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03-09-26-R
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03-09-26-R
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6 <br />4. the Continuation Coverage Premium, as determined by Employer, <br />and the payment by Continuation Participants of the cost of <br />Continuation Coverage; <br />5. the length of each Continuation Participant’s Continuation Coverage; <br />and <br />6. the offer of any required conversion coverage (if any). <br /> <br />G. General Notices. Benefit Extras shall, based upon information provided by <br />Employer, issue a general COBRA notice to all individuals who enroll in the <br />Plan(s) subject to COBRA coincident with or subsequent to the Effective <br />Date. Benefit Extras is entitled to rely upon the information provided by <br />Employer and is under no obligation to independently verify such <br />information. <br />H. Continuation Coverage Eligibility, Notification of Right to Elect, and <br />Notification of Unavailability. Benefit Extras shall determine if a Qualifying <br />Event has occurred based upon information provided to it by Employer <br />and/or the person making the claim for Continuation Coverage. Such <br />determinations regarding claims shall be made in accordance with the <br />written terms and conditions of the Plan. With respect to this responsibility, <br />Benefit Extras is entitled to rely upon the information provided by Employer <br />and/or person making the claim and is under no obligation to independently <br />verify such information. If Benefit Extras determines a Qualifying Event has <br />occurred, Benefit Extras will generate and mail to the Qualified Beneficiaries <br />any notices and/or election forms required under applicable law or <br />otherwise necessary to facilitate the provision of Continuation Coverage. <br />If Benefit Extras determines no Qualifying Event has occurred, or a Covered <br />Individual is not entitled to Continuation Coverage or an extension of <br />Continuation Coverage, if required by COBRA or other applicable law, <br />Benefit Extras shall notify any person whose claim for Continuation <br />Coverage is denied of the reasons for the denial and of the person’s rights, <br />if any, to have the denial reviewed in accordance with the terms and <br />provisions of the Plan. The notification and review will be in a manner <br />agreed upon by Employer and Benefit Extras. Benefit Extras will refer to <br />Employer and Plan Administrator any claim or class of claims specified by <br />them in writing as well as any claim that is disputed after the initial denial. <br />Employer and/or Plan Administrator shall have final discretionary authority <br />to make all determinations regarding Continuation Coverage under the Plan. <br />Notices described herein will be provided based upon the address <br />information provided by Employer.
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