertebrae, fractured thoracic vei-~_Dra, dislocated right la~c~ration of rlq_ht .lec~ ~' ' _ ~ Automobile Carrier: -~rie insurance Group Name 1~0 Erie Insurance Place, Erie, PA 16530 Address Q10 2508244 H Erie Claim No. Auto Policy Number Auto Claim Number Have the auto benefits exhausted? ~Ye~ No If yes, please send a copy of the exhausUon letter. of Samantha Jo Miller 010170661624 717- 2,45-0164 Phone Number (Tnclude area code) 03/26/03 Date \ll7cl-cob Subscriber Agreement IMPORTANT Benefits described in this agreement are covered only when provided or authorized by the primary care physician. Keystone Health Plan Central, Inc. P.O. Box 898812 Camp Hill, PA 17089-8812 (717) 763-3894 or (800) 622-2843 Independeut Licensee of the Blue Cross and Blue Shield Association KC520 11-94 Independent Licensee of the Blue Cro~s and Blue Shield Association, Upon payment in advance of the applicable premium, Keystone Health Plan Central, Inc. agrees to make payment for those Covered Services performed as set forth in this Agreement. This Agreement is renewable subject to the consent of Keystone Health Plan Central, Inc. A CORPORATION OPERATING UNDER THE SUPERVISION OF THE INSURANCE DEPARTMENT AND THE DEPARTMENT OF HEALTH OF THE COMMONWEALTH OF PENNSYLVANIA. KEYSTONE HEALTH PLAN CENTRAL SUBSCRIBER AGREEMENT TABLE OF CONTENTS Page ARTICLE I DEFINITIOI',IS ......................................................... 1 ARTICLE II BENEFITS ............................................................. 5 Outpatient Services ........................................... 5 Inpatient Services ............................................ 10 Emergency Services ........................................15 ARTICLE III EXCLUSIONS ....................................................... 16 ARTICLE IV GENERAL PROVISIONS ...................................... 19 Eligibility and Enrollment ....................................... 19 Effective Date of Coverage .................................. 21 Multiple Coverage ............................................... 22 Limitations .......................................................... 23 Relationship of Parties ......................................... 23 Payment of Benefits .............................................. 23 Identification Card ........................................... 23 Reports and Records ....................................... 23 Member' Liability .............................................. 24 Determination of Medical Necessity ................. 24 Assignment ..................................................... 24 Coordination of Benefits .................................. 24 Subrogation ..................................................... 26 Waiver of Liability ........................................... 27 Legal Action .................................................... 27 Grievance Procedure ....................................... 27 Subscriber Agreement ........................................... 28 Entire Contract ............................................... 28 Premium Rate ................................................. 29 Change,s of Premium Rate ............................... 29 Termination of Group ...................................... 29 Termination of Subscribers and Members ........................... 29 Obligations on Termination .............................. 30 Reinstatement ................................................. 30 Other Changes in Status ................................. 30 Erroneous Payments .......................................30 Conversion ..................................................... 30 Continuation of Coverage ................................ 31 Miscellaneous ............................................... 32 Schedule of Copayments ...................................... 34 ARTICLE I - DEFINITIONS For the purpose of this Subscriber Agreement (the "Agreement"), the terms below have the following meanings: 1. ~AFTER HOURS PRIMARY CARE PHYSICIAN OFFICE VISIT - An office visit to the Primary Care Physician occurring during hours other than those published in the newest edition of the Keystone Health Plan Central Physician r~,irectory. Each After Hours Primary Care Physician Office Visit shall be subject to a copayment Please refer ~o the schedule of copayments. BENEFIT MAXIMUM - The greatest amount payable by t(HP Central for a specific Covered Service under this or a prior KHP Central contract providing payment for such Covered Service. 3 BENEFITS (See COVERED SERVICES) 4~ COPAYMENT means the amount required to be paid by a Member in connection with the Covered Services set forth in this Agreement. Copayments, if any, are identified in the Schedule of Copayments or in the applicable Rider to this Agreement. 5 COVERED SERVICES means the Benefits described ~n Article II of this Agreement. 6. DEPENDENT - Any member of a Subscriber's family who meets the applicable eligibility requirements, is enrolled hereunder through submission of a properly completed Enrollment Form, and for whom, or on whose behalf, the appropriate premium payment has been received by Keystone Health Plan Central (KHP Central), 7 DETOXlFICATION is the process whereby an alcohol or drug intoxicated or alcohol or drug dependent person is assisted, in a facility licensed by the Department of Health, through the, period of time necessary to eliminate, by metabolic o,' other means, the intoxicating alcohol or drug, alcohol or drug dependency factors, or alcohol in combination with drugs, as determined by a licensed physician, while keeping the physiological risk to the patient at a m~nimum EFFECTIVE DATE OF COVERAGE means the date coverage under this Agreement begins as shown on the records of KHP Central 9 EMERGENCY - An Emergency Is an accidental injury or the sudden and unexpected onset of a condition which poses a $~gnificant jeopardy to the Member's health, requiring ~mmed~ate medical or surgical care Heart attacks, strokes, po~somngs, loss of consciousness or respiration, and convulsions are examples of rned~ca[ emergencies 10. ENCOUNTER FORM means the written report submitted to KHP Central on a form provided by KHP Central on which all Covered Services provided to Members by the Primary Care Physician are identified. 11. ENROLLMENT FORM means the properly completed, written request for membership or enrollment submitted on a form provided by KHP Central, together with any amendments or modifications thereof. 12. EQUIVALENT PARTIAL SESSION VISIT - A visit consisting of a period of 20-30 minutes devoted to individual or family medical psychotherapy for the treatment of problems related to substance abuse, with continuing medical diagnostic evaluation, and drug management when indicated, to include individual psychoanalysis, insight oriented, behavior modifying or supportive psychotherapy. Two Equivalent Partial Sessions equal one Full Session Visit. 13 EXPERIMENTAL/INVESTIGATIVE The use of any treatment, procedure, facility, equipment, drug, or drug usage device or supply which KHP Central, relying on the advice of the general medical community which includes but is not limited to medical consultants, medical journals and/or governmental regulations does not accept as standard medical treatment of the condition being treated, or any such items requiring federal or other governmental agency approval which approval has not been granted at the time the services were rendered 14 FULL SESSION VISIT - A visit consisting of a period of 45-50 minutes devoted to individual or family medical psychotherapy for the treatment of problems related to substance abuse, with continuing medical diagnostic evaluation, and drug management when indicated, to include individual psychoanalysis, insight oriented, behavior modifying or supportive psychotherapy. 15¸ GROUP - The party entering into a contract with KHP Central on behalf of the Members, including the employer or representative of and remitting agent for the Members who collects and remits premium payments on behalf of the Members. 16, GROUP CONTRACT means an agreement between KHP Central and a Group pursuant to which KHP Central coverage under this or other applicable KHP Central Subscriber Agreement is made available to persons eligible to enroll in KHP Central's programs, 17. GROUP OPEN ENROLLMENT PERIOD means those periods of time established by the Group and KHP Central from time to time, but no less frequently than once in any 12 consecutive months, during which eligible persons who have not previously enrolled with KHP Central may do so. 2 18. HOME HEALTH AGENCY is an organization licensed by the Commonwealth of Pennsylvania to render home health care Services to Members. 19. HOSPICE CARE - Custodial care rendered to a terminally ill member with a life expectancy of six (6) months or less. 20. HOSPITAL - any institution duly licensed, certified and operated as a Hospital. In no event shall the term Hospital include a convalescent facility, nursing home, or any institution or part thereof which is used as a convalescent facility, rest facility, nursing facility or facility for the aged. 21. HOSPITAL SERVICES (except as limited or excluded herein) are those acute-care Covered Services furnished by a Hospital or Skilled Nursing Facility which are authorized by a KHP Central Primary Care Physic[an and set forth in Article I1, Benefits, 22, INFERTILITY - The diminished or absent capacity to produce offspring regardless of underlying cause, including but not limited to diminished or absent capacity to conceive 23. INPATIENT means a Member who is admitted as a bed patient in a Hospital, a Rehabi[itation Hospital, a Skilled Nursing Facility or a Substance Abuse Treatment Facility. 24. KEYSTONE HEALTH PLAN CENTRAL (KHP Central) is a health maintenance organization which arranges for the provision c,f Covered Services to Members in a KHP Central Service Area, 25. MEDICAID means Hospital or medical insurance benefits provided by the United States Government under Title XIX of the Social Security Act of 1965, as amended. 26. MEDICAL DIRECTOR means a physician designated by KHP Central to monitor appropriate utilization and quality of covered services received by Members. 27. MEDICALLY NECESSARY OR MEDICAL NECESSITY means the appropriate and necessary Covered Services as determined by the Primary Care Physician and KHP Central which are rendered by a Provider to a Member for a condition requiring, according to generally accepted principles of good medical practice, the diagnosis or direct care treatment of an illness or injury and which are not provided only as a convenience. 28 MEDICARE means Hospital or medical insurance benefits provided b,y the United States Government under Title XVlll of the Social Security Act of 1965, as amended, 29. MEMBER means an individual who is contractually entitled to receive Covered Services arranged by KHP Central under this Agreement. 30. OUT OF AREA SERVICES are those Covered Services provided outside KHP Central's Se~'ice Area. Covered Services are limited to Emergency Services and Covered Services that are arranged or authorized by a KHP Central Primary Care Physician and/or the KHP Central Medical Director. 31. OUTPATIENT means a Member who receives Covered Services or supplies while not an Inpatient 32. PARTIAL HOSPITALIZATION means the provision of medical, nursing, counseling or therapeutic Covered Services on a planned and regularly scheduled basis in a facility licensed as a substance abuse treatment program by the Department of Health, designed for a patient or ctient who would benefit from more intensive Covered Services that are offered in Outpatient treatment but who does not require Inpatient care. 33. PARTICIPATING PROVIDER means a physician, allied health professional, Hospital, Skilled Nursing Facility, Rehabilitation Hospital, Home Health Agency, or any other health care institution or practitioner, licensed by the Commonwealth of Pennsylvania, with which KHP Central has arranged to provide Covered Services to Members. 34. PRIMARY CARE PHYSICIAN means a duly licensed doctor of medicine or osteopathy who has a contract with KHP Central under this Agreement to supervise, coordinate and provide initial and basic care to members, initiate their referral for a specialist care and maintain continuity of patient care. 35. REHABILITATION HOSPITAL is a facility Provider which is engaged in providing rehabilitation Services on an Inpatient basis. 36. REIMBURSEMENT VALUE means the amount charged or the amount KHP Central has expended for a particolar health service in the geographical area ~n which it is performed. 37 SERVICE AREA means the geograph~ca~ areas as approved by the State within which KHP Central arranges for provision of Covered Services to Members 38. SKILLED NURSING FACILITY - An institution, or a distinct part of an institution, facility, rest facility, or facility for the aged, which is licensed as a Skilled Nursing Facility by the Commonwealth of Pennsylvania and approved by KHP Central 39. SUBSCRIBER means a Member whose employment or other status, except for family dependency, is the basis for eligibility for enrollment in KHP Central. 40. SUBSCRIBER DATA CHANGE FORM means a form upon which the written submission to KHP Central of changes in Subscriber data affecting Member eligibility is made This form may be obtained from the employer or directly from KHP Ceritral. 41.SUBSTANCE ABUSE - The use of alcohol or other addictive drugs which produces a pattern of pathological use causing impairment in social or occupational functioning or which produces physiological dependency evidenced by physical tolerance or withdrawal. Drugs shall be defined as addictive drugs and drugs of abuse listed as scheduled drugs in the Pennsylvania Controlled Substances, Drug, Device and Cosmetic Act. 42. SUBSTANCE ABUSE TREATMENT FACILITY - A facility Provider which is licensed by the Department of Health and approved by the Joint Commission on the Accreditation of Hospitals and by KHP Central or its designee which is primarily engaged in providing Detoxification and/or rehabilitation treatment for alcoholism and/or drug abuse ARTICLE II - BENEFITS Subject to the terms, conditions, definitions and exclusions specified in this Agreement and subject to the payment by Members of the applicable Copayments, if any, Members shall be entitled to receive the Covered Services listed below Services will be covered by KHP Central only if they are Medically Necessary, and, except for emergencies, are provided or authorized by the Member's Primary Care Physician or KHP Central. OUTPATIENT SERVICES ALLERGY TESTING AND TREATMENT Allergy tests and testing materials and treatment, when a~thorized by the Primary Care Physician AMBULANCE SERVICES Medically Necessary ambulance services when ordered or authorized by the Primary Care Physician and KHP Central. In an Emergency, the Primary Care Physician's prior authorization is not required. ANESTHESIA Anesthesia Services when performed in connectiion with Covered Services which have been authorized by the Primary Care Physician and KHP Central 4 CHEMOTHEPJ~PY Federally approved chemotherapy drugs, the administration of these drugs and all associated laboratory tests/procedures when provided or authorized by the Primary Care Physician and KHP Central. DIAGNOSTIC, LABORATORY and X-RAY SERVICES Medically Necessary x-ray and laboratory tests, procedures, services and materials, including diagnostic x-rays, fluoroscopy, and electrocardiograms when authorized or performed by the Primary Care Physician and/or authorized by KHP Central. DIALYSIS Medically Necessary dialysis services when authorized by the Primary Care Physician and approved by KHP Central and when provided at the Hospital, a free-standing renal dialysis facility which has been approved by KHP Central or, with KHP Central's approval, in the home. In the case of home dialysis, services will include equipment, training, and medical supplies. The decision to purchase or rent necessary equipment~for home dialysis will be made by KHP Central. When the Member becomes eligible for Medicare coverage of dialysis, coverage will be transferred to Medicare coverage. HEARING SCREENING Hearing screening for diagnostic purposes, when provided or authorized by the Primary Care Physician. (SeeArtic[e III, Exclusions.) HOME HEALTH CARE Care provided by home health care personnel in the Member's home if located within the Service Area, determined to be Medically Necessary, and authorized by the Primary Care Physician and KHP Central. Such care is limited to 100 visits per calendar year. Private duty nursing will only be covered if specifically approved in advance by the KHP Central Medical Director. Homemaker services or other non-medical services are not covered. HOME VISITS Physician visits to the Member's home, if within the Service Area, when performed or authorized by the Primary Care Physician. Members may be required to pay a Copayment for each home visit. Please refer to the Schedule of Copayments. 10. HOSPICE CARE Hospice care services for a terminally ill Member with a life expectancy of six (6) months or less when authorized by the Primary Care Physician. Subject to a Benefit Maximum of $7,500. 11. IMMUNIZATIONS Medically Necessary adult immunizations and pediatric immunizations as provided for below when provided or authorized by the Primary Care Physician (except those required for foreign travel). Coverage will be provided for those child immunizations, including the immunizing agents, which, as determined by the Department of Health, conform with standards of the (Advisory Committee on Immunization Practices of the Center for Disease Control) United States Department of Health and Human Services. Coverage for these child immunizations will not be subject to Copayments or Benefit Maximums. 12. INDIVIDUAL CASE MANAGEMENT KHP Central may . elect to arrange for services under this Subscriber Agreement through professional or facility providers pursuant to an individualized treatment plan. Any such arrangements shall be made solely at KHP Central's discretion and only when and for so long as it determines that the alternative services are Medically Necessary and cost effective. In no event shall KHP Central be obligated to provide such alternative services at a total cost greater than for services to which the Member would otherwise be entitled under this Subscriber Agreement. KHP Central's election to provide services in such a manner shall not obligate it to continue to provide the same or similar services for that or any other member. 13. INDIVIDU~-',LIZATION OF BENEFITS Under certain circumstances, KHP Central may be able to arrange alternative services for Members by providing services not specified in this Agreement. KHP Central may provide such alternative services at its sole discretion, and only when and for so long as it determines that the alternative services are Medically Necessary and cost effective. The provision of alternative services in a specific situation shall not obligate KHP Cenl~rai to provide the same or similar services in another situation; nor shall it be construed as a waiver of KHP Central's right to administer this Subscriber Agreement in accorda[nce with its express terms. 14. INFERTILITY Infertility counseling, testing and services, including artificial insemination, but excluding in vitro fertilization, subject to a copayment of 50% of the cost of treatment, with a Benefit Maximum of $2,500, including injectable~ related to infertility services. 15. INJECTIONS Injectable medications for the treatment oran illness or injury administered in a physician's office as deemed appropriate by the Primary Care Physician. 16. MAMMOGRAMS One baseline mammogram at or after 35 years of age; one mammogram in each calendar year at 40 years of age and older; and additional mammography services es authorized by the Primary Care Physician. 17. MENTAL HEALTH CARE Outpatient mental health care, as deterrnined by the Primary Care Physician and KHP Centrel and/or its designated agent to be necessary and appropriate for short term evaluation and/or crisis intervention, for up to twenty (20) visits per Member in a calendar year. Each Outpatient mental health visit will be subject to a Copayment. Please refer to the Schedule of Copayments. 18. NEWBORN CARE Care of a newborn child of a member for a period of thirty-one (31) days following birth, [f medically 7 necessary and approved by the Primary Care Physician. Such care shall include routine nursery care, prematurity services, preventive health care services, as well as coverage for injury or illness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. Continuing care is covered only if: a) the newborn is eliaible for enrollment; b) the newborn is enrolled within thirty-one (31) days of birth; and c) appropriate premium payments from the date of birth are received. 19. NURSE MIDWIVES The services of a nurse midwife are covered when authorized by the Primary Care Physician and KHP Central. 20. OBSTETRICAL CARE Obstetrical care including pre- and post-natal care, complications of pregnancy and childbirth. Members may be required to pay a Copayment. Please refer to the Schedule of Copayments or copay riders. (See Article III, Exclusions.) 21. OFFICE VISITS Office visits performed or authorized by the Primary Care Physician. Members may be required to pay a Copayment for each office visit. Please refer to the Schedule of Copayments or copay riders. 22. ORAL SURGERY Limited oral surgical procedures in an Outpatient setting when approved by a Primary Care Physician and KHP Central and required in connection with the following: A. accidental injury to the jaw or structures contiguous to the jaw, including accidental injury to the teeth, provided that care or treatment is sought within twenty-four (24) hours of the accident causing such injury; B. the correction of a non-dental physiological condition which as resulted in severe functional impairment; and C. treatment for tumors and cysts requiring pathological examination of the jaws, cheeks, lips, tongue, roof and floor of the mouth. (See Article I[I, Exclusions.) 23. PREVENTIVE HEALTH SERVICES Preventive health services, including periodic health assessments, well child care, and periodic Papanicolaou (PAP) tests, according to schedules approved by KHP Central, when provided or authorized by the Primary Care Physician or when authorized by KHP Central. 24. RADIATION THERAPY Radiation therapy services, when provided or authorized by the Primary Care Physician and KHP Central. 25. REFERRALS Referrals to Participating Providers when authorized by the Primary Care Physician. Referrals to non-participating specialists and other du~y licensed allied health care personnel will be covered only when authorized by the Primary Care Physician and KHP Central Self referrals ars excluded except in the case of Emergencies. 26~SHORT-TERM REHABILITATION THERAPY SERVICES Occupational, physical, respiratory and speech rehabilitation therapy on an Outpatient basis, when authorized by the Primary Care Physician and KHP Central. These rehabilitation therapy Services are limited to treatment for conditions which, in the judgment of the Primary Care Physician and KHP Central, will result in significant improvement. These therapies are limited to 60 days from initiation of treatment per condition, per lifetime. Short term rehabilitation therapy services include: A. Occupational Therapy when provided by a licensed provider acting within the scope of such license; B. Physical Therapy when provided by a licensed provider acting within the scope of such license; C. Respiratory Therapy when provided by a licensed provider acl:ing within the scope of such license; D. Speech Therapy when provided by a licensed provider acting within the scope of such license; (See Article HI, Exclusions.) 27. STERILIZATION - Outpatient vasectomies and tubal ligations are covered if Medically Necessary, as determined by the Medilcal Director. 28. SUBSTANCE ABUSE - Diagnosis and medical treatment for the abuse of or addiction to alcohol or drugs when determined to be Medically Necessary and referred by the Primary Care Physician and approved by KHP Central and/or its designated agent, to include: A. Diagnostic Services, including psychiatric, psychological and medical laborato~ tests; B. Services provided by a staff Physician, Psychologist, Registered or Licensed Practical Nurse, and/or Certified Addictions Counselor; C Rehabi;litation therapy and counseling; D Family counseling and intervention; E. Drugs, medicines, supplies and use of equipment provided b,.t a Substance Abuse Treatment Facility. Services for treatment of ali forms of Substance Abuse are limited to sixty (60) outpatient Full Session Visits, Equivalent Partial Session Visits, or Partial Hospitalization Sessions per year, 'with a lifetime limit of one-hundred and twenty (120) Full Session Visits Each Equivalent Partial Session Visit will count as one-half visit against the annual maximum of sixty (60) Outpatient Full Session Visits. in addition, thirty (30) Outpatient Visits or Partial Hospitalization Sessions per calendar year may be exchanged on a two-for-one basis to secure up to fifteen (15) additional non-hospital, residential substance abuse treatment days, which are in addition to the annual and lifetime maximums described in Article II, INPATIENT SERVICES. Outpatient substance abuse treatment visits may be subject to a Copayment. Please refer to the Schedule of Copayments. (See Article III, Exclusions). 29. SURGERY Surgical services required for treatment of disease or injury when authorized by the Primary Care Physician and KHP Central and performed by a KHP Central Participating Provider and at a KHP Central participating facility. Non-participating providers or facilities may be approved by the Medical Director and/or KHP Central if the required services are not available from participating providers or facilities. 30. VISION SCREENING Vision screening for diagnostic purposes when provided by the Primary Care Physician. (See Article III, Exclusions. INPATIENT SERVICES ANESTHESIA Anesthesia services only when performed in connection with Covered Services which have been authorized by the Pdmary Care Physician and KHP Central. CHEMOTHERAPY Federarly approved chemotherapy drugs and all associated laboratory tests/procedures when provided or authorized by the Primary Care Physician and KHP Central. DIAGNOSTIC, LABORATORY AND X-RAY SERVICES Medically Necessary x-ray and laboratory tests, procedures, services and materials, including diagnostic x-rays, fluoroscopy, and electrocardiograms when authorized by the Primary Care Physician and KHP Central. DIALYSIS Medically necessary dialysis services and supplies when authorized by the Primary Care Physician and approved by KHP Central. When the Member becomes eligible for Medicare coverage of dialysis, KHP Central dialysis coverage will be transferred to Medicare coverage. DRUGS AND MEDICATIONS Drugs, medications, and injections received and used as an inpatient in connection with Covered Services which have been authorized by the Primary Care Physician. HEARING SCREENING Hearing screening for diagnostic purposes when provided or authorized by the Primary Care Physician and KHP Central. (See Article Iii, Exclusions.) HOSPITAL Un[imited Inpatient days in a Hospital for Medically Necessary treatment when authorized by the Primary Care Physician or KHP Central, except as noted herein for Inpatient mental hea~th services and short-term - rehabilitative Services. [See inpatient Services, Article 11(21) and (24).] Except in Emergencies, Hospital admissions must be coordinated through the Member's Primary Care Physician. When' authorized by the Primary Care Physician and KHP Central, covered Hospital Services include: A. Semi-private room and board (or private or specialty accommodations when certified as Medically Necessary by the attending physician, the Primary Care Physician and KHP CentraQ. General nursing care. C. Privata duty nursing care when Medically Necessary and authorized by the Primary Care Physician and KHP Central. D. Drugs, medications, and biologicals. E. Meals (including special diets when Medically Necessary). F. Use of the operating room and related facilities. G. Use of intensive care or cardiac units and related Services. H. Oxygan Services. I. Administration of whole blood and blood plasma to include the processing and preparation. J. Medically Necessary supplies, appliances and equipment. (See Article Ill, Exclusions.) iMMUNIZATIONS Medically Necessary adult immunizations and pediatric immunizations as provided for below when provided or authorized by the Primary Care Physician (except those required for foreign travel). Coverage will be provided for those child immunizations, including the immunizing agents, which, as determined by the Department of Health, conform with standards of the (Advisory Committee on Immunization Practices of the Center for Disease Control) United States Department of Health and Human Services. Coverage for these child immunizations will not be subject to Copayments or Benefit Maximums. IMPLAN'rABLE DEVICES Surgicatly implanted prosthetic devices when determined to be Medically Necessary by the Primary Care Physician and KHP Central. (See Article III, Exclusions.) 10. INDIVIDUAL CASE MANAGEMENT KHP Central may elect to arrange for services under this Subscriber Agreement through professional or facilities providers (pursuant to an individualized treatment plan). Any such arrangements shall be made solely at KHP Centrai's discretion and only when and for so long as it determines that the alternative services are Medically Necessary and cost effective. In no event shall KHP Central be obligated to provide such alternative services at a total cost greater than for services to which the Member would otherwise be entitled under this Subscriber Agreement. KHP Central's election to provide services in such a manner sha~l not obligate it to continue to provide the same or similar services for that or any other member. 11.INDIVIDUALIZATION OF BENEFITS Under certain circumstances, KHP Central may be able to arrange more effective medical care for Members by providing services not specified in this Agreement. KHP Central may provide such a~ternative services at its sole discretion, and only when and for so long as it determines that the alternative services are Medically Necessary and cost effective. The provision of alternative services in a specific situation shall not obligate KHP Central to provide the same or similar services in another situation; nor shall it be construed as a waiver of KHP Central's right to administer this Subscriber Agreement in accordance with its express terms. 12. INPATIENT PHYSICIAN CARE Generally accepted and Medically Necessary health services performed, prescribed, or supervised by physicians within a hospital for registered bed patients, including diagnostic and therapeutic care. 13. MENTAL HEALTH CARE Inpatient mental health care services in a Provider facility when authorized by the Primary Care Physician and KHP Central and/or its designated agent, limited to thirty (30) inpatient days per Member in a calendar year. (See Article Ill, Exclusions.) NEWBORN CARE Care of a newborn child of a member for a period of thirty-one (31) days following birth, if medically necessary and approved by the Primary Care Physician. Such care shall include routine nursery care, prematurity services, preventive health care services, as well as coverage for injury or illness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. Continuing care is covered only if: a) the newborn is el/q/hie for enrollment; b) the newborn is enrolled within thirty-one (31) days of birthl and c) appropriate premium payments from the date of birth are received. 15. NURSE MIDWIVES The services of a nurse midwife are covered when authorized by the Primary Care Physician and KHP Central. t6. OBSTETRICAL CARE Obstetrical care including pre- and post-natal oare, complications of pregnancy and childbirth. (See Article III, Exclusions.) 17. ORAL SURGERY Limited oral surgical procedures when approved i.,y the Primary Care Physician and KHP Contra{ and required in connection with the following; A. accidental injury to the jaw or structures contiguous to the jaw (exoluding teeth); B. the correction of a non-dental physiological condition which has resulted in a severe functional impairment; and C. treatment for tumors and cysts requiring pathological examination of the jaws, cheeks, lips, tongue, roof and floor of the mouth. 18. ORGAN TRANSPLANT Medically Necessary transplantE~tion services for member recipients when not deemed to be Experimental/Investigational and authorized by the Primary Care Physician and KHP Central. Determination of medical necessity shall also take into account the procedure's suitability for the potential member and availa~)ility of appropriate facilities for performing such procedures. KHP Central may arrange for certain transplant procedure.~i in accordance with the Individual Case Management provision of this Agreement. Services required by a Member related to organ donation when the Member serves as the donor are not covered (See Article III, Exclusions). If not paid for by any other source, the following services of donors donating organs to Member recipients are covered: A. the removal ofthe organ from the donor, B. donor preparatory pathologic and/or medical examinations, donor post-surgical care. 19. RADIATION THERAPY Radiation therapy services when provided or authorized by the Primary Care Physician and KHP Central. 20. REFERRALS Referrals to participating specialists when authorized by the Primary Care Physician. Referrals to non-participating specialists and other duly licensed allied health care personnel will be covered only when authorized by the Prirnary Care Physician and KHP Central 21.SHORT-TIERM REHABILITATION THERAPY SERVICES Occupational, physical, respiratory and speech rehabilitation therapy on an Inpatient basis, when authorized by the Primary Care Physician and KHP Central. These rehabilitation therapy services are limited to treatment for conditions which, in the judgment of the Primary Care 13 Physician and KHP Central, will result in significant improvement. These therapies are limited to 60 days from initiation of treatment per condition, per lifetime. Short term rehabilitation therapy services include: A. Occupational Therapy when provided by a licensed provider acting within the scope of such ~icense; B. Physical Therapy when provided by a licensed provider acting within the scope of such license; C. Respiratory Therapy when provided by a licensed provider acting within the scope of such license; D Speech Therapy when provided by a licensed provider acting within the scope of such license (See Article III, Exclusions). 22. SKILLED NURSING FACILITY SERVICES Skilled Nursing Facility Services up to 180 days per year when authorized by the Primary Care Physician and KHP Central Charges which relate to non-custodial care and Covered Services which are Medically Necessary and not excluded elsewhere in this Agreement (see Article III, Exclusions) are covered. Custodial or domiciliary care in a Skilled Nursing Facility or elsewhere is not covered. Benefits are limited to semi- private accommodations or an allowance equal to the facility's most frequent established charge for semi-private accommodations which may be applied to the cost of private accommodations. 23. STERILIZATION Inpatient vasectomies and tubal ligations are covered only if Medically Necessary, as determined by the Medical Director, or if the procedure is coincident with hospitalization for another reason (i.e., post-partum tubal ligation). 24. SUBSTANCE ABUSE Diagnosis and short-term medical treatment for the abuse of, or addiction to, alcohol or drugs including Detox[fication, in an acute care Hospital or a Substance Abuse Treatment Facility for the abuse of or addiction to alcohol, when determined to be Medically Necessary and arranged through appropriate referral by the Primary care Physician. As a separate benefit, non-medical, rehabilitative services for substance abuse will be covered in a Substance Abuse Treatment Facility when determined to be Medically Necessary and arranged through appropriate referral by the Primary Care Physician. inpatient Benefits include: A. Detoxification; B. Lodging and Dietary Services; C. Diagnostic Services, including psychiatric, psychological and medical laboratory tests; 14 D. Services provided by a staff Physician, Psychologist, Registered or Licensed Practical Nurse, and/or Certified Addictions Counselor; E. Rehabilitation therapy and counseling; F. Family counseling and intervention; G. Drugs, medicines, supplies and use of equipment provided by the Substance Abuse Treatment Facility. For all forms of Substance Abuse, the detoxification benefit is limited to no more than seven (7) days per admission and four (4) admissions per lifetime. Similarly, the rehabilitative Services benefit is limited to thirty (30) days per year in a Substance Abuse Treatment Facility, with a lifetime limit of ninety (90) days. (See Article II1, Exclusions.) 25. SURGERY Surgical services required for treatment of disease or injury when authorized by the Primary Care Physiciar~ and KHP Central and performed by a KHP Central participating provider and at a KHP Central participating facility. Non-participating providers or facilities may be approved by the Medical Director. 26. VISION SCREENING Vision screening for diagnostic purposes when provided or authorized by the Primary Care Physician and KHP Central. (See Article III, Exclusions.) EMERGENCY SERVICES Within the Service Area. Medical care is available through KHP Central Primary Care Physicians 7 days a week, 24 hours a day. Under almost all circumstances, the Member must obl~ain treatment or authorization for treatment from the Prin'~ary Care Physician or his designated covering physician. In the event the member experiences an Emergency condition, the member should contact their Primary Care Physician. If they cannot, the Member should seek medical care from the most readily available source. If a Mernber obtains care in what they believe to be an Emergency without obtaininq authorization from the Primary Care Physician, the Member will be requested to provide information about the occurrence. KHP Central will then review the facts of the situation and the nature of the services provided. Only if KHP Central determines the services constitute an Emergency as defined in this Agreement will charges incurred be covered. Each emergency room visit shall be subject to a copayment Please refer to the Schedule of Copayments. An Emergency is an accidental injury or the sudden onset oll a condition which poses a significant jeopardy to the Nlember's health, requiring immediate medical or surgical care. Heart attacks, strokes, peisonings, loss of consciousness or respiration, and convulsions are examples of medical emergencies. 15 Outside the Service Area. Subject to the Continuing Care provisions set forth below, the charges for Medically Necessary Covered Services which are the~ result of an Emergency occurring outside the Service Area are covered only if, in the determination of KHP Central: (1) the Member could not have anticipated the need for such services prior to leaving the Service Area, and (2) delaying care until the Member could be expected to return to the care of the Primary Care Physician might significantly jeopardize the Member's health or life. Continuing Care. Services of any Provider other than the Primary Care Physician will be covered only until the Member can be transferred, without medically harmful consequences, to the care of the Member's Primary Care Physician or a specialist designated by the Primary Care Physician. ARTICLE III - EXCLUSIONS The following are excluded from coverage under this Agreement: Services or supplies which are: (A) not provided by or authorized by the Primary Care Physician; (B) not Medically Necessary, as determined by the Primary Care Physician and/or KHP Central, for the diagnosis or treatment of illness, injury or restoration of physiological functions, 2. The cost of services or supplies which are payable under Worker's Compensation or employer's liability laws or other legislation of similar purpose. 3. Care for military service connected disabilities and conditions for which the Member is legaily entitled to services, and for which facilities are reasonably accessible to the Member. 4 Care for conditions that federal, state or local law requires to be treated in a public facility. 5 The cost of services covered under the Medicare Act when Medicare is primary. In such situations, KHP Central or its designee will file the Member's Medicare claims for health services. Medicare will pay KHP Central or its designee directly. However, if for any reason Medicare pays the Member directly, KHP Central or its designee will bill the Member for the amount to which the Member is entitled under Meclicare. However, this exclusion shall not apply when the group is obligated by law to offer the Subscriber all the benefits of this contract and the Subscriber so elects this coverage as primary. 6: The cost of Hospital, medical or other Covered Services resulting from accidental bodily injuries arising out of a motor vehicle accident, to the extent such benefits ara payable under any medical expense payment provision (by whatever terminology used, including such benefits mandated by law) of any automobile insurance policy unless otherwise prohibited by applicable law, 7. Dental care, periodontal care, including but not limited to treatment of the teeth, extraction of teeth, treatment of dental abscesses or grenuloma, treatment of gingival tissues (other than for tumors), dental examinations, and any other dental product or service unless specifically provided elsewhere in this Agreement. Anesthesia and facility charges related to non-covered dental services shall not be cowgred. 8. Any services related to and rendered in connection with a non-coverad service shall not be covered. Treatment of temporomandibular joint syndrome (only evaluation covered) if dental in nature or not Medically Necessary as determined by the Primary Care Physician and/or KHP Central 10. The cost cf any Experimental/Investigative medical, surgical, or other health care services, procedures or supplies, including organ transplant procedures deemed to be Experimental/Investigative will not be covered, 11, Routine physical examination and preparation of specialized reports solely for insurance, licensing, employment, or other non-preventive purposes, such as pre-marital examinations, physicals rot college, camp, sport or travel, which are not Medically Necessary. 12. Cosmetic surgery, defined as any plastic surgery done primarily to improve the appearance of any portion of the body, and from which no improvement in physiologic function could be reasonably expected. 13. AII rehabilitative therapy except as described in this Agreement, including but not limited to play and recreational therapy. 14. AII rout/ns, vision and hearing examinations and services except as described in this Agreement. 15. Hearing aids, eyeglasses, contact lenses, or the fitting thereof. 16. Acupuncture ]7 17. Radial keratotomy. 18. Mental health/substance abuse services that are not covered include: biofeedback; chronic care; court ordered care, including care as a condition of parole or probation; educational testing; evaluation testing; hypnosis; interpreter services; methadone maintenance, mental retardation services; psychological testing and attention deficit disorder and other learning disabilities. 19. Immunizations required for foreign travel. 20. Custodial and domiciliary care, residential care, protective and supportive care including educational services, rest cures, convalescent care. 21 ..Weight reduction programs, including all diagnostic testing related to weight reduction programs. 22. Personal or comfort items, including but not limited to, admission kits, slippers, television, telephone, air conditioners, humidifiers, barber or beauty services, guest service and similar incidental services and supplies which are not Medicaliy Necessary. 23. Normal deliveries outside the Service Area within thirty (30) days of the expected delivery date. 24. Any procedure or treatment designed to alter physical characteristics cf the Member to those of the opposite sex, and any other treatment or studies related to sex transformations. 25. Treatment of bunions (except capsular or bone surgery), toe nails, .(except surgery for ingrown nails), corns, calluses, fallen arches, flat feet, weak feet, chronic foot strain or symptomatic complaints of the feet, unless deemed Medically Necessary by the Primary Care Physician and KHP Central 26 Contraceptive devices, including their insertion and implantatio~k and birth control pills 27 In vitro fertilization, embryo transplants 28. Reversal of voluntary steril~zetion. 29. Services or supplies for which there is no legal obligation on the part of the Member to pay 30. Except as specifically provided for in this Agreement, prosthetic devices, home medical equipment, durable medical equipment and appliances, including health services associated with such devices. 31 Prescribed drugs and medications, except those which are administered to an Inpatient or are provided by a Substance Abuse Treatment Facility 32. Ambulanee services, untess Medically Necessary as determined by the Primary Care Physician and KHP Central 33. Whole blood, blood plasma or blood components. 34. Services required by a Member related to organ donation where the Member serves as the organ donor. Expenses for donors donating organs to Members are covered only as described in this Agreement. No payment will be made for human organs which are sold rather than donated. 35. Court ordered services when not Medically Necessary, as determined by the Primary Care Physician and KHP Central. 36. Charges for completion of any insurance form. 37. Any Services, supplies or treatments not specifically listed in this Agreement, except those required by the Pennsylvania Department of Health as basic health services. 38. Artificial hearts. 39. Surgical aperations or procedures for correction of obesity, including but not limited to gastric stapling or balloon procedures. 40. Infertility injectables or other supplies and drugs prescribed on an out-patient basis for or in connect[on with artificial insemination. 41.Growth hormones, unless determined to be Medically Necessary by KHP Central. 42. Services for sleep disorders and sleep therapy. 43. Private duty nurses, except as specified in this Agreement. 44. Charges for failure to keep a scheduled appointment. 45. Any services related to injuries incurred while committing a felony. ARTICLE IV - GENERAL PROVISIONS 1. ELIGIBILITY AND ENROLLMENT A, The ,~ubscriber. To be eligible to be a Subscriber, an individual must reside in a KHP Central Service Area and: (1) be a member of an eligible Group who is entitled to pa~licipate in his Group's health benefits program, including compliance with any probationary or waiting period established by the Group; and/or 19 (2) be entitled to coverage under a trust agreement or employment contract; and/or (3) having been a Subscriber, leave a Group and continue KHP Central coverage without interruption. B. Eligible Dependents. To be eligible to be enrolled as a Member, a Dependent of a Subscriber must meet all eligibility requirements established by the Group, be listed on an EnrollmentJChange Form completed by the Subscriber, and be: (1) The Subscriber's legal spouse, or (2) an unmarried dependent child (including natural child, legally adopted child, or stepchild) of either the Subscriber or the Subscriber's spouse, who is under the age of 19 years of age. Additionally, a dependent child shall include a child for whom the Subscriber or Subscriber's spouse is a court-appointed guardian, or (3) an unmarried Dependent child 19 years of age or older, who, in the judgment of KHP Central, is incapable of self-support because of mental or physical handicap (for which continuing justification is required) and whose disability occurred prior to age 19, or (4) an unmarried Dependent child, between 19 and 23 years of age, who resides in the Service Area and is a full-time student enrolled in and attending an accredited educational institution. KHP Central may require appropriate proof of a Dependent's status before enrolling said Dependent. C. Newborn children. Newborn children of a Member are covered under this Agreement for the first thirty-one (31) days immediately following birth. Coverage after thirty-one (31) days is contingent upon the newborn being eligible for enrollment and the Subscriber enrolling the newborn child as a Dependent within the thirty-one (31) day period and paying any applicable premium charges due. O. Enrollment. (1) Initial Enrollment. During the initial Group Enrollment Period, each eligible employee shall be entitled to apply for coverage for himself and eligible Dependents who must be listed on the EnrollmentJChange Form provided by KHP Central No proof of insurability shall be required, (2) Newly Eligible Employee. Each new employee of the Group entering employment subsequent to the Group's initial Effective Date of Coverage shall be permitted to apply for coverage for himself and e~igible Dependents within thirty-one (31) days of becoming ~0 eligible, subject to the enrollment regulations in effect with the Group, without proof of insurability (3) Newly Eligible Dependents. Any person attaining eligibility to become a Dependent may be enrc, lled by the Subscriber by completing and submitting to KHP Central a signed EnroHmentJChange Form within thirty-one (31) days of the Dependent's attaining eligibility. No proof of insurability shall be required. (4) Group Open Enrollment. A Group Open Enrollment Period shall be held at least annually at which time eligible Subscribers and/or eligible Dependents may enroll as Members under this Agreement. No proof of insurability shall be required. (5) Limitation. Persons initially or newly eligible for enrollment who do not enroll within thirty-one (31) days of bacoming eligible, or already-eligible Dependents who do not enroll during a Group Open Enrollment Period may only be enrolled during a subsequent Group Open Enrollment Period. Exceptions may be made only by written consent of the Group and KHP Central E. Notice of Ineligibility. It shall be the Subscriber's or Group's responsibility to notify KHP Central of any changes which will affect the Subscriber's eligibility or that of Dependants for Services or Benefits under this Agreement Failure of the Subscriber or Group to notify KHP Central within thirty (30) days of any such changes shall render Subscriber and Group liable for any costs of Services or Benefits provided by KHP Central after the Subscriber or a Dependant became ineligible to continue coverage under this Agreement. F. Rul,es of Eligibility. No person will be refused enrollment or re-enrollment by KHP Central because of health status, age {except as provided in Article IV, Section 1.B.), requirements for health Services, or the existence, on the Effective Date of Coverage under this Agreement, of a pre-existing physical or mental condition, including pregnancy. In addition, no Member's coverage shall be terminated by KHP Central due to health status or health care needs. 2. EFFECTIVE DATE OF COVERAGE A. Subject to the payment of applicable premium payments by the Group for the individuai, KHP Central's receipt of an EnrollmentJChange Form from or on behalf of each prospective Member and the provisions of this Agreemant (except as may be otherwise provided in the Group Contract), coverage under this Agreement shall become effective on the earliest of the following dates: (1) When a person makes written application for membership on or prior to the date he satisfies the eligibility requirements of Article IV, Section 1, coverage shall be effective as of the date the eligibility requirements are satisfied. (2) When a person makes written apptication for membership after the date he satisfies the eligibility requirements for Article IVl Section 1, coverage will be effective as of the first day of the calendar month following the month in which the Enrollment/Change Form is received by KHP Central, except as otherwise provided by the Group Contract. In addition, services shall be provided starting at birth for newborn children of Members for thirty-one (31) days, and continue in effect thereafter if the newborn is eligible and enrolled by the Subscriber within thirty-one (31) days of the newbom's birth. (3) Except as otherwise agreed to by Group and KHP Central, when a person makes written application for membership during the Group Enrollment Period, coverage will be on the first day of the calendar month next following the conclusion of the Group Enrollment Period. (4) Except as provided in Article iV, Section 7 hereof, this Agreement continues in force for the period of one year from the Effective Date of Coverage as shown on the records of KHP Central and from year to year thereafter unless terminated as hereinafter specified, provided that KHP Central may change the premium rates as hereinafter provided, with the approval of the Commonwealth of Pennsylvania. B. If, on the date on which coverage under this Agreement becomes effective, the Member is an inpatient in a Hospital, benefits will be provided under this Agreement to the extent that they are not provided under a prior group insurance agreement. MULTIPLE COVERAGE A. Workers' Compensation. The Benefits under this Agreement for Members eligible for Workers' Compensation are not designed to duplicate any Benefit to which such Members are eligible under the Workers' Compensation Law. All sums payable pursuant to Workers' Compensation for Services provided hereunder to Members are payable to and retained by KHP Central. It is understood that coverage hereunder is not in lieu of, and shall not affect, any requirements for coverage under Workers' Compensation. B. Medicare. Except as otherwise provided by applicable federal law, the Benefits under this Agreement for Members age 65 and older, or Members otherwise eligibie for Medicare payments, do not duplicate any Benefit to which such Members are eligible under the Medicare Act, including Part B of such Act. Where Medicare is the responsible payor, all sums payable pursuant to the Medicare program for Services provided hereunder to Members are payable to and retained by KHP Central. C. Membera' Cooperation. Each Member shall complete and submit to KHP Central such consents, releases, assignments and other documents as may be required by KHP Central in order to obtain or assure reimbursement under Medicare or Workers' Compensation. Any Member who fails to so cooperate (including a Member who fails to enroll under Part B of the Medicare program where Medicare is the responsible payor) will be responsible to KHP Central for the Reimbursement Value of Services subject to this Section 3, and may be terminated in accordance with Article IV, Section 7, E. LIMITATIONS In the even that, due to circumstances not within the control of KHP Central, including but not limited to a major disaster, epidemic, the complete or partial destruction of facilities, riot, cMl insurrection, or similar causes, the rendition of Services provided under this Agreement is delayed or rendered impractical, KHP Central shall make a good faith effort to arrange for an alternative method of providing coverage. In such event, KHP Central shall provided Covered Services covered under this Agreement insofar as practical, and according to its best judgment; but neither KHP Central nor Providers shall incur liability or obligation for delay, or failure to provide or arrange for Services if such failure or delay is caused by such event(s). Except in Emergencies, the Primary Care Physician must coordinate and approve Services to be covered. 5. RELATIONSHIP OF PARTIES KHP Central Primary Care Physicians maintain the physician-patient relationship with Members and are solely responsible to Members for all medical Services. The relafionship between KHP Central and KHP Central Primary Care Physicians, and between KHP Central and other contracting Providers of health Services, is an independent contract relationship. KHP Central Primary Care Physicians are no1; agents or employees of KHP Central, nor is any employee of KHP Central an employee or agent of KHP Central Primary Care Physicians. KHP Central shall not be liable for any claim or demand on account of damages arising out of, or in any manner connected with, any injuries suffered by the Member while receiving care from any KHP Central Primary Care Physician or from any Provider to which the Member has been referred by the Primary Care Physician or KHP Central. 6. PAYMENT OF BENEFITS KHP Central, in determining whether KHP Central or another Group health plan has primary liability, the following will apply: A. Identification Card. For purposes of identiflca*ion and specific coverage information, a Member's identification card must be presented when a service is requested. B. Reports and Records. The Member consents to and authohzes any person or organization which provides Covered Services to Member to furnish to KHP Central and to other providem of Covered Services, information or records pertaining to the Member, including but not limited to records and information regarding the Member's physical or mental condition, history, or treatment. Further, the Member consents to and authorizes KHP Central to furnish such information or records concerning the Member to such providers of Covered Services and to other individuals or organizations for peer review or ~ilization review purposes, and as otherwise required by law. Finally, the Member agrees that approval by KHP Central of payments for any Covered Services, facilities, or supplies is contingent on KHP Central's receipt of such information or records as it may request. C. Member Liability. Except when certain Copayment or other limitations ara specified in this Agreement, the Member is not liable for any charges for Covered Services when Covered Services have been authorized by the Member's Primary Care Physician or the KHP Central Medical Dirac{or. D. Determination of Medical Necessity. The Services, facilities or supplies described in Article II of this Agreement are covered only when they are Medically Necessary for the restoration of the Member's health, as determined by the Primary Care Physician or KHP Central. Any Services requested by a Member which are not Medicarly Necessary will not be covered. E. Assignment. Any rights of a Member to receive Covered Services or payments under this Agreement are personal to the Member and may not be assigned to any person, Provider or entity, without written consent of KHP Central. F. Coordination of Benefits With Other Health Care Plans. If the Member is also entitled to receive Benefits under any other Group health care plan for services covered by this Agreement or under any governmental program for which any periodic premium payment is made by or for the Member, payments may be coordinated between KHP Central and the other health care plan. In all cases, KHP Central will pay benefits first and determine liability later. If it is determined that KHP Central is the secondary plan, KHP Central has the right to recover the expense already paid in excess of its liability as the secondary plan. The Member will be required to furnish information and to take such other action as is necessary to assure the rights of 24 (1) If the other plan does not include a coordination of benefits or non-duplication provision, that plan will be the primary plan. (2) If the other plan does include a coordination of benefits or non-duplication provision: (a) The plan covering the patient other than as a Dependent will be the primary plan, (b) Where both plans cover the patient as a Dependent child, the plan covering the patient as a Dependent child of a parent whose date of birth. excluding the year of birth, occurs earlier in a calandar year, shall be the primary plan. If both parents have the same birthday, the plan which covered the parent longer will be the primary plan. If the other plan does not include this provision, the provisions of that plan will determine the order of benefits. (c) If the parents are separated or divorced, the following will apply: (i) The plan which covers the Member as a Dependent of the parent with custody will be the primary plan. The stepparent will have secondary responsibility and the parent without custody will have final responsibility. (ii) Where there is a court decree which establishes financial responsibility for the health care expenses of the Dependent child, the plan which covers the child as a Dependent of the parent with such financial responsibility will be the primary plan (iii) The Benefits of a plan covering the patient as a laid-off or retired employee or as the Dependent of a laid-off or retired employee shall be determined after the Benefits of any other plan covering such person as an employee shall be determined after the Benefits of any other plan covering such person as an employee or Dependent of such person. If the other plan does not have the tale regarding laid-off or retired employees, and if, as a result, the plans do not agree on the order of benefits, the rule will be ignored. (iv) Where the determination cannot be made m accordance with the preceding paragraphs, the plan which has covered the patient for the longer period of time will be the primary plan 2~ (v) Services provided under any governmental program for which any periodic premium payment is made by or for the Subscriber shall always be the primary plan, except where prohibited by law. (3) Services under this Agreement for the treatment of injury arising out of the maintenance or use of a motor vehicle shall be covered only to the extent that such Benefits are in excess of, and not in duplication of Services paid or payable: (a)under a plan or policy of motor vehicle insurance, provided that non-duplication as contained herein is not prohibited by law; or (b)through the Catastrophic Loss Trust Fund; or (c)through a program or other arrangement of qualified or certified self-insurance. KHP Central may release to or obtain from any person or organization any information about coverage, expenses and Benefits which may be necessary to coordinate Benefits. For the purpose of coordination of Benefits, if the Member receives services, facilities or supplies available under this Agreement but not provided by nor authorized by the Member's Primary Care Physician, payment will not be made by KHP Central. This provision does not apply to: an individual health care plan issued to or in the name of the Member; group or group-type hospital indemnity benefits of $100 per day or less; or school accident-type coverage. Subrogation. (1) If any Covered Service is provided to the Member under this Agreement, KHP Central shall be subrogated and succeed to the Member's rights or recovery with respect to the Covered Services or supplies involved against a responsible third party and/or insurance company. (2) Subrogation means that if the Subscriber or the Subscriber's Dependent(s) is injured because of the negligence or wrong doing of another party, KHP Centrel has the right to seek recovery of the Reimbursement Value of related Covered Services provided. The Member is expected to cooperate with KHP Central and take any action necessary to protect and to assure the subrogation rights of KHP Central. (3) This provision does not apply to an individual insurance policy covering a Member. There will be no right of subrogation where prohibited by law. 26 KHP Central may, without consent of or notice to any person, release to or obtain from any insurance company or other organization or person any information, with respect to any person, which KHP Central deems to be necessary for the purpose of determining its liability under this Agreement, Any person claiming Benefits under this Agreement agrees to furnish KHP Central such information as may be necessary to implement this provision. KHP Central has the right, at any time, to require such information to be furnished 1:o it without cost or expense as a condition precedent to liability for any claim for Covered Services under the terms of this provision. H. Waiver of Liability. KHP Central shall not be liable for injuries resulting form negligence, misfeasance, nonfeasance or malpractice on the part of any Provider in the course ~f performing Covered Services for Members. I. Legal Action. No legal action may be commenced against KHIP Central with respect to the Agreement until ninety (90) days after KHP Central has received a properly completed claim form or Encounter Form, nor may such action be taken at all later than two years after the Covered Services or supplies were performed or provided. J. Grievance Procedure. Informal Resolution Procedure Members having concerns, problems or complaints involving Benefits under this Agreement, the availability or delivery of Covered Services; the Member's Primary Care Physician or other providers; t:he operation of KHP Central; or the terms of this Agreement should contact KHP Central's Member Services Department:. Staff members wi[I work with the Member to attempt to resolve concerns or disputes informally. In communicating with the Member Services Department, the Member should provide pertinent information regarding their concerns. Inquiries may be directed to the Member Services Department at the following address, or by calling the Department at 1-800-622-2843. Member Services Department Keystone Health Plan Central Post Office Box 898812 Camp Hill, Pennsylvania 17089-8812 If a Member is not satisfied with KHP Central's response concerning their complaint, the Member may file a formal grievance. There are two steps in the Keystone Health Plan Central grievance process. Formal Grievance Procedure The grievance will first be reviewed and investigated by the Initial Grievance Committee., composed of two or more management staff The member should forward pertinent written information regarding the grievance to the committee. The committee 27 will provide a written decision within thirty (30) days of its receipt of a grievance. The Initial Grievance Committee's decision will be binding, unless the Member appeals the decision. The appeal of the Initial Grievance Committee's decision shall be to the Grievance Review Board. The Grievance Review Board is established by the Board of Directors and includes at least one-third Subscribers to the HMO. The Grievance Review Board will hold an informal hearing in which the Member (and any other interested party) may present, in person or in writing, their positions on the disputed matter. The Member has the right, but is not required, to attend the hearing. Such a hearing will be held at a time which is mutually acceptable to the Member, the Board and any other persons involved. KHP Central will provide the Member with written information on the hearing procedures. KHP Central will hold the hearing within thirty (30) days of receipt of the Member's request. At any stage of the grievance process, the Member has the right to request that KHP Central appoint a staff member who has no direct involvement to assist the Member. The Grievance Review Board will issue a formal decision within ten (10) days of the hearing. The Board's decision is binding unless the Member appeals the decision to the Bureau of Health Financing and Program Development, located in the Pennsylvania Department of Health, Room 1026 Health and We[fare Building, Post Office Box 90, Harrisburg. Pennsylvania 17108-0090, (717) 787-5193. Grievances usually deal with claim denials and the remedy sought is payment of the claim by KHP Central However, m those cases in which a Member believes that serious medical consequences will arise from KHP Central's failure to provide the requested health services, the member may request an expedited review. To do so, the Member should contact the Member Services Department, identifying the particular need for an expedited review. An expedited rewew may be considered: Urgent Review: Case ~s reviewed by the medical director and a decision is rendered in writing to the Member within fifteen (15) days. Emergency Review: Case is reviewed by the medical director and a decision is rendered in writing to the Member within two (2) working days, with initial notification by telephone, when appropriate If the medical director's dec~sion is adverse to the Member, the Member may appeal the decision immediately to the Medical Review Committee by contacting the Member Services department The medical director will contact the Medical Review Committee to present the Member's case. This committee, 2A composed of at least two physicians, will review the case and render an immediate decision. The Member will be informed via letter and by telephone, when appropriate, The Member will be informed of the right to appeal the decision - to the Pennsylvania Department of Health. SUBSCRIBER AGREEMENT A. Entire Contract. The entire contract between KHP Central and the Member consists of the Group Contract, the Enrollment Form, this Agreement, any amendments to it and the appropriate premium rate, B. Premium Rate. The Group, or in the case of individual or group canversion contracts, the Subscriber, agrees to pay KHP Central in advance, on a monthly basis, unless otherwise agreed, the applicable premium rate as filed with and eppro~red by the Commonwealth of Pennsylvania C. Changes of Premium Rate. KHP Central. subject to the approval of the Commonwealth of Pennsylvania, may change the premium rates. In the event of such change, the Group shall be notified in advance of the effective date cf change. ,~ny notice will be considered given when delivered to the Greup. Termination of Group (1) Subject to annual renewal by the Group and KHP Central, this Agreement, as amended from time to time. will remain in effect from year to year unless terminated either hy the Group or KHP Central (2) The Group or KHP Central may terminate th~s Agreement upon thirty (30) days written notice of termination given to the other party. (3) This Agreement shall automatically terminate at KHP Central's sole discretion if KHP Central does not receive the periodic premium payment within thirty (30) days following the due date (4) In the event of terminat~oh of the Group, coverage for Members of that Group will end as of the last day of the period for which the last premium payment has been received. (5) Members of a d~scontinued Group may become convere~on Members provided the Group does not particiFate in or secure coverage under a health benefit plan made available by some other organization and the termination is not done with the anticipation of securing health benefit coverage with another organization E. Termination of Subscribers and Members In addition tc terminating coverage under this Agreement for the Group as a whole KHP Central n~ay terminate thru .'9 Agreement as to an individual Subscriber or Member as follows: (1) upon thirty (30) days written notice of termination for cause (such as fraudulent use of an identification card) by KHP Central. However, KHP Central will not terminate this Agreement because of a Member's Medically Necessary utilization of Services covered under this Agreement; (2) if the Subscriber in obtaining coverage hereunder, shall have acted fraudulently or misrepresented or failed to disclose a material fact. In such case, KHP Central may, as its option, terminate this Agreement in accordance with paragraph (1) above. The Group or Subscriber will forfeit any charges paid to the extent of the liability incurred by KHP Central; (3) if the Member is unable to maintain a satisfactory physician-patient relationship (See Article IV, Section 7, J); (4) if the Group or Subscriber fails to cooperate on coordination of benefits or subrogation issues; (5) for misuse of the Member identification card. F. Obligations on Termination. In the event of termination by the Group or by KHP Central: (1} KHP Central shall not be liable for any services incurred by any Member in the name of KHP Central beyond the period for which the premium rate shaft have been paid, and KHP Central shall be entitled to indemnification by either the Group or the Subscriber for any expense paid by KHP Central under such circumstances. (2) When this Agreement is terminated, except for termination by incorrect information or misrepresentation, and a Member is receiving Inpatient Services billed by a Hospital on the date of termination, benefits will continue to be provided only to the date of discharge or expiration of eligible benefit days, whichever is earlier. G. Reinstatement. Any individual Member whose membership shall have been terminated may be reinstated at the discretion of KHP Central, and upon payment of any retroactive premium payments and penalty due. H. Other Changes in Statue. Applications for changes is contract type or additions or deletions of eligible Dependents shall be filed on Subscriber Data Change Forms supplied by KHP Central and shall become effective and a part of this Agreement upon acceptance by KHP Central. 30 I. Erroneous Payments. If KHP Central shall pay for any excluded Services or supplies through inadvertence or error, the Group or Member shall reimburse KHP Central for such payments. - j. (1) The Subscriber who becomes ineligible for coverage under this Agreement because of termination of employment under his Group and who is not eligible to become enrolled under any other group health benefit plan, may apply within thirty (30) days after such termination of employment to continue coverage under an Agreement of the type for which he is then eligible, For Members currently enrolled under a family contract, this conversion privilege is a~so available to the surviving Dependents in the event of the Subscriber's death, to a spouee when divorced from the Subscriber, and to a child who ceases to be an eligible Dependent due to attaining the maximum age of eligibility. This conversion privilege is not available to Members who have been terminated for cause by KHP Central (See Article IV, Section 7, E.), or for Members who have failed to apply for conversion within the thirty (30) day period. The terms of conversion coverage may be different than the terms herein. (2) If the Member becomes eligible for Medicare Part A or Part B, the Member shall have the right at that time to convert to such programs as may then be available to provide coverage in conjunction with governmental programs. (3) If a Member enrolled in KHP Central through a Group voluntarily elects to terminate his coverage with KHP Central while remaining eligible for Group coverage, the Member shall not be eligible for conversion to such non-Group programs as KHP Central may have available. K. Continuation of Coverage. Federal law ("COBRA") requires that under certain circumstances the Group offer to the Subscriber and/or Dependents of the Subscriber ("Qualified Beneficiaries") the option of continuing coverage under the Group's contract with KHP Central when such coverage would otherwise terminate. The circumstances under which this option is to be extended to the Qualified Beneficiaries include: (a) termination of the Subscriber's employment, either voluntarily or involuntarily; (b) the death of the Subscriber; (c) divorce or legal separation of the Subscriber; (d) Dependent children reaching otherwise applicable age limits under this Agreement; and (e) Subscriber becoming eligible for Medicare benefits. Such Qualified Beneficiaries may obtain the same coverage as the Subscriber is entitled to, for a period of three years following tfieevent in question. Inthe caseofterminafion of employment, the applicable period is eighteen months. The 3] Beneficiary must pay the applicable premium for this coverage. Further, the Beneficiary may, within one hundred eighty (180) days prior to the expiration of continued coverage under COBRA, apply for conversion coverage under the type of individual conversion Agreement for which he is then eligible. Conversion to such an Agreement shall be governed by the terms of the Subscriber Agreement which provides continued coverage under COBRA. Since provision of continued coverage under COBRA is the Group's responsibility, Subscribers or Dependents who may be eligible for such continued coverage should contact their Group's representative for more information. 8 MISCELLANEOUS. A. Notice of Claim. If submission of a claim is required to receive Benefits under this Agreement, such claim shall be allowed only if notice of claim is made to KHP Central within sixty (60) days from the date on which covered expenses were first incurred, unless it shall be shown not to have been reasonably possible to give notice within the time limit, and that notice was furnished as soon as was reasonabty possible. However, Benefits shall not be allowed if notice of claim is made beyond one year from the date on which expenses were incurred, B. Changing Primary Care Physician. If a Member wishes to transfer from one Primary Care Physician to another Primary Care Physician, the Member must submit a written request for transfer to KHP Central. This request for transfer shall become effective thirty (30) days after the end of the month in which the request is submitted. (1) Transfer of a Member to another Primary Care Physician may be required if KHP Central determines the Member-Primary Care Physician relationship is unsatisfactory. (2) If the Member's Primary Care Physician terminates his relationship with KHP Central, the Member must select another Primary Care Physician. KHP Centrat will assist the Member in the selection of another Primary Care Physician. If Member does not select another Primary Care Physician, KHP Central may assign the Member to a new Primary Care Physician C. Interpretation of Agreement. The laws of the Commonwealth of Pennsylvania sha~l be applied to interpretations of this Agreement Where applicable, the ~nterpretation of this Agreement shall be guided by the direct service nature of KHP Central's operations as opposed to ~- fee-for-service indemnity D. Gender. The use of any gender herein shall be deemed to include the other gender, and, whenever appropriate, the use of the singular herein shall be deemed to include the plural (and vice versa). E. Modification. By this Agreement, the Group makes KHP Central coverage available to Members who are eligible under Section I of this Article However, this Agreement shall be subject to amendment, modification. and termination in accordance with any provision hereof or by mutual agreement beb,veen KHP Central and Group without the consent of concurrence of the Members By electing KHP Central or accepting KHP Central Benefits, all Members legally capable of contracting, and the lega~ represental:ives of all Members incapable of contracting agree to all terms, conditions, and provisions hereof F. Clerical Error. Clerical error, whether of the Group or KHP Central, in keeping any record pertaining to the coverage hereunder, will not invalidate coverage otherwise validly in force or continue coverage otherwise validly terminated G. Policies and Procedures. KHP Central may acoDt reasonable policies, procedures, rules and interpretations to promote the orderly and efficient administration of th~s Agreement, with which Members shall comply Schedule of Copaymenta The copayment listed below is the amount that you, the Member, are required to pay in connection with the services below. These services are defined in your KHP Central Subscriber Agreement. Outpatient mental health care: $25/visit* *Your KHP Central benefits cover a maximum of 20 visits in a calendar year. Outpatient Services for alcohol abuse: 1. First course of treatment: No copayment Second and additional course of treatment: Full session: $25/visit Partial session: $15/visit Emergency Room: $25/Visit This copayment is waived if Member is admitted to the hospital at the time of the emergency room visit. If the Member is referred to the emergency mom by the primary care physician or KHP Central and the service could have been provided in the primary care physician's office, then the emergency room copayment is limited to the amount of the copayment for a primary care physician office visit, if any. After Hours Primary Care Physician Office Visit: $10/Visit Infertility: 50% of the cost of treatment subject to a Benefit Maximum of $2,500. 34 PENNSTATE ~ Milton S. Hershey Medical Center College of Medicine ne Penn state Shock Traunm Center Trauma Pro.am Mldicul Director Robert A. ChenT, MD, FAC5 Sam L Scrvic~ BSN,CEN Penn State Miltos S. He.hey M~dical Center Penn S~ Collegc of Medicine Mail Code: H0~ 500 University Drive, P.O. Box 8~0 l-le~hey, PA 17033-08~0 Tel: (717) 531-~066 Fax: (717) 5314)3;21 Chairman Department of'Sur~xy V~rfley W. Souba, MD Adult Trauma Surgeons RobeR Cooney, MD Jam~s Kas, MD J. Stanley Smith, Ir.. MD M~dicul Director pediatric Traunm Pro,ram Robert £. Cilley, MD Pediatric Trauma Surgeon Pe~z~ Dillon, MD Andros Meier, MD Pediah-ic Tram~ Coordlaator Susan E. Rzucidlo, MSN, RN Trauma Case ~ent Rita Bani,, BSN. CEN Rena Shelly. RN, BSN Beverly Shirk. BSN. CCRN Tcacy Siaopoli, RNC Bounle Wilson, BSN. CCRN Trauma Re~str.ars Teresa Longcnecker K..ristine Lucabaugh Sharon Marcantino Thursday, February 06, 2003 ' Cumberland Valley High Sdhool Samantha Miller sustained traumatic injuries on January 26, 2003 and was admitted to the Penn State Children's Hospital. She sustained Right claVicle and scapula fractures, multiple cervical, thoracic and lumbar spinal fractures, right aeetabular fracture and sacral fracture, liver and spleale lacerations. As a result of these injuries and medical treamaent, she has the following a~etiVity restrietinns: · Non weight-bearing Right upper extremity · Non weight-bearing Right lower extremity · Stand and pivot transfers Left lower extremity · Torso rigid cast and Aspen Cervical collar on at all times She requires homebound instmction'at tW.s time for a duration of 12 weeks minimum, to commence after discharge fi:om inpatient hospitalization.* Thank you for your attention to this matter. I am available at (717) 531- 7161 for any additional questions. Beverly Shirk, RN BSN CCRN - Pediatric Trauma Case Manager EXHIBIT "G" II state 6345 FLANIf DRIVE SUITE 1000 HARRISBURG PA 1711~ * PHONE NUMBER: 71%540-7500 OFFICE HOURS: MONDAY-FRIDAY 8:00-~;-.30 You're in good hands. March 2~, 2003 RICHARD MOFFITF 2201 N 2ND ST }~RRISBURG PA 17010 Allstate Indemnity Company Cla/m N~ber: 1554556561 B19 Our Insured: PATRICIA COIl Date of Loss: January 26~ 2003 RE: Samatha Miller Dear Mr. Maffett: I am in receipt of your letters dated March 18, 2003 addressed to Heather Bean and Pat Hickey. Please be advised that I have assu~ed the handl±ng of these files. Claim number 155~556561 refers to the pr~ary liability policy and claim number 1554555480 refers to the excess liability policy. Kindly direct all records etc. to the primary policy. Please be advised that the policy limits under t]~e primary policy are $15,000/$30s000 and the limits ander the excess policy are $100~000/$300,000. ?ATRIClA A. HOFFMAN Allstate Indemnity Company sM06/0/01/1 RECEIVED MAR 2 5 2D03 EXHIBIT "H" MARKET CLAIM OFFICE 6345 FLANK DRIVE S~glTE 1000 HARRISBURG PA 17112 PHONE NUMBER: 717-.540-7500 OFFICE HOURS: MONDAY-FRIDAY 8:00-5'.30 AIIstate. You're in good hands. September 23, 2003 RICHARD MOFFITT 2201 N 2ND ST HARRISBURG PA 17010 Allstate Inde~ity Company Claim Number: 1554556561 B19 Our Insured: PATRICIA COIA Date of Loss: January 26, 2003 RE: Samantha Miller Dear Mr. Moffitt: Please be advised that ~ am prepared to extend an offer of our policy limits under both the primary and the excess policy. I have enclosed a copy of various structured settlement proposals for your client's review. As I am sure you are aware this tax exempt option may well be in your client's best interest. Please contact me once you have had the opportunLty to meet with your clients. PATRICIA A. HOFFMAN Allstate Indemnity Company SM06/0/01/1 01 Enclosure G52-2 EXHIBIT 03/18/04 T~U 10:49 FAX 6108345442 RINGLER ASSOC RINOLER ASSOCIATES (610) 834-5553 (800) 869-9450 Fax (610) 834-5442 or (610) 834,8266 Via Facsimile (717) 233-2342 002 March 18, 2004 Richard Moffitt Attorney at Law 2201 N. 2nd Street Harrisburg, PA 17110 Samantha Miller File: #1554556561 and 1554555480 Dear Mr. Moffitt: Enclosed is the updated structured settlement proposal in regarqs to Samantha's claim. I will lock-in th/s quote and wiI1 prepare the Settlement Agreement and Release, Please feel free to call if you have any questions or if we can be of further assistance. Sincerely, RINGLER ASSOCIATES MPM.'jad Enclosures OFFIC'~ COURT AT WALTON POINT · 490 NORRISTOWN ROAD * SUITE 251 o BLUE BELL, PA 19422 MAILING ADDRESS: P.O. BOX 1252 · BLUE BELL, PA 19422 www. RinglerAssoctates,com Ha~d~ ~o~[Mu, ~t ~ ~ ~, ~ Hilb (~),,~ M~ (NJ), Minr~p~ Mo~i~m~ ~), New ~le~, New y~, EXHZBI~ J 03/18/04 THU 10:40 FAX 6108345442 RINGLER ASSOC ~003 INDIVIDUALLY DESIGNED SETTLEMENT NAME: Samantha Miller FBMALB: 8/1/1986 TAX-FREE GUARANTEE C~sh: Guaranteed Lump Sums: $10,000 at a§e 20 (8/1/06) $10,000 at age 22 (8/1/08) $15,000 at age 24 (8/1/10) $20,000 at age 26 (8/1/12) $24,125 at age 28 (8/1/14) $30,000 at age 30 (8/1/16) Total Cost: $115~000 38,333 109~125 $147,458 ** This proposal expires on 3/25/04 or the date of a rate change, if earlier. **This is an illustration, not a contract. Should it contain any clerical errors, we reserve the right to correct ERIE INSURANCE EXCHANGE E PIONEER FAMILY AUTO POLICY AMENDED DECLARATIONS 05 * * EFFECTIVE 01/21/03 ATTACH T~IS TO YOUR POLICY. REASON FOR AMENDMENT - COMP AND/OR COLLISION DEn AMENDED AA7507 SHINER INSURANCE AGY PC 10/25/02 TO 10/25/03 Q10 2508246 H I.,,lll,.lll,.,,,,ll,,ll,l,,I,,I,l,,.,ll,,l{,hl,.ll,,,ll,,I JAMES L MILLER & AS LISTED BELON STEPHANIE L MILLER 296 OLD STONEHOUSE RD CARLISLE PA 17013-8513 AGENT - SHINER INSURANCE AGY PC 1001 S. MARKET STREET SUITE C AGENT PHONE - (717) 766-1200 MECHANICSBURG PA 17055 6748 ITEM 4. AUTOS COVERED AUTO YR MAKE VIN ST TER Siq4 RATING CLASS DDP ~ 02 TOYO SEQUOIALTD 5TDBT48A92S137460 PA 4F P A2BL-M FM40 88 FORD PU F150 2WD 1FTDF15YOJNB14640 PA 4F A1AL-M MM45 ITEM 5. INSURANCE IS PROVIDED WHERE A PREMIUM. OR INCL, IS SHOWN FOR THE COVERAGE. COVERAGES, LIMITS AND ANNUAL PREMIUMS ARE AS FOLLOWS- %1 %2 *****GOOD DRIVER RATES APPLY***** --- THE FULL TORT OPTION APPLIES TO ALL PRIVATE PASSENGER VEHICLES. --- LIABILITY PROTECTION- --. BODILY INJURy ~lO~/gmR~ON~$300M/ACC -PROPERTY DAMAG~iODM/ACC FIRST PARTY BENEFIT.~--~ MEDICAL EXPENSE<.%l/IH~ INCOME LOSSSIM/N0~H, $15MMAXIMUM ACCIDENTAL DEATH SSM ' FUNERAL BENEFIT S2.5M UNINSURED MOTORISTS COVERAGE- ROD INJ S100M/~ERSON $300M/ACC-STACKED UNDERINS 0 R COVE GE- ROD IN~$30oMR~AcC-STACKED PHYSICAL COWRAGBS- CO REHBNSIVE - 55o0 DED COLLISION -SlM nED OPTIONAL COVERAGES- ROAD SERVICE TOTAL ANNUAL PREMIUM FOR BACH AUTO TOTAL ANNUAL POLICY PREMIUM PREMIUM REDUCTION DUE TO THIS CHANGE 86 80 86 82 41 41 2L3 13 2 2 2 2 :L5 15 79 79 114 22L3 655 314 $ 9159 $ 135CR ITEM 6. APPLICABLE PoLIcY, ENDORSEMENTS. EXCEPTIONS TO DECLARATIONS ALL AUTOS - FAP 04~97, UF2106 05/01, AFPN01 10/98, AFPA03 10/02. AUTO I - AFPU01 04Z99. AUTO 2 - AFPU01 04~99. ITEMS ANTI-THEFT DISCOUNT APPLIES-ALARM AUTO'I MULTI POLICY DISCOUNT APPLIES - AMOUNT OF DISCOUNT IS $ 40 PASSIVE RESTRAINT DISCOUNT APPLIES - DUAL AIRBAGS AUTO 1 ANTI-LOCK BRAKE DISCOUNT APPLIED AUTO 1 EXPLANATION OF ADULT &/OR YOUTHFUL DRIVER RATING CLASS AUTO 1-TO WORK 11-14 MILES ONE WAY, 8,501 OR MORE MILES ANNUALLY FEMALE. MARRIED, AGE 40-66 AUTO 2-PLEASURE USE. 8.501 OR MORE MILES ANNUALLY MALE, MARRIED, AGE 65-69 MISCELLANEOUS INFORMATION EXHIBIT "K" ITEM 7. EACH AUTO WE INSURE WILL BE PRINCIPALLY GARAGED AT THE ADDRESS SHOWN IN ITEM 1, UNLESS ANOTHER ADDRESS IS SHOWN BELOW. ITEM 9. UNLESS A CO-OWNER OR LIENHOLDER IS LISTED BELOW, THE NAMED INSURED IS THE SOLE OWNER OF EACH AUTO WE INSURE. LIENHOLDER FOR AUTO 1 TOYOTA MOTOR CREDIT CORP 2 WALNUT GROVE DR 310 HORSRAM PA 19044-4295 DRIVER 1 JAMES L MILLER 2 STEPHANIE L MILLER ST LICENSE NUMBER PA 17122748 PA 19440843 BIRTM DATE YOUR COLLISION COVERAGE AND DEDUCTIBLE APPLY TO PRIVATE PASSENGER AUTOS YOU OR A RESIDENT RELATIVE RENT FOR 45 DAYS OR LESS. THIS IS SUBJECT TO LIMITS, TERMS AND CONDITIONS IN THE POLICY. Q10 2508244 October 17, 2003 KERRY J. Rr1'CHEY, CPCU, AIC Claims M~ger ERIE INSURANCE GROUP Branch Office · 4901 Louise Dr. · Rossmoyne Business CenTer · P.O. Box 2013 · Mechanicsburg, PA 17055~0710 (7~7) 795-8200 · Toll Free 1-800-382-1304 , Fax (717) 795-2315 · www.efieinsu'ar~ce.com Richard Maffett, Jr., Esquire 2201 North Second Street Harrisburg, PA 17110 Re: Your Client: Erie Claim No.: Erie Insured: Date of Loss: James & Stephanie Miller 010170661624 Samatha Miller January 26, 2003 Dear Mr. Maffett: As per our conversation, this will confirm that Erie Insurance is offering the $200,000.00 Underinsured Motorist Coverage limits as final settlement of Ms. Miller's Claka. As you are aware, th& settlement is contingent upon completion of court approval. Also, I would appreciate it if you would discuss the possibility of the Miller's structuring a portion of the settlement. Thank you for your assistance. Sincerely, Claims Representative (717) 795-2311 EXHIBIT "L" The ERIE Is Above Ail In sERvIcF-~ Since 1925 JAMES L. MILLER, Parent and Natural Guardian of SAMANTHA JO MILLER, a Minor, Petitioner v JORDAN L. BRANDT, Re spondent IN THE CO~T OF CO~ON PLEAS CUMBERLAND COU1TTY, PENNSYLVANIA NO. 04-14713 CIVIL ACTION - LAW PETITION ~RAPPROVAL OF COMPROMISE SETTLEMENT INVOLVING A MINOR AFFIDAVIT I, STEPHANIE L. MILLER, an adult individual residing at 296 Old Stonehouse Road, Carlisle, PA. 17013, hereby aver the following: 1. I am the natural mother of SAMANTHA JO MILLER, a minor, age seventeen (17), born August 1, 1986. 2. JAMES L. MILLER, Petitioner in the aforesaid matter, is my husband, and natural father of SAMANTHA JO MILLER, the minor. 3. SAMANTHA JO MILLER, the minor, resides with my husband Petitioner JAMES L. MILLER and me, at 296 Old Stonehouse Road, Carlisle, Cumberland County, PA. 17013. We have sole custody of SAMANTHA JO MILLER. 4. I have carefully read and reviewed the foregoing Petition For Approval of Minor's Settlement and believe it to be true and correct. 5. I believe the proposed settlement and compromise of my minor daughter, SAMANTHA JO MILLER'S claim against JORDAN L. BRANDT and Allstate Insurance Company, in the amount of EXHIBIT M $115,000.00, is in her best interests; and., I desire that the proposed settlement be accepted and approved. 6. I also agree with, and approve of, the proposed distribution contained in the Petition. I verify the averments set forth in the foregoing Affidavit are true and correct to the best of my knowledge, information, and belief, and understand that false statements herein are made Pa.C.S.A. Section 4904, relating subject to the penalties of 18 to unsworn falsifications. Dated: 03/24/04 Respectfully submitted, EXHIBIT JAMES L. MILLER, Parent and Natural ~uardian of SAMARTHA JO MILLER, a Minor, Petitioner v ERIE INSURANCE COMPANY, INC., ResDondent IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-14713 CIVIL ACTION - LAW PETITION FOR APPROVAL OF COMPROMISE SETTLEMENT INVOLVING A MINOR I, STEPHANIE L. Old Stonehouse Road, following: 1. I am the natural mother of SAMANTHA JO MILLER, age seventeen (17), born August 1, 1986. AFFIDAVIT MILLER, an adult individual residing at 296 Carlisle, PA. 17013, hereby aver the a minor, 2. JAMES L. MILLER, Petitioner in the aforesaid matter, is my husband, and natural father of SAMANTHA JO MILLER, the minor. 3. SAMANTHA JO MILLER, the minor, resides with my husband Petitioner JAMES L. MILLER and me, at 296 Old Stonehouse Road, Carlisle, Cumberland County, PA. 17013. We have sole custody of SAMANTHA JO MILLER. 4. I have carefully read and reviewed the foregoing Petition For Approval of Minor's Settlement and believe it to be true and correct. 5. I believe the proposed settlement and compromise of my minor daughter, SAMANTHA JO MILLER'S claim against Erie Insurance Company, in the amount of $200,000.00, is in her best interests; E]~IIBIT M and, I desire that the proposed settlement be accepted and approved. 6. I also agree with, and approve of, the proposed distribution contained in the Petition. I verify the averments set forth in the foregoing Affidavit are true and correct to the best of my knowledge, information, and belief, and understand that false statements herein are made Pa.C.S.A. Section 4904, relating subject to the penalties of 18 to unsworn falsifications. Dated: 03/24/04 Respectfully submitted, S~EPH~N:CE L. MILLER ~ EXHIBIT M RICHARD F. MAFFETT, JR. ATTORNEY-AT-LAw 2201 North Second Street Harrisbur§, Pennsylvania 17110 FAX (717} 233-234,2 PERSONAL INoo~ POWER OF ATTORNEY AND CONTINGENT :FEE AGREEMENT KNOW ALL ~ BY THESE PRESENTS, that I/we, JAM~S L. MILLER and STEP~NIH L. MIT.?.~, PA~F-~TS k~'r~' O~IAN OF SAMANTHA JO MILLER, A MINOR, do hereby retain RICHARD F. MAFFETT, JR., a member of the Bar of the Supreme Court of Pennsylvania, as my/our attorney to negotiate for an adjustment, or to institute for me/us in my/our name any legal actions or proceedings that in his judgment are necessary, in connection with my/our claim for damage against JORDAN BRANDT, ALLSTATE INSURANCE COMPANY, ERIE INSU~_~wCE COMPANY, T~Y aLL~I, KEITH BRAMLETT, EMPIRE F!~ AND MARINE, PennDOT0 or anyone else as a result of injuries or damage sustained by SAMANTHA JO MILLER on or ~oUt the 26TH da~ of JANUARY , 2003. KNOW, THEREFORE, in consideration of the.services to be so rendered by my/our said attorney, I/we hereby covenant, promise and agree to pay my/our said attorney for his professionalservices rendered TWENTY-FIVE (25%) PERCENT of whatever sum is recovered as a result of settlement, or of the verdict in the event trial is held. I/we also agree to pay any necessary expenses, i.e., court costs, stenographer and transcription fees, records fees, e~ert witness, investigation costs, whether or not there is a recovery, with a cost advance of $ -0- This agreement is for representation through trial only and does not include an appeal. In the event an appeal is necessary, additional fee arrangements must be made. AND NOW, this _~ day of ~--~. , 2003, the above Contingent Fee Agreement and Power of Attorney has been read, approved and understood by me/us and the receipt of a copy 'thereof acknowledged. The terms set forth are agreeable. WITNESS WITNESS J~s L. ]~xller, Parent & Guardian of Samantha Jo Miller, a Minor Stephanie L. Mmller, Parenn Guardian of Samantha Jo Miller, a Minor EXHIBIT "N" PENNbTATE ~ ~ nc MiltOn S. Hershe~ RE:Account # Patient Name: Enclosed are the copies of the bills you requested. Based upon your request please remit $15.00 for copies of hills. Checks should be made payable to: Hershey Medical Center P.O. Box 853 Hershey Pa 17033 Arm: Cindy Fra_m:z Our Federal Tax LD. #'s are: Physician 25 185 7035, Hospital 25 185 4772 If the patient was ~li~ble for Medical Assistemce Beuefit.% copies of bills will be sent to and reviewed by the Mediml Assistmme R~cov~ry Board. Dep~'tu~mt oft:~blic W*lfare ...- Bm ofFi~-~cial Opea'z~oas ... TPL section Casually Unit P.O. Box 8486 l:-I,m'risburg PA 17105. Plea.s, ,o-ta~'t The medicul Asistm~e Reyvea'y Board directly 717-772-6623.. H~r~hey Meclic. aI"C'~mr Patient Fir~ncial Services 717-531-5984 EXHIBIT "0" v .r- 2 2003 REOORDEX AC ~Q~JI~ITION CORP SOURCECOR~,~EALTHSERVE 17 LEE BLVD, STE D Malvern PA 19355 Phone: (610)640-0600 Fax : ()- Invoice No. : 17BQ-54362 Invoice Date : 09/29/2003 Sales Code : CT8227 Class / Type : LAW / LAW Price Class : STD EIN : 51-0370082 RICHARD F MAFFETT 2201 N2ND ST HARRISBURG, PA 17110 Patient: Hospital: RequestNo: SAMANTHAMILLER HERSHEY MEDICAL CENTER 170698 Request Date: 09/16/2003 Birth Date: 08/01/1986 Reference %: SS1657800992 CODE SERVICE RENDERED 5 BASIC CHARGE 10 COPY CHARGE 40 ARCHIVAL FEE TERMS: DUE IMMEDIATELY SUMMARY OF CHARGES FOR MEDICAL RECORDS UNIT AM'T QTY. TAX EXT. AM'T 12.5600 1 N 1.1100 16 N 4.0000 1 N POSTAGE: TAX: LESS: PAID IN ADVANCE: 12.56 17.76 4.00 1.06 0.00 0.00 35~38 PLEASE SEND PAYMENT TO RECORDEX ACQUISITION CORP PLEASE INCLUDE YOUR INVOICE NUMBER ON YOUR REMITTANCE. PLEASE RETURN A COPY OF THE INVOICE WITH YOUR REMITTANCE. RECEIVEO OCT - 2 2003 ~ Thc Mihon ~,. ,h~rsne.;' Enclosed are the copies of the bills you requested. Based upon your request please rem/t $15.00 for copies of bills. Chee~ should be made payable to: Hershey Medical Center P.O. Box 853 Hershey Pa 170.33 Arm: Cindy Frantz Our Federal Tax I.D. #'s are: Physician 25 185 7035, Hospital 25 185 4772 If the patient warn eligible for Medical Assistance Benefits, copies of b/lis will be sent to and reviewed by the Medical Assistance Recovery Board. Depm'tment of Public Welfare ' -- Bm~au ofFinaucia~ Opmfions TPL section Casualty P.O. Box 8486 Yrlarr'isburg pA 17105. Please contact The medical ~istance Recovery Board d/reedy 717-772-6623.. Patient Fimm=ial Services 717-531-5984 APR - 281 ~OUR~CORP. HEALTHSET?VE Fax : 0 - INVOICE 2201 VISA / MASTERCARD ACCEPTF_X) ORIGINAL 03/l~/Zuoq 13:47 FAX 717 728 1502 RINGLER ASSOCIATES ~001 RINGLER ASSOCIATES, INC. FACSIMILE TRANSMITTAL SHEET TO: RICHARD MAFFETT, ESQ. FROM: JOHN W. CAMERON COMPANY: DATE: 3-18-2004 FAX NUMBER: 717-233-2342 CC: DOUG KOCHER TOTAL NO. OF PAGES INCLUDING COVER: 2 RE: SAMA~'~{A MILLER. FAX PHONE: 717-774-0233 CLAIMS NUMBER: 010170661624 [] URGENT [] FOR REVIEW [] PLEASE COMMENT [] PLEASE REPLY [] PLEASE RECYCLE NOTES/COMMENTS; Dear Mr, Maffett: This will confirm our conversation on March 18, 2004 r~garcling your client, Samatha Miller. Attached is the structured settlement proposal you requested. If it Es acceptable to you and your client, please call me and I will lock it in and process the necessary paperwork, to include preparation of the release. The enclosed figures are for illustrative purposes ordy and should not be construed as a contract. All figures are subject to approval by the life insurance carrier prior to contract issuance. If you have any questions rega~ting this proposal, please call so we can discuss them. John W. Cameron 4902 CARLISLE PIKE + PMB 395 ~ MECHANICSBURG, PA 17050 PHONE: 717-728-1500 * FAX: 717-728-l$02 E~HIBIT P 03/18/2U04 13;47 FA~ 717 728 1602 RINGLER ASSOCIATES ~002 O0 ~NGL.FJ~ ASSOCIATES John W, Cameron jcameron@ringlerassociates,com (717) 728-1500 (800) S15-5033 (717) 728-1502 (FAX) March 18, 2004 Individually Designed Settlement Samatha Miller D/O/B 8/1/88 BENEFIT COST GUARANTEED YIELD Guaranteed Lump Sums Tax-frae payments: $ 10,500 on 08/01/06 (age 20) $ 10,500 on 08/01/08 (age 22) $ 10,500 on 08/01/10 (age 24) $ 10,500 on 08101112 (age 26) $ 10,500 on 08/01/14 (age 28) $130,000 on 08/01/16 (age 30) 9,763 10,500 9,158 10,500 8,590 10,500 8,058 10,500 7,559 10,500 87,784 130,000 $130,912 $182,500 4902 CARl TSI F P[KE, PMB 395, MECHANICS;BURG, PA 17050-3079 www.dnglermidam.corn VERIFICATION I, JAMES L. MILLER, Parent and Natural Guardian of Samantha Jo Miller, have read the foregoing Petition for Approval of Minor's Settlement and hereby affirm that it is true and correct to the best of my knowledge, or information and belief. This verification and statement is made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unsworn falsification to authorities; I verify that all statements made in the foregoing are true and correct and that false statements may subject me to the penalties of 18 Pa. C.S.A. §4904. Dated: 03/24/04 MILLER, Parent and ~uardian of Samantha Jo Miller JAMES L. MILLER, Parent an~ Natural Guardian of SAMANTHA JO MILLER, a Minor· Petitioner v *.TOI~.DA,N L · BE~'~· Defendant IN THE COURT OF CO~ON PLEAS CUMBERLAND COUITTY, PENNSYLVANIA NO. 04-1473 CIVIL ACTION - LAW AND NOW, this~ consideration of the Petition For it is hereby ORDEHED AND DECREED that: PETITION FOR A~PROVAL OF COMPROMISE SETTLEMENT INVOLVING A MINOR o __ day of~~__, 2004, upon ' A~oval of Minor's Settlement, I. DEFENDANT JORDAN L. BI~%NDTANDALLSTATE INSURANCE COMPANY Petitioner is authorized to enter into a settlement with Defendant, JORDAN L. BRANDT, and her insurance company, Allstate Insurance Company, in the gross sum of $11.5,000.00. Petitioner is authorized to sign a release and to mark the matter settled, discontinued and ended as to the above Defendant. These settlement proceeds shall be distributed as follows: $28,750.00 to Richard F. Maffett, Jr., Esquire, in payment of attorneys fees; $9,583.00 to JAMES L. MILLER, as Parent and Natural Guardian of SAMANTHA JO MILLER, a minor, to be deposited into a restricted, federally insured account marked UNo withdrawals prior to age eighteen (18) without prior court approval. $76,667.00 to Allstate Life Insurance Company to fund a structured settlement by the purchase of an Annuity Contract whereby guaranteed payments shall be made to SAMANTHA JO MILLER. II. ERIE INSURANCE GROUP Petitioner is authorized to enter into a settlement of underinsured motorist benefits for which the Minor, SAMANTHA JO MILLER, is eligible pursuant to Petitioner's policy of automobile insurance with Erie Insurance Group, in the gross sum of $200,000.00. Petitioner is authorized to sign a release as to Erie Insurance Group. These settlement proceeds shall be distributed as follows: $50,000.00 to Richard F. Maffett, Jr., Esquire, in payment of attorneys fees: $266.74 to Richard F. Maffett, Jr., Esquire, in reimbursement of litigation costs; $9,733.26 to Petitioner, JAMES L. MILLER, for payment of medical bills; $9,088.00 to Petitioner, JAMES L. MILLER, as Parent and Natural Guardian of SAMANTHA JO MILLER, a minor, to be deposited into a restricted, federally insured account marked "No withdrawals prior to age eighteen (18) without prior court approval. $130,912.00 to Erie Life Insurance Company to fund a structured settlement by the purchase of an Annuity Contract whereby guaranteed payments shall be made to SAMANTHA JO MILLER. BY THE COURT: