ȽƎǯǘNJɜǘǻNj]ǘNJƷ*ɕƷǻȴȪ After your initial enrollment period or a subsequent annual open enrollment period has expired, ]SYGERRSXIRVSPPMRSVQEOIGLERKIWXS]SYVFIRIƼXIPIGXMSRWYRXMPXLIRI\XERRYEPSTIR IRVSPPQIRXTIVMSHYRPIWW]SYI\TIVMIRGIE5YEPMJ]MRK0MJI)ZIRX EWHIƼRIHF]XLI-67 WYGLEW • Marriage, divorce or legal separation • Birth, adoption or placement of adoption or becoming the court-appointed legal guardian of a child(ren) • Death of your spouse or child • Gain or loss of coverage for you or your dependents with your spouse’s employer as a result of an employment event • Change in your child’s eligibility • Becoming eligible for Medicare or Medicaid • Receipt of a Qualified Medical Child Suppor t Order (QMCSO) • Significant change in cost or coverage in your spouse’s or child’s health insurance plan • +EMRSVPSWWSJFIRIƼXWIPMKMFMPMX]WYGLEWEXVERWMXMSRJVSQJYPPXMQIXSTEVXXMQISVTEVXXMQIXSJYPPXMQI Changes made on account of a qualifying life event must be consistent with the event. You have HE]WJVSQXLIHEXISJEUYEPMJ]MRKPMJIIZIRXXSRSXMJ]XLI&IRIƼXWHITEV XQIRXERHQEOI GLERKIWXS]SYVFIRIƼXIPIGXMSRWMR;SVOHE]&IRIƼXIPIGXMSRWQEHIJSPPS[MRKEUYEPMJ]MRKPMJI event will become effective on the date of the event (such as the date of marriage or bir th), in most situations. *SVUYIWXMSRWSVEHHMXMSREPMRJSVQEXMSR GSRXEGXXLI&IRIƼXWHITEV XQIRXEX SV send an email to Benefits@maac.com. Notice of Special Enrollment Rights If you are declining coverage for yourself and/or your eligible dependent(s) during your initial enrollment period or a subsequent annual open enrollment period because of other health coverage (such as COBRA coverage or coverage under another health plan), you may be able to enroll yourself and your eligible dependent(s) in MAA’s medical coverage if you or your dependents lose eligibility for such other coverage (such as due to the end of the maximum COBRA period, ceasing to meet the eligibility requirements or as otherwise required by law) or if employer contributions toward that other coverage cease. However, you must request enrollment within 30 days after loss of other coverage. If the other coverage ends voluntarily, such as due to failure to pay the required premiums, there is no right to special enrollment. If you or your dependent (1) becomes eligible for state-granted premium assistance or (2) lose health coverage under Medicaid or State Children’s Health Insurance Plan (CHIP), you will have a special enrollment right under MAA’s group medical plan. To enroll , you must request coverage within 60 days of either of these two events.
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