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Date Contact name Company name Address one Address two City, State ZIP Dear Valued Customer, We are pleased to offer COBRA administration services to our large group employers at no cost. We understand that managing COBRA compliance and risk can be an administrative burden. Providence Health Plan has selected Ceridian, the nation's largest COBRA services vendor, to provide this service, including consolidating COBRA services for employers with multiple insurance carriers, e.g. other medical, dental and vision plans. Ceridian services include: • • • • • • An implementation support team to get you up and running All required COBRA notifications Participants election via Web, mail, phone and fax Monthly billing and premium collection from COBRA participants A customer service hotline for you and your employees Online reporting Our colleagues at Ceridian will be reaching out to you to follow up on this offer; you may also contact them with questions at [email protected] or 866-221-9214. Visit www.providence.org/php/cobra for more information about Ceridian and their COBRA services. If you are ready to move forward with this service, please complete the enclosed acceptance form and return it in the enclosed envelope. You also can fax your completed form to Ceridian at 727-906-3505. Please note that the earliest available effective date is Aug. 1, 2011. Whether you currently have a COBRA services vendor or are managing COBRA yourself, we invite you to take advantage of the many benefits of this program. Sincerely, Brad Garrigues Chief Sales and Marketing Officer Providence Health Plan Enclosures: COBRA administrative services acceptance form