When you lose entitlement to Medicaid, your request to reinstitute coverage under this plan must be received by us within 90 days of the date Medicaid entitlement ends. Upon receipt, your coverage will restart on the first day on which Medicaid is no longer available. You must also pay subscription charges starting on the date your coverage is once more in force. Your subscription charges will be determined on terms at least as favorable to you as the terms that would have applied had your coverage not been suspended. WHEN COVERAGE ENDS Cancellation By You You can cancel your coverage by giving at least 30 days' written notice or by not paying your subscription charges. You are responsible to cancel your coverage if you get other Medicare supplement coverage or Medicare Advantage coverage after this plan takes effect. You are also responsible to cancel if you lose coverage under Medicare Part A or B. In the event of your death, all unearned subscription charges will be refunded to your estate. We reserve the right to ask for proof of the date of death. Cancellation By The Group The Group has the right to cancel your coverage when you no longer meet the Group's eligibility requirements for coverage under this plan. Cancellation By Premera We can only cancel your coverage under this plan when one of the following is true: • Subscription charges are not paid within the Grace Period required under the contract, which will be no less than 10 days. In this case, your coverage will end on the last day for which subscription charges were paid. • The contract for this plan is canceled as described below. • There is material misrepresentation on your application. In this case, we may cancel this contract retroactively to its effective date. Should this occur, subscription charges paid for the ineligible period will be refunded, subject to our recovery of benefit payments made on your behalf. After your coverage under this plan has been in force two years from your effective date, no statement you made on your application shall be used to void your coverage under this plan. IMPORTANT NOTE: If you are no longer eligible for coverage under this plan or the Group cancels the contract for this plan, you have a right to continued Medicare supplement coverage as stated under Conversion Right below. 7 Group Plan G/Age