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Governing law ............................................................................................................................................................................. 138 Anti-assignment ......................................................................................................................................................................... 138 No waiver ...................................................................................................................................................................................... 138 Acronyms ........................................................................................................................................................................................... 139 Eligibility and enrollment ........................................................................................................................................................... 140 Eligibility for subscribers and dependents ..................................................................................................................... 140 Enrollment for subscribers and dependents ................................................................................................................. 141 Medicare eligibility and enrollment .................................................................................................................................. 144 When medical coverage begins .......................................................................................................................................... 144 Making changes ......................................................................................................................................................................... 146 When medical coverage ends .............................................................................................................................................. 151 General provisions for eligibility and enrollment ....................................................................................................... 154 Eligibility and enrollment for a retiree or survivor .......................................................................................................... 155 Eligibility for subscribers and dependents ..................................................................................................................... 155 Enrollment for subscribers and dependents ................................................................................................................. 157 Medicare eligibility and enrollment .................................................................................................................................. 159 When medical coverage begins .......................................................................................................................................... 160 Making changes ......................................................................................................................................................................... 161 When medical coverage ends .............................................................................................................................................. 166 General provisions for eligibility and enrollment ....................................................................................................... 168 Definitions ......................................................................................................................................................................................... 169 Disclosures ......................................................................................................................................................................................... 192 12 2024 UMP Plus–UW Medicine ACN (PEBB) Certificate of Coverage

UMP Plus–UW Medicine Accountable Care Network (UW Medicine ACN) COC (2024) - Page 13 UMP Plus–UW Medicine Accountable Care Network (UW Medicine ACN) COC (2024) Page 12 Page 14