Part 11 – Group Policy (continued) WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 103 first 30 months of your ESRD Medicare coverage. After 30 months, the benefits that are provided by this health plan will be reduced by the amount that Medicare allows for the same covered services. Under Age 65 with Other Disability If your group employs 100 or more employees and if you are under age 65 and you are eligible for Medicare only because of a disability other than ESRD, this health plan will provide benefits before Medicare benefits. This is the case only if you are the actively employed subscriber or the enrolled spouse or dependent of the actively employed subscriber. If you are an inactive employee or a retiree or the enrolled spouse or dependent of the inactive employee or retiree, the benefits that are provided by this health plan will be reduced by the amount that Medicare allows for the same covered services. (In some cases, this provision also applies to certain smaller groups. Your plan sponsor can tell you if it applies to your group.) Age 65 or Older If your group employs 20 or more employees and if you are age 65 or older and are eligible for Medicare only because of age, this health plan will provide benefits before Medicare benefits as long as you have chosen this health plan as your primary payor. This can be the case only if you are an actively employed subscriber or the enrolled spouse of the actively employed subscriber. (If you are actively employed at the time you reach age 65 and become eligible for Medicare, you must choose between Medicare and this contract as the primary payor of your health care benefits. For more help, contact your plan sponsor.) Dual Medicare Eligibility If you are eligible for Medicare because of ESRD and a disability or because of ESRD and you are age 65 or older, this health plan will provide benefits before Medicare benefits. This is the case during the first 30 months of your ESRD Medicare coverage only if the coverage under this health plan was primary when you became eligible for ESRD Medicare benefits. Then, for as long as you maintain dual Medicare eligibility, the benefits that are provided by this health plan will be reduced by the amount that Medicare allows for the same covered services. (This provision may not apply to you. To find out if it does, contact your plan sponsor.)