TABLE OF CONTENTS PAGE. Summary of Benefits 9 Introduction to the Blue Shield Access+ HMO Health Plan 15 How to Use This Health Plan 15 Selecting a Primary Care Physician 15 Primary Care Physician Relationship 16 Role of the Primary Care Physician 16 Obstetrical/Gynecological (OB/GYN) Physician Services 16 Referral to Specialty Services 16 Role of the Medical Group or IPA 17 Changing Primary Care Physicians or Designated Medical Group or IPA 17 Access+ Specialist 17 Access+ Satisfaction 18 Mental Health and Substance Use Disorder Services 18 Continuity of Care 19 Second Medical Opinion 19 Urgent Services 19 Emergency Services 20 Claims for Emergency and Urgent Services 21 NurseHelp 24/7 sm 21 Life Referrals 24/7 21 Blue Shield Online 21 Health Education and Health Promotion Services 21 Timely Access to Care 21 Cost Sharing 22 Limitation of Liability 23 Out-of-Area Services 24 Inter-Plan Arrangements 24 BlueCard Program 24 Blue Shield Global Core 25 Utilization Management 25 Principal Benefits and Coverages (Covered Services) 26 Allergy Testing and Treatment Benefits 26 Ambulance Benefits 26 Ambulatory Surgery Center Benefits 26 Clinical Trial for Treatment of Cancer or Life-Threatening Conditions Benefits 26 Diabetes Care Benefits 27 Durable Medical Equipment Benefits 28 Emergency Room Benefits 28 Family Planning and Infertility Benefits 29 Home Health Care Benefits 29 Home Infusion and Home Injectable Therapy Benefits 30 Hospice Program Benefits 31 Hospital Benefits (Facility Services) 32 Medical Treatment of the Teeth, Gums, or Jaw Joints and Jaw Bones Benefits 33 Mental Health and Substance Use Disorder Benefits 33 Orthotics Benefits 34 Outpatient X-Ray, Pathology and Laboratory 35 PKU Related Formulas and Special Food Products Benefits 35 Podiatric Benefits 35 Pregnancy and Maternity Care Benefits 35 Preventive Health Benefits 36 Professional (Physician) Benefits 36 Prosthetic Appliances Benefits 37 Reconstructive Surgery Benefits 38 Rehabilitation and Habilitative Services Benefits (Physical, Occupational and Respiratory Therapy) 38 Skilled Nursing Facility Benefits 38 Speech Therapy Benefits (Rehabilitation and Habilitative Services) 38 Transplant Benefits 39 Urgent Services Benefits 39 Principal Limitations, Exceptions, Exclusions and Reductions 40 General Exclusions and Limitations 40 Medical Necessity Exclusion 43 Limitations for Duplicate Coverage 43 Exception for Other Coverage 44 Table of Contents Page Claims Review 44 Reductions - Third Party Liability 44 Coordinatio...
TABLE OF CONTENTS PAGE. Section 1. Certain Definitions 4 Section 2. Appointment of Rights Agent 8 Section 3. Issue of Right Certificates 8 Section 4. Form of Right Certificates 9 Section 5. Countersignature and Registration 10 Section 6. Transfer, Split Up, Combination and Exchange of Right Certificates; Mutilated, Destroyed, Lost or Stolen Right Certificates 10 Section 7. Exercise of Rights, Purchase Price; Expiration Date of Rights 11 Section 8. Cancellation and Destruction of Right Certificates 12 Section 9. Availability of Shares of Preferred Stock 12 Section 10. Preferred Stock Record Date 13
TABLE OF CONTENTS PAGE. PART I - CLAIMANT IDENTIFICATION 2 PART II - GENERAL INSTRUCTIONS 3 PART III - SCHEDULE OF TRANSACTIONS IN K12 COMMON STOCK 4 PART IV - SUBMISSION TO JURISDICTION OF COURT AND ACKNOWLEDGMENTS 5 PART V - RELEASE AND CERTIFICATION 5 Important - This form should be completed IN CAPITAL LETTERS using BLACK or DARK BLUE ballpoint/fountain pen. Characters and marks used should be similar in the style to the following: AB C DE FG H IJ KL MNOP QR ST UVWXY Z1 2 3 45 67 0 PART I - CLAIMANT IDENTIFICATION LAST NAME (CLAIMANT) FIRST NAME (CLAIMANT) Last Name (Beneficial Owner if Different From Claimant) First Name (Beneficial Owner) Last Four Digits of the Beneficial Owner’s Employer Identification Number or Social Security Number1 Last Name (Co-Beneficial Owner) First Name (Co-Beneficial Owner) Company/Other Entity (If Claimant Is Not an Individual) Contact Person (If Claimant is Not an Individual) Trustee/Nominee/Other Account Number (If Claimant Is Not an Individual) Trust/Other Date (If Applicable) Address Line 1 Address Line 2 (If Applicable) City State Zip Code Foreign Province Foreign Country Foreign Zip Code Telephone Number (Day) Telephone Number (Night) - - - - Email Address (Email address is not required, but if you provide it you authorize the Claims Administrator to use it in providing you with information relevant to this claim.) IDENTITY OF CLAIMANT (check only one box): Individual Joint Owners Estate Corporation Trust Partnership Private Pension Fund Legal Representative IRA, Keogh, or other type of individual retirement plan (indicate type of plan, mailing address, and name of current custodian) Other (specify, describe on separate sheet) NOTICE REGARDING ELECTRONIC FILES: Certain claimants with large numbers of transactions may request to, or may be requested to, submit information regarding their transactions in electronic files. To obtain the mandatory electronic filing requirements and file layout, you may visit the website at www.gcginc.com or you may email the Claims Administrator at eClaim@gcginc.com. Any file not in accordance with the required electronic filing format will be subject to rejection. No electronic files will be considered to have been properly submitted unless the Claims Administrator issues an email after processing your file with your claim numbers and respective account information. Do not assume that your file has been received or processed until you receive this email. If you do not receive such an email within 10 days of y...
TABLE OF CONTENTS PAGE. ARTICLE I. Definitions 1 SECTION 1.01. Defined Terms 1 SECTION 1.02. Classification of Loans and Borrowings. 27 SECTION 1.03. Terms Generally. 27 SECTION 1.04. Accounting Terms; GAAP 28 SECTION 1.05. Interest Rates; LIBOR Notification 28 SECTION 1.06. Status of Obligations 29 ARTICLE II. The Credits 29 SECTION 2.01. Commitments 29 SECTION 2.02. Loans and Borrowings 29 SECTION 2.03. Borrowing Procedures; Requests for Revolving and CapEx Borrowings 30 SECTION 2.06. Letters of Credit 31 SECTION 2.05. Funding of Borrowings. 34 SECTION 2.06. Interest Elections. 34 SECTION 2.07. Termination of Commitment 35 SECTION 2.08. Repayment and Amortization of Loans; Evidence of Debt. 36 SECTION 2.09. Prepayment of Loans 37 SECTION 2.10. Fees. 38 SECTION 2.11. Interest 39 SECTION 2.12. Alternate Rate of Interest; Illegality. 39 SECTION 2.13. Increased Costs. 41 SECTION 2.14. Break Funding Payments. 42 SECTION 2.15. Taxes 42 SECTION 2.16. Payments Generally; Allocation of Proceeds 43 SECTION 2.17. Indemnity for Returned Payments 44 ARTICLE III. Representations and Warranties 45 SECTION 3.01. Organization; Powers 45 SECTION 3.02. Authorization; Enforceability 45 SECTION 3.03. Governmental Approvals; No Conflicts. 45 SECTION 3.04. Financial Condition; No Material Adverse Change 45 SECTION 3.05. Properties 45 SECTION 3.06. Litigation and Environmental Matters. 46 SECTION 3.07. Compliance with Laws and Agreements; No Default. 46 SECTION 3.08. Investment Company Status. 46 SECTION 3.09. Taxes. 46 SECTION 3.10. ERISA 47 SECTION 3.11. Disclosure. 47 SECTION 3.12. Material Agreements 47 SECTION 3.13. Solvency. 47 SECTION 3.14. Insurance. 48 SECTION 3.15. Capitalization and Subsidiaries. 48 SECTION 3.16. Security Interest in Collateral 48 SECTION 3.17. Employment Matters 48
TABLE OF CONTENTS PAGE. 12.1 In the event of a proposed assignment or subletting, Landlord shall also have the right, by notice to Tenant, to terminate this Lease in the event of an assignment as to all of the Premises and, in the event of a sublease, as to the subleased portion of the Premises and to require that all or part, as the case may be, of the Premises be surrendered to Landlord for the balance of the Term (collectively "Recapture the Lease"). Notwithstanding the previous sentence, if, before entering into a proposed assignment or sublease, Tenant gives written notice to Landlord of Tenant's intention to sublease or assign, and Landlord does not, within fifteen (15) business days after Landlord's actual receipt of such written notice and all information requested by Landlord relating to such proposed assignment or subletting, inform Tenant that Landlord intends to Recapture the Lease, then Landlord may not Recapture the Lease by reason of such proposed assignment or subletting, provided that: (i) if Landlord consents to the proposed assignment or subletting, Tenant shall complete such assignment or sublease within one hundred twenty (120) days after the end of such fifteen (15) day period, and (ii) nothing contained in this Section 13.2 shall be deemed to waive any of Landlord's rights to approve or disapprove a Transfer as provided in Section 13.1 of this Lease.
TABLE OF CONTENTS PAGE. ARTICLE I DEFINITIONS 1 1.1 Account Balance 1 1.2 Adoption Date 1 1.3 Annual Compensation 1 1.4 Annual Valuation Date 1 1.5 Authorized Leaves of Absence 1 1.6 Beneficiary 1 1.7 Board 1 1.8 Break in Service 2 1.9 Code 2 1.10 Company 2 1.11 Effective Date 2 1.12 Eligible Participant 2 1.13 Employee 2 1.14 Employer 2 1.15 Employer Contribution Account 2 1.16 Employer Stock 3 1.17 Employment 3 1.18 ERISA 3 1.19 ESOP Committee 3 1.20 Fiduciaries 3 1.21 FMLA Leave 3 1.22 Hour of Service 3 1.23 Normal Retirement Date 5 1.24 Participant 5 1.25 Plan 5 1.26 Plan Administrator 5 1.27 Plan Year 5 1.28 Qualified Election Period 5 1.29 Service 5 1.30 Trust (or Trust Fund) 5 1.31 Trustee 5 1.32 Year of Service 5 ARTICLE II PARTICIPATION AND SERVICE 6 2.1 Participation 6 2.2 Service 7 2.3 Effect of Break in Service 7 2.4 Inactive Account Status 8 2.5 Transfers of Employment Among Employers 9 2.6 Election Not to Participate 9 Table of Contents Page (continued)
TABLE OF CONTENTS PAGE. Section 1: Leased Premises and Common Use Areas 4 Section 2: Condition of Premises 5 Section 3: Authorized Uses 5 Section 4: Common Use Areas 7 Section 5: Sublease Term 8 Section 6: Rent and Fees 9 Section 7. Rent and Fee Adjustments 10 Section 8: Rent and Fee Payment 11 Section 9: Subject to Master Lease 11 Section 10. Records and Reporting by SUBLESSEE 11 Section 11: Undertakings of SUBLESSEE 11 Section 12: Improvement 12 Section 13: Ownership of Improvements, Acceptance, Care, Maintenance Improvements and Repair 13 Section 14: Ingress and Egress 13 Section 15: Radio Transmission 15 Section 16: Insurance 15 Section 17: SUBLESSEE's Use - Insurance Increase 18 Section 18: Governmental Requirements 18 Section 19: Airport Changes and Improvements 19 Section 20: Utilities and Services 20 Section 21: Liens 20 Section 22: Damage or Destruction 21 Section 23: Condemnation 22 Section 24: Default and Termination 23 Section 25: Handling and Storage of Hazardous Material 24 Section 26: Surrender of the Premises 26 Section 27: Insolvency and Bankruptcy 26 Section 28: Discrimination, Affirmative Action 27 Section 29: BOROUGH'S Reservation of Rights 28 Section 30: Assignment and Subletting 28 Section 31: Subordination 30 Section 32: Indemnification 30 Section 33: National Emergencies 31 Section 34: Natural Disasters 31 Section 35: Right of BOROUGH to Return Airport Operation to State of Alaska 31 Section 36: Modification 32 Section 37: Compliance with Rules and Regulations 32 Section 38: Special Conditions 33 Section 39: Repairs and Maintenance 34 Section 40: Right of the BOROUGH to Enter, Inspect and Make Repairs 35 Section 41: Miscellaneous 35 Acknowledgements State Consent Addendum: Exhibit A – Sublease Premises, Common and Joint Use Space Exhibit B - Rents and Fees Exhibit C - Utilities and Services KETCHIKAN INTERNATIONAL AIRPORT TERMINAL SUBLEASE and AIRLINE OPERATING AGREEMENT This Terminal Sublease (hereafter “Sublease”) is made effective this day of 2018, by and between the KETCHIKAN GATEWAY BOROUGH (hereafter “BOROUGH” or “LESSEE”), and AIRPORT LOUNGE & SNACK BAR, LLC. (hereafter “SUBLESSEE”).