Page 75 - 2021 Medical Plan SPD

Texas Mutual Insurance Company Medical Plan

Initial Enrollment Period
When the Plan Sponsor purchases coverage under the Plan from the Claims Administrator, the Initial
Enrollment Period is the first period of time when Eligible Persons can enroll themselves and their
Dependents.
Coverage begins on the date shown in the Plan. The Plan Sponsor must receive the completed
enrollment and any required contribution within 31 days of the date the Eligible Person becomes eligible.

Open Enrollment Period
The Plan Sponsor sets the Open Enrollment Period. During the Open Enrollment Period, Eligible Persons
can enroll themselves and their Dependents.
Coverage begins on the date identified by the Plan Sponsor. The Plan Sponsor must receive your
completed enrollment and any required contribution within 31 days of the date the Eligible Person
becomes eligible.

New Eligible Persons

Coverage for a new Eligible Person and his or her Dependents begins on date of hire. The Plan Sponsor
must receive your completed enrollment and any required contribution within 31 days of the date the new
Eligible Person first becomes eligible.

Adding New Dependents

Participant's may enroll Dependents who join their family because of any of the following events:
• Birth.

• Legal adoption.
• Placement for adoption.

• Marriage.
• Legal guardianship.

• Court or administrative order.
Coverage for the Dependent begins on the date of the event. The Plan Sponsor must receive your
completed enrollment and any required contribution within 31 days of the event.

Special Enrollment Period

An Eligible Person and/or Dependent may also be able to enroll during a special enrollment period. A
special enrollment period is not available to an Eligible Person and his or her Dependents if coverage
under the prior plan ended for cause, or because premiums were not paid on a timely basis.
An Eligible Person and/or Dependent does not need to elect COBRA continuation coverage to preserve
special enrollment rights. Special enrollment is available to an Eligible Person and/or Dependent even if
COBRA is not elected.
A special enrollment period applies to an Eligible Person and any Dependents when one of the following
events occurs:
• Birth.

• Legal adoption.

72 Section 3: When Coverage Begins