CCP 12-13-2004 - Laserfiche WebLink

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Citv of Arden Hills Summary Plan DescriDtion For all other benefits, including health care reimbursement benefits, the Period of Coverage will . generally be the same as for dependent care reimbursement benefits. However, if you are no longer on the Employer's payroll and you stop paying for Ihese other benefits, your Period of Coverage will end early. For example, if you terminate employment or take anunpaidleave()f absence, your. Period oJ Coverage will cease as of the end of the last month for which you pay for coverage. (SEE eONTINUATION COVERAGE). If you take a "family or medical leave," you may beable to reinstate your health/dental coverage and health care reimbursement benefits. ThiswouldaffecLyoutperiodofCo'lerage for health care rein1bursement benefits (SEE LEAVES OF ABSENCES AND FAMILY ORMEDICAL LEAVES) g) PLAN - This Cily of Arden Hills Flexible Spending Accounts Plan, as may be amended from time to time. h) PLAN YEAR - The Plan Year is the calendar year. i) QUALIFYING INDIVIDUAL -- A participant's dependent who is under the age ofthirteen (13), and a participanl's spouse or dependent of any age who is physically or mentally incapable of caring for him or herself. j) STATUS CHANGE - Changes in status for which a benefit election change may be pcrrnitted includes change in legal marital status, change in the number of tax dependents, employment status . change for you, your spouse or dependent, a dependent satisfying or ceasing to satisfy eligibility requirements, a residence change by you, your spouse or dependent, a change in the cost or coverage for dependent care, a change in coverage due to your spouse or dependent's open enrollment or the beginning or ending of adoption proceedings for adoption benefits. Please note: the event must affect eligibility for benefits and the requested change to your election must be consistent with the event. WHAT TYPE OF PLAN IS THIS? This is a flexible benefit plan that pennits participants to choose among more than one benefit. It is classified as a "cafeteria plan" for federal income tax purposes. ELIGIBILITY WHEN CAN I PARTICIPATE IN THE PLAN? A newly Eligible Employee may elect to become a participant in the Plan on the date after he or she first becomes an Eligible Employee and satisfies the participation conditions. Eligible Employees who do not become participants when they first become eligible may become participants on the first day of a Plan Year, or under certain circumstances when a status change occurs. WHAT ARE THE CONDITIONS OF PARTICIPATION? As a condition to participate in the Plan and to receive reimbursement benefits under this Plan, you must: I. Execute and deliver to the Employer within 30 days of becoming eligible 10 participale in Ihe Plan an application to participate in the Plan and a benefit election form; . SPD-2