ELIGIBILITY PROVISIONS: INSURANCE FOR YOU (continued) Employer-Paid Insurance for an employee who regains eligibility, including following a period of leave or after being between periods of leave will take effect on the first day of the month in which the employee is in pay status 8 or more hours, or on the first day of the month in which the quarter or semester begins for faculty who regain eligibility within 12 months. When an employee who is called to active duty in the uniformed services under Uniformed Services Employment and Reemployment Rights Act (USERRA) loses eligibility for the employer contribution toward PEBB benefits, they regain eligibility for the employer-contribution toward PEBB benefits the day they return from active duty. Employer-Paid insurance will take effect the first day of the month in which You return from active duty. You must be Actively at Work on that date. If You are not Actively at Work on the date the Employer-Paid Insurance would otherwise take effect, insurance will take effect on the first day of the month following the date You resume Active Work. Requirements for Employee-Paid Insurance: Plan 1 Supplemental Life Insurance and Supplemental Accidental Death and Dismemberment Insurance If You request Employee-Paid Insurance before the date You become eligible for such insurance, such insurance will take effect as follows:  if You are not required to give evidence of Your insurability, such insurance will take effect on the first day of the month following the date We receive Your completed enrollment form, provided that You are eligible on that date. You must be Actively at Work on that date.  if You are required to give evidence of Your insurability and We determine that You are insurable, such insurance will take effect on the first day of the month following the date We approve Your evidence of insurability, provided that You are eligible on that date. You must be Actively at Work on that date. If You are not Actively at Work on the date insurance would otherwise take effect, insurance will take effect on the first day of the month following the day You resume Active Work. If You request Employee-Paid Insurance no later than 31 days after You become newly eligible or regain eligibility for PEBB benefits, life insurance will take effect as follows:  if You are not required to give evidence of Your insurability, such insurance will take effect on the first day of the month following the date We receive Your completed enrollment form. You must be Actively at Work on that date. Except, if You self-paid Employee-Paid Insurance during a period of leave, such insurance will be continue upon Your return.  if You are required to give evidence of Your insurability and We determine that You are insurable, such insurance will take effect on the first day of the month following the date We approve Your evidence of insurability. You must be Actively at Work on that date. If You are not Actively at Work on the date insurance would otherwise take effect, insurance will take effect on the first day of the month following the day You resume Active Work. If You request Employee-Paid Insurance more than 31 days after the date You become eligible for such insurance, You must give evidence of Your insurability satisfactory to us. You must give such evidence at Your expense. If We determine that You are insurable, such insurance will take effect on the first day of the month following the date We approve Your evidence of insurability. Accidental Death and Dismemberment Insurance does not require evidence of Your Insurability. You must be Actively at Work on that date. If You are not Actively at Work on the date insurance would otherwise take effect, insurance will take effect on the first day of the month following the day You resume Active Work. Transfer in Coverage due to a Qualifying Event Qualifying Event means employment of Your Spouse or State-Registered Domestic Partner, who is covered in the PEBB insurance plan, ends due to termination or retirement from an Employing Agency. GCERT2024-WSHCA-WA-LIFE-EMPLOYEE1 45