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© Peak One Administration 2016 29 <br />5. Election Form. Client will review the Election Form with its selected legal counsel to ensure that <br />it is consistent with applicable law, its health plans and any requirements imposed with regard to <br />its health plans by the health plan vendors. <br />6. Eligibility and Notification to PSP of Right to Elect. Client is solely responsible for determining <br />whether an initial Qualifying Event has occurred and for timely notifying PSP of the names and last <br />known address of each Qualified Beneficiary entitled to elect coverage as well as the Qualifying <br />Event that has occurred and coverage that is to be offered. Client is also responsible for notifying <br />PSP which health plan options covering the Qualified Beneficiaries can be elected separately or <br />not. <br />7. Review of COBRA Election Report. Client is responsible for reviewing the report of Qualified <br />Beneficiaries who have elected COBRA submitted by PSP and notifying PSP of any errors of which <br />it is aware within five (5) business days of receipt from PSP. <br />8. Open Enrollment and Changes in Coverage. Client, for each Benefit Plan, will notify PSP of the start <br />and duration of the open enrollment period as well as the Benefit Plan options that must be made <br />available to Qualified Beneficiaries during the open enrollment period. <br />9. Cost of COBRA Coverage. Client will notify PSP of the applicable premium(s) and any changes to <br />the applicable premium(s) at least thirty (30) days prior to the start of the twelve-month period to <br />which they relate <br />10. COBRA Coverage Conversion Rights. Client is responsible for notifying PSP of any conversion rights <br />that must be offered. <br />11. Continuation Coverage Required by State Law. Client is responsible for compliance with any <br />applicable state law requiring the provision of continuation coverage. PSP will not provide <br />administrative services with respect to such continuation coverage. <br /> <br />Optional Services <br /> <br />These are provided only upon request of the Client. <br />Optional Fees <br />1. Benefit Plan consulting, including but not limited to, discussions <br />regarding Benefit Plan design, compliance and communications. <br />Quote <br />2. Requested changes to any standard administrative procedures <br />established by PSP. <br />Quote <br />3. Exchanging information by means other than the standard procedure <br />established by PSP (as set forth above). PSP will provide Client with several <br />options for transferring data, including diskette, model file transfer or if the <br />foregoing transfer methods are not available for the Client’s payroll system, in <br />a mutually acceptable format. <br />Quote