Part 11 – Group Policy (continued) WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 98 Qualified Medical Child Support Order If the subscriber chooses not to enroll an eligible dependent for coverage in this health plan under a group contract on the initial group eligibility date, the subscriber may be required by law to enroll the dependent if the subscriber is subject to a Qualified Medical Child Support Order (QMCSO). This QMCSO order is a state court or administrative agency order that requires an employer’s group to provide coverage to the child of an employee who is covered, or eligible to enroll for group coverage, in this health plan. Open Enrollment Period If you choose not to enroll for coverage in this health plan under a group contract within 30 days of your initial group eligibility date, you may enroll during your group’s open enrollment period. The open enrollment period is the time each year during which eligible persons may enroll for or change coverage for the next year. The open enrollment period is announced by the group to all eligible employees. To enroll for coverage in this health plan under a group contract during this enrollment period, you must complete the enrollment form provided in the group’s enrollment packet and return it to the group no later than the date specified in the group’s enrollment packet. Other Membership Changes Generally, the subscriber may make membership changes (for example, change from a subscriber only plan to a family plan) only if the subscriber has a change in family status. This includes a change such as: marriage or divorce; birth, adoption, or change in custody of a child; death of an enrolled spouse or dependent; or the loss of an enrolled dependent’s eligibility under the subscriber’s group contract. If you want to ask for a membership change or you need to change your name or mailing address, you should call or write to your plan sponsor. The plan sponsor will send you any special forms that you may need. You must request the change within the time period required by the subscriber’s group to make a change. If you do not make the change within the required time period, you will have to wait until the group’s next open enrollment period to make the change. All changes are allowed only when they comply with the eligibility and enrollment rules set by the plan sponsor for your group coverage. They must also comply with the conditions outlined in the group contract and in the Blue Cross Blue Shield HMO Blue Manual of Underwriting Guidelines for Group Business. (If you enrolled in this health plan through the Massachusetts Health Connector, changes must comply with the Health Connector’s policies. If this applies to you, you must call the Health Connector directly for any questions about any membership changes you need to make such as a change to your name or address.) Termination of Group Coverage Loss of Eligibility for Group Coverage When your eligibility for a group contract ends, your coverage in this health plan under the group contract will be terminated as of the date you lose eligibility (subject to the continuation of coverage provisions described on page 102). You will not be eligible for coverage in this health plan under a group contract when any one of the following situations occurs.  Subscriber’s Group Eligibility Ends. Your coverage in this health plan under a group contract will end when the subscriber loses eligibility for the group’s health care coverage. This means: the subscriber’s hours are reduced; or the subscriber leaves the job; or the subscriber no longer meets the rules that are set by the group for coverage under the group contract. (You will also lose eligibility for group coverage if you are an enrolled dependent when the subscriber dies.)  Your Dependent Status Ends. Your coverage in this health plan under a group contract will end when you lose your status as a dependent under the subscriber’s group contract. In this case, you may