Terminating Coverage

You may terminate medical insurance coverage on yourself or your dependents at any time. However, as prescribed by State statute, if you terminate coverage on yourself and/or your dependents, you CANNOT enroll in the plan at a later date. In addition, if you terminate medical coverage, then your dental and vision coverage are also cancelled. Retirees cannot maintain dental and/or vision coverage without medical.

You may only terminate dental and/or vision insurance coverage on yourself and/or your dependents:

• At the end of the plan year.
• When you terminate medical coverage. If you terminate dental and/or vision coverage, you cannot enroll in these plans at a later date.

If a covered dependent dies, coverage ends on the date of death. If there is a change in your level of coverage, your premium is pro-rated the month of the death. You must submit a Change/Cancellation (M-2) form and a copy of the death certificate to MCHCP within 31 days of the death.