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Reporting and Communication - Employer · Employer Administrative Guide · Monthly report on status of spending account balances · Consult on interpretation of IRS regulations · Report status changes and terminations Compliance, Reporting and Disclosure · Plan Document · Summary Plan Description · Plan Document and Summary Plan Description Updazes · Annual Filing Form 5500 (ERISA Plans) · Section 125 25% Aggregate Discrimination Testing · Section 129 55% Average Benefits Testing · Section 129 25% Aggregate Discrimination Testing 1.5 Reporting Obligations. DBI shall provide general information regarding reporting and disclosure requirements relating to the Plan and shall assist the Employer in the preparation and filing of required governmental reports, Lq_formation or other tax returns or documents and the preparation and distribution of required reports to participants and beneficiaries. However, DBI shall not be responsible for the accuracy of any information provided by the Employer in preparation of any of these rel: orts and information nor shall DBI be responsible for determining the level of compliance required by the Employer's Plan. It is the ultimate responsibility of the Employer to as sure compliance with all legal reporting and disclosure requirements. 1.6 Forms. DBI shall provide administrative forms for the Employer's use in administering the Plan. These forms include: Plan Design Guide, Enrollment Forms, Reimbursement Request Forms, Employee Termination Forms, Status Change Forms, and check stock. All forms and user guide information shall be sabject to periodic updates and revisions. DBI shall also provide instructions and forms for the processing of benefit claims under the Plan. All participants should apply for benefits under the Plan using forms provided by DBI. Forms are available on the Intemet at ,u~rw.flexiblebenefits. com. 1.7 Plan Payments. Using funds received fi:om th~ Employer, DBI shall pay the amounts due as a result of the operation of the Plan md in compliance with the participant's current Plan election. 1.8 Claims Processing. DBI shall process claims received fi:om the Employer or its qualifying participants for the payment of benefits an~ arrange for the payment of approved reimbursement requests as provided in the Plan. DBI shall consider any claim for benefits made under the Plan, provided the claim is in accordance with the Plan, the Summary Plan Description and any reasonable rules established by DBI and communicated to participants. DBI shall grant or deny each participant's c'_aim for benefits at~er making such investigation, as it deems necessary. Administrative Services Agreement - October 2003 10.30.03