isolved Benefit Services – Service Agreement
General Notice Blanket Mailing and Open Enrollment Mailing
Additional Service Agreement

This Additional Service Agreement is incorporated into and made a part of the Service Agreement (including the General Terms and Conditions). The effective date of this Additional Service Agreement is the effective date of the Service Agreement or, if later, the Service Date related to the services hereunder. The responsibilities of the Parties set forth in this Additional Service Agreement are in addition to any responsibilities set forth in the Service Agreement (including the General Terms and Conditions). If there is a conflict between this Additional Service Agreement and the Service Agreement (including the General Terms and Conditions), the Service Agreement (including the General Terms and Conditions) controls.

Employer agrees to the following:

A. Data To the extent necessary, isolved Benefit Services will provide Employer with a form (hereinafter “Data Sheet”) requesting data necessary to complete each administrative service. isolved Benefit Services is not required to provide administrative services if the data submitted is incomplete, inaccurate or untimely and is not liable for any adverse action based on tests conducted with incomplete, inaccurate or untimely data. Such data shall include but not be limited to:

• Legal name of group health plan (if uncertain, simply identify it as “Group Health Plan of [Employer Name]”)
• Contact information for the group health plan(s) (if uncertain, isolved Benefit Services will use any current information in our system)

B. Payment isolved Benefit Services will charge Employer, and Employer agrees to pay isolved Benefit Services, the fees for the services that are checked in the Service Agreement. For Open Enrollment service please note that special pricing may or may not apply to the mailing of the Summary of Benefits & Coverage, depending on the volume of the compliance mailing. isolved Benefit Services will notify Employer of the applicable pricing in advance if special pricing applies. isolved Benefit Services will charge Employer based on the number of individuals reported on the Data Sheet, including notices returned as undeliverable. Payment is due on receipt of the MOA, unless otherwise specified. All fees are nonrefundable once administrative services have been provided.

C. Notice Delivery isolved Benefit Services will send the notices via first class mail. Undelivered notices will be returned to Employer to be re-sent at its discretion with instructions on how to complete correctly. All documentation regarding the mailing will be returned to Employer for its records

D. Open Enrollment isolved Benefit Services will provide Open Enrollment notifications to current COBRA Qualified Beneficiaries, other COBRA participants, individuals who have elected but not yet paid for COBRA coverage and individuals currently within their election periods (collectively, “COBRA OE Individuals”). Employer must provide the following documents:

• a. Completed client questionnaire
• b. Audited Participant Status Report
• c. Current plan and rate information and, if applicable, any new plan(s) information
• d. All inserts that are to be included in the mailing, including benefits at a glance, enrollment forms, etc. (these documents can be e- mailed in a PDF format or mailed to us with a sufficient quantity of inserts for participants)
• After receiving accurate and complete information, isolved Benefit Services will:

• Prepare an Open Enrollment packet/notification to all COBRA OE individuals and send by first class mail
• Send an e-mail confirmation to Employer’s designated contact when the mailing has been completed
• Contact Employer for new address information in the event of returned packets (only if the COBRA OE Individual cannot be reached)

E. Miscellaneous Items All isolved Benefit Services obligations under this MOA are conditioned on Employer complying with the requirements set forth above. Unless either party indicates otherwise, isolved Benefit Services will continue to provide the selected services on the Service Agreement every year under the same terms and conditions. isolved Benefit Services will notify Employer of the need to provide new data at the appropriate time.