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Reso 2012-821RESOLUTION NO. 2012 -821 A RESOLUTION OF THE BOARD OF DIRECTORS OF THE COSTA MESA SANITARY DISTRICT AMENDING THE DISTRICT'S CAFETERIA PLAN DOCUMENT TO COMPLY WITH THE INTERNAL REVENUE CODE (IRC) SECTION 125 REGULATIONS AND THE 2010 HEALTH CARE REFORM ACT WHEREAS, the Costa Mesa Sanitary District previously approved and implemented an IRC Section 125 Cafeteria Plan for its employees, and WHEREAS, the Cafeteria Plans are subject to federal regulatory changes and updates, which require periodic amendment and restatement of the plan documents as needed in order to remain in compliance with the Internal Revenue Code, and WHEREAS, specifically the 2010 Health Care Reform Act caused the District to make amendments to the Cafeteria Plan for compliance, and WHEREAS, the District's third party administrator for the Cafeteria Plan has prepared an updated Plan Document and Summary Plan Description to reflect the necessary changes and updates in accordance and in compliance with the current federal regulations in effect, and WHEREAS, IRC Section 125 Rules require any amendments to the Cafeteria Plan be adopted by resolution of the governing body; ` NOW, THEREFORE, the Board of Directors does hereby resolve: The Cafeteria Plan presented to this Board is approved and adopted as amended, and that the proper officers of the District are hereby authorized and directed to execute and deliver to the Administrator of the Plan one or more counterparts of the Plan. 2. That the Administrator shall be instructed to take such actions deemed necessary and proper in order to implement the Plan, and to set up adequate accounting and administrative procedures to provide benefits under the Plan. 3. That the proper officers of the Costa Mesa Sanitary District shall act as soon as possible to notify employees that the Cafeteria Plan has been adopted by giving each employee a copy of the updated and approved Summary Plan Description of the Plan. PASSED and ADOPTED on this 20th e7xo- Secretary osta Me a Sanitary District Board of rectors day of September 2012. President, Costa Mesa Sanitary District Board of Directors STATE OF CALIFORNIA) COUNTY OF ORANGE ) SS CITY OF COSTA MESA ) I, Scott Carroll, Clerk of the Costa Mesa Sanitary District, hereby certify that the above and foregoing Resolution No. 2012 -821 duly and regularly passed and adopted by said Board of Directors at a regular meeting thereof held on the 20th day of September 2012. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of the Costa Mesa Sanitary District, this ?J��day of SPPi6tA1bW- 2012. Scott Carroll Clerk of the Costa Mesa Sanitary District 4 gr 3e� X z a 3t . -4 te,,�M, r� x -� . - n Effect of Termination Upon and after the expiration or termination of this Agreement, the rights granted to the (employer) pursuant to this Agreement shall revert back to (FlexSystem), a division of Total Administrative Services Corporation. Within 20 days after termination or expiration of this Agreement the (employer) shall return to (FlexSystem) all manuals, brochures, computer programs, customer and vendor data bases and any other documents regarding the (FlexSystem) programs and systems ( "Confidential Information ") and any copies thereof. In addition, the (employer) shall refrain from any further direct or indirect use of or reference to the (FlexSystem) marks, systems, publications, manuals, brochures, documents, computer programs and computer data bases in con- nection with the marketing, use, implementation, license, sale or distribution of any program or system that enable (employers or offer employee benefits on a pre -tax basis). Finally, the termination of this Agreement shall not affect the duty of the (employer) to not infringe on (FlexSystem's) trademarks and copyrights and to not disclose and keep confidential all said Confidential Infor- mation supplied to the (employer) by (FlexSystem). Request for Confidentiality This Plan Document is proprietary confidential business property of FlexSystem and may be used for the benefit of FlexSystem Participants only. Important Notice This Plan Document is intended as a prototype Plan Document for use with FlexSystem. This Plan Document does not stand alone with respect to complete compliance of Internal Revenue Code Section 125. The Plan Document, in addition to admin- istrative polices, procedures, etc., offered by TASC, represents full operation and compliance with a Cafeteria Plan. It may only be used with respect to that manner under any circumstances. Become familiar with its terms. FlexSystem and TASC do not warrant that this prototype will meet the needs and requirements of any individual adopting employer. If you have any questions regarding your particular needs, requirements, or circumstances, seek competent legal advice. FlexSystem, TASC and their repre- sentatives are not attorneys and do not provide legal advice. FlexSystem is a division of Total Administrative Services Corporation (TASC), Madison, Wisconsin. Used with permission pursuant to license. Article I Table of Contents Article I Table of Contents Article II Purpose 2.01 Creation and Title 2.02 Effective Date 2.03 Purpose Article III Definitions Article IV Administration 4.01 Plan Administrator 4.02 Appointed Agent or Representative 4.03 Named Fiduciary 4.04 Powers and Duties 4.05 Facility of Payment 4.06 Information to be Furnished 4.07 Reasonable Care 4.08 Indemnification for the Administrator and /or a Representative Thereof 4.09 Reporting Requirements Article V Eligibility and Participation 5.01 Eligibility Requirements 5.02 Current Employees at the Time of Plan Inception 5.03 New Employees 5.04 Re- employment of Former Employees 5.05 Application for Participation 5.06 Notification of Participation 5.07 Determination of Eligibility 5.08 Notification to Employees 5.09 Termination of Participation 5.10 Layoff, Leave of Absence and Sabbaticals 5.11 Family Medical Leave Act 5.12 Uniformed Services Employment and Reemployment Rights Act (USERRA) 5.13 Qualified Reservist Distribution 5.14 Effect of Disability 5.15 Effect of Participant Death 5.16 Run Out Period 5.17 Grace Period Article VI Election of Available Benefits 6.01 Available Benefits 6.02 Election Amounts and Procedures 6.03 Failure to Elect 6.04 Effective Periods for Elections 6.05 Change in Family Status 6.06 Prohibited Deposits 6.07 Forfeitures 6.08 Non - Discrimination Article VII Contributions 7.01 Employer Contributions 7.02 Employee Salary Reductions 7.03 Contributions 7.04 Interest 7.05 Plan Assets Article VIII Medical or Medical- Related Premium Benefit and Premium Reimbursement Benefit 8.01 Purpose 8.02 Intent 8.03 Maximum Limitations 8.04 Claim Procedure Article IX Medical or Medical- Related Expense Reimbursement Benefit 9.01 9.02 9.03 9.04 9.05 9.06 9.07 Purpose Intent Maximum Limitations Claim Procedure COBRA HIPAA ERISA Article X Dependent Care Benefit 10.01 Purpose 10.02 Intent 10.03 Maximum Limitations 10.04 Dependent Care Expenses 10.05 Dependent Care Service Provider 10.06 Claim Procedure Article XI Group Term Life Insurance Benefit 11.01 Purpose 11.02 Intent 11.03 Maximum Limitations 11.04 Claim Procedure Article.XII Disability Income Benefit 12.01 Purpose 12.02 Intention 12.03 Maximum Limitations 12.04 Claim Procedure Article XIII Health Savings Accounts 13.01 Purpose 13.02 Intent 13.03 Maximum Limitation 13.04 Trustee and /or Custodian 13.05 Claim Procedure 13.06 Other Coverages 13.07 HSA Transfer Article XIV Claims 14.01 14.02 14.03 14.04 14.05 14.06 4 When to File How to File Information for Claim Payment Coordination of Benefits Denial Procedure Article XV Records and Reports 15.01 Responsibility 15.02 Records 15.03 Examination of Records Article XVI Plan Termination 16.01 Plan Termination 16.02 Employer Rights to Terminate Article XVII Plan ( 17.01 17.02 17.03 17.04 17.05 17.06 17.07 17.08 17.09 17.10 ,onstruction Taxation Adoption by Related Organizations Uniform Exercise of Powers Construction Entire Document Controlling Law Severabilicy Benefits Provided through Third Parties Rights Against the Employer Successor - Businesses Article II Purpose 2.01_ Creation and Title. As defined in the Plan Application, the employer creates a Cafeteria Plan under the terms and conditions set forth in this document as well as through various administrative procedures. The Plan is known as the Full Flex Cafeteria Plan for the specific employer identified in the Plan Application. This prototype Plan Document encompasses all of the Plan elections and design elements indicated by the employer on the Plan Application. 2.02 Effective Date. The effective date shall be as identified in the Plan Application. 2.03 Purpose. The Plan allows employees to select among cash compensation or certain nontaxable benefits, namely coverage under one or more benefits programs maintained by the Employer. The Employer intends.that the Plan qualify as a Cafeteria Plan under Section 125 of the Internal Revenue Code and that the benefits provided under the Plan be eligible for exclusion from Federal income tax. Article III Definitions Administrator. The employer. A representative may be designated by the employer to perform certain record - keeping and other functions, but such named representative shall not be the administrator. Beneficiary Any one or more primary or contingent beneficiaries designated by the Participants to receive any benefits payable under the Plan. Benefits. Any benefit provided to a Participant under the employee's (1) medical premium or medical- related premium reimbursement benefit, (2) medical or medical- related expense reimbursement benefit, (3) dependent care assistance benefit, (4) term life insurance benefit, (5) dis- ability income benefit, or (6) other allowable benefits provided by the employer under the Plan. Code. The Internal Revenue Code of 1986, as amended from time to time. Compensation. Compensation shall mean the total wages or salary actually paid to a Participant by the employer reported in the Wages, Tips and Other Compensation Box on the Participants Form W -2 for income tax purposes, including overtime pay, scheduled bonuses, commis- sions and severance pay. Constructive Receipt. The effect of an unpermitted change in an election causing an elected benefit to be included in a Participant's gross in- come. To avoid constructive receipt of an elected benefit, the Participant must make irrevocable elections prior to the start of the Plan year, but shall not include employer contributions to Social Security, contributions to any retirement plan or program, or the value of any other fringe benefits provided at the expense of the employer. Dependent. The term " Dependent" means: (a) for purposes of accident or health coverage (to the extent funded under the Medical or Medical - Related Premium Benefit and Premium Reimbursement Benefit, and for purposes of the Medical or Medical- Related Expense Reimburse- ment Benefit), (1) a dependent as defined as in Code § 152, determined without regard to subsections (b)(1), (b)(2), and (d)(1)(B) thereof, (2) any child (as defined in Code § 152(f)(1)) of the Participant who as of the end of the taxable year has not attained age 27, and (3) any child of the Participant to whom IRS Rev. Proc. 2008 -48 applies (regarding certain children of divorced or separated parents who receive more than half of their support for the calendar year from one or both parents and are in the custody of one or both parents for more than half of the cal- endar year); and (b) for purposes of the Dependent Care Benefit, a Qualifying Individual. Notwithstanding the foregoing, the Medical- Related Expense Reimbursement Benefit will provide benefits in accordance with the applicable requirements of any qualified medical child support order (QMSCO), even if the child does not meet the definition of "Dependent" Dependent Care Assistance. The payment or reimbursement of expenses incurred for the care of a qualifying individual — either in the employee's home or at a qualifying day care provider — to enable the employee to be gainfully employed. A qualifying individual is a dependent under the age of 13 or a dependent or spouse who is physically or mentally disabled who regularly spends at least eight hours per day in the employees home. Dependent Care Service Provider. A person who provides care or other services as defined in" Dependent Care Assistance," but not a depen- dent care center (as defined in Section 21 (b)(2)(D) of the Code), unless such center satisfies the requirements of Code Section 21(b)(2)(C), or (b) a related individual as described in Section 129(c) of the Code. Disability A physical or mental inability to perform work, resulting from injury or disease, which is expected to be permanent and which, if applicable, entitles the Participant to a disability benefit under the employer's disability Plan or under its qualified pension Plan. Effective Date. The date specified in the Plan Application on which the Plan is effective and applicable to the eligible Employees. Election. When a Participant chooses or "elects" specific benefits, and the amount allocated by the Participant toward the purchase of such benefit. Eligible Employment- Related Expenses. Expenses incurred for the care of a Qualifying Individual which are paid to a person who is not a child (within the meaning of Code Section 151(e)(3)) of the Participant under the age of 19 at the close of the taxable year. Employee. Any person defined as a common law employee. - ERISA. The Employee Retirement Income Security Act. Employer. The employer named in the Plan Application and any affiliate or subsidiary that, with the consent of the employer becomes an employer, by adopting the Plan, or any successor business organization that assumes the obligations of the employer. Entry Date. The date(s) specified by the Employer in the Plan Application as of which eligible employees may become Participants. Ex ense. Any expense paid or incurred by a Participant, the reimbursement of which makes the Plan not includable in the Participant's in- come under any provision of the Code. Fiduciary. The Employer shall be the "Named Fiduciary" and shall be subject to service or process on behalf of the Plan. Flexible Compensation Enrollment Form. An agreement between a Participant and the Employer under which the Employer reduces the Participants current salary and contributes the amount of the reduction to the Plan on behalf of the Participant, as a before -tax contribution. Forfeiture. Any amounts remaining in a Participant's account after all valid reimbursement claims for a given Plan year have been paid. Health Savings Account - This is a medical reimbursement account governed by Section 223 of the Internal Revenue Code. Highl_�Compensated: An employee, individual, or Participant defined as highly compensated under the applicable provisions of Code sections 79, 105, 125 and 129, and applicable regulations, in favor of whom this Plan may not discriminate to the detriment of the non - highly com- pensated employee with respect to the eligibility for, participation in, or benefit amounts paid or payable under a benefit offered pursuant to this Plan and the particular Code Section. Generally, under Code Section 125, the highly compensated are officers, shareholders holding more than 5% of the employing company, individuals paid disproportionately high compensation (as determined under the applicable guidelines established by regulation of the Department of Treasury), and the spouse or dependent of such persons. Medical or Medical - Related Premium Reimbursement. The payments by the Employer to reimburse Participants for medical or medical -re- lated premium is to the extent provided for in the Participants signed Authorization Agreement. Medical or Medical- Related Expense Reimbursement. The payments by the Employer to reimburse Participants for medical or medical- related expenses to the extent provided for in the Participants signed Authorization Agreement. Such payments shall be for expenses incurred by a Participant, or by the spouse or Dependent of such Participant, for non - cosmetic medical care as defined in Section 213 of the Code (includ- ing, without limitation, amounts paid for hospital bills, doctor and dental bills), medicine or drugs "prescribed" within the meaning of Section 106(f) of the Code (determined without regard to whether such drug is available without a prescription), and insulin, but only to the extent that the Participant or other person incurring the expense is not reimbursed for the expense through insurance or otherwise (other than under the Plan). Participant. Any person who has been or is an employee and who qualifies to participate in this Plan. Plan. The Cafeteria Plan adopted by the employer pursuant to the Plan Application. The Plan includes the requirements of the Internal Rev- enue code, ERISA, and the administrative operations that support the Plan. Plan Application. Instrument used to adopt a Section 125, Cafeteria Plan. Plan Operations. The administrative procedures or operations that make up the Plan. Plan Year. Commencing on the first day of the Plan year as specified in the Plan Application and each anniversary thereof, except that the first Plan year may include a period of fewer than twelve (12) consecutive months. Q-ualifyingIndividual. As provided in Code Section 21 (b)(1): (a) a Participant's dependent who is under age 13, and who, with respect to the Participant is entitled to an exemption under Section 151(e) of the Code; (b) A dependent or spouse of a Participant who is physically or mentally incapable of caring for themselves. Article IV Administration 4.01 Plan Administrator. The Plan Administrator is the employer. The employer may appoint a representative or agent to carry out the administration of the Plan. The administration of the Plan shall be under the supervision of the Administrator or the appointed representative. It shall be a principal duty of the Administrator to see that the Plan is carried out, in accordance with its terms, for the exclusive benefit of persons entitled to participate in the Plan. 4.02 Al2 Pointed Agent or Representative. The agent or representative who will carry out the terms of the Plan in accordance with this Plan Document at the direction of the administrator. 4.03 Named Fiduciary. The administrator is the Named Fiduciary and under no circumstance shall any other person or entity be the Named Fiduciary under the Plan. 4.04 Powers and Duties. The Administrator shall have the power and duty to do all things necessary or convenient to affect the intent and purpose of this Plan that are not inconsistent with any of the provisions hereof, whether or not such powers and duties are specifically set forth herein. Not in limitation, but in amplification of the foregoing, the Employer shall have power to: (a) Provide rules and regulations for the administration of the Plan, and from time to time, amend or supplement such rules and regulations. (b) Construe the provisions of the Plan; such construction shall be final and binding. (c) Correct any defect, supply any omission, or reconcile any inconsistency in the Plan in such a manner and to such extent as it shall be deemed expedient to administer the Plan. (d) Determine all questions that may arise under the Plan including questions submitted by a Participant. (e) The Plan Administrator shall perform the duties and exercise the powers and discretion given to it in this section, and its decision and actions shall be final and conclusive as to all persons affected therein. (f) Any and all disputes which may arise involving Participants, Former Participants, or Beneficiaries shall be referred to the Plan Administrator. 4.05 Facility of Payment. Whenever, in the administrator's opinion, a Participant, who is entitled to receive any payment of benefit hereunder, is under legal disability or is incapacitated in any way so as to be unable to manage his or her personal financial affairs, the administrator may make payments to the Participants legal representative, relative or for the benefit of such Participant in such manner as the administrator considers advisable. Any such payment of a benefit or installment thereof in accordance with the provisions of this document shall be a complete discharge of any liability for the making of such payment under the provisions of the Plan. 4.06 Information to be Furnished. Participants shall provide the company and Administrator with such information and evidence, and shall sign such documents, as may be requested reasonably from time to time for the purpose of administering the Plan. 4.07 Reasonable Care. The Administrator shall use reasonable care and diligence in the exercise of its powers and the performance of its duties hereunder. 4.08 Indemnification for the Administrator and /or its Representative. The Administrator and /or its representative shall be indemnified by the employee against any and all liabilities arising by reason of any act or failure to act in good faith pursuant to the provisions of the Plan, including expenses reasonably incurred in the defense of any claim relating thereto. 4.09 Reporting Requirements. The administrator or agent shall file such forms as required by law to maintain this Plan in compliance with applicable statutes, rules and regulations, including, but not limited to, the Internal Revenue Service Form 5500. The Plan Sponsor further agrees that if it creates, receives, maintains, or transmit any electronic PHI (other than enrollment /disenrollment information and Summary Health Information, which are not subject to these restrictions) on behalf of the covered entity, it will implement administrative, physical and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of the electronic PHI, and it will ensure that any agents (including subcontractors) to whom it provides such electronic PHI agrees to implement reasonable and appropriate security measures to protect the information. The Plan Sponsor will report to the Plan an security incident of which it becomes aware. Article V Eligibility and Participation 5.01 Eligibility Requirements. Each employee is eligible to participate in this Plan if they meet the eligibility requirements as set forth in the Plan Application. The Plan Application's eligibility requirements may be established individually, but not in excess of the following parameters: O Part -time employees working less than a maximum of 30 hours. O Seasonal employees working less than a maximum of 6 months. O Employees under a maximum age of 21. O New employees not working a maximum of 24 months. O Current employees not working a maximum of 24 months. O Employees of a collective bargaining unit. 5.02 Current Employees at the time of Plan inception. At the time of Plan adoption, all employees who meet the eligibility requirements may participate. 5.03 New Employees. New employees engaged for employment after Plan adoption, who meet the eligibility requirements, may participate in the Plan the next following entry date as indicated in the Plan Application. 5.04 Re- employment of Former Employees. Unless otherwise indicated in the Summary Plan Description or Plan Application, a re- employed former employee may become a Participant immediately upon re -hire by complying with the application requirements set forth in Section 5.05, below. A re- employed former employee that has been rehired within thirty (30) days of termination will be automatically reinstated into their original elections. A former employee rehired more than thirty (30) days after termination may make new benefit elections. 5.05 Application for Participation. To become a Participant, an eligible employee shall sign any application or agreements as may be required by the Administrator and shall specify his or her election of salary reduction benefits within a reasonable time after his /her entry date. By signing such applications, the eligible employee shall be deemed for all purposes to have agreed to participate and to conform to the Plan requirements. An eligible employee, electing to participate in the Plan, is choosing to participate for the entire Plan year. The annualized sum of salary reduction benefit elections shall constitute a current obligation of the employee to the employer. Such obligation may be periodically reduced under the terms set forth in the salary reduction agreement. 5.06 Notification of Participation. The employer shall provide each employee written notice, by a means chosen by the Administrator, of his or her eligibility to participate in the Plan in sufficient time to enable such employee to submit an application for participation in the Plan on or before the date on which he or she becomes an eligible employee. 5.07 Determination of Eligibility The Administrator shall determine each employee's eligibility for participation in the Plan based on information furnished, and such determination shall be conclusive and binding upon all persons. 5.08 Notification to Employees. The employer will communicate (in writing) to all Participants the terms and conditions of this Plan through a Summary Plan Description and other administrative communications. 5.09 Termination of Participation. A Participant will automatically cease to be a Participant on the earliest of the following dates: (a) the date on which the Plan terminates, (b) the end of the Plan year, unless the Participant makes another election to receive benefits under the Plan for the next Plan year, (c) the date on which he or she fails to pay any required premium (including payment by salary reduction), (d) the date on which the Participant's employment with Plan Sponsor is terminated, whether termination is initiated by the Participant or the Plan Sponsor. Unless the Summary Plan Description provides otherwise, Terminated Participants will be able to submit claims against any positive account balance in accordance with Plan requirements through the Terminated Participants eligibility end date. The employer will indicate at the time of termination whether or not qualified expenses include those that incurred prior to date of termination or whether they can include expenses that incurred within the Plan Year. Notwithstanding anything to the contrary herein, this Section 5.09 and /or the Summary Plan Description shall not be construed to limit any continuation coverage required and properly elected by a Terminated Participant pursuant to COBRA (or similar state law continuation coverage). 5.10 Layoff Leave of Absences and Sabbaticals. Continuation under the Plan may occur in one of the following ways: 1. In the case of a planned layoff, an employee may be able to pre -fund his /her FSA for the period in which he /she is off through the end of the Plan Year. 2. During the period which the employee is off and receiving a salary, the pre -tax deductions may continue. If the employee is not receiving a salary, he or she may continue to fund his /her FSA with after -tax dollars while on leave. (Payment schedule to be agreed upon between the employer and employee prior to the commencement of the leave.) 3. The employer carries the employee while on leave and then recovers contributions upon the employee's return. 5.11 Family Medical Leave Act. A period in which an employee is off due to the Family Medical Leave Act shall be treated in accordance with the rules for a layoff or a leave of absence and provided to the extent required by the FMLA (e.g., the employer will continue to pay its share of the contribution to the extent you opt to continue coverage). If the employer is subject to the FMLA, a Participant may revoke or continue an election through the Plan upon commencement of the FMLA Leave, whether such leave is paid or unpaid. This provision applies in addition to any other right to revoke and reelect benefits under the Plan. Upon return from FMLA Leave, a Participant may be reinstated to all pre -leave elections. 5.12 Uniformed Services Employment and Reemployment ent Rights Act (USERRA). The Plan Administrator shall permit Participants to continue benefit elections as required under the Uniformed Services Employment and Reemployment Rights Act and shall pro- vide such reinstatement rights as required by such law. The Plan Administrator shall also permit Participants to continue benefit elec tions as required under any other applicable state law to the extent that such law is not pre - empted by federal law. 5.13 Qualified Reservist Distribution. A Participant may elect to receive a Qualified Reservist Distribution of all or a portion of the unused balance in his or her.individual Plan account subject to the requirements of Code Section 125(h) and the applicable regula- tions thereunder. 5.14 Effect of Disability. A Participant who. suffers a disability shall remain a Participant until the end -of the Plan year in which such disability commences. 5.15 Effect of Participant Death. When a Participant suffers death their Plan contributions for qualified medical expenses will be paid to their estate. Any monies left over will be returned to the employer. 5.16 Run Out Period. The Plan allows Participants to access account balances remaining at the end of the Plan Year to pay for expenses incurred during the previous Plan Year. Unless otherwise indicated by the employer, the run out period will last 90 days. Any amounts remaining at the end of the run out period will be forfeited to the employer. 5.17 Grace Period. At the employer's discretion, a grace period may be offered under the Plan. The Plan may allow Participants to access account balances remaining at the end of the year to pay or reimburse expenses for qualified benefits (such as health FSA or DCAP expenses) incurred during a grace period" of up to two- and-a-half- months (two months plus 15 days) after the close of a Plan Year. Besides including expenses incurred during the grace period, expenses incurred during the Plan Year may continue to be sub- mitted for reimbursement as well. At the employer's discretion, the grace period may be less than the two -and- a-half- months, but cannot be any longer. The Plan Sponsor will ensure that the provisions of this Section are supported by reasonable and appropriate security measures to the extent that the designees have access to electronic PHI. The Grace Period, if any, under the Plan is not applicable to terminated Participants with an eligibility end date occurring prior to the last day of the Plan Year. Terminated Partici- pants with an eligibility end date that is the same as the last day of the Plan Year will be eligible to submit claims in accordance with Section 5.09 during any Grace Period available under the Plan. Article VI Election of Available Benefits 6.01 Available Benefits. The benefits offered under this Plan shall consist of one or more of the following benefits: 1. Medical or Medical- related Premium Benefit (Code Sections 105 and 106) 2. Medical or Medical- related Expense Reimbursement Benefit (Code Section 105) 3. Term Life (Code Section 79) 4. Dependent Care (Code Section 129) 5. Disability Income Benefit (Code Section 105) 6. Health Savings Accounts (Code Section 223) The benefits chosen for the Plan are identified in the employer's Plan Application. 10 6.02 Election Amounts and Procedures. Each Participant shall elect any combination of the benefits made available pursuant to the Plan Application. No Participant may choose available benefits costing more than the maximum amount, if any, as indicated in the Maximum Limitations for such benefit. The Administrator may establish a maximum limitation which may be different than the limitation set forth in this Plan Document. This election must be made prior to the commencement of each Plan year by each Participant, and shall be irrevocable except as provided for in a qualifying event that would allow an election change. 6.03 Failure to Elect. A Participant failing to return a completed enrollment form to the administrator on or before the specified due date for the initial Plan year of the Plan, or for the Plan year in which he or she becomes a Participant, shall be deemed to have elected to receive his full compensation in cash. 6.04 Effective Periods for Elections. Participants may not carry over any unused employer contributions or available benefits from one Plan year to a subsequent Plan year. Further, Participants may not use any employer contributions from one Plan year to purchase any available benefits that will be provided in a subsequent Plan year. 6.05 Change in Family Status. A Participant may not change an election of any available benefit after the start of the Plan year nor make a new election with respect to the remainder of the Plan year unless the following circumstances occur. The differing events are based on the particular benefit. Notwithstanding anything in this Section to the contrary, the gain of eligibility or change in eligibility of a child up to the end of the year in which a child attains age 26, as allowed under Code Sections 105(b) and 106 and IRS Notice 2010- 38, shall qualify as a change in status. The following changes in status apply to health and term life insurance as well as to the dependent care and medical flexible spending account: Change in an employees legal marital status — this includes marriage, divorce, death of spouse, legal separation and annulment. Change in number of dependents — this includes birth, adoption, placement for adoption, and death. Change in employment status — if any of the following events change the employment status of employee, the employee's spouse or the employees dependent would qualify: a termination or commencement of employment; a strike or lockout; a commencement of or return from an unpaid leave of absence; and a change in worksite. In addition, if the eligibility conditions of the Cafeteria Plan or other employee benefit plan of the employer or the employee, spouse, or dependant depend on the employment status of that individual, and there is a change in that individual's employment status with the consequence that the individual becomes (or ceases to be) eligible under the Plan, then that change constitutes a change in employment under this paragraph. For example, if a Plan applies only to salaried employees and an employee switches from salaried to hourly paid, with the consequence that the employee ceases to be eligible for the Plan, then that change constitutes a change in employment status. Dependent satisfies or ceases to satisfy eligibility requirements — events that cause an employee's dependents to satisfy or cease to satisfy eligibility requirements for coverage on account of attainment of age, student status, or any similar circumstances. Residence — a change in the place of residence of the employee, spouse, or dependent. The following events also apply to the above benefits: 6. HIPAA Special Enrollment Rights — a change may be made if an employee has a right to enroll in an employer's group health plan; or to add coverage for a family member under HIPAA, the employee may make a conforming election under the Cafeteria Plan, 7. Judgement, Decree or Order — a change may be made as a result of a judgement, decree or order resulting from a divorce, annulment, or legal separation, including a qualified medical child support order (QMCSO). 8. Entitlement to Medicare or Medicaid — a change may be made as a result of Medicaid and Medicare entitlement. 9. COBRA — a change may be made if a COBRA event (or similar state law continuation coverage event) occurs with respect to the employee, the employee's spouse, or a dependent. 10. A leave of absence under the Family Medical Leave Act. The following events relating to a change in cost or change in coverage allow a change in Plan election for all benefits under the Cafeteria Plan, with the exception of the health flexible spending account. Changes in Cost The Plan allows for an automatic election change that corresponds to an increase or decrease in the cost of the coverage. Moreover, if there is a significant cost increase, a Plan may allow participants to make a corresponding election increase or to elect alternative coverage. Change in Coverage Significant Curtailment — if the coverage under a Plan is significantly curtailed or ceases during a period of coverage, the Cafeteria Plan may permit affected employees to revoke their elections under the Plan and to make a new election for coverage under another benefit package option providing similar coverage. Coverage under a Plan is significantly curtailed only if there is an overall reduction in coverage provided to participants under the Plan so as to constitute reduced coverage to participants. Addition to or elimination of benefit package — if during a period of coverage a Plan adds a new benefit package option or other coverage option (or eliminates an existing benefit package option or other coverage option), the Cafeteria Plan may permit affected employees to elect the newly added option (or elect another option if an option has been eliminated) prospectively on a pre -tax basis, and to make corresponding election changes with respect to other benefit package options providing similar coverage. Change in coverage of spouse or dependent under other employer's plan — a Cafeteria Plan may permit an employee to make a prospective election change that is on account of and corresponds to a change made under the plan of the spouse's, former spouses or dependent's employer if (1) a Cafeteria Plan or qualified benefits plan of the spouse's, former spouses, or dependent's employer permits participants to make an election change that would be permitted under the proposed and final regulations; or (2) the Cafeteria Plan permits participants to make an election for a period of coverage that is different from the period of coverage under the Cafeteria Plan or qualified benefits plan of the spouses, former spouses, or dependent's employer. Consistency Rule (applicable to all events except 6 -10) — The election change must be on account of and correspond to a change in the status that affects eligibility for coverage under an employer's plan. An exception to this rule is that an impact on eligibility is not required for marital status or employment status events to support election changes for group term life insurance or long term disability coverage. 6.06 Prohibited Deposits. Participants shall not be permitted to deposit their own after -tax dollars into their accounts except as specifically provided herein. 6.07 Forfeitures. If a Participant fails or is unable to fully utilize a benefit during the Plan year, unused benefit election dollars will be forfeited by the Participant to the employer. 6.08 Non- Discrimination. A. Benefits payable under the Plan to each Highly Compensated Participant or Highly Compensated individual shall be limited to the extent necessary to avoid violating Code section 125(b)(1). B. Benefits payable under the Plan to each key employee, as defined in Code section 416(i)(1), are limited to the extent necessary to avoid violating Code section 125(b)(2). Article VII Contributions 7.01 Employer Contributions. In addition to direct salary reduction contributions, employer contributions shall include the amount which the employer is contributing to the Plan or a select benefit. 7.02 Employee Salary Reductions. The Participant shall agree to reduce his /her compensation from the employer by such amounts as are necessary to provide for those salary reduction benefits which the Participant has elected. "Employee" salary reduction amounts are "employer" contributions for purposes of Internal Revenue Code Section 125 and its applicable regulations. No Participant shall have, by virtue of the Plan, any interest in any specific asset or assets of the Employer. A Participant has only an unsecured contractual right to receive payments in accordance with the Plan. 7.03 Contributions. All agreed contributions will be considered to be contributed for the entire Plan year and shall be made available at any time, per the Participants request, in compliance to the Uniform Coverage Rule (if applicable) to such available and elected benefits pursuant to the Regulations located under Code Section 125. 7.04 Interest. No interest will be credited or paid to or for a Participants benefit account balances unless otherwise indicated by the Administrator. 7.05 Plan Assets. The employer and employee contributions are considered assets of the employer. They are not considered to be the assets of TASC. Assets (Plan contributions) are owned proportionately by each employer under the administration of TASC. 12 Article VIII Medical or Medical- Related Premium Benefit and Premium Reimbursement Benefit 8.01 Pu ose. This benefit provides for non - discriminatory payments, or reimbursements, by the employer for Participants' medical or medical related premiums to the extent provided on the enrollment form. 8.02 Intent. This benefit is intended to comply with the provisions of the Internal Revenue Code, Sections 105 and 106, and therefore will be deemed to be automatically amended to comply with all appropriate regulations to these parts, issued by any appropriate government agency as of the effective date of each such regulation, unless the employer instead elects to terminate the Plan following issuance of new or amended regulations. This benefit is to include medical or medical - related premiums for a group- sponsored health plan or individual health plan and shall include costs of medical and hospitalization insurance, major medical insurance, dental insurance and /or vision insurance. 8.03 Maximum Limitations. If any maximum limitation applies, it shall be set forth in the Plan Application. 8.04 Claim Procedure. A. Group- Sponsored Health Plan The employer will pay directly to the appropriate billing entity the group medical premiums due on behalf of the employee. Administratively, this payment shall be construed as: 1. A reduction of income from the employee, and 2. A payment made by the employer to an insurance company or appropriate billing entity. B. Individual Health Insurance Premiums Premiums for individual policies, which are not otherwise Employer- sponsored, may be paid or reimbursed by the Employer in one of three ways: (a) by reimbursing the Participant directly in the amount of the substantiated premium; (b) by issuing a check payable to the insurer for the amount of the premium, which the Participant must tender to the insurer; or (c) by issuing a check payable jointly to the insurer and the Participant for the amount of the premium. Article IX Medical or Medical - Related Expense Reimbursement Benefit 9.01 Purpose. This benefit provides non - discriminatory payments by the employer to reimburse Participants for medical or medical - related expenses via a Flexible Spending Arrangement implemented through a salary reduction agreement. 9.02 Intent. This benefit is intended to comply with the provisions of the Internal Revenue Code Section 105 and, therefore will be deemed to be automatically amended to comply with all appropriate regulations to these parts, issued by any appropriate government agency as of the effective date of each such regulation, unless the employer instead elects to terminate the Plan following issuance of new or amended regulations. The employer shall reimburse each Participant for all expenses incurred for medical care (as defined in Code Section 213(d)) by said Participant, and by Participant's spouse and Dependents. 9.03 Maximum Limitations. If any maximum limitation applies, it shall be set forth in the Plan Application, and such amount shall be available for reimbursement throughout the Plan Year during which the employee is participating. 9.04 Claims Procedure, The Participant need not pay an expense prior to being reimbursed. The Participant shall provide such information and verification at such rimes and in such manner as required by the Administrator. Reimbursement or payment of these benefits shall be made by the employer in the event and to the extent that such reimbursement or payment is: (1) not provided for under any insurance policy, whether the premium on such policy is paid by the employer or the individual Participant, and (2) not provided for or reimbursable under any other Plan or policy. Finally, the Employer will not pay the applicable amounts directly to the service provider in lieu of reimbursement to the Participant unless otherwise indicated by the employer. 9.05 Continuation of Coverage (COBRAS This benefit is subject to COBRA. 13 9.06 Health Insurance Portability and Accountability Act ( HIPAA). HIPAA restricts the Plan Sponsor's ability to use and disclose protected health information. PHI is defined as information that is created or received by the Plan and relates to the past, present or future physical or mental health or condition of a Participant; the provision of health care to a Participant or the past, present, or future payment for the provision of health care to a Participant; and that identifies the Participant or for which there is a reasonable basis to believe the information of persons living or deceased. The Plan Sponsor shall have access to PHI from the Plan only as permitted under this plan or as otherwise required or permitted by HIPAA. I. The Plan may disclose to the Plan Sponsor information on whether the individual is participating in the Plan or is enrolled in or has dis- enrolled from a health insurance issuer or HMO offered by the Plan. II. The Plan may disclose Summary Health Information to the Plan Sponsor, provided the Plan Sponsor request the Summary Health Information for the purpose of (a) obtaining premium bids from health plans for providing health insurance coverage under the Plan; or (b) modifying, amending, or terminating the Plan. Summary Health Information means: information that (a) summarizes the claims history, claims expenses, or type of claims experienced by individuals for whom a Plan sponsor had provided health benefits under a Health Plan; and (b) from which the information described at 42 CFR Section 164.514(b)(2)(i) has been deleted, except that the geographic information described in 42 CFR Section 164- 514(b)(2)(i)(B) need be aggregated only to the level of a five digit zip code. III. Unless otherwise permitted by law, and subject to the conditions of disclosure described in paragraph IV and obtaining written certification pursuant to paragraph VI, the Plan may disclose PHI to the Plan Sponsor, provided the Plan Sponsor uses or discloses such PHI for administrative purposes only. Administration purposes means administration functions performed by the Plan Sponsor on behalf of the Plan, such as quality assurance, claims processing, auditing, and monitoring. Plan administration functions do not include functions performed by the Plan Sponsor in connection with any other benefit or benefit plan of the Plan Sponsor, and they do not include any employment related functions. Notwithstanding the provisions of this Plan to the contrary, in no event shall the Plan Sponsor be permitted to use or disclose PHI in a manner that is inconsistent with 45 CFR Section 164.504(f). IV. Plan sponsor agrees that with respect to any PHI disclosed to it by the Plan, the Plan Sponsor shall: (a) Not use or further disclose the PHI other than as permitted or required by the Plan or as required by law. (b) Ensure that any agent, including a subcontractor, to whom it provides PHI received from the Plan agrees to the same restrictions and conditions that apply to the Plan Sponsor with respect to PHI. (c) Not use or disclose the PHI for employment related actions and decisions or in connection with any other benefit or employee benefit plan of the Plan Sponsor. (d) Report to the Plan any use or disclosure of the information that is inconsistent with the uses or disclosures provided for of which it becomes aware. (e) Make available PHI to comply with HIPAAs right to access in accordance with 45 CFR Section 164 -524. (f) Make available PHI for amendment and incorporate any amendments to PHI in accordance with 45 CFR Section 164.526 (g) Make available the information required to provide an accounting of disclosures in accordance with 45 CFR Section 164 -528. (h) Make its internal practices, books and records relating to the use and disclosure of PHI received from the Plan available to the Secretary of Health and Human Services for purposes of determining compliance by the Plan with HIPAAs privacy requirements. (i) If feasible, return or destroy all PHI received from the Plan that the Plan Sponsor still maintains in any form and return no copies of such information when no longer needed for the purpose for which disclosures was made, except that, if such return or destruction is not feasible, limit further uses and disclosures to those purposes that make the return or destruction of the information infeasible. (j) Ensure that the adequate separation between the Plan and the Plan Sponsor required in 45 CFR Section 504(f)(2)(iii), is satisfied. Plan Sponsor further agrees that if it creates, receives, maintains, or transmits any Electronic PHI (other than enrollment/ disenrollment information) on behalf of the Plan, it will: (k) Implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the Electronic PHI that it creates, receives, maintains or transmits on behalf o the Plan; (1) Ensure that the adequate separation between the Plan and Plan Sponsor (I.e. the firewall), required by 45 CFR Section 504(f)(2)(iii) is supported by reasonable and appropriate security measures; 14 (m) Ensure that any agent, including a subcontractor, to whom it provides Electronic PHI agrees to implement reasonable and appropriate security measure to protect the information; and (n) Report to the Plan any security incident of which it becomes aware, as follows: Plan Sponsor will report to the Plan, with such frequency and at such times are agreed, the aggregate number of unsuccessful, unauthorized attempts to access, use, disclose, modify, or destroy Electronic PHI or to interfere with systems operations in an information system containing Electronic PHI; in addition, Plan Sponsor will report to the Plan as soon as feasible any successful unauthorized access, use, disclosure, modification, or destruction of Electronic PHI or interference with systems operations in any information system containing Electronic PHI. U The Plan Sponsor shall allow those employees identified as needing access to PHI to have access to the PHI. No other persons shall have access to PHI. These specified employees or classes of employees shall have access to and use PHI only to the extent necessary to perform the Plan administration functions that the Plan Sponsor performs for the Plan. In the event that any of these specified employees fail to comply with the provisions of this section, said employee shall be subject to discipline and termination procedures. 9.07 Employee Retirement Income Security Act (FRIBA). The Health Flexible Spending Account is defined as a welfare benefit plan subject to the ERISA Reporting requirements. Summary Plan Description — The SPD informs the employees of their rights under the Plan. It must be provided to all Participants of all welfare benefit plans, regardless of size. New Participants must receive the SPD within 90 days of becoming Participants or of receiving benefits. Summary of Material Modification — The SMM informs the employees of any changes to the Plan. Participants must receive a SMM reflecting any such changes. However, a SMM is not required if a change is described in the SPD and is redistributed. Summary Annual Report — A SAR is the highlight of the financial information detailed on Form 5500. The SAR is to be distributed to Plan Participants within nine months following the end of the Plan year. Unfunded plans with fewer than 100 participants at the beginning of the Plan year are exempt from the SAR distribution rules. Form 5500 — Form 5500 is required under ERISA Section 104, applicable to welfare benefit plans. Unfunded plans with fewer than 100 participants are exempt from the filing requirement if Plan assets are not held in trust. Article X Dependent Care Benefit 10.01 Pur ose. This benefit provides non - discriminatory payment by the employer to reimburse Participants for dependent care assistance via a Flexible Spending Arrangement implemented through a salary reduction agreement. 10.02 Intent. This benefit is intended to comply with the provisions of the Internal Revenue Code Section 129 and, therefore will be deemed to be automatically amended to comply with all appropriate regulations to these parts, issued by any appropriate government agency as of the effective date of each such regulation, unless the employer instead elects to terminate the Plan following issuance of new or amended regulations. 10.03 Maximum Limitations. The maximum amount which the Participant may receive in any Plan Year in the form of dependent care assistance under this Plan shall be the lessor of (a) the Participant's earned income for the Plan Year (after all reductions in compensation including the reduction related to dependent care assistance), or (b) the actual, dual, or deemed earned income of the Participants spouse for the Plan Year, but shall in no event exceed $5,000 for taxable years beginning after December 31, 1986. In the case of a spouse who is a full -time student at an educational institution or is physically or mentally incapable of caring for himself /herself, such spouse shall be deemed to have earned income of not less than $250 per month if the Participant has one dependent and $500 per month if the Participant has two or more dependents. A married individual who files a separate income tax return shall be further restricted to $2500.00. Dependent care benefits may not be claimed by the Participant as a dependent care tax credit. 10.04 Dependent Care Expenses. Dependent care expenses include expenses incurred by a Participant which are (a) incurred for the care of a dependent of the Participant, (b) paid or payable to a dependent care service provider, and (c) incurred to enable the Participant to be gainfully employed for any period for which there are one or more dependents with respect to the Participant. Dependent care expenses shall be deemed to be incurred at the time the service for which the related expenses are rendered. 15 10.05 Dependent Care Service Provider. This term means a person who provides care or other services and shall include a qualified dependent care center and an individual who is not related to the Participant as described in Section 129(c) of the Internal Revenue Code. 10.06 Claim Procedure. The Participant need not actually pay an expense prior to being reimbursed. 'Ihe Participant shall provide such information and verification at such times and in such manner as required by the Administrator. The employer will not pay such dependent care assistance directly to the service provider in lieu of reimbursement to the Participant unless otherwise indicated by the employer. Article XI Group Term Life Insurance Benefit 11.01 Purpose. This benefit provides non - discriminatory group term life insurance to Participants. 11.02 Intent. This benefit is intended to comply with the provisions of the Internal Revenue Code, Section 79, and therefore is deemed to be automatically amended to comply with all appropriate regulations to these parts, issued by an appropriate government agency as of the effective date of each such regulation, unless the employer instead elects to terminate the Plan following issuance of new or amended regulations. This benefit is to include employer- sponsored insurance or individual term life insurance policies. 11.03 Maximum Limitations. Any maximum limitation relating to the insurance premium will be established in the Plan Application. The benefit of the term life policy may not exceed $50,000. 11.04 Claim Procedure. A. Group - Sponsored Term Life The employer will pay directly to the appropriate billing entity the group medical premiums due on behalf of the employee. Administratively, this payment shall be construed as: 1. A reduction of income from the employee, and 2. A payment made by the employer to an insurance company or appropriate billing entity. B. Individual Term Life Insurance Premium An individual policy, which is not otherwise employer- sponsored, may be reimbursed to the employee. Article XII Disability Income Benefit 12.01 Pu ose. This benefit provides non - discriminatory disability income insurance benefits designed to provide income to Participants during periods of absence from employment because of personal injury or sickness. 12.02 Intention. It is the intention of the employer that the premiums paid for these benefits shall be eligible for exclusion from the gross income of the Participant covered by this benefit, as provided in Code Section 104 and Section 105, and all provisions of this Plan shall be construed in a manner consistent with that intention. Any benefits received from such disability policy, with respect to the premium paid and thus excluded from the Participant's gross income, will be taxable income. 12.03 Maximum Limitations. If any maximum limitations apply, they shall be set forth in the Plan Application. 12.04 Claim Procedure. A. Group- Sponsored Disability Plan The employer will pay directly to the appropriate billing entity the group premiums due on behalf of the employee. Administratively, this payment shall be construed as: 1. A reduction of income from the employee, and 2. A payment made by the employer to an insurance company or appropriate billing entity. 16 B. Individual Disability Plan An individual policy, which is not otherwise employer- sponsored, may be reimbursed to the employee. Article X111 Health Savings Account 13.01 Purpose. This benefit provides non - discriminatory benefits by the employer to reimburse Participants for medical or medical related expenses via a Health Savings Account implemented through a salary reduction agreement or employer contributed. 13.02 Intent. This benefit is intended to comply with the provisions of Section 223 of the Internal Revenue Code and, therefore will be deemed to be automatically amended to comply with all appropriate regulations to these parts, issued by any appropriate government agency as of the effective date of each such regulation, unless the employer instead elects to terminate the Plan following issuance of new or amended regulations. This benefit may be offered under a Section 125 Cafeteria, however is not governed by the other rules applicable to benefits offered under a Cafeteria Plan. It is also the intent that this benefit abides by any rules required by the trustee or custodian holding the account. 13.03 Maximum Limitation. Any benefit limitations that may be applicable are identified in Section 223 of the Internal Revenue Code and will be followed accordingly. 13.04 Trustee and /or Custodian. The Plan Participant will identify a designated trustee or custodian. If a trustee or custodian is not selected, one will be assigned and will hold all HSA contributions. 13.05 Claim Procedure. Claims and reporting procedures will be provided by the identified trustee or custodian. 13.06 Other Coverages. It will be the Participant's responsibility to assure that any other coverages will qualify as permitted coverages pursuant to Section 223 of the Internal Revenue Code. If there is a health Flexible Spending Account (FSA) in addition to the Health Savings Account, the FSA will be a limited purpose FSA. 13.07 HSA Transfer. If elected by the employer, the health Flexible Spending Account may allow for a qualified HSA distribution. Article XIV Claims 14.01 When to File. Claims should be filed as soon as reasonably possible after the Participant or eligible dependent incurs an eligible expense. 14.02 How to File. The "Request for Reimbursement' form or similar form should be completed for all claims submitted. The completed and signed form(s) should then be sent to the Administrator for processing. 14.03 Information for Claim. Evidence of an incurred expense must accompany the request for reimbursement to the extent required by the Administrator. The expense must meet specific requirements, including the date the expense was incurred, in order to confirm the expense was incurred during the current Plan Year. Said expense is not reimbursable if it has been reimbursed from an insurance company. The Participants must insure that these requirements are met. The Plan Administrator may require the Participant to provide additional information and complete appropriate documents or forms necessary for the proper administration of the claim. 14.04 Payment. After reviewing the request, the Administrator shall issue benefit payment, if appropriate, to the Plan Participant. The time frame in which this is done is at the Administrator's discretion. 14.05 Coordination of Benefits. The Participant must make certain that claimed expenses have not been previously reimbursed by any other benefit Plan nor claimed as a tax deduction. Additionally, if there is a Health Reimbursement Arrangement in addition to the health Flexible Spending Account, and they reimburse the same medical expenses, the HRA must be depleted first before any funds can be drawn from the FSA unless the employer chooses to deplete the FSA first. 14.06 Denial Procedure. The Administrator will provide adequate notice in writing to any Participant or beneficiary whose claim for benefits under the Plan has been denied, setting forth the specific reasons for such denial. The Participant or beneficiary will be given an opportunity for a full and fair review of the denial decision. The Participant or beneficiary will be given a reasonable time from the 17 date of the notice of denial of such claim in which to request such review. Article XV Records and Reports 15.01 Responsibility. The Administrator shall exercise authority and responsibility to comply with the Plan relating to Participant records, balances, and benefits payable under this Plan. The Administrator shall also be responsible for all Plan reporting and disclosure requirements. 15.02 Records. The Administrator will process claims and maintain Participant account records, which shall record "deposits" and check "balances" prior to each reimbursement. An information report will be provided periodically to. Plan Participants showing previous balances, deposits, payments, reimbursements, and current balances. 15.03 Examination of Records. The Administrator will make each Participant's records under the Plan available for his /her examination at reasonable times and during normal business hours. Article XVI Plan Termination 16.01 Plan Termination, The Plan or any portion of the Plan shall be subject to termination at any time by the employer, provided however, that such termination shall not affect any right or claim arising under the Plan prior to termination. Any unclaimed funds shall become payable as the Administrator may direct. Such direction may include, but not be limited to: (a) A continuation of the Plan in order to pay balances in accordance with elected benefits, or (b) A distribution of the Participant balances subject to the Plan. 16.02 Employer Rights to Terminate. In accordance with the procedures set forth in this section, the employer may terminate the Plan at any time. In the event of a dissolution, merger consolidation, or reorganization of the employer, the Plan shall terminate unless the Plan is continued by a successor to the employer in accordance with the resolution of its Board of Directors. Article XVII Plan Construction 17.01 Taxation. The employer intends that this Plan be in compliance with Sections 79, 105, 106, 125 and 129 of the Internal Revenue Code, and therefore, the employer may deduct the amount paid for the benefits provided under Section 162 of the Code. Meanwhile, we note that this Plan has not been submitted to the Internal Revenue Service, and that there is no assurance that the intended tax benefit under this Plan will be realized. Neither the Administrator nor its designated representative makes any commitment or guarantee that any amounts elected or paid for the benefit of a Participant will be excludable from the Participant's gross income for federal or state income tax purposes, or that any other federal or state tax treatment will apply to or be available to any Participant. It shall be the obligation of each Participant to determine whether each payment is excludable from the Participant's gross income for federal and state income tax purposes, and to notify the employer if the Participant has reason to believe that any such payment is not so excludable. Any Participant, by accepting a benefit under this Plan, agrees to be liable for any tax penalties and interest which may be imposed by the Internal Revenue Service with respect to these benefits. 17.02 Adoption by Related Organizations. Upon the approval of the employer, this Plan may be adopted by any organization in affiliation with the employer. For the purpose of this Plan affiliated organizations are described in Section 414(6), (c) or (m) of the Internal Revenue Code. The adopting organizations shall execute and deliver to the employer a supplemental agreement providing for the adoption of this Plan and such other documents as the employer deems necessary or desirable. The provisions of this Plan shall be applicable to such organization to the extent provided in the supplemental agreement. 17.03 Uniform Exercise of Powers. In the exercise of any of its powers, duties and discretion under this Plan, and within the scope of its authority, and in all of its acts, decisions, and determinations hereunder, the employer shall at all times act in good faith and in a non- discriminatory manner and shall follow a consistent policy on comparable issues. All employer actions and determinations shall be duly recorded. All such recordsi together with such other documents as may be necessary for the administration of this Plan, shall be preserved. Decisions regarding any Employer - disputed questions relative to the rights of a Participant hereunder and upon all matters within the scope of its authority shall be final and binding on all parties in interest. 18 17.04 Construction. No provision of this Plan shall be construed to conflict with any Treasury Department, Department of Labor, or Internal Revenue Service Regulation, Ruling, Release, or Proposed Regulation or other order which affect, or could affect, the terms of the Plan. This Plan will be in compliance with any changes related to the Internal Revenue Code, ERISA, COBRA, and Department of Labor. 17.05 Entire Document. This document, including any appendices or supplements thereto, shall constitute the entire and complete document, and as such shall govern the rights, liabilities and obligations of the Plan, except as the Plan may be modified. 17.06 Controlling Law. This Agreement shall be construed and enforced according to the laws of the state of the employer's domicile, except to the extent such state laws are preempted by federal law. 17.07 Severability In the event any provisions of this document shall be held illegal or invalid for any reason by law or a court of competent jurisdiction, said illegality or invalidity shall not affect the remaining provisions included herein either initially, or beyond the date said provisions are first held to be illegal or invalid, provided the basic purposes hereof can be affected through the remaining valid and legal provisions. 17.08 Benefits Provided Through Third Parties. In the case of any benefit provided through a third party, such as an insurance company, pursuant to a contract or policy with such third party, if there is any conflict or inconsistency between the description of benefits contained in this Plan and such contract or policy the terms of such contract or policy shall control. 17.09 Rights Against the Emplo_yeer. Neither the establishment of the Plan, nor any modification thereof, nor any distribution hereunder, shall be construed as giving to any Participant or any person whomsoever any legal or equitable rights against the employer, its shareholders, directors, or officers, as such, or as giving any person the right to be retained in the employ of the employer. 17.10 Successor - Businesses. Unless this Plan be sooner terminated, a successor to the business of the employer, by whatever form or manner resulting, may continue this Plan by appropriate supplemental agreement. 19 Item 08 1 S C O s T � J S .� � IA (Y DISC2 1C 2 ... an Independent Specia[District Memorandum To: Board of Directors Via: Scott Carroll, General Manag From: Anna Sanchez, Administrative Service ManagerA� Date: September 20, 2012 Subject: Adopt Resolution 2012 -821 amending the District's Cafeteria Plan to comply with the 2010 Health Care Act Summary The Costa Mesa Sanitary District currently offers an Internal Revenue Code (IRC) Section 125 "Cafeteria Plan" to its employees. As required by IRC Section 125, all plan amendments must be adopted by the governing body by resolution. Staff Recommendation That the Board of Directors adopt Resolution 2012 -821 amending the District's Cafeteria Plan to comply with the 2010 Health Care Act. Analysis Under the 2010 Health Care Act, group health plans must make health coverage available for adult children until attainment of 26 years of age, whether or not the child is a dependent. Coverage can continue as long as the adult child has not reached the age of 27 as of the end of the tax year. Plan sponsors are required to amend Cafeteria Plan language to allow employees to make pre -tax salary reductions for such contributions. These amendments to the Cafeteria Plan document have been made. Additionally, staff has retained the services of Total Administrative Services Corporation (TASC), as a third party administrator for the District's Cafeteria Plan document. They have an extensive and active legal team available to update cafeteria plan documents so they Protecting our community's fieaft6 and the environment 6y providing solid waste and sewer coffection services. www.cnisdca.gov Board of Directors September 20, 2012 Paae 2 of 2 are compliant with current regulations. These updates will be made available to the District on a regular basis. Each update to the District's Cafeteria Plan must be adopted by the governing body by resolution., Strategic Plan Element & Goal This item complies with the objective and strategy of Strategic Element 5.0., Administrative Management, which states: "Objective: To create, maintain and implement policies and procedures to ensure sound management of the District. " "Strategy: We will conduct periodic reviews, refine and implement policies and procedures, and assure the General Manager has the direction and tools necessary for successful District operations." Legal Review The resolution was reviewed by Liebert Cassidy Whitmore, the law firm the District currently seeks advisement from for personnel related matters. Liebert Cassidy Whitmore is a leading law firm with offices based in southern California that specializes in public sector employment law. Financial Review The cost for a third party administrator to continuously update the District's cafeteria plan document is estimated at $300 annually. The District has budgeted adequate funds for this expense in the legal expense account. . Public Notice Process Copies of this report are on file and will be included with the entire agenda packet for the September 20, 2012 Board of Directors meeting at District Headquarters and on District website. Reviewed by: Teresa Gonzalez Accounting Manager Attachment: Resolution 2012 -821 Cafeteria Plan Document Summary Plan Description