OPEN ENROLLMENT GET READY! GET SET! GO! See page 6 for important information concerning Medicare Part D coverage.

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1 OPEN ENROLLMENT 2015 GET READY! Your Dates To Enroll (Elections become effective January 1, 2015): October 20 - October 31, 2014 GET SET! It is time to review your benefit elections for the new Plan year. A summary of the changes are included in this newsletter, and full details on all the Plans, including costs, can be found in the Benefits Guide at Remember: If you make no changes to your other benefit elections (except Medical, Flexible Spending Accounts and Health Savings Accounts), they will remain the same for the new Plan year. See below for important changes on the medical plan. HIGHLIGHTS OF 2015 BENEFITS OPEN ENROLLMENT The Medical Plan will offer three medical options. You have the option to choose from three qualified High Deductible Health Plans (HDHP), all of which allow you to contribute to a Health Savings Account (HSA). Please see the Medical Plan comparison chart on page 2. If you do not call to enroll or change your medical plan options, then your election will be as follows: Plan 1000 moves to HDHP 1350 and HDHP 1600 moves to HDHP All three plans have some changes including the deductibles, coinsurance and out-of-pocket maximums. Blue Value Advisor is required to be contacted prior to scheduling CT Scans and MRIs. California participants will now use a new BCBS provider network. The Health Care Flexible Spending Account will NOT be available in Tobacco Testing for Medical Plan will take place November 3-14, The test is performed by a urine test at a participating LabCorp lab. Tobacco testing is required as follows: If you and your spouse are enrolling for the first time, you must complete and pass a tobacco test between November 3, 2014 and November 14, 2014 conducted by an approved lab in order to receive discounted medical plan contributions in If you and your spouse are currently enrolled AND would like an opportunity to change your status to non-tobacco user to receive the Medical Plan contributions discount in 2015, you and your spouse must complete and pass the tobacco test between November 3, 2014 and November 14, 2014, conducted by an approved lab. If you and/or your spouse are currently enrolled and are non-tobacco users now by either previously testing negative for tobacco or completing the tobacco cessation program prior to Open Enrollment, you are not required to take the tobacco test in order to receive the discounts for non-tobacco users in For more information on tobacco testing, please review the instructions in your Open Enrollment packet. There are no other plan changes to the dental, vision, life or disability (LTD or STD) plans for If you would like to add or increase your supplemental life coverage for yourself, spouse, or children, you may do so without evidence of insurability at certain coverage increments. Please look for detailed supplemental life insurance information in your open enrollment packet. Medical plan participants will be eligible for the HSA. If you are currently enrolled in a Healthcare Flexible Spending Account for 2014, you will need to review the HSA information as the Healthcare FSA is being discontinued in Dependent Care Flexible Spending Account will be available in 2015 and requires an annual election. GO! Call and/or complete paperwork to enroll or make changes during the enrollment period. Call to enroll or make plan changes to Medical, Dental, Vision, Short and Long Term Disability and Group and Supplemental Life; and/or Go to for forms to enroll in the Dependent Care Spending Account Plan and to elect a Health Savings Account. All forms should be returned to your office administrator, HR representative or ClubCorp Benefits by October 31, If you are enrolling for the first time in any benefit plans, you will also need to complete an authorization form and a designation of beneficiary form for group life elections. Dependent Eligibility Verification Required Verification is required for newly added dependents. If you are enrolling new or additional dependents for medical coverage during this year s Open Enrollment, you will be required to provide documentation to verify dependent eligibility. Please see the Dependent Verification Information & Instructions enclosed in your Open Enrollment packet. See page 6 for important information concerning Medicare Part D coverage. or call People Strategy Benefits at

2 2015 MEDICAL PLANS EMPLOYEE PARTNER BIWEEKLY COST MEDICAL PLAN A (HDHP 1350) MEDICAL PLAN B (HDHP 2000) MEDICAL PLAN C (HDHP 5000) COVERAGE LEVEL Non-Tobacco User * Tobacco User * Non-Tobacco User * Tobacco User * Non-Tobacco User * Tobacco User * Employee Partner Only $ $ $67.68 $ $42.75 $ Employee Partner + Spouse $ $ $ $ $ $ Employee Partner + 2 Children (or Less) $ $ $ $ $ $ Employee Partner + 3 or More Children $ $ $ $ $ $ Employee Partner + Spouse + 2 Children (or Less) $ $ $ $ $ $ Employee Partner + Spouse + 3 or More Children $ $ $ $ $ $ To find participating Blue Choice providers for all states EXCEPT FLORIDA, GEORGIA, and CALIFORNIA, go to and click on Find a Doctor: For Florida Go to Find a Doctor, select Florida for the state and Network Blue for the network. For Georgia Go to Find a Doctor, select Georgia for the state and Blue Open Access POS Network for the network. For California - Go to Find a Doctor, select California for the state and Select PPO for the network. Or, you can call Blue Cross and Blue Shield of Texas (BCBSTX) at * Please see Medical Plan Contribution Discounts for Non-Tobacco Users and the Tobacco Cessation Program on page 5. MEDICAL PLAN A (HDHP 1350) MEDICAL PLAN B (HDHP 2000) MEDICAL PLAN C (HDHP 5000) DEDUCTIBLE Employee Partner Only $1,350 Employee Partner + Dependents 1 $4,000 $2,000 $6,000 $5,000 $10,000 OUT-OF-POCKET MAXIMUM 2 (after out-of-pocket is met, eligible charges are covered at 100%) Employee Partner Only $6,000 Employee Partner + Dependents 1 $12,500 NON-NETWORK PROVIDERS $6,000 $12,500 Not covered $6,450 $12,900 PREVENTIVE SERVICES 100% (No Deductible) 100% (No Deductible) 100% (No Deductible) COINSURANCE (amount plan pays after deductible) ER SERVICES (amount you pay) 75% 70% 70% Plan Deductible + $250 Copayment, then Plan Coinsurance Applies RETAIL PHARMACY (amount you pay after deductible) Generic $20 copay $20 copay $20 copay Preferred 3 Non-Preferred 3 MAIL ORDER Rx MANDATORY FOR MAINTENANCE MEDICATIONS (amount you pay after deductible) Generic $40 copay $40 copay $40 copay Preferred 3 Non-Preferred 3 1 The family deductible and out-of-pocket maximum must be met by one participant or a combination of two or more participants. 2 All Prescription costs will apply to the out-of-pocket maximum. 3 When a generic is available, you pay the applicable coinsurance plus the cost difference between the generic and brand-name drug. or call People Strategy Benefits at

3 2015 DENTAL PLANS For more information about these plans and participating DPO and DHMO providers, go to and click on Delta Dental. DENTAL DPO DHMO* You Pay (In-Network): You Pay (In-Network): ** DEDUCTIBLE Individual $50 None Family $150 PREVENTIVE Covered at 100% $5 per visit SERVICES BASIC SERVICES Filling Simple Extraction Root Canal 20% after deductible $0-$75 $0 $95-$335 MAJOR SERVICES 50% after deductible $355 for a crown ORTHODONTIA Adult Child Not Covered $2,100 $1, VISION PLANS To find a VSP provider, go to and click on VSP. VISION PLAN You Pay (In-Network): EYE EXAM $15 copay EYEGLASS $15 copay LENSES & FRAMES Frames up to $120 CONTACT LENSES Charges up to $120 VISION COVERAGE LEVEL EMPLOYEE PARTNER BIWEEKLY COST VISION PLAN Employee Partner Only $3.66 Employee Partner + Spouse $5.45 Employee Partner + Child(ren) $5.83 Employee Partner + Family $9.31 *States where DHMO Plan is offered: Alabama, Arkansas, Arizona, California, Colorado, District of Columbia, Florida, Georgia, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Nevada, New York, Ohio, Pennsylvania, South Carolina (small number of providers), Tennessee, Texas, Washington, Wisconsin and West Virginia. **You must select and use a DeltaCare USA contracted dentist in order for dental services to be covered. DENTAL EMPLOYEE PARTNER BIWEEKLY COST COVERAGE LEVEL DPO DHMO Employee Partner Only $15.28 $7.90 Employee Partner + Spouse $31.74 $13.56 Employee Partner + Child(ren) $32.37 $13.66 Employee Partner + Family $51.46 $19.68 HEALTH SAVINGS ACCOUNT (HSA) (Only available to participants in the HDHP) A Health Savings Account (HSA) is an account that you can put money into to save for future medical expenses. Your money is deposited into an account with pre-tax dollars and you can use the money in your account for qualified medical expenses. You can save it or spend it you decide when to use your HSA dollars. You must re-enroll each year. Go to for the 2015 annual HSA election form. DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT (FSA) Dependent Care FSA allows you to set aside up to $5,000 for dependent day care expenses that are necessary for you and your spouse to work or attend school full time. The benefit of this Plan is that your payroll deductions reduce your taxable income for the year. You must re-enroll each year. Go to for the 2015 annual FSA election form. 3

4 2015 GROUP TERM LIFE AND AD&D Your coverage amount is 1.5x pay, up to a maximum of $50,000. Please refer to the enrollment guide at for more information. HOW TO CALCULATE THE COST FOR BASIC LIFE AND AD&D Take your annual earnings x 1.5 (not to exceed $50,000) Take your coverage amount divided by 1,000 x $0.12 Take the total monthly cost x 50% Multiply your monthly cost x 12 then divide by 26 = Your coverage amount = Total monthly cost = Your monthly cost = Your biweekly cost 2015 LONG TERM DISABILITY (LTD) (Note: You must be employed in an eligible position to participate in the LTD Plan) Disability coverage helps protect part of your income if you get hurt or sick and cannot work. After a 90-day waiting period, the LTD plan replaces 60% of your weekly pay as long as you are disabled or until you reach age 65. A Salary Continuation benefit of 66 2/3% of your weekly pay is available from days after two years of service. Please refer to the benefits guide at for more information on eligible positions. HOW TO CALCULATE YOUR LTD COST Take your monthly salary divided by 100 Take the basis number x $0.38 Take the total monthly cost x 50% Take your monthly cost x 12 then divide by 26 = Your basis amount = Total monthly cost = Your monthly cost = Your biweekly cost 2015 SHORT TERM DISABILITY (STD) (Note: You must be a regular, full-time employee that is not eligible for Long Term Disability) After a 14-day waiting period, the STD plan will provide a weekly benefit for up to 13 weeks if you are disabled due to an accident or illness. If you are eligible, a personalized enrollment form will be included in your enrollment packet that includes cost information and the weekly benefit amount(s) for which you are eligible. 4

5 Medical Plan Contribution Discounts Non-Tobacco Users Discount and Tobacco Cessation Program In an effort to encourage overall good health for covered Employee Partners and their covered dependents, Employee Partners and dependents covered under the ClubCorp Medical Plan who are non-smoker/non-tobacco users can receive discounted medical contributions on their medical plan coverage effective date. You will need to telephonically certify the tobacco user status for you and any newly added dependents when you call to enroll. Your eligibility for the nontobacco user discount is subject to change based on and after receipt of the tobacco test results. Employee Partners and spouses who are enrolling for the first time in the Medical Plan and who wish to receive contribution rate discounts for the Medical Plan in 2015, ClubCorp is offering an opportunity to Employee Partners (and spouses) to receive a free tobacco test. If you and your covered spouse test negative for tobacco use, you will qualify for the contribution rate discounts in The free test is available November 3-14, 2014, at an approved location. These test results will be shared with ClubCorp Medical Plan in order to determine your eligibility for the non-tobacco user discounts in If you and your spouse are currently enrolled in the Medical Plan and are NOT receiving the non-tobacco user discounts, you will also have an opportunity to take the free tobacco test November 3-14, 2014, in order to qualify for the discounted medical plan costs in Note: If you and your spouse are currently enrolled in the Medical Plan and have already tested negative for tobacco use or have completed the tobacco cessation program AND are currently receiving the non-tobacco user discounts, you DO NOT need to re-test for tobacco use; you will receive the discounted medical plan costs in Please review the tobacco instructions in your open enrollment packet for more information. For covered Employee Partners and dependents who are smokers/tobacco users, ClubCorp offers assistance with the company-sponsored smoking/ tobacco cessation program through the American Institute for Preventive Medicine. You and/or your covered dependents can participate in the Medical Plan smoking/tobacco cessation program (at no cost to you) beginning on your coverage effective date. Upon receipt of proof of participation in the smoking/tobacco cessation program, you will receive the discounted medical plan contributions. If it is unreasonably difficult due to a health factor for you to meet the requirement or if it is medically inadvisable for you to attempt to meet the requirements of this program, we are making available a reasonable alternative standard for you to obtain the discounted medical plan contributions the Medical Plan smoking/tobacco cessation program. If satisfying this reasonable alternative outlined above is medically inadvisable and you can provide a physician s statement indicating so, then please contact the ClubCorp Benefits Department, who will work with you to develop an additional reasonable alternative. Proof of participation in the Medical Plan smoking/tobacco cessation program is a certificate/diploma issued to the participant by the American Institute for Preventive Medicine after a participant has completed the program requirements and final exam (with a passing score). To enroll in the Medical Plan smoking/tobacco cessation program, please call the American Institute for Preventive Medicine at x1. You or your covered dependents can enroll any time once your Medical Plan coverage becomes effective. One is considered a non-smoker/non-tobacco user if you (and your covered dependents): Have not used tobacco products (cigarettes, cigars, chewing tobacco, etc.), for at least 6 months (from the date you certify your tobacco user status), or Enroll in the ClubCorp Medical Plan smoking/tobacco cessation program offered in partnership with the American Institute of Preventive Medicine and provide proof of participation. Upon receipt of the proof of participation from you, ClubCorp Benefits will apply the discounted medical plan contributions. One is considered a smoker/tobacco user if: You (or your covered dependents) are currently using any form of tobacco (cigarettes, cigars, chewing tobacco, etc.) in any amount (including occasional social use), or You (or your covered dependents) have used tobacco based products (cigarettes, cigars, chewing tobacco, etc.) within the last 6 months (from the date you certify your tobacco user status). Any of the above applies if you (or your covered dependents) do not enroll in and complete the ClubCorp Medical Plan smoking/tobacco cessation program. Definition of smoker: An Employee Partner (or your covered dependents) who smokes cigarettes, cigars or chews tobacco, etc. Casual or social smoking constitutes smoking by the ClubCorp Medical Plan definition. Right to request documentation: ClubCorp Benefits has the right to request documentation at any time from an Employee Partner or covered dependent who declares him/herself a smoker enrolled in the approved smoking/tobacco cessation program or from the vendor providing the smoking/tobacco cessation program to the Employee Partner or covered dependent for the sole purpose of verifying enrollment and participation. Recourse for making a false statement: An Employee Partner who intentionally falsifies his/her or covered dependent s non-smoking status will be subject to immediate revocation of the non-smoker contribution discount and could face a loss of coverage for intentional falsification of enrollment. or call People Strategy Benefits at

6 Required Notices Important Notice from ClubCorp USA, Inc. About Your Prescription Drug Coverage and Medicare under the BCBS of Texas plans HDHP 1350 and HDHP 2000 Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with ClubCorp USA, Inc. and about your options under Medicare s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. ClubCorp USA, Inc. has determined that the prescription drug coverage offered by the BCBS of Texas plans HDHP 1350 and HDHP 2000 is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare during a seven-month initial enrollment period. That period begins three months prior to your 65th birthday, includes the month you turn 65, and continues for the ensuing three months. You may also enroll each year from October 15th through December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current ClubCorp USA, Inc. coverage will not be affected. For most persons covered under the Plan, the Plan will pay prescription drug benefits first, and Medicare will determine its payments second. For more information about this issue of what program pays first and what program pays second, see the Plan s summary plan description or contact Medicare at the telephone number or web address listed herein. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with ClubCorp USA, Inc. and don t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. Important Notice from ClubCorp USA, Inc. About Your Prescription Drug Coverage and Medicare under the BCBS of Texas Plan HDHP 5000 Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with ClubCorp USA, Inc. and about your options under Medicare s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are three important things you need to know about your current coverage and Medicare s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. ClubCorp USA, Inc. has determined that the prescription drug coverage offered by the BCBS of Texas plan HDHP 5000 is, on average for all plan participants, NOT expected to pay out as much as standard Medicare prescription drug coverage pays. Therefore, your coverage is considered Non-Creditable Coverage. This is important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage from the ClubCorp USA, Inc. plan. This also is important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first become eligible. 3. You can keep your current coverage from ClubCorp USA, Inc.. However, because your coverage is non-creditable, you have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, depending on if and when you join a drug plan. When you make your decision, you should compare your current coverage, including what drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Read this notice carefully - it explains your options. If you do decide to join a Medicare drug plan and drop your current ClubCorp USA, Inc. coverage, be aware that you and your dependents will not be able to get this coverage back. 6

7 When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare during a seven-month initial enrollment period. That period begins three months prior to your 65th birthday, includes the month you turn 65, and continues for the ensuing three months. You may also enroll each year from October 15th through December 7th. However, if you decide to drop your current coverage with ClubCorp USA, Inc., since it is employer/union sponsored group coverage, you will be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan; however you also may pay a higher premium (a penalty) because you did not have creditable coverage under the ClubCorp USA, Inc. plan. What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current ClubCorp USA, Inc. coverage will not be affected. For most persons covered under the Plan, the Plan will pay prescription drug benefits first, and Medicare will determine its payments second. For more information about this issue of what program pays first and what program pays second, see the Plan s summary plan description or contact Medicare at the telephone number or web address listed herein. If you do decide to join a Medicare drug plan and drop your current ClubCorp USA, Inc. coverage, be aware that you and your dependents will not be able to get this coverage back. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? Since the coverage under ClubCorp USA, Inc. is not creditable, depending on how long you go without creditable prescription drug coverage you may pay a penalty to join a Medicare drug plan. Starting with the end of the last month that you were first eligible to join a Medicare drug plan but didn t join, if you go 63 continuous days or longer without prescription drug coverage that s creditable, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information about This Notice or Your Current Prescription Drug Coverage Contact the person listed at the end of these notices for further information. NOTE: You ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through ClubCorp USA, Inc. changes. You also may request a copy of this notice at any time. For More Information about Your Options under Medicare Prescription Drug Coverage More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You handbook. You ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: Visit Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the Medicare & You handbook for their telephone number) for personalized help Call MEDICARE ( ). TTY users should call If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at or call them at (TTY ). Remember: Keep this Medicare Part D notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty). Date: January 1, 2015 Name of Entity/Sender: Contact Position/Office: ClubCorp USA, Inc. People Strategy Address: 3030 LBJ Freeway, Suite #600 Dallas, TX Phone Number: Women s Health and Cancer Rights Act The Women s Health and Cancer Rights Act of 1998 was signed into law on October 21, The Act requires that all group health plans providing medical and surgical benefits with respect to a mastectomy must provide coverage for all of the following: Reconstruction of the breast on which a mastectomy has been performed Surgery and reconstruction of the other breast to produce a symmetrical appearance Prostheses Treatment of physical complications of all stages of mastectomy, including lymphedema This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsurance provisions which apply for the mastectomy. For deductibles and coinsurance information applicable to the plan in which you enroll, please refer to the summary plan description or contact People Strategy Benefits at HIPAA Privacy and Security The Health Insurance Portability and Accountability Act of 1996 deals with how an employer can enforce eligibility and enrollment for health care benefits, as well as ensuring that protected health information which identifies you is kept private. You have the right to inspect and copy protected health information that is maintained by and for the plan for enrollment, payment, claims and case management. If you feel that protected health information about you is incorrect or incomplete, you may ask your benefits administrator to amend the information. The Notice of Privacy Practices has been recently updated. For a full copy of the Notice of Privacy Practices, describing how protected health information about you may be used and disclosed and how you can get access to the information, contact People Strategy Benefits at

8 HIPAA Special Enrollment Rights If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents other coverage). Loss of eligibility includes but is not limited to: Loss of eligibility for coverage as a result of ceasing to meet the plan s eligibility requirements (i.e. legal separation, divorce, cessation of dependent status, death of an employee, termination of employment, reduction in the number of hours of employment); Loss of HMO coverage because the person no longer resides or works in the HMO service area and no other coverage option is available through the HMO plan sponsor; Elimination of the coverage option a person was enrolled in, and another option is not offered in its place; Failing to return from an FMLA leave of absence; and Loss of coverage under Medicaid or the Children s Health Insurance Program (CHIP). Unless the event giving rise to your special enrollment right is a loss of coverage under Medicaid or CHIP, you must request enrollment within 31 days after your or your dependent s(s ) other coverage ends (or after the employer that sponsors that coverage stops contributing toward the coverage). If the event giving rise to your special enrollment right is a loss of coverage under Medicaid or the CHIP, you may request enrollment under this plan within 60 days of the date you or your dependent(s) lose such coverage under Medicaid or CHIP. Similarly, if you or your dependent(s) become eligible for a state-granted premium subsidy towards this plan, you may request enrollment under this plan within 60 days after the date Medicaid or CHIP determine that you or the dependent(s) qualify for the subsidy. In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption. To request special enrollment or obtain more information, contact People Strategy Benefits at