i. On the first day of the month following the date you become eligible; or ii. On the first working day of the month, if you become eligible on the first working day of the month; or iii. Except that eligibility for employees of participating employer groups will be determined based on the employer group’s contract with the HCA. A Member who is insured under the Buy Down Plan is also insured for the Retirement Supplement Benefit or Higher Education Retirement Contributions Benefit, if eligible. 3. Employer-Paid Insurance If you Decline Insurance under the Default Plan and Buy Down Plan, your Employer-Paid Insurance becomes effective as follows: i. On the first day of the month following the date you become eligible; or ii. On the first working day of the month, if you become eligible on the first working day of the month; or iii. Except that eligibility for employees of participating employer groups will be determined based on the employer group’s contract with the HCA. After your Employee-Paid Insurance becomes effective, at any time you may: a) Decline Insurance under the Default Plan and elect the Buy Down Plan, or b) Elect to reduce benefits to the Employer-Paid, by Declining Insurance under both the Default Plan and Buy Down Plan. The change in your insurance will take effect on the first day of the calendar month following the date the required election is received by your Employer. Evidence Of Insurability is required if you Decline Insurance and decide later you want to become insured. Decline(ing) Insurance means you provide the required form declining coverage to the Employer. "Forms" or "form" means both paper forms and forms completed electronically as described in PEBB Program rules. B. Insurance Subject To Evidence Of Insurability Insurance subject to Evidence Of Insurability becomes effective on the date we approve Evidence of Insurability. ACTIVE WORK PROVISIONS A. Active Work Requirement If you are incapable of Active Work because of Sickness, Injury or Pregnancy on the day before the scheduled effective date of your Employee-Paid Insurance, your Employee-Paid Insurance will not become effective until the day after you complete one full day of Active Work as an eligible Member. Active Work and Actively at Work mean performing the material duties of your own occupation at your Employer's usual place of business. B. Changes In Insurance This Active Work Requirement also applies to any increase in your insurance. However, if you return to Active Work during a period of Disability or Temporary Recovery (see Temporary Recovery), you will not qualify for any change in insurance caused by a change in: 1. The rate of earnings used to determine your Predisability Earnings; or 2. The terms of the Group Policy. 377661-B - 20 6/29/2022