CobraOne

Cobra One, Inc., is a comprehensive COBRA compliance system that can remove you, the employer, from the hassles of COBRA administration. No matter whether you are self-funded, have a fully insured benefit plan or participate in an HMO, Cobra One can provide all notifications, billings and customer service support for your medical, dental, vision and flexing spending account plans. Our service fully documents that you have properly notified all qualified beneficiaries.

Our Services:

Cobra One eliminates the confusion and risk of COBRA administration by performing all of the following functions on your behalf:

• Mail Initial Notice to current and newly covered employees via USPS first class mail with Proof of Mailing.
• Mail Qualifying Event notices to qualified beneficiaries via USPS First-Class mail with Proof of Mailing.
• Process COBRA elections.
• Provide payment coupons to qualified beneficiaries for monthly premium payments.
• Send non-payment notice warnings to continuants.
• Process premiums monthly.
• Notify continuants of termination for non-payment of premium.
• Notify continuants of termination for end of continuation period.
• Notify continuants of anniversary rate increases.
• Handle continuant calls.
• Administer disability extensions.
• Administer dependent Qualifying Events.
• Provide required 180 day warning for end of continuation period.
• Deposit all premiums into an Escrow Account and send you a consolidated premium check once a month.
• Provide full management reports for all COBRA activity.

REPORTING:

Each month you will receive a comprehensive reporting package detailing your company's COBRA activities as follows:

• Listing of Qualifying Event notices showing Qualifying Event date and date notice sent.
• Detailed listing of continuants with all election information to provide carriers on coverages to be started and/or terminated.
• List of terminations from previous month.
• Premium reconciliation report showing COBRA premiums and administration fees.

IMPLEMENTATION:

Implementation is a simple and easy process. In just a matter of days, you can be relieved of the tedious administrative burden of COBRA compliance.

COST:

Cobra One has also taken the confusion out of the cost for providing COBRA administration. There are no separate notice fees, no set-up fee, no surcharges.

You choose from either the Standard Service package or, for only $.15 PEPM more, you can upgrade to the Standard Plus package which also includes mailing of the initial notification of rights required when an employee or spouse becomes a plan participant. Fees are based on the number of employee participants enrolled in your plan as follows:

Standard Services:             $ 1.35   PEPM

(Includes the following services)

• Takeover of current COBRA continuants
• Qualifying Event Notification by USPS Proof of Mailing
• Processing and adjudication of COBRA elections
• Monthly billing/collections processing
• Grace reminder letters
• Monthly accounting management reports
• Archiving of all records for a minimum of 7 years
• Administer Disability extensions and dependent Qualifying Events

Standard Plus Services:             $ 1.50   PEPM

( Includes all of the Standard Services shown above plus the following)

• Initial Notification of Rights to Continuation Coverage

(Sent to newly covered employees after the effective date of this Agreement)

Additional Services:

• Retro COBRA Initial Notification of Rights to Continuation Coverage  $5.00 per Notice

(Sent to existing employees currently covered)

• Manual Notification to CobraOne.                                                  $5.00 per Notice

(No charge for notifications entered through the CobraOne web site)

Note: In addition to the fees and charges set forth above, CobraOne shall retain the 2% administrative charge paid by each continuant under the Plan(s) as compensation for the handling of premium payments, or shall retain any greater administration charge allowed by law whichever is higher. A minimum monthly fee of $30.00 to include the Standard Plus Services will be charged for employees with under 20 employees. PEPM rates go into effect when the employer exceeds 20 employees.

Let Cobra One begin making your life easier today. For additional information regarding our services, please contact us at:

Cobra One, Inc.

1350 South Boulder , Suite 300

Tulsa , Oklahoma 74119

1-800-485-0191