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<br />City of Arden Hills <br /> <br />Summarv Plan Description <br /> <br />SUMMARY OF ADMINISTRATIVE INFORMATION <br /> <br />. <br /> <br />Name of the Plan: <br />The name of the Plan is the City of Arden lIiIls Flexible Spending Accounts Plan. <br /> <br />Employer, Plan Sponsor and Plan Administrator: <br />City of Arden Hills <br />1245 West Hwy 96 <br />ArdenHiIls,MN 55112 <br />651-634-5125 <br /> <br />Employer I.D. Number: 41-6008992 <br /> <br />Plan Numbers: <br /> <br />Cafeteria Benefits Plan: 501 <br />Premium Conversion Plan: 502 <br />Health Care Expense Reimbursement Plan: 503 <br />Dependent Care Expense Reimbursement Plan: 504 <br /> <br />Type of Plan: <br />This Plan is commonly known as a "Cafeteria Plan," and it includes a Premium Conversion Plan, <br />a Health Care Expense Reimbursement Plan, and a Dependent Care Expense Reimbursement <br />Plan. <br /> <br />. <br /> <br />Type of Funding: <br /> <br />This Plan is funded by employec contributions made through salary reduction ("Pre-tax <br />Contributions") elections under the Plan. No health insurance issuer is responsible for the <br />financing or administration of the Plan. <br /> <br />Type of Administration: <br />Records are maintained by the Plan Sponsor. <br /> <br />Agent for Service of Legal Process: <br />Service may be made upon the Plan Administrator. <br /> <br />Requests for fuformation: <br /> <br />If you have any questions regarding your benefits, please contact the Assistant to the City <br />Administrator. AU requests, appeals, elections and other communications should be in writing <br />and should be hand delivered or sent by certified mail. <br /> <br />Plan Year: January I through December 31. <br /> <br />. <br /> <br />SPD-20 <br />