Ending Georgia Health Insurance Coverage

General Information About When Coverage Ends

We may discontinue this benefit Plan and/or all similar benefit plans at any time.

Your entitlement to benefits automatically ends on the date that coverage ends, even if you are hospitalized or are otherwise receiving medical treatment on that date.

When your coverage ends, we will still pay claims for covered health services that you received before your coverage ended. However, once your coverage ends, we do not provide benefits for health services that you receive for medical conditions that occurred after your coverage ended, even if the underlying medical condition occurred before your coverage ended.

An enrolled Dependent's coverage ends on the date the Employee's coverage ends.

Events Ending Your Coverage
For You Your coverage will end if: You no longer qualify under any category listed under the Eligibility rules and your payroll deductions for coverage have ceased. You do not make direct-pay premium payments on time You resign or otherwise end your employment You are laid off because of a formal plan to reduce staff Your hours are reduced so that you are no longer benefits eligible You do not return to active work after an approved unpaid leave of absence You are terminated by your Employer Participant contributions not remitted to the Plan by the due date may result in suspension/and or termination of coverage Coverage for Participants ends at the end of the month following the month in which the last premium is deducted from your earned paycheck or at the end of paid coverage. Premiums will not be deducted from final leave pay.
For Your Dependents Coverage for your Dependents will end at the same time you lose coverage because you are no longer eligible. Here are other situations that can affect coverage for you and your Dependents.
Situation	Effect On Coverage
If enrolled Dependent is a stepchild under age 19 and does not meet the 180-day residency requirement	Coverage ends at the end of the month in which Dependent moves out
If enrolled Dependent is a full-time student at an accredited college, university or other institution NOTE: Failure to submit full-time student verification before coverage ends at age 19 and each subsequent year to keep the student's eligibility active. If you allow the student's coverage to lapse because verification documentation is submitted late, you will not be able to add the student to your coverage until the following open enrollment or if you experience a qualifying event. Verification documentation must be submitted timely for a student to be covered under the Plan.	Coverage ends on the last day of the month in which the earliest of these events occurs: Graduation or completion of requirements if graduation is delayed Full-time attendance ends - unless child has attended previous two consecutive semesters and plans to return after a one semester break Dependent reaches age 26 Dependent marries Dependent becomes employed in a benefits-eligible position
If you divorce and your Spouse loses coverage as your Dependent*	Coverage ends at the end of the month in which the divorce becomes final*
If you or your Spouse or eligible Dependent(s) loses other group health insurance coverage because of change in employment	Before you lose coverage or within 31 days after losing coverage, file request for SHBP coverage, which will start on the first day of the month following the request
If you declined coverage for yourself or your Dependents because of other group health insurance coverage, and you later lose that coverage	You may enroll yourself or your family if you request this coverage within 31 days of the event

*If you receive a court order to provide health coverage for a divorced Spouse, you may temporarily continue Plan coverage for the divorced Spouse by electing COBRA continuation coverage, which is limited to 36 months of coverage. You must request a COBRA information packet from the SHBP within 60 days of the event.

Coverage for a Disabled Child

Coverage for an unmarried enrolled Dependent child who is not able to be self-supporting because of mental or a physical disability may not end just because the child has reached age 19. Consideration may be given for extension of coverage for that child beyond the age 19 if both of the following are true and certified by the Plan:

• Is not able to be self-supporting because of mental or physical disability
• Depends mainly on the Employee for support

Coverage will continue as long as the enrolled Dependent is disabled and dependent unless coverage is otherwise terminated in accordance with the terms of the Plan.

We will ask you to furnish SHBP with proof of the child's disability and dependency within 31 days of the date coverage would otherwise have ended because the child reached age 19.

SHBP may continue to ask you for proof that the child continues to meet these conditions of disability and dependency.

If you do not provide proof of the child's disability and dependency within 31 days of SHBP's request as described above, coverage for that child will end and your child will no longer be eligible to be covered under the Plan.

How to Request a Change

During open enrollment and the Retiree option change period, Participants can go online to make coverage changes for the upcoming Plan year. See the current Health Plan Decision Guides for web addresses and instructions. If you do not have Internet access or if your request is in the middle of a Plan year, then:

• Notify your personnel/payroll office. If you are retired, contact the SHBP eligibility unit directly or your former Employer's personnel office.
• Return completed forms. You must make your change by the appropriate deadline.

If you miss the deadline, you won't be able to make your change until the next open enrollment or qualifying event period. Changes permitted for Retirees are limited, please refer to the Retiree section for more details.