OptumHealth Financial Services provides comprehensive administration services for COBRA and state benefit continuation requirements.

COBRA Administration Installation and Set-Up Installation package for plan sponsors includes electronic forms for collecting rates, yplus information about current continuees and Qualified Beneficiaries (QBs) in their election period and future QBs Mail introductory materials, contact information and premium payment coupons to ycurrent QBs

Qualifying Event Services Prepare and mail election package and enrollment form to each new QB ySend a separate election package to spouses, if any yFollow-up on any returned or undeliverable election packages yTrack COBRA election and payment timelines yIssue HIPAA certificate to each QB as of the Qualifying Event y Provide information anytime online for qualified beneficiaries and COBRA yadministration clients Provide enrollment information to carriers when QBs elect to continue ySend premium payment coupons to QBs who elect to continue y

Ongoing Administration Services Provide toll-free customer service to address QB questions yReceive and track premium payments yTrack payment timelines ySend monthly payment reminder letters to QBs during the grace period yCommunicate with QBs regarding insufficient or NSF checks y Forward one check to plan sponsor on a monthly basis representing all premiums yreceived during the month Provide detailed monthly reports of all COBRA activity to the plan sponsor yNotify QBs of conversion opportunity, if appropriate yNotify carriers when QB’s continuation coverage ceases yMail Notice of Termination of COBRA to QBs when coverage ceases yIssue HIPAA certificate to each QB as of the termination of COBRA continuation y

COBRA Administration Services

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Contact a tax, legal or account professional for personal advice on tax-related filings and issues.Federal and state regulations are subject to change.

About OptumHealth Financial ServicesOptumHealth Financial Services provides tax-advantaged accounts for health care savings and spending, innovative medical and debit card technology, benefits administration services, and print and electronic payables solutions for the health care industry. We make health care simpler, more accessible and more affordable. Visit us at OptumHealthFinancial.com.

We offer these options for you and your employees:

Health Accounts for Active Employee Health CareHealth savings accounts (HSAs) y 1 • Flexible spending acounts (FSAs) Health reimbursement accounts y • Health incentive accounts (HIAs) (HRAs)

Health Accounts for Retiree Health CareRetirement reimbursement y • Funded health reimbursement accounts (RRAs) arrangements (FHRAs) Hybrid retirement solution y

Benefits AdministrationCOBRA y • Retiree billing Consolidated billing y • VEBA/115 trusts and daily valued investments2

2 Investments are not FDIC insured, are not guaranteed by OptumHealth, and may lose value.

1 Health Savings Accounts are offered by OptumHealth Bank, Member FDIC, and are subject to eligibility.

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COBRA Administration Services

Give account access online to QB’s and employers yIssue HIPAA certificate not related to a COBRA event* ySend General COBRA Notice (also known as Initial COBRA Notice and COBRA yRights Notice) to new participants*

*Optional services for an additional fee.

Open Enrollment Services Provide QB mailing labels or address files to the plan sponsor for use in sending yopen enrollment materials to QBs* Send rate change notices and new premium payment coupons to QBs yManage the open enrollment process for QBs* y

*Optional services for an additional fee.

OptumHealth Financial Services retains all records relating to each client’s administration services for seven years.

Contact us today to learn more about our COBRA administration service. Call (866) 427-6804 or visit OptumHealthFinancial.com.