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3. ELIGIBILITY, EFFECTIVE DATES AND TERMINATION OF EMPLOYEE INSURANCE When are you eligible for Employee Accident Insurance? You are initially eligible for Employee Accident Insurance on the latest of: · January 1, 2019; · your first day of employment; or · the date you first are Actively at Work in an Eligible Class. You are also eligible for Employee Accident Insurance during any Enrollment Period or as a result of a Family Status Change, provided you are Actively at Work and in an Eligible Class. When must you enroll for Employee Accident Insurance? You must enroll within 90 days of the date you are initially eligible for Employee Accident Insurance or within 31 days of the date of a Family Status Change or during any Enrollment Period. If you refuse your insurance and do not enroll when you are eligible, then you will not be allowed to enroll until the next Enrollment Period. When does your Employee Accident Insurance start? For Contributory Employee Accident Insurance, your insurance starts on the latest of the date: · you are eligible; · you enroll; and · you agree to make any required contribution toward the cost of insurance; if you are Actively at Work on that date. If you are not Actively at Work on that date, your insurance will not start until you resume being Actively at Work. When can you make changes in your Employee Accident Insurance? You may request a change in your Employee Accident Insurance benefit elections during any Enrollment Period while the Policy is in force. You may also request a change in Employee Accident Insurance at any time due to a Family Status Change. Such request must be made within 31 days of the date the Family Status Change occurred. When does a change in your Employee Accident Insurance start? If you are Actively at Work, any increase in Employee Accident Insurance or benefits, for reasons other than a Family Status Change, will start: · on the January 1st following the date of change, when you apply for a different coverage option and you agree to make any required contribution toward the cost of insurance; · on the date of the Policy change. If you are not Actively at Work on that date, any increase in Employee Accident Insurance will not start until you resume being Actively at Work. Whether or not you are Actively at Work, any reduction in Employee Accident Insurance or benefits for reasons other than a Family Status Change, will start: · on the January 1st following the date of change, when you apply for a different coverage option; · on the date of the Policy change. If you are Actively at Work, any increase in Employee Accident Insurance or benefits due to a Family Status Change will start on the latest of: · the date you apply for such change in Employee Accident Insurance and you agree to make any required contribution toward the cost of the insurance; or · the date of your Family Status Change. If you are not Actively at Work on that date, any increase due to a Family Status Change in Employee Accident Insurance or benefits will not start until you resume being Actively at Work. 16-AC-C-01 Page16

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