b'When Can I Join? An eligible annuitant and/or dependent may initially enroll in a CTPF plan INFO once in a lifetime, unless he or she experiences a qualifying event noted below. Initial Enrollment PeriodOne Time Opt-InYou may initially enroll in CTPF coverage when one of theEligible members may re-enroll in a CTPF health insurance following events occurs: plan one time without a qualified change in status Within 30 days after COBRA continuation coverage(marriage, birth, death, etc.). Individuals who wantunder the Board of Education or Charter School activeto rejoin a CTPF plan must do so during a CTPF Open employee group health program ends,* unless coverageEnrollment Period. A member applying to re-enroll must is cancelled due to non-payment of premium have proof of insurance coverage (medical and prescription Within 30 days of the effective date ofdrug) as of the beginning of the open enrollment period (October 1), and maintain coverage through December 31 pension/survivor benefitsDuring the Annual Open Enrollment Periodof that year. CTPF insurance coverage becomes effective(once in a lifetime)the following January 1.Within 30 days of first becoming eligible for Medicare2021 Open Enrollment When coverage is cancelled by a former group plan The annual Open Enrollment Period is the time when you through no fault of your own or a dependent can enroll in a CTPF plan or change plans. *If COBRA coverage ends December 31, 2020, you mayOpen Enrollment runs October 1 - 31, 2020. Changes made enroll in a CTPF plan during the Open Enrollment Period,during Open Enrollment become effective January 1, 2021.October 1 - 31, 2020. Coverage becomes effectiveGet started by following these steps:January 1, 2021.1.Make sure you understand any plan changes. (See page 5) Special Enrollment Period 2. If you are currently enrolled in a CTPF plan and you In addition to the annual Open Enrollment Period, youwant to continue coverage, you do not need to take any action. Your coverage will continue. have 30 days after a qualifying event to change plans or3. If you or a dependent want to enroll or change plans, add an eligible dependent. Qualifying events may include:you must complete the appropriate enrollment forms. change in permanent address that affects theAn enrollment form for most plans is included in availability of an HMO or Medicare Advantage planthis handbook. See the How to Enroll section of marriage/civil union or divorce/dissolution the comparison charts for plans not included on thebirth, adoption, or legal guardianship enrollment form. ermination of a Primary Care Physician for 4. Return all completed enrollment forms and requiredtHMO plan enrollees documentation to CTPF. Forms returned to an insurancebecoming eligible for Medicare carrier will not be processed.During the pandemic, we encourage members to submit Please indicate the qualifying event on CTPF Form 350forms by fax or email when possible. See page 48 for and include any supporting documents detailing youremail, fax, and mailing information. reason for loss of coverage.CTPF 2021 HEALTH INSURANCE HANDBOOKCTPF 2021 HEALTH INSURANCE HANDBOOK13'