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C®N EXIS <br />-. human resourceful' <br />(a) CONEXIS or Card Administrator will provide a Card to each Participant in the Health and/or <br />Dependent Care FSAs (if applicable) who elects to use a Card or, at the Client's option, a Card will <br />be sent to all employees who enroll in the Plan by default. The Card will be deactivated upon <br />notice from the Client that the Participant is no longer employed by the Client or has ceased to <br />satisfy the eligibility requirements. Neither CONEXIS nor the Card Administrator is responsible for <br />any damages or costs arising from use of such Card by an ineligible individual prior to notice being <br />received by CONEXIS or the Card Administrator, as applicable. <br />(b) Participants must agree to use the Card in accordance with the terms of the Cardholder Agreement <br />that accompanies the Card. CONEXIS or the Card Administrator will deactivate the Card if the <br />Card is used in a manner that is inconsistent with the Cardholder Agreement. Client shall make <br />reasonable efforts to collect any permanently deactivated cards, returning same to CONEXIS (upon <br />request). <br />(c) The Card may be used by Participants to pay for Eligible Expenses (as defined by the applicable <br />Reimbursement Plan and consistent with CONEXIS standard operating procedures) in accordance <br />with applicable IRS guidance and other applicable rules and regulations. <br />(d) The Card will be administered in accordance with the requirements set forth in the applicable IRS <br />guidance and other applicable rules and regulations, including but not limited to the substantiation <br />requirements. The Card will be deactivated if the Participant fails to provide any information related <br />to Card Transactions requested deemed reasonably necessary by CONEXIS or Card Administrator <br />to process the claim. CONEXIS will make at least one attempt to collect repayment of claims paid <br />through the Card for ineligible expenses or that are otherwise unsubstantiated. If repayment is not <br />made, Client will be informed and will be responsible for taking any necessary action required by <br />law (e.g. including such amounts in income). <br />(e) CONEXIS and the Card Administrator will incur no liability for any Card payments except those <br />arising solely from CONEXIS' or the Card Administrator's material breach of its obligations under <br />this Agreement. It is the Client's responsibility to ensure that they comply with all applicable tax and <br />other laws. <br />(f) All Cards will be deactivated on the last day of the Plan Year administered. <br />(g) CONEXIS and Card Administrator are under no obligation to issue a Card to an individual and/or to <br />keep a Card active to the extent such action would violate applicable law and/or the applicable <br />policies and procedures of CONEXIS or the Card Administrator or such action would be <br />commercially unreasonable under the circumstances. <br />(h) Duties of Client Selecting Card Services. Client agrees to provide all co -pays and/or carrier files <br />within ten (10) business days upon receipt of request from CONEXIS. In the event Client fails to <br />provide requested co -pays and/or carrier files information, Client: <br />i. acknowledges that CONEXIS will not activate and/or issue Cards until the next <br />renewal period if information is not provided; and <br />ii. assumes full responsibility for compliance with relevant IRS regulations; and <br />iii. acknowledges that each third party claims processor, including but not limited to an <br />insurance carrier or pharmacy benefit manager ("PBM") will require written <br />authorization and other information in order to send claims data to CONEXIS and/or <br />the Card Administrator. <br />(i) Client agrees upon termination of this Appendix, Client shall maintain a settlement account with the <br />service provider or depository institution designated by service provider for at least one hundred <br />twenty (120) business days by which service provider may charge to settle any trailing activity <br />which accrues prior to the Effective Date of Termination, and which is not known by service <br />PEPM Billing — Less Than 1000 lives <br />RAS Fee Schedule/Service Appendix 4 V9.0-040111 <br />