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This document outlines the procedures and terms for retired employees of Nortel Networks Inc. to elect participation in the Retiree Settlement Agreement regarding their retiree benefits and the COBRA

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How to fill out NORTEL NETWORKS INC. AND AFFILIATED U.S. DEBTORS RETIREE SETTLEMENT ELECTION AND RELEASE FORM FOR COBRA PARTICIPANTS

01

Obtain the NORTEL NETWORKS INC. AND AFFILIATED U.S. DEBTORS RETIREE SETTLEMENT ELECTION AND RELEASE FORM.

02

Carefully read the instructions provided with the form.

03

Fill in your personal information in the designated sections, including your name, address, and contact details.

04

Indicate your election choice regarding the settlement in the appropriate section of the form.

05

Review the terms and conditions outlined in the form before signing.

06

Sign and date the form in the specified area.

07

Submit the completed form by the deadline mentioned in the instructions, either by mailing it to the designated address or submitting it electronically if allowed.

Who needs NORTEL NETWORKS INC. AND AFFILIATED U.S. DEBTORS RETIREE SETTLEMENT ELECTION AND RELEASE FORM FOR COBRA PARTICIPANTS?

01

Former employees of NORTEL NETWORKS INC. who are COBRA participants and are eligible for the retiree settlement.

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What is NORTEL NETWORKS INC. AND AFFILIATED U.S. DEBTORS RETIREE SETTLEMENT ELECTION AND RELEASE FORM FOR COBRA PARTICIPANTS?

It is a legal document that allows eligible retirees of Nortel Networks Inc. and affiliated U.S. debtors to make an election regarding their COBRA health benefits as part of a settlement agreement.

Who is required to file NORTEL NETWORKS INC. AND AFFILIATED U.S. DEBTORS RETIREE SETTLEMENT ELECTION AND RELEASE FORM FOR COBRA PARTICIPANTS?

Eligible retirees who wish to elect coverage under COBRA as part of the settlement agreement are required to file this form.

How to fill out NORTEL NETWORKS INC. AND AFFILIATED U.S. DEBTORS RETIREE SETTLEMENT ELECTION AND RELEASE FORM FOR COBRA PARTICIPANTS?

Individuals must complete the form by providing their personal information, indicating their election choice regarding COBRA benefits, and signing the form as required.

What is the purpose of NORTEL NETWORKS INC. AND AFFILIATED U.S. DEBTORS RETIREE SETTLEMENT ELECTION AND RELEASE FORM FOR COBRA PARTICIPANTS?

The purpose of the form is to document the retirees' decision regarding health benefit coverage under COBRA as part of the settlement reached by Nortel Networks and to release any claims related to these benefits.

What information must be reported on NORTEL NETWORKS INC. AND AFFILIATED U.S. DEBTORS RETIREE SETTLEMENT ELECTION AND RELEASE FORM FOR COBRA PARTICIPANTS?

The required information includes the retiree's name, contact information, election choice regarding COBRA coverage, and signature, along with any other pertinent information specified on the form.

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