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DocuSign Envelope ID: 29EAB906-1936-4BAB-83BE-97C974FOO293 <br />. "MedicallyNecessaryService" means a healthcare item or service which a Provider determines to be <br />both reasonable and necessary to diagnose or treat an illness, injury, condition, disease or symptom of a <br />Participant which is consistent with accepted standards of medicine. <br />"Network" has the meaning set forth in the Recitals to this Agreement. <br />"Network Services" means those services offered by EDH to Participants who elect to utilize the <br />Network for Covered Services, including, without limitation, intake and referrals of Participants to Providers, <br />non -clinical care coordination and administration, administration of Claims processing and payment, <br />coordination of Travel Services, and/or administration of Plan Incentives. <br />"Network Use Fee" has the meaning set forth in Section 4.3(b) of this Agreement. <br />"Participant" means any individual who has enrolled for coverage in the Plan who is eligible to receive <br />Covered Services through the Network. <br />"Plan" has the meaning set forth in the Recitals to this Agreement. <br />"Plan Administrator" means a third party administrator specifically designated in the Plan Documents <br />to provide administrative services for and manage the Plan. For the avoidance of doubt, EDN is not the Plan <br />Administrator. <br />"Plan Carveout" means any requirement by the Plan or included in the Plan Documents that EDH <br />and/or the Network be the required or designated source of medical coverage for any Medically Necessary <br />Service. <br />"Plan Documents" means the instrument(s), as amended from time to time, that set forth and govern <br />the benefits provided under the Plan and the duties of Sponsor with respect thereto. Plan Documents include, <br />without limitation, the summary plan description, summary of material modifications, and schedule of <br />benefits. <br />"Plan Incentives" has the meaning set forth in Section 3.6 of this Agreement. <br />"Project Executive" has the meaning set forth in Section 3.1 of this Agreement. <br />"Protected Health Information" shall have the same meaning ascribed to such term in HIPAA. <br />"Provider" means an appropriately licensed or otherwise legally authorized provider of medical, <br />surgical, hospital, professional, and/or other health-related services that offers Covered Services through the <br />Network. A Provider may be, without limitation, a physician, physician group, anesthesia provider, anesthesia <br />provider group, facility (both hospital and non -hospital facilities), system of facilities (including hospitals, non- <br />hospital facilities, or any combination), or any other provider of medical or health related services. <br />"Renewal Term" has the meaning set forth in Section 5.1 of this Agreement. <br />"Report Date" has the meaning set forth in Section 4.4(a) -of this Agreement. <br />"Total Network Use Fee" has the meaning set forth in Section 4.4(a).of this Agreement. <br />"Travel Services" means the services coordinated by EDH pursuant to this Agreement relating to a <br />Participant's, and person accompanying such Participant, transportation and lodging during or in relation to an <br />Episode of Care. The specific Plan requirements to be administered by EDH with respect to Travel Services will <br />be mutually agreed by the Parties in writing. <br />