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DocuSign Envelope ID:97D49820-FEB8-4DCA-BA8C-7909CD9FA2F9 <br /> (2) SELIERIX warrants that if SUBSCRIIBER's data uploaded in the Licensed Product is <br /> accurate and affirmatively approved by SUBSCRIBER, then the IRS Forms will be <br /> sufficiently accurate for SUBSCRIBER to comply with ACA requirements. SEILERIIX <br /> does not undertake any obligation to determine whether or not SUBSCRIIBER's data <br /> is accurate or complete. <br /> SUBSCRIBER responsibilities:. <br /> (1) SUBSCRIBER is solely responsible for the accuracy and iintegrilty of data stored in <br /> the Licensed Product from which the IRS Forms are based. SUBSCRIBER is <br /> responsible for all data input and maintenance of SUBSCRIIBIER's employee and <br /> benefit plan information. SUBSCRIBER is solely responsible for SUBSCRIIBER's <br /> compliance with the ACA law, rules and regulations. <br /> (2) SUBSCRIBER shall thoroughly review the draft IRS Forms. Once SUBSCRIBER <br /> determines the IRS Forms are accurate and complete, SUBSCRIBER slhalll notify <br /> SELIERIX of the same and instruct SELERIX to electronically file with the IRS. If the <br /> IRS rejects the SUBSCRIBER's IRS Forms filing, SUBSCRIBER will work to identify <br /> and resolve the issue with SUBSCRIIBER's data causing the IRS Forms to be <br /> rejected. SUBSCRIBER will provide written notification to SEILERIIX that the issue <br /> has been corrected and to refiille the IRS Forms. <br /> (3) SUBSCRIBER shall bear the risk of loss during any transmission of SUBSCRIIIBIER's <br /> records and data over all communications links and devices. <br /> c. Lookback Monitoring <br /> SELERIIX. Responsibilities: <br /> (1) SELIERIX will provide a standard template (Pay History)that outlines the hourly data <br /> required to drive the ACA Reporting Module. Based on the data provided by <br /> SUBSCRIBER„ SELERIX will provide a 'ilLookback Report"'based on SUBSCRIBER- <br /> defined report parameters and SUBSCRIIBIEIR's requested schedule. <br /> (2) SEILIERIX's ACA Lookback Reports are system-generated reports that identify <br /> employees who may be eligible for a medical coverage offer based on the <br /> employee's average hours worked during the SUBSCRIBER defined 'measurement' <br /> and'stability".periods. <br /> SUBSCRIBER Responsibilities: <br /> (1) SUBSCRIBER is responsible for uploading Pay History data which includes <br /> employee hours worked and compensation subject to SUBSCRIBERS designated <br /> schedule. <br /> (2) SUBSCRIBER is responsible for review of Lookback Reports indicating each <br /> employee who may gain or lose medical eligibility based on the employee's hours <br /> worked. SUBSCRIBER is responsible for reclassifying these employee records <br /> based on SUBSCRIBERS knowledge of all applicable facts and circumstances. <br /> d. Account Manager Support Services. <br /> SELERIIX will provide 20 hours of account manager support hours each calendar year for <br /> IRS Forms Generation and Lookback Monitoring (described above). The intent of the <br /> parties is that the account support activities will be focused on improving SUBSCRIBERS <br /> ability to effectively and efficiently utilize the ACA Reporting system capabilities. <br /> To the extent SUBSCRIBER requests it, SELERIIX will assist with ancillary tasks such as <br /> significant data clean up and data mapping,and will hellp with identifying missing plan <br /> and job class information; however, such assistance by SELERIIX will be charged against <br /> the 20 hours of support described above. More than 20 hours annually of ACA support <br /> will be billed as outline in Section 1., B., 1), e., (3). <br /> 2017 ACA SUBSCRIPTION AGREEMENT FOR NON-LICENSEES PAGE 3 <br />