AMERICAN SPECIALTY HEALTH PLANS GROUP SUBSCRIBER AGMT 1998

5. LIMITATION OF BENEFITS S.O1 Acts Bevond ASHP's Control. In the event of circumstances not reasonably within the control of ASHP, such as any major disaster, epidemic, earthquakes, complete or partial destruction of ASHP, war, riot, or civil insurrection, which results in the unavailability of ASHP's personnel or the Participating Chiropractors, ASHP and the Participating Chiropractors shall provide or attempt to arrange for Chiropractic Services insofar as practical, according to their best judgment, within the limitation of such ASHP personnel and the Participating Chiropractors. Neither ASHP nor any Participating Chiropractor shall have any liability or obligation for delay or failure to provide or arrange for Chiropractic Services if such delay or failure is the result of any of the circumstances described above. 6. PARTIES AFFECTED BY THIS AGREEMENT: RELATIONSHIPS BETWEEN PARTIES 6.01 Member Non-Liability. In the event ASHP fails to pay a Participating Chiropractor for a Covered Service in Attachment A, Member shall not be liable to the Participating Chiropractor for any sums owed by ASHP. 6.02 Participating Chiropractors are Independent Contractors. ASHP and the Participating Chiropractors are independent contractors. None of the Participating Chiropractors or their employees or agents are employees or agents of ASHP and none of ASHP's employees or agents are employees or agents of any Participating Chiropractor. 6.03 Relationship to Parties to this Agreement. Group is not the agent or representative of ASHP, and shall not be liable for any acts or omissions of ASHP, its agents or employees, or independent contractors, or any other person or organization with which ASHP has made, or hereafter shall make, arrangements for the performance of services under this Health Plan. Member is not the agent or representative of ASHP, and shall not be liable for any acts or omissions of ASHP, its agents or employees. 7. GRIEVANCE PROCEDURE AND DISPUTE RESOLUTION 7.01 Grievance and Ouality Assurance Reviews. Members and providers can initiate a Grievance Procedure or Quality Assurance Review by calling ASHP at 1-800-678-9133 or by requesting a grievance form from any ASHP contracting Provider. ASHP shall not discriminate against a Member solely on the grounds that the Member filed a grievance or quality of care complaint. All grievances and quality of care complaints will be reviewed by the Member Services Department for identification of quality of care issues, including inappropriate denial of services or accessibility problems. Quality of care complaints shall be handled by the Quality Assurance Program described in Section 7.01.02; non-quality of care issues will be reviewed according to the Grievance Procedure, described in Section 7.01.01. If the complaint involves both quality of care and non-quality of care issues, the non- quality of care issues will be handled through the Grievance Procedure, described in Section 7.01.01 and the quality of care issues will be reviewed pursuant to the Quality Assurance Review Procedure described in Section 7.01.02. In some cases a Member may file a complaint with the Department of Coroorations California law sets forth this risht in the following statement: The California Department of Corporations is responsible for regulating health care service plans. The department has atoll-free telephone number (1-500-400-0815) to receive complaints regarding health plans. If a Member has a grievance against the health plan, the Member should contact the plan and use the plan's grievance process If the member needs the department's help with a complaint involving an emergency grievance or a grievance that has not been satisfactorily resolved by the plan, the Member may call the department's toll-free telephone number.