POLICY TERMINATION
Revised December 2, 2010

Termination – SAMBA Term Life Insurance Plan:

PARTICIPANT INSURANCE

  • Your Participant Insurance under a Coverage will terminate on the earliest of any of the following: 1) the date the Group Contract providing the insurance ends; 2) the date for Contributory Insurance under a Coverage of the Group Contract, you fail to pay, when due, any contribution required; 3) the date you enter active military service of any country. For purposes of this insurance, active military service for training purposes of one month or less is not full-time service; 4) the next premium due date following the date you request cancellation of coverage. You must make this request in writing to SAMBA. No portion of the premiums already paid for premiums which were due prior to the request for cancellation will be refunded; 5) the date on which the Participant attains the limiting age.

DEPENDENTS INSURANCE

  • Your Dependents Insurance under a Coverage will end when the first of these occurs: 1) the date your coverage terminates, unless otherwise shown below; 2) the end of the period for which any required premiums have not been made for Dependents Coverage; 3) the date the Dependent enters active military service of any country. For purposes of this coverage, active military service for training purposes of one month or less is not full-time service; 4) the first day of the month following the date Dependents as a class are no longer eligible for coverage under the Contract if the Contract has been amended to discontinue Dependents coverage for all or certain classes of Dependents; 5) the premium due date following the date the Dependent no longer meets the definition of Dependent; 6) the date on which the Dependent attains the limiting age.

Termination - for Group Term Life, Dependent Group Term Life, Supplemental Group Term Life and Personal Accident Insurance:

  • The Insured’s coverage terminates on the earliest of: the date the Policy terminates; the date the Insured ceases to pay premiums; the date the Insured enters active military service; the date the Insured is no longer employed by an eligible Employer (however, if the insured continues to be actively at work with another branch of the Federal Government, the Insured may make arrangements for continued payments of premiums); the day your employment status with the Federal Government ends; the first anniversary of the date that you went on non-pay status on an approved leave or the date the Insured turns age 62.
  • The Dependent’s coverage under the Policy will terminate on the earliest of: the date the Insured’s coverage terminates; the date for which required premiums were not paid; the date the Dependent enters active military service; the first day of the month following the date Dependents as a class are no longer eligible; the premium due date following the date the Dependent no longer meets the definition of Dependent; 12 months following the date premiums were first waived (if applicable); the date the Insured turns age 62, or the date on which the Limiting Age, if any, is attained, for life coverage only.

Termination – Disability Income Protection Program

  • Your coverage under this Program will terminate on the earliest of any of the following: 1) the date the Program terminates; 2) the date you cease to make the required premiums; 3) the date you enter active military service of any country. For purposes of this coverage, active military service for training purposes of one month or less is not full-time service; 4) the date you are no longer employed by an eligible Employer. However, if you continue to be Actively at Work with another agency or branch of the Federal Government, coverage may continue during such Active Work provided that within 60 days of termination of employment by the eligible Employer, you make arrangements for continued payment of premiums either by direct bill to the Program or by a new allotment form; 5) the date on which you are no longer Actively at Work. However, coverage may be continued for a period not to exceed 90 days during an Employer-approved period of leave, with or without pay. Note: If you are terminated due to a period of leave (with or without pay) in excess of 90 days, and you return to Active Employment within 6 months of the date your leave began, you will not be required to submit new Evidence of Insurability provided that you apply for coverage within 30 days of your return to Active Employment; or 6) The next premium due date following the date you request cancellation of coverage. You must make this request to Us in writing. No portion of premiums already paid before the cancellation date that We approve will be refunded.
  • A Dependent's coverage under this Program will terminate on the earliest of any of the following: 1) the date your coverage terminates; 2) the date the Dependent enters active military service of any country. For purposes of this coverage, active military service for training purposes of one month or less is not full-time service; 3) the first day of the month following the date Dependents as a class are no longer eligible for Program coverage; 4) the date the Dependent no longer meets the definition of Dependent; or 5) if the premiums are being waived, 12 months following the date premiums were first waived.

Termination – for the Dependent Children Health Plan

  • The Dependent Children Health Benefit Plan (DHBP) eligibility will terminate after the earliest of the following events: 1) the date the dependent child reaches age 27; 2) the date the dependent child is married; 3) the date the dependent child no longer is wholly dependent upon you (the member) for support and maintenance; 4) the date on which the member's SAMBA Health Benefit Plan coverage terminates; 5) the date the Program terminates; 6) the last day of the month in which we receive your request for voluntary termination (or the following pay period if paying premium through payroll allotment); or 7) the last date on which the Plan premium was paid.

NOTE: This plan terminated January 1, 2011 for everyone

Termination – for the Dental and Vision Care Program

PARTICIPANT INSURANCE

  • Your coverage will terminate under this Program on the earliest of any of the following dates: 1) If enrolled in the DMO® Plan – the last day of the month in which we receive your request for voluntary termination provided your request is received in the SAMBA office by the 10th of the month (or the 2nd pay period after we receive your request if paying through payroll allotment). Note: Termination requests received after the 10th day of any month may have a two month delay before coverage actually terminates; 2) If enrolled in the Alternate Dental Plan – the last day of the month in which we receive your request for voluntary termination (or the following pay period after we receive your request if paying through payroll allotment; 3) The date you cease to make the required premium payments; 4) The date you enter active full-time military service for any country (full-time military service does not include service of one month or less); 5) The date you are no longer employed by a Federal agency (does not include retirement); or 6) The date the Program is terminated.

DEPENDENTS INSURANCE

  • Your dependent's coverage will terminate under this Program on the earliest of any of the following dates: 1) The date your coverage terminates; 2) The date your dependent enters active military service for any country (full-time military service does not include service of one month or less); or 3) The date your dependent ceases to be an Eligible Dependent.

    If Program enrollment is terminated for any reason (except for active military service), you must wait two years from the date of termination before you are eligible to re-enroll.

Termination for Legal Services Plan

  • You may voluntarily terminate your enrollment in the Legal Services Plan at any time. Active members should submit a SAMBA Enrollment/Allotment Form 299 for the SAMBA LegalRx Plan to cancel the payroll allotment.

    Members paying monthly or quarterly, send your written request to the SAMBA office. Your coverage will terminate effective the 1st day of the following month.

  • Otherwise, your enrollment will terminate on the last day of the pay period that:
    • You are furloughed because of a reduction in force; or
    • Your employment status changes so that you are excluded from coverage.

  • Your enrollment also will terminate:
    • On the date you enter a leave without pay status unless you submit your premium payment for the Legal Services Plan to the SAMBA office.
    • On the day you are separated, furloughed, or placed on leave of absence for the purpose of performing military service for a period not limited to 30 days or less.