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2021-089C
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2021-089C
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Entry Properties
Last modified
10/5/2021 10:46:36 AM
Creation date
10/5/2021 10:43:50 AM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
06/22/2021
Control Number
2021-089C
Agenda Item Number
8.D.
Entity Name
P&A Administrative Services, Inc
Area
Cobra Services Agreement
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DocuSign Envelope ID: FAA4141C-02DF-41B5-A6D3-14CDB4ABD65B <br />SCHEDULE B <br />FEES <br />INSTALLATION FEE. NIA <br />2. SUPPLEMENTAL INSTALLATION FEES -STATE CONTINUATION COVERAGE. The Employer shall pay to P&A <br />an installation fee of $125.00 for each state continuation law with respect to which the Employer requests (at any time while <br />this Agreement remains in effect) the optional services describe at Section 2(f) above. This fee shall be due and payable <br />within thirty (30) days after receipt by the Employer of P&A's invoice with respect to same. <br />3. MONTHLY ADMINISTRATION FEES. The Employer shall pay to P&A administration fees with respect to each <br />calendar month or portion of a calendar month during which P&A performs any of the services described herein. During the <br />second month of the Agreement, P&A shall begin to provide the Employer with invoices for services during the preceding <br />month. The fees for a given month shall equal $.50 for each individual enrolled in the Plan as of the first day of that month <br />(including for purposes of this Agreement any COBRA Continuant and any former employee whose COBRA election period <br />had not expired as of that date). Each such invoice shall be due and payable within thirty (30) days after receipt by the <br />Employer <br />4. MAILING EXPENSES. The Employer shall reimburse P&A for the cost of any mailing required under the Agreement <br />the rate for which exceeds the first-class rate charged by the U.S. Post Office after P&A provides the Employer with proof <br />of same. <br />5. PARTICIPANT FEES. An individual who has coverage under the Plan shall pay to P&A a fee of $25.00 should a <br />check tendered by him or her in payment of a premium be returned on account of insufficient funds. Further, if an individual's <br />COBRA coverage must be reinstated due to non-payment of premiums or other circumstances for which he or she is <br />responsible, he or she shall pay P&A a reinstatement fee of $30.00. <br />Note: Should changes in applicable federal or state law or regulations make it necessary or advisable for services other than those <br />enumerated in this Agreement to be rendered in connection with the administration of the Plan (e.g., a new type of notice is required to <br />be provided to certain covered persons) and should the Employer desire to retain P&A to provide such additional services, the addition <br />of such services to P&A's responsibilities shall require an amendment to this Agreement. P&A reserves the right to request an adjustment <br />in its fees hereunder under such circumstances. <br />14 <br />
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