2020-2021 Benefits Guide rev 6.22.2021

Coverage Effective Dates The following effective dates apply provided the appropriate enrollment transaction (electronic or paper form) has been completed within the applicable enrollment period. Your coverage is effective for you and your dependent as follows: New Hire If you enroll within 30 days from date of hire, coverage for you and any dependents you enroll will be effective on the first of the month following date of hire. Annual Open Enrollment If you enroll during annual Open Enrollment, coverage for you and any dependents you enroll will be effective on the beginning of the plan year, October 1st. If you do not submit the appropriate enrollment forms during the required eligibility period of 30 days, you will have to wait until the next open enrollment period or experience a qualifying life event to make enrollment changes to your medical health plans. Coverage End Dates Coverage for you and your dependents will end on the earliest of the following: • The date the plan in question is terminated. • The last day of the month, in which you voluntarily terminate you or your dependents’ coverage. • The last day of the month in which you or your dependents no longer meet eligibility requirements. • The last day of the month your dependents no longer meet eligibility due to age. Waiving Coverage If you have medical coverage under another plan, you may choose to decline (waive) the EAA’s medical plans. When an employee makes this choice, a “Declination of Coverage” form must be completed and returned to Human Resources. If you decide later that you would like coverage, you will not be able to enroll until the next Open Enrollment period or within 30 days of a qualifying life event. Some examples of other coverage could be: • Your spouse’s or parents’ plan • A government insurance program • An individual policy or other group coverage Qualifying Life Events A qualifying event is a life event that may allow an employee to add or drop coverage after being hired and outside of the Open Enrollment period. The change must be consistent with the event and documentation (i.e., marriage license, birth certificate, divorce decree, etc., ) must be provided to the HR Administrator within 30 days of the event. Please call or email the HR Administrator to schedule an appointment. You can add, drop or change coverage for yourself and your dependents when you experience a Qualifying Life Event such as: • Marriage • Divorce • Birth or adoption of a child

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