| http://www.w3.org/ns/prov#value | - ll be covered when deemed medically necessary by the medical director, or his or her designee, subject to any referral and formulary requirements. (6) The health care service contractor need not include the coverage required in this section in a group contract offered to an employer or other group that offers to its eligible enrollees a self-insured health plan not subject to mandated benefits sta
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