(1) Every subscriber shall be issued an evidence of coverage which shall contain a clear and complete statement of: (a) The services to which each enrollee is entitled; (b) Any limitation of the services, kind of services, or benefits to be provided and exclusions, including any deductible, copayment, or other charges; (c) Where and in what manner information is available as to where and how services may be obtained; and (d) The method for resolving complaints.
(2) Any amendment to the evidence of coverage may be provided to the subscriber in a separate document.
