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C NE6S <br />�'a human resource/uV <br />8. CONEXIS shall provide, upon request from Client, any information maintained in CONEXIS' database that is required <br />to be included on the Form 5500 for the Reimbursement Plans. Such information will be provided within a reasonable <br />period of time following Client's request. Client is responsible for determining whether a Form 5500 is required to be <br />filed. Client is responsible for completing and filing Form 5500s. <br />9. Client shall furnish to CONEXIS any information reasonably determined by CONEXIS to be necessary to fulfill its <br />duties (e.g. information requested by regulatory agencies etc.) as described in 2.4 of the Agreement. <br />10. Upon Client request, CONEXIS shall conduct the following nondiscrimination testing required under the Code <br />(collectively referred to as the "Nondiscrimination Tests") to the extent requested in the Fee Appendix: <br />Section 125 Tests (Cafeteria Plan) <br />• The Key Employee Concentration Test required under Code § 125 <br />• The Eligibility Test required under Code § 125 <br />Section 105 Tests (Healthcare FSA/or Health Reimbursement Arrangement (HRA) <br />• The Eligibility Test required under Code § 105 <br />Section 129 Tests (Dependent Care FSA) <br />• The 55% Average Benefits Test required under Code § 129 <br />• The 5%+ Shareholder Concentration Test required under Code § 129 <br />• The Eligibility Test required under Code § 129 <br />To the extent necessary, CONEXIS shall provide Client with a data request packet for each Code Section. Upon <br />CONEXIS' receipt of the completed packet from Client, CONEXIS shall complete the Nondiscrimination Tests and <br />provide a report summarizing its interpretations of the results within a reasonable amount of time after receipt of the <br />requested information. Results are based solely on information provided by Client in the data request packets. Client <br />is responsible for making appropriate adjustments to bring its Plans into compliance, based on the results of the <br />Nondiscrimination Tests. <br />11. CONEXIS shall provide written monthly reports summarizing the Reimbursement Plan activities from the previous <br />month. Client is responsible for reviewing the reports submitted by CONEXIS and notifying CONEXIS of any errors of <br />which it is aware within a reasonable period of time after reviewing them. Upon receipt of such notification, CONEXIS <br />will correct Participant records as appropriate and directed by Client. <br />12. In accordance with IRS Notice 2005-42, Client may adopt an additional 2 % month grace period at the end of the plan <br />year during which unused amounts remaining in the healthcare and/or dependent care FSA, or other cafeteria plan <br />benefits, may be used to reimburse eligible expenses incurred during the grace period. The grace period begins on <br />the first day of the next plan year and ends two months and fifteen days later. One hundred percent of the <br />Participant's remaining account balances will be available during the grace period. There will be no cap or limited <br />benefit definition applied to the carry-over amount. The run out period for claims incurred during the plan year and <br />claims incurred during the grace period will end on the same day. If Client offers a benefit card, card transactions will <br />be applied to the current year election amount only. To access carry-over amounts during the grace period, manual <br />claims must be submitted via mail, fax or Web site. Manual claims submitted during the grace period are paid from <br />carry-over funds first and then from current year balances if necessary. If claims are submitted out of order, <br />CONEXIS will provide a one-time reallocation at the end of the run -out period. The administrative cost will be a one- <br />time charge of $3.00 per participant per plan as of the end of the plan year ($100 minimum) regardless of account <br />balance at the end of the year. <br />13. Third Party Beneficiaries. Nothing express or implied in this Appendix is intended to confer, nor shall anything herein <br />confer, upon any person other than Client, CONEXIS, Card Administrator(s) and their respective successors or <br />assigns, any rights, remedies or obligations whatsoever. <br />14. Fraud Detection. CONEXIS shall not independently determine fraudulent activities by employee participants, such as <br />(a) whether a submitted receipt is authentic; <br />PEPM Billing — Less Than 1000 lives <br />RAS Fee Schedule/Service Appendix 8 V9.0-040111 <br />