ELIGIBILITY PROVISIONS: INSURANCE FOR YOU (continued) Class 2 Legacy Retiree Term Life Plan: Your Legacy Retiree Term Life Plan will become effective on January 1, 2017. If You return to work and regain eligibility for enrollment under the WA State Health Care Authority PEBB or WA State Health Care Authority SEBB Basic Life Insurance Group Policy, You may choose to maintain Your Legacy Retiree Term Life Plan; however, You must continue to pay the cost of such insurance. If You choose not to maintain Your Legacy Retiree Term Life Plan enrollment, You may elect to re-enroll in such insurance provided Your enrollment form is received no later than 60 days after the date Your Basic Life Insurance ends. Please note that once You drop Your Legacy Retiree Term Life Plan, any future re-enrollment would be in the MetLife Retiree Term Life Plan, following the provisions outlined for Class 1 Retiree Term Life as outlined in this certificate. Increase in Insurance: Class 1 Benefit and Class 2 Benefit You are not eligible to increase Your amount of Life insurance after the date You retire. Decrease in Insurance: Class 1 Benefit If You make a Written request to decrease Your insurance, that decrease will take effect as of the first day of the month following the date We receive Your Written request. Decrease in Insurance: Class 2 Benefit You are not eligible to decrease Your amount of Life insurance after the effective date of such insurance. DATE INSURANCE ENDS Your insurance will end on the earliest of: 1. the date the Group Policy ends; or 2. the last day of the calendar month insurance ends for Your class; or 3. the last day of the calendar month for which the premium has been paid; or 4. the last day of the calendar month in which You are no longer a PEBB Eligible Retiree; or 5. the last day of the calendar month in which the Employer Group You were employed by ends participation in the WA State Health Care Authority PEBB or WA State Health Care Authority SEBB Group Plan for the group of employees You were included in prior to retirement. Please refer to the section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU for information concerning the option to convert to an individual policy of life insurance if Your Life Insurance ends. GCERT2024-WSHCA-WA-LIFE-RETIREE1 24