Consent to Receive Electronic Disclosures
By entering or accepting the pre-filled email address and clicking the “Agree to Electronic Delivery” button or otherwise opting in via mail or phone, you are accepting the following terms and conditions:
With respect to the Consolidated Omnibus Budget Reconciliation Act (“COBRA”) for any group health & wellness plan ("Plan") that I have access to on the Kept, Inc (“Kept”) websites, including but not limited to www.kept.io or app.kept.io, (“Platform”), I authorize you to send, and I consent to receiving, the following documents, now and in the future, by electronic means:
- COBRA notifications under ERISA § 606 (29 U.S.C. § 1166);
- COBRA General Notice;
- any other notices or communications related to COBRA or other health & welfare options I use now or in the future through the Platform.
To access these documents, I understand that I can visit the Platform or follow the links sent to the email that I indicated for electronic delivery. If I cannot access these documents via the Platform, I can contact Kept via the other forms of contact at the end of these terms.
These documents will be furnished to me via a link to the Platform which will be sent to the email I indicated. These documents will be accessible online and in PDF form. To access the documents I understand that I must have:
- a computer or other device with internet access; and
- Adobe Acrobat Reader installed, allowing me to open and read the document. I understand that I should keep a copy of any attached or linked documents for future use.
Furthermore, I understand that I must be able to either:
- print a copy on a printer attached to my computer or device; or
- save a copy in electronic form to my computer or device.
I understand that if my mailing address or email address changes, I must notify Kept via the Platform or via the other forms of contact at the end of these terms. If by mail or email, I will send it with the subject line “Email Address Change,” and include my full name, address, and phone number in the body.
I affirm that I have the ability to access information in Adobe Acrobat Reader. I understand that I will receive the documents listed above only in electronic form unless I request a paper copy of such documents by either requesting it on the Platform or via the other forms of contact at the end of these terms. If by mail or email, I will send it with the subject line “Request for Paper Copy,” and include my full name, address, and phone number in the body.
I understand that the documents available on the website are not required to be available for more than one year or, if later, after it is superseded by a subsequent version.
I understand that this consent may be withdrawn at any time, free of charge, by notifying Kept on the Platform or via the other forms of contact at the end of these terms. If by mail or email, I will send it with the subject line “Consent Withdrawn for Electronic Disclosure,” and include my full name, address, and phone number in the body.
I further agree to provide copies of all notices I receive electronically, consistent with this consent form, to my spouse and other dependents, if they are covered by the Plan, and confirm that they have access to this email. If, in the future, they no longer have access to this email, I agree to reach out to Kept via the Platform or via the other forms of contact at the end of these terms, in order to provide proper email and physical address information for delivery of such notices to them.
I consent to receiving the type of documents described above electronically and understand this will apply to all future notices issued by Kept except to the extent I withdraw my consent as specified above. Kept reserves the right, and you also agree to allow Kept, to send any notices to you by ordinary mail if Kept, in its sole discretion, determines it to be necessary.
Kept's methods of contact
Phone
1-877-TRY-KEPT (1-877-879-5378)
Kept, Inc.
668 N Coast Hwy Unit 1311
Laguna Beach, CA 92651