TABLE OF CONTENTS HOW TO CONTACT US ........................................ (SEE BACK COVER OF THIS BOOKLET) INTRODUCTION ...................................................................................................................................... 1 BENEFITS ................................................................................................................................................ 2 WHAT THIS PLAN DOES NOT COVER .................................................................................................. 4 ELIGIBILITY ............................................................................................................................................. 4 LATE AND OPEN ENROLLMENT ........................................................................................................... 5 WHEN COVERAGE STARTS .................................................................................................................. 6 SUSPENSION DURING MEDICAID COVERAGE ................................................................................... 6 WHEN COVERAGE ENDS ...................................................................................................................... 7 CONVERSION RIGHT.............................................................................................................................. 8 EXTENDED BENEFITS FOR TOTAL DISABILITY ................................................................................. 8 YOUR CLAIMS FOR BENEFITS ............................................................................................................. 9 OTHER INFORMATION ABOUT YOUR PLAN ..................................................................................... 14 DEFINITIONS ......................................................................................................................................... 15