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<br />Citv of Arden Hills <br /> <br />Summary Plan Description <br /> <br />Consistency rule - the requested change must be consistent with the Status Change event. Generally, the . <br />Status Change event will result in an eligibility change for you, your spouse or dependent, and your <br />election may increase or decrease depending on the gain or loss of coverage that occurred. <br /> <br />For example, if a participant's spouse becomes unemployed, the participant can stop or reduce the rate of <br />additions to his or her dependent care reimbursement account. However, you may not stop or reduce <br />your health care reimbursement coverage. <br /> <br />Change in Cost or Coverage - Pre-tax Elections <br />If a cost increase is "significant," you may increase your Pre-tax Contribution election or revoke your <br />Pre-tax Contribution election and make a new election for coverage under a similar welfare benefit plan. <br />If your coverage is "significantly curtailed," you may revoke your ejection and make a new election for <br />coverage under a similar benefit plan. To meet the "significant curtailment" standard, there must be an <br />"overall reduction in coverage" resulting in reduced coverage to participants in general, not just you, <br />your spouse or dependent. If a new option is added or if an option is eliminated, you may make a new <br />election that corresponds to the change. <br /> <br />Change in Cost or Coverage - Dependent Care Reimbursement <br />Dependent care reimbursement elections can also be changed under the Change in Cost or Coverage rules <br />described abovc. This means that if your dependent carc provider changes its rates, you may modify <br />your dependcnt care account elections to conform to thc changc. Also, if you change providers and there <br />is a cost difference with the change, you may changc your elcction. (Note: where the dependent care <br />providcr is a family member, some rcstrictions apply.) Under fedcrallaw, hcalth care spending account <br />clcctions are not eligible for modification under the change in cost or covcrage rules. <br /> <br />Medicare or Medicaid Coverage <br />If you become eligible for Medicare or Medicaid coverage you may bc able to rcduce or stop your <br />Pre-tax Contribution amounts, if thc undcrlying hcalth care plan allows such a changc. If you lose <br />Medicare or Medicaid coverage, you may be ablc to begin or increase Pre-tax Contribution amounts, <br />again, ifthe hcalth carc plan allows you to begin or incrcase coverage. <br /> <br />. <br /> <br />Timing for Elcction Changes <br />Any such change in your clcction must be made using Employer designated forms or systems prior to or <br />after the Status Changc, but not later than 30 days after thc datc of the Status Change. Such a change will <br />generally be cffcctive as of the first day of the month after the Employer receives the form, or, if later, <br />the date the Status Change occurs. Please note that to be effective as of a Status Change, the Employer <br />must rcceive your form no later than the datc of the Status Change. <br /> <br />Automatic Changes <br />Thc Employer reserves the right to automatically initiate changes to your clcctions whcrc a significant <br />change in cost occurs or where the Plan is required to follow a judgment, dccree or order that mandates <br />coverage for your dependent. <br /> <br />Rehires <br />If you terminate employment and arc rchired within 30 days of your most rccent termination date, your <br />most rccent election amounts will be automatically reinstated. If you arc rehired more than 30 days after <br />your most recent tennination of employment you can make ncw Prc-tax Contribution elections as a new <br />hire. <br /> <br />. <br /> <br />SPD-8 <br />