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03-09-26-R
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03-09-26-R
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3/16/2026 8:57:34 AM
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3/16/2026 8:44:15 AM
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22 <br />EXHIBIT A <br />Administrative Fees and Optional Services <br /> <br />ADMINISTRATIVE FEES <br />In accordance with Section III.N., the administrative fees payable under this Agreement <br />are as provided in the following schedule: <br /> <br />Initial Set-Up Fee $450.00 <br /> <br />Annual Renewal Fee $375.00 <br /> <br />Annual Online Services Fee No Charge <br /> <br />Monthly Administration Fee $15.00 per Continuation Participant1 per month <br />(Employer retains 2% administration fee) <br /> <br />Initial COBRA Notice Fee $4.50 per notice <br />Qualifying Event Notice Fee $35.00 per notice <br />Third-Party EDI File Feed Set Up $250/file (2 files max) <br />Third-Party EDI File Feed Changes $125/file ((2 files max) <br />2% COBRA Administration Fee Retained by the Employer <br />Monthly Minimum No Monthly Minimum <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />1 Based upon the number of Continuation Participants as of the first day of the month as reflected in the COBRA <br />Tracking Report. For this purpose, Continuation Participants that are part of a single-family unit are considered a single <br />Continuation Participant.
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