TABLE OF CONTENTS HOW TO CONTACT US ........................................ (SEE BACK COVER OF THIS BOOKLET) INTRODUCTION ...................................................................................................................................... 2 BENEFITS ................................................................................................................................................ 3 WHAT THIS PLAN DOES NOT COVER .................................................................................................. 5 ELIGIBILITY ............................................................................................................................................. 5 LATE AND OPEN ENROLLMENT ........................................................................................................... 6 WHEN COVERAGE STARTS .................................................................................................................. 7 SUSPENSION DURING MEDICAID COVERAGE ................................................................................... 7 WHEN COVERAGE ENDS ...................................................................................................................... 8 CONVERSION RIGHT.............................................................................................................................. 9 EXTENDED BENEFITS FOR TOTAL DISABILITY ................................................................................. 9 YOUR CLAIMS FOR BENEFITS ........................................................................................................... 10 OTHER INFORMATION ABOUT YOUR PLAN ..................................................................................... 15 DEFINITIONS ......................................................................................................................................... 16