2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) Chapter 1: Getting started as a member 3 The contract is in effect for months in which you are enrolled in the plan between January 1, 2024 and December 31, 2024. Each plan year, Medicare allows us to make changes to the plans that we offer. This means we can change the costs and benefits of the plan after December 31, 2024. We can also choose to stop offering the plan, or to offer it in a different service area, after December 31, 2024. Medicare (the Centers for Medicare & Medicaid Services) must approve our plan each year. You can continue each year to get Medicare coverage as a member of our plan as long as we choose to continue to offer the plan and Medicare renews its approval of the plan. Section 2 What makes you eligible to be a plan member? Section 2.1 Your eligibility requirements You are eligible for membership in our plan as long as: · You meet the eligibility requirements of your former employer, union group or trust administrator (plan sponsor - PEBB) · You have both Medicare Part A and Medicare Part B · — and — you live in our geographic service area (Section 2.2 below describes our service area). Incarcerated individuals are not considered living in the geographic service area even if they are physically located in it. · — and — you are a United States citizen or are lawfully present in the United States Section 2.2 Here is the plan service area for UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) Our plan is available only to individuals who live in our plan service area. To remain a member of our plan, you must continue to reside in the plan service area. The service area is described below. Our service area includes the 50 United States and the District of Columbia, Puerto Rico, the United States Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. If you plan to move out of the service area, you cannot remain a member of this plan. Please contact Customer Service and your plan sponsor (PEBB) to see if we have a plan in your new area. It is also important that you call Social Security if you move or change your mailing address. You can find phone numbers and contact information for Social Security in Chapter 2, Section 5. Section 2.3 U.S. Citizen or Lawful Presence A member of a Medicare health plan must be a U.S. citizen or lawfully present in the United States. Medicare (the Centers for Medicare & Medicaid Services) will notify UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) if you are not eligible to remain a member on this basis.