COBRA NOTICE PROCEDURES THE NOTICE(S) A COVERED PERSON MUST PROVIDE UNDER THIS SUMMARY PLAN DESCRIPTION In order to be eligible to receive COBRA continuation coverage, covered Employees and their Dependents have certain obligations with respect to certain Qualifying Events (including divorce or legal separation of the Employee and spouse or a Dependent Child’s loss of eligibility for coverage as a Dependent) to provide written notices to the administrator. Follow the rules described in this procedure when providing notice to the administrator, whether to Your employer or to the COBRA administrator. A Qualified Beneficiary’s written notice must include all of the following information (a form for notifying the COBRA administrator is available upon request.) • The Qualified Beneficiary’s name, current address, and complete phone number, • The group number and the name of the Employee’s employer, • A description of the Qualifying Event (i.e., the life event experienced), and • The date the Qualifying Event occurred or will occur. For purposes of the deadlines described in this Summary Plan Description, the notice must be postmarked by the deadline. In order to protect Your family’s rights, the Plan Administrator should be informed of any changes to the addresses of family members. Keep copies of all notices You send to the Plan Administrator or COBRA administrator. COBRA NOTICE REQUIREMENTS AND ELECTION PROCESS EMPLOYER OBLIGATIONS TO PROVIDE NOTICE OF THE QUALIFYING EVENT Your employer will give notice to the COBRA administrator when coverage terminates due to the Employee’s termination of employment or reduction in hours, the death of the Employee, or the Employee’s becoming entitled to Medicare benefits due to age or disability (Part A, Part B, or both). Your employer will notify the COBRA administrator within 30 calendar days of when one of these events occurs. EMPLOYEE OBLIGATIONS TO PROVIDE NOTICE OF THE QUALIFYING EVENT The Covered Person must give notice to the Plan Administrator in the case of divorce or legal separation of the Employee and a spouse, a Dependent Child ceasing to be eligible for coverage under the Plan, or a second Qualifying Event. The covered Employee or Qualified Beneficiary must provide written notice to the Plan Administrator in order to ensure rights to COBRA continuation coverage. The Covered Person must provide this notice within the 60-calendar-day period that begins on the latest of: • The date of the Qualifying Event; or • The date on which there is a Loss of Coverage (or would be a Loss of Coverage) due to the original Qualifying Event; or • The date on which the Qualified Beneficiary is informed of this notice requirement by receiving this Summary Plan Description or the General COBRA Notice. The Plan Administrator will notify the COBRA administrator within 30 calendar days from the date that notice of the Qualifying Event has been provided. The COBRA administrator will, in turn, provide an election notice to each Qualified Beneficiary within 14 calendar days of receiving notice of a Qualifying Event from the employer, the covered Employee or the Qualified Beneficiary. -45- 7670-00-413597