If (1) Aetna denied your request for precertification or your claim for artificial insemination (intracervical insemination (“ICI”) or intrauterine insemination (“IUI”)) or in vitro fertilization (“IVF”) procedures, or if Aetna would have denied your request for coverage for artificial insemination that you underwent, between September 1, 2017 and June 1, 2024 and you were in an Eligible LGBTQ+ Relationship as described in the Settlement Notice, (2) you have not requested exclusion from the settlement, and (3) you experienced additional, miscellaneous harm arising from Defendant’s actual or anticipated denial of your coverage request(s) that are not covered by any of the other benefits provided by this settlement (including the out-of-pocket expense submission), you may be eligible for additional compensation and should complete this Miscellaneous Harm Submission.