Dear Participant

According to our records we have not received documents requested to verify eligibility for the dependents listed below. This letter is to inform you that if you do not respond or submit the required documentation,the Southern California IBEW-NECA Health Trust Fund will terminate your dependent(s) coverage.

Dependent Name	Birth Year
Andrew Smith	2003

Please submit a legible response postmarked by July 18, 2018 so your dependent(s) health coverage will continue without interruption.

Submittal Options and Contact Information

• Upload documentation by logging into www.Consova.com/IBEWNECA, you will need your PIN number, which was mailed to you, to log in to the website.
• Mail documentation in the enclosed postage-paid envelope with a postmark on or before July 18, 2018.
• If you have any questions or need assistance, please call Consova's Dependent Eligibility Verification Assistance Center at (855) 864-9391Monday – Friday from 7:00 a.m. – 3:00 p.m. Pacific Standard Time.

Once your submitted documentation has been reviewed, Consova will mail a letter to you regarding the updated status and notify you if any additional information is required.

If your dependent's coverage is terminated, a COBRA Continuation of Coverage Election Notice will be mailed to your dependent(s) by the Southern California IBEW-NECA Health Trust Fund. The Election Notice provides information regarding COBRA rights. If you have questions about rights to COBRA continuation coverage, please contact the Southern California IBEW-NECA Health Trust Fund at (800) 824-6935.

Consova's Privacy Policy can be found on our corporate website at http://www.Consova.com/privacy-policy.

Sincerely,

Consova Corporation