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PLAN ADMINISTRATION The Plan is a sponsor-administered plan, and the Employer is the Plan Administrator, whose address, business telephone number, and Employer ldentification Number are: City of Roseville 2660 Civic Center Drive Roseville, MN 55113 Telephone: (651) 792-7025 Employer ldentification Number: 41-6007849 The Employer (and persons to whom it has delegated powers, to the extent of such delegations) has total and complete authority to (1) determine conclusively for all parties all questions arising in the administration of the Plan, (2) interpret and construe the terms of the Plan, and (3) determine all questions of eligibility and status of Employees, participants, and beneficiaries under the Plan and their respective interests. Such determinations are binding on all persons, subject to the claims procedures under the Plan. CLAIMS FOR BENEFITS These claims procedures apply to the Medical Reimbursement Plan and the Dependent Care Reimbursement Plan. Claims and appeals for other benefits are administered in accordance with the claims procedures set forth in the plan documents for those benefits. The Employer, or its designee, shall notify a person within thirty (30) days of receipt of a written claim for Benefits of that person's eligibility or non-eligibility for Benefits under the Plan. If your claim for benefits is denied in whole or in part, the Employer, or its designee, must notify you in writing of (1) the specific reasons for the denial, (2) the specific provision of the Plan on which the denial is based, (3) a description of any additional information or material necessary for you to perfect your claim (and an explanation of why such information or material is necessary), and (4) an explanation of the Plan's claims review procedure. If the Employer, or its designee, determines that there are special circumstances requiring additional time to make a decision, the Employer, or its designee, shall notify the Participant of the special circumstances and the date by which a decision is expected to be made, and may extend the time for up to an additional fifteen (15) days. You may have any claim that has been denied in whole or in part reviewed by the Employer, or its designee, by filing a petition for review within one hundred eighty (180) days after receipt by the Participant of the notice issued by the Employer, or its designee. If the claim is made post-service (i.e., after service is rendered), a determination must be made within 60 days after receiving your petition. This petition is required to state the specific reasons you believe you are entitled to benefits, or to greater or different benefits. The Employer, or its designee, must give you (and your counsel) an opportunity to present your position orally or in writing. You (or your counsel) also have the right to review the pertinent documents. If you do not request a hearing, within the appropriate period after the Employer, or 23