96 2024 Evidence of Coverage for WA PEBB Kaiser Permanente Senior Advantage Chapter 8: Ending your membership in our plan Chapter 8 — Ending your membership in our plan Section 1 — Introduction to ending your membership in our plan Ending your membership in our plan may be voluntary (your own choice) or involuntary (not your own choice): • You might leave our plan because you have decided that you want to leave. Section 2 and Section 3 provide information on ending your membership voluntarily. • There are also limited situations where we are required to end your membership. Section 5 in this chapter tells you about situations when we must end your membership. If you are leaving our plan, we must continue to provide your medical care and you will continue to pay your cost share until your membership ends. Section 2 — When can you end your membership in our plan? You may terminate (disenroll from) your Senior Advantage membership at any time. However, before you request disenrollment, please check with your group to determine if you are able to continue your group membership. If you request disenrollment during your group's open enrollment, your disenrollment effective date is determined by the date your written request is received by us and the date your group coverage ends. The effective date will not be earlier than the first day of the following month after we receive your written request, and no later than three months after we receive your request. If you request disenrollment at a time other than your group's open enrollment, your disenrollment effective date will be the first day of the month following our receipt of your written, signed, and dated disenrollment request. Other Medicare health plans If you want to enroll in another Medicare Advantage health plan or a Medicare prescription drug plan, you should first confirm with the other plan and your group that you are able to enroll in their plan. Your new plan will tell you the date when your membership in that plan begins and your Senior Advantage membership will end on that same day (your disenrollment date). The Centers for Medicare & Medicaid Services will let us know if you enroll in another Medicare Advantage health plan, so you will not need to send us a disenrollment request. If you enroll in some other type of Medicare Supplemental coverage, a signed disenrollment request must be received prior to the date of your new coverage, requesting your specific disenrollment date. Original Medicare If you request disenrollment from Senior Advantage and you do not enroll in another Medicare health plan, you will automatically be enrolled in Original Medicare when your Senior Advantage membership terminates (your disenrollment date). On your disenrollment date, you kp.org