• They lost coverage under a Medicare Advantage plan, Medicare cost or risk plan, federal health care prepayment plan, PACE plan, or Medicare Select plan due to: • A permanent move outside the plan’s service area • The termination of the plan for all enrollees or for enrollees in the applicant's area • The bankruptcy or a material breach of the contract by the issuer • The material misrepresentation by the issuer, producer or other entity acting on the issuer's behalf when the applicant was offered the coverage. • They lost coverage under a Medicare supplement coverage due to: • The bankruptcy or material breach of the issuer • The material misrepresentation by the issuer, producer or other entity acting on the issuer's behalf when the applicant was offered the coverage. • Other involuntary termination of coverage Enrollment Time Limit Eligible people must apply no later than 63 days after the date their prior coverage ended. However, if the prior plan was retiree group coverage, the 63-day period will start on the date the applicant received a notice that the retiree plan would be terminated. Applicants who received no notice must apply no later than 63 days after the date they found out that a claim was denied because the retiree group coverage had been canceled. WHEN COVERAGE STARTS Coverage will start on the effective date agreed upon by us and the Group for enrollment when newly eligible or during an open enrollment period or for late enrollment, whichever applies to you. SUSPENSION DURING MEDICAID COVERAGE Your coverage under this plan can be suspended at your request if you become entitled to medical assistance under Medicaid. Within 90 days of the date you become entitled to Medicaid, send us evidence of your Medicaid This plan cannot be suspended entitlement, along with your request to suspend due to your Medicaid assistance this plan. Upon receipt, we will suspend for more than 24 months. subscription charges and return the balance of any subscription charges collected after your Medicaid entitlement, after we subtract paid claims. We will suspend benefits under this plan until you notify us in writing to put your coverage back in force. 6 Group Plan G/Age