HomeMy Public PortalAbout09 September 10, 2008 Executive85182
RECORDS
RIVERSIDE COUNTY TRANSPORTATION COMMISSION
EXECUTIVE COMMITTEE
(COMMISSIONERS STEVE ADAMS, MARION ASHLEY, BOB BUSTER,
MARY CRATON, TERRY HENDERSON, BOB MAGEE, JEFF STONE,
JOHN TAVAGLIONE, MICHAEL WILSON, ROY WILSON)
9:00 A.M.
WEDNESDAY, SEPTEMBER 10, 2008
Palm Springs Convention Center
Mesquite B
277 N. Avenida Caballeros, Palm Springs, CA
In compliance with the Brown Act and Government Code Section 54957.5, agenda
materials distributed 72 hours prior to the meeting, which are public records relating to
open session agenda items, will be available for inspection by members of the public prior
to the meeting at the Commission office, 4080 Lemon Street, Third Floor, Riverside, CA,
and on the Commission's website, www.rctc.org.
In compliance with the Americans with Disabilities Act and Government Code Section
54954.2, if you need special assistance to participate in an Executive Committee meeting,
please contact the Clerk of the Board at (9511 787-7141. Notification of at least 48 hours
prior to meeting will assist staff in assuring that reasonable arrangements can be made to
provide accessibility at the meeting.
1. CALL TO ORDER
2. PUBLIC COMMENTS
3. APPROVAL OF MINUTES — TO BE SUBMITTED AT THE NEXT MEETING
4. ADDITIONS/REVISIONS - The Committee may add an item to the Agenda after
making a finding that there is a need to take immediate action on the item and
that the item came to the attention of the Committee subsequent to the
posting of the agenda. An action adding an item to the agenda requires 2/3
vote of the Committee. If there are less than 2/3 of the Committee members
present, adding an item to the agenda requires a unanimous vote. Added
items will be placed for discussion at the end of the agenda.
11.36.21
RCTC Executive Committee Agenda
September 10, 2008
Page 2
5. PERSONNEL POLICIES AND PROCEDURES MANUAL UPDATE SECTION 4.12,
"EDUCATION REIMBURSEMENT AND SECTION 5.3 "HOLIDAY LEAVE"
Overview
This item is for the Committee to:
1) Approve the revision to the Personnel Policies and Procedures Manual
to amend Section 4.12 "Education Reimbursement" and Section 5.3
"Holiday Leave"; and
2) Adopt Resolution No. 08-021, '"Resolution of the Riverside County
Transportation Commission Amending lts Personnel Policies and
Procedures Manual".
6. FLEXIBLE BENEFITS PLAN AMENDMENT
Overview
This item is for the Committee to:
1) Approve the revision to the Flexible Benefits Plan;
2) Approve the revision to the Flexible Benefits Plan "Frequently Asked
Questions" for distribution to employees; and
3) Adopt Resolution No. 08-022, '"Resolution of the Riverside County
Transportation Commission Amending the Flexible Benefits Plan".
7. ADOPTION OF ORDINANCE NO. 08-001 TO AMEND THE ADMINISTRATIVE
CODE TO REFLECT THE DISBANDMENT OF THE TRANSIT POLICY
COMMITTEE
Overview
This item is for the Committee to Adopt Ordinance 08-001, "An Ordinance
Amending the Riverside County Transportation Commission Administrative
Code", to reflect changes related to the disbandment of the Transit Policy
Committee.
8. ADJOURNMENT
The next Executive Committee meeting is scheduled to be held at 9:00 a.m.,
Wednesday, October 8, 2008, 4080 Lemon Street, Third Floor, Conference
Room A, Riverside.
•
•
EXECUTIVE COMMITTEE
COMMISSIONER SIGN -IN SHEET
SEPTEMBER 10, 2008
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E MAIL ADDRESS
RIVERSIDE COUNTY TRANSPORTATION COMMISSION
DATE:
September 10, 2008
TO:
Executive Committee
FROM:
Michele Cisneros, Accounting and Human Resources Manager
THROUGH:
Anne Mayer, Executive Director
SUBJECT:
Personnel Policies and Procedures Manual Update Section 4.12,
"Education Reimbursement and Section 5.3 "Holiday Leave"
STAFF RECOMMENDATION:
This item is for the Committee to:
1) Approve the revision to the Personnel Policies and Procedures Manual to
amend Section 4.12 "Education Reimbursement" and Section 5.3 "Holiday
Leave"; and
2) Adopt Resolution No. 08-021, "Resolution of the Riverside County
Transportation Commission Amending Its Personnel Policies and Procedures
Manual".
BACKGROUND INFORMATION:
Staff has completed a review and has revised the Personnel Policies and
Procedures Manual. The revised Personnel Policies and Procedures Manual has
been reviewed by legal counsel and approved by the Executive Director. The major
changes to the Personnel Policies and Procedures Manual include:
Section 4.12 'Education Reimbursement"
Currently, the Commission's Personnel Policies and Procedures Manual contains
language that states ". . . upon an employee's voluntary termination of
employment within 24 months following receipt of an education reimbursement
payment, there shall be a deduction for his or her final check as follows: the
amount of the education reimbursement minus one twenty-fourth of the education
reimbursement for each month of service following the receipt of the
reimbursement."
This language is contrary to the California labor law (Barnhill v. Robert Saunders &
Co., 125 Cal. App.3d 1 (1981)), which states that employers may not deduct from
an employee's final check any amount representing the unpaid balance of a debt
owed by the employee even though the indebtedness is contained in a written
Agenda Item 5
.<
agreement to pay the full amount of the debt on demand, at termination or
otherwise.
Staff requests approval to remove the language from the policy referring to a .. a
deduction from his or her final check . . . ". Therefore, staff will seek
reimbursement from voluntarily terminated employees through the Commission's
accounts receivable process.
Section 5.3 '"Holiday Leave"
Holiday Accrual
Currently, the Commission's Personnel Policies and Procedures Manual provides
exempt employees an accumulated holiday bank, not to exceed eight hours for any
work period, when staff works on a holiday and/or for hours worked in excess of
80 hours during a work period that includes a paid holiday. After review of this
benefit in comparison to other similar agencies as the Commission, the
management team concluded that this benefit was not of typical public policy or
practice. Although the average cumulative cost of this benefit, approximately
$400 per employee, does not have significant financial impact on the Commission,
the management team agreed that since an administrative leave benefit was
currently provided, that the accrued holiday leave did not make sense or promote
good public policy. Therefore, the management team wishes to revise the holiday
accrual process and only allow those exempt employees who are required to work
on a scheduled holiday the ability to accrue holiday hours not to exceed eight
hours.
Floating Holiday
The Commission observes 12 paid holidays plus a floating holiday. An eight hour
floating holiday is provided to regular and probationary employees at the beginning
of each fiscal year. However, the current policy does not address the basis of
accrual for those new employees that may begin employment with the Commission
toward the end of a fiscal year. Given this scenario, new staff would be able to
accrue eight hours of floating holiday. time on the first day of work and then an
additional eight hours of floating holiday time at the beginning of the new fiscal
year. Staff is seeking approval to amend the policy to reflect the basis of floating
holiday accrual on a pro-rata based on the date of hire.
Attachment: Resolution No. 08-021
Agenda Item 5
•
"
R E S O L U T I O N N O . 0 8 - 0 2 1
R E S O L U T I O N O F T H E
R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N
A M E N D I N G I T S P E R S O N N E L P O L I C I E S A N D P R O C E D U R E S M A N U A L
W H E R E A S , t h e C o m m i s s i o n h a s p r e v i o u s l y a d o p t e d p e r s o n n e l p o l i c i e s
a n d p r o c e d u r e s e s t a b l i s h i n g t h e t e r m s a n d c o n d i t i o n s o f e m p l o y m e n t t h e
C o m m i s s i o n ; a n d
W H E R E A S , t h e C o m m i s s i o n w i s h e s t o u p d a t e i t s p e r s o n n e l p o l i c i e s a n d
p r o c e d u r e s ;
N O W , T H E R E F O R E , b e i t r e s o l v e d b y t h e R i v e r s i d e C o u n t y
T r a n s p o r t a t i o n C o m m i s s i o n a s f o H o w s ;
S e c t i o n 1 . T h e p r e v i o u s l y a d o p t e d p e r s o n n e l p o l i c i e s a n d p r o c e d u r e s m a n u a l o f
t h e C o m m i s s i o n a r e h e r e b y a m e n d e d f o r t h e r e v i s i o n s o f S e c t i o n 4 . 1 2
" E d u c a t i o n R e i m b u r s e m e n t " a n d S e c t i o n 5 . 3 " H o l i d a y L e a v e " , s e t f o r t h i n
A t t a c h m e n t " A " , a t t a c h e d h e r e t o a n d i n c o r p o r a t e d h e r e i n .
S e c t i o n 2 . T h i s r e s o l u t i o n s h a l l t a k e p l a c e i m m e d i a t e l y u p o n i t s a d o p t i o n .
A P P R O V E D A N D A D O P T E D t h i s 1 0 t h d a y o f S e p t e m b e r , 2 0 0 8 .
J e f f S t o n e , C h a i r
R i v e r s i d e C o u n t y T r a n s p o r t a t i o n C o m m i s s i o n
A T T E S T :
J e n n i f e r H a r m o n
C l e r k o f t h e B o a r d
"
A t t a c h m e n t " A "
S e c t i o n 4 . 1 2 E d u c a t i o n R e i m b u r s e m e n t
R e g u l a r f u l l - t i m e e m p l o y e e s o f R C T C , w h o h a v e c o m p l e t e d a t l e a s t 2 , 0 8 0 h o u r s o f
c o n s e c u t i v e s e r v i c e , s h a l l b e e l i g i b l e f o r e d u c a t i o n r e i m b u r s e m e n t p u r s u a n t t o t h i s s e c t i o n .
T h e R C T C w i l l m a k e a v a i l a b l e a m a x i m u m o f $ 2 5 , 0 0 0 p e r f i s c a l y e a r f o r e d u c a t i o n
r e i m b u r s e m e n t .
A n e m p l o y e e m a y b e r e i m b u r s e d u p t o $ 2 , 5 0 0 t o c o v e r e d u c a t i o n e x p e n s e s
i n c u r r e d i n a n y f i s c a l y e a r . I f t o t a l e m p l o y e e e d u c a t i o n r e i m b u r s e m e n t r e q u e s t s e x c e e d
a v a i l a b l e f u n d i n g i n a g i v e n f i s c a l y e a r , r e i m b u r s e m e n t w i l l b e m a d e o n a f i r s t - c a m e , f i r s t -
s e r v e d b a s i s .
R e q u i r e m e n t s f o r e d u c a t i o n r e i m b u r s e m e n t a r e a s f o l l o w s :
. , � 1 . C o u r s e i s s a t i s f a c t o r i l y c o m p l e t e d w i t h a g r a d e o f " C " o r h i g h e r ;
2 . A p p r o p r i a t e p r o o f o f s u c c e s s f u l c o m p l e t i o n i s s u b m i t t e d t o t h e i r F i r s t L i n e
S u p e r v i s o r a n d t h e H u m a n R e s o u r c e s D e p a r t m e n t ;
"
3 . C o u r s e o f i n s t r u c t i o n w i l l e n a b l e t h e e m p l o y e e t o p e r f o r m h i s o r h e r p r e s e n t
d u f i e s m o r e e f f e c t i v e l y , o r w i l l p r e p a r e t h e m f o r f u t u r e o p p o r t u n i t i e s i n t o
w h i c h h e o r s h e c o u l d r e a s o n a b l y e x p e c t p r o m o t i o n o r t r a n s f e r a t R C T C ;
4 . T h e h o u r s o f i n s t r u c t i o n f o r t h e c o u r s e d o n o t c o n f l i c t w i t h t h e e m p l o y e e ' s
r e g u l a r l y s c h e d u l e d w o r k d a y ;
5 . T h e c o u r s e o f i n s t r u c t i o n m u s t b e p r e s e n t e d b y a t e c h n i c a l s c h o o l ,
v o c a t i o n a l s c h o o l , c o l l e g e , u n i v e r s i t y , b u s i n e s s o r h i g h s c h o o l w h i c h h a s
b e e n a c c r e d i t e d b y a r e c o g n i z e d g o v e m m e n t a l o r p r o f e s s i o n a l a c c r e d i t i n g
b o d y a n d h a s b e e n a p p r o v e d b y t h e E x e c u t i v e D i r e c t o r .
E m p l o y e e s s h a g b e e l i g i b l e f o r r e i m b u r s e m e n t o f t h e f o l l o w i n g e d u c a t i o n e x p e n s e s :
t u i t i o n , t e x t b o o k s , r e g i s t r a t i o n f e e s , a n d l a b o r a t o r y f e e s r e l a t e d t o a n a p p r o v e d c o u r s e o f
i n s t r u c t i o n . E m p l o y e e s s h a l l b e l i m i t e d t o a m a x i m u m r e i m b u r s e m e n t o f $ 2 , 5 0 0 p e r
e m p l o y e e p e r y e a r .
E m p l o y e e s s h a l l n o t b e e l i g i b l e f o r r e i m b u r s e m e n t o f l a t e r e g i s t r a t i o n p e n a l t i e s o r
f e e s , t r a n s p o r t a t i o n c o s t s , p a r k i n g , i n t e r e s t o r a n y o t h e r c h a r g e n o t s p e c i f i e d a s
r e i m b u r s a b l e i n t h i s s e c t i o n .
E m p l o y e e s s h a g s u b m i t a r t E d u c a t i o n R e i m b u r s e m e n t R e q u e s t t o t h e i r F i r s t L i n e
S u p e r v i s o r f o r a p p r o v a l p r i o r t o r e g i s t r a t i o n f o r t h e c o u r s e . T h e F i r s t L i n e S u p e r v i s o r w i l t
r e v i e w t h e r e q u e s t f o r c o m p l i a n c e w i t h R C T C p o l i c i e s a n d e i t h e r a p p r o v e o r d i s a p p r o v e
t h e r e q u e s t . I f t h e r e q u e s t i s d e n i e d , t h e F i r s t L i n e s u p e r v i s o r w i l l s t a t e t h e r e a s o n f o r
d e n i a l . T h e s u p e r v i s o r s h a g f o r w a r d t h e c o m p l e t e d f o r m t o H u m a n R e s o u r c e s f o r r e v i e w
to assure compliance with RCTC policy. One copy of the completed form, indicating the
Executive Directors approval or disapproval, shall be forwarded to the employee.
Employees who successfully complete an approved course shall submit a request
for reimbursement to Human Resources. The request must include receipts for all items
for which the employee wishes to be reimbursed and a copy of the final grade report with
a grade of "C" or higher.
RCTC expects employees who use the Education Reimbursement Program to
continue as RCTC employees for at least two years after completion of the Program.
Thus, as part of his or her Education Reimbursement Request, the employee shall agree
that upon voluntary termination of employment within 24 months fallowing receipt of an
education reimbursement payment, the employee is required to remit to RCTC the
amount of the education reimbursement minus one twenty-fourth of the education
reimbursement for each month of service following the receipt of the reimbursement.
Required education and/or training outside an employees' regular wort( hours shall
be considered as hours worked. RCTC is responsible for all costs associated with
required education and training.
Section 5.3 Holiday Leave
All regular and probationary employees of RCTC who are on the payroll the day
before and day after a designated holiday shall be paid for said holiday. Full-time
employees shall receive eight (8) holiday pay hours for a holiday. Part-time employees
shall receive holiday pay on a pro-rata basis. Temporary employees do not receive
holiday benefits. The following holidays are observed by RCTC (the actual day of
observance may be changed at the discretion of RCTC management):
1. New Year's Day
2. Dr. Martin Luther King, Jr. Day
3. Presidents' Day
4. Memorial Day
5. Independence Day
6. Labor Day
7. Veterans' Day
8. Thanksgiving Day
9. Day After Thanksgiving Day
10. Day Before Christmas Day
11. Christmas Day
12. Day Before New Years Day
13. Floating Holiday
Holidays which fall on a Saturday shall normally be observed on the preceding
Friday. Holidays which fall on Sunday shall normally be observed on the following
Monday. When a fixed holiday falls within a vacation period, the holiday shall not be
charged against the employee's accumulated vacation benefits.
Deleted: there shall be a deduction
from his or her final check as follows:
the amount of the education
reimbursement minus one twenty-
fourth of the education reimbursement
for each month of service following
the receipt of the reimbursement
"
"
, N p n - e x e m p t e m p l o y e e s r e q u i r e d t o w o r k o n a h o l i d a y w i l l r e c e i v e e i g h t h o u r s o f
p a y p l u s o v e r t i m e . E x e m p t e m p l o y e e s w h o a r e r e q u i r e d t o w o r k o n a s c h e d u l e d h o f i d a v
s h a l l b e g r a n t e d t i m e f o r t h o s e h a i r s w o r k e d . n o t t o e x c e e d e i g h t h o u r s . S u c h t i m e s h a l l
a c c u m u l a t e i n a h o l i d a y t i m e b a n k a n d c a n b e u s e d l i k e v a c a t i o n .
R e g u l a r a n d p r o b a t i o n a r y f u l l - t i m e e m p l o y e e s o f R C T C s h a l l r e c e i v e e i g h t h o u r s o f
f l o a t i n g h o l i d a y o n t h e f i r s t p a y d a t e o f t h e f i s c a l y e a r . N e w e m p l o y e e s t o R C T C s h a l l
r e c e i v e t h e f l o a t i n g h o l i d a y o n a p r o - r a t a b a s i s b a s e d o n t h e d a t e o f h i r e .
D e l e t e d : E x e m p t e m p l o y e e s w h o
w o r k o n a h o l i d a y s h a g b e g r a n t e d
t i m e f o r h o u r s w o r k e d o n a s c h e d u l e d
h o k d a y a n d f o r h o u r s w o r k e d i n
e x c e s s o f 8 0 d u r i n g a w o r k p e r i o d t h a t
i n c l u d e s a p a i d h o l i d a y . S u c h t i m e
c h a t a c c u m u l a t e i n a h o l i d a y t i m e
b a r d s a n d c a n b e u s e d l i k e v a c a t i o n .
N o e m p l o y e e s h a l l a c c u m u l a t e m o r e
M a n e i g h t y ( 8 0 ) h o u r s o f h o l i d a y t i m e .
A c a a a l o f h o l i d a y t i m e w i l l c e a s e
o n c e t h e e m p l o y e e ' s a c c u m u l a t e d
h o l i d a y h o u r s e q u a l e i g h t y ( 8 0 ) h o u r s .
A m n i a ! o f h o l i d a y a n t e w i l l n o t
r e c o m m e n c e u n t i l a n e m p l o y e e h a s
u s e d s o m e h o l i d a y t i m e a a n d t h e
a c c u m u l a t e d h o l i d a y t i m e h a s o n c e
a g a i n f a l l e n b e l o w t h e m a x i m u m
a c c u m u l a t i o n l i m i t T h e E x e c u t i v e
D i r e c t o r h a s t h e d n s a e t i o n t o
a u t h o r i z e a c c u m u l a t e d h o l i d a y l i m e i n
e x c e s s o f e i g h t y ( 8 0 ) h o u r s . T h e
E x e c u t i v e D i r e c t o r s h a l l p r o v i d e
p a y r o l l w i t h a w r i t t e n n o t i c e o f
a p p r o v a l t o a c c r u e h o l i d a y t i m e i n
e x c e s s o f e i g h t y ( B O ) h o u r s . I
4
"
R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N
D A T E :
S e p t e m b e r 1 0 , 2 0 0 8
T O :
E x e c u t i v e C o m m i t t e e
F R O M :
M i c h e l e C i s n e r o s , A c c o u n t i n g a n d H u m a n R e s o u r c e s M a n a g e r
T H R O U G H :
A n n e M a y e r , E x e c u t i v e D i r e c t o r
S U B J E C T :
F l e x i b l e B e n e f i t s P l a n A m e n d m e n t
S T A F F R E C O M M E N D A T I O N :
T h i s i t e m i s f o r t h e C o m m i t t e e t o :
1 ) A p p r o v e t h e r e v i s i o n t o t h e F l e x i b l e B e n e f i t s P l a n ;
2 ) A p p r o v e t h e r e v i s i o n t o t h e F l e x i b l e B e n e f i t s P l a n " F r e q u e n t l y A s k e d
Q u e s t i o n s " f o r d i s t r i b u t i o n t o e m p l o y e e s ; a n d
3 ) A d o p t R e s o l u t i o n N o . 0 8 - 0 2 2 , " R e s o l u t i o n o f t h e R i v e r s i d e C o u n t y
T r a n s p o r t a t i o n C o m m i s s i o n A m e n d i n g t h e F l e x i b l e B e n e f i t s P l a n " .
B A C K G R O U N D I N F O R M A T I O N :
O n S e p t e m b e r 1 1 , 2 0 0 2 , t h e E x e c u t i v e C o m m i t t e e a p p r o v e d t h e e s t a b l i s h m e n t o f a
S e c t i o n 1 2 5 P r e m i u m C o n v e r s i o n P l a n ( P l a n ) t o p r o v i d e e l i g i b l e C o m m i s s i o n
e m p l o y e e s w i t h a m e a n s o f p u r c h a s i n g c e r t a i n h e a l t h b e n e f i t s i n a t a x - e f f e c t i v e
m a n n e r . T h e P l a n w o u l d a l s o q u a l i f y a s a c a f e t e r i a p l a n u n d e r S e c t i o n 1 2 5 o f t h e
I n t e r n a l R e v e n u e C o d e ( I R C ) w h e r e b y b e n e f i t s t h a t t h e e m p l o y e e e l e c t s t o r e c e i v e
u n d e r t h e P l a n a r e e l i g i b l e f o r e x c l u s i o n f r o m t h e e m p l o y e e ' s i n c o m e f o r f e d e r a l t a x
i n c o m e p u r p o s e s . A s a r e s u l t o f t h i s p l a n , e m p l o y e e s w e r e a l l o w e d t o m a k e
p r e m i u m p a y m e n t s f o r h e a l t h c o v e r a g e w i t h p r e - t a x d e d u c t i o n s .
O n J u n e 1 4 , 2 0 0 6 , a r e s t a t e m e n t o f t h e F l e x i b l e B e n e f i t s P l a n w a s r e q u i r e d i n
o r d e r t o b e i n c o m p l i a n c e w i t h t h e I R C , E m p l o y e e R e t i r e m e n t I n c o m e S e c u r i t y A c t
o f 1 9 7 4 ( E R I S A ) , a n d H e a l t h I n s u r a n c e P o r t a b i l i t y a n d A c c o u n t a b i l i t y A c t o f 1 9 9 6
( H I P A A ) . O n A u g u s t 3 , 2 0 0 7 , t h e I n t e r n a l R e v e n u e S e r v i c e ( I R S ) h a s p r o p o s e d
n e w r e g u l a t i o n s . T h e p r o p o s e d n e w r e g u l a t i o n s a r e e f f e c t i v e f o r p l a n y e a r s
b e g i n n i n g o n o r a f t e r J a n u a r y 1 , 2 0 0 9 .
S t a f f h a s r e q u e s t e d t h a t l e g a l c o u n s e l r e v i e w t h e c u r r e n t P l a n a n d d e t e r m i n e w h a t
r e v i s i o n s w e r e n e c e s s a r y t o b r i n g t h e P l a n i n c o m p l i a n c e w i t h t h e p r o p o s e d n e w
r e g u l a t i o n s . L e g a l c o u n s e l h a s i d e n t i f i e d t h e f o l l o w i n g n e c e s s a r y c h a n g e s a n d h a s
r e c o m m e n d e d a m e n d m e n t s t o t h e P l a n :
A g e n d a I t e m 6
" H e a l t h c o v e r a g e f o r n o n - d e p e n d e n t i n d i v i d u a l s - T h e I R S h a s c o n f i r m e d t h a t
a c a f e t e r i a p l a n m a y p r o v i d e h e a l t h a n d m e d i c a l b e n e f i t s t o a n i n d i v i d u a l w h o
i s n o t t h e l e g a l d e p e n d e n t o r q u a l i f y i n g r e l a t i v e o f t h e p a r t i c i p a t i n g e m p l o y e e
a n d w h i c h i s o f t e n t h e c a s e w i t h m o s t d o m e s t i c p a r t n e r r e l a t i o n s h i p s .
" P a r t i c i p a n t e l e c t i o n s - T h e n e w r e g u l a t i o n h a s p r o v i d e d c o m p r e h e n s i v e "
g u i d a n c e o n h o w e l e c t i o n s s h o u l d b e a d m i n i s t e r e d a n d w h e n e l e c t i o n s m a y
b e c h a n g e d m i d - y e a r . T h e r e g u l a t i o n a l s o c o n f i r m s t h a t t h e p l a n
a d m i n i s t r a t o r m a y u s e e l e c t r o n i c m e d i a s u c h a s e m a i l a n d t h e i n t r a n e t f o r
s e n d i n g a n d r e c e i v i n g e n r o l l m e n t m a t e r i a l a n d o t h e r p l a n - r e l a t e d m a t e r i a l .
" R e i m b u r s e m e n t ( s u b s t a n t i a t i o n o f e x p e n s e s ) - T h e P l a n i s p r o h i b i t e d f r o m
a d v a n c i n g f u n d s f r o m a f l e x i b l e s p e n d i n g a c c o u n t o r r e i m b u r s i n g e x p e n s e s
t h a t w e r e n o t p r o p e r l y s u b s t a n t i a t e d b y a r e c e i p t o r i n v o i c e f r o m a t h i r d
p a r t y s e r v i c e p r o v i d e r .
" P e r i o d o f c o v e r a g e - T h e r e g u l a t i o n s d e f i n e w h a t i s a p e r i o d o f c o v e r a g e f o r
p u r p o s e s o f d e t e r m i n i n g p l a n b e n e f i t s .
T h e r e i s n o c o s t t o t h e C o m m i s s i o n f o r i m p l e m e n t i n g t h e s e c h a n g e s t o t h e P l a n .
A t t a c h m e n t s :
1 ) R e s o l u t i o n N o . 0 8 - 0 2 2
2 ) F l e x i b l e B e n e f i t s P l a n A m e n d m e n t N o . 1
3 ) F l e x i b l e B e n e f i t s P l a n " F r e q u e n t l y A s k e d Q u e s t i o n s "
A g e n d a I t e m 6
RESOLUTION NO.08-022
RESOLUTION OF THE
RIVERSIDE COUNTY TRANSPORTATION COMMISSION
REGARDING THE AMENDED FLEXIBLE BENEFITS PLAN
WHEREAS, the Riverside County Transportation Commission (the
"Commission") currently retains the authority to add, delete or otherwise modify
the Commission's policies and procedures; and
WHEREAS, the Commission has granted the Executive Committee the
authority to add, delete or otherwise modify the Commission's policies and
procedures; and
WHEREAS, the Commission previously established the Riverside County
Transportation Commission Flexible Benefits Plan on September 11, 2002
("Flexible Benefits Plan") to allow participating employees the opportunity to
contribute salary reduction amounts on a pretax basis for the purchase of
benefits made available under the Flexible Benefits Plan; and
WHEREAS, the Commission desires to adopt changes to the Flexible
Benefits Plan as required under regulations issued by the Internal Revenue
Service applicable to "cafeteria -benefit plans" under Section 125 of the Internal
Revenue Code effective for plan years beginning on or after January 1, 2009;
and
WHEREAS, the Commission has been advised by the Commission's
attomey, Best Best & Krieger LLP, that it will be necessary to formally amend the
Commission's Flexible Benefits Plan to adopt such provisions; and
WHEREAS, the proposed form of amendment to the Flexible Benefits
Plan, which said amendment incorporate the necessary regulatory changes, has
been submitted to the Executive Committee for consideration and action
NOW, THEREFORE, the Riverside County Transportation Commission
does hereby resolve as follows:
Section 1. The Riverside County Transportation Commission hereby approves
and adopts Amendment No. 1 to the Flexible Benefits Plan, as heretofore
discussed, to be effective September 10, 2008.
Section 2. The Riverside County Transportation Commission hereby
authorizes the Commission's Chair to execute said amendment on behalf of the
Commission.
APPROVED AND ADOPTED this 10th day of September, 2008.
Jeff Stone, Chair
Riverside County Transportation Commission
ATTEST:
Jennifer Harmon
Clerk of the Board
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R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N
F L E X I B L E B E N E F I T S P L A N
A M E N D M E N T N O . 1
1 . R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N ( t h e
" E m p l o y e r " ) e s t a b l i s h e d t h e R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N
F L E X I B L E B E N E F I T S P L A N ( t h e " N a n " ) e f f e c t i v e S e p t e m b e r 1 1 , 2 0 0 2 .
2 . I t i s n e c e s s a r y t o a m e n d t h e P l a n i n o r d e r t o c o m p l y w i t h p r o p o s e d
r e g u l a t i o n s i s s u e d b y t h e I n t e r n a l R e v e n u e C o d e o n A u g u s t 3 , 2 0 0 7 c o n c e r n i n g t h e
a d m i n i s t r a t i o n a n d o p e r a t i o n o f S e c t i o n 1 2 5 c a f e t e r i a p l a n s .
3 . S e c t i o n 1 3 . 2 o f t h e P l a n p r o v i d e s t h a t t h e e m p l o y e r r e s e r v e s t h e r i g h t s t o
a m e n d t h e P l a n a t a n y t i m e .
2 0 0 8 .
N O W , T H E R E F O R E , E m p l o y e r h e r e b y a m e n d s t h e P l a n , e f f e c t i v e S e p t e m b e r 1 0 ,
A R T I C L E I
T I T L E A N D P U R P O S E
T h i s P l a n s h a l l b e k n o w n a s t h e R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N
C O M M I S S I O N F L E X I B L E B E N E F I T S P L A N ( t h e " P l a n " ) . T h e p u r p o s e o f t h e P l a n i s t o
f u r n i s h t o e l i g i b l e e m p l o y e e s c h o i c e s a m o n g c e r t a i n B e n e f i t s p r o v i d e d b y t h e E m p l o y e r , s o t h a t
e m p l o y e e s m a y r e c e i v e B e n e f i t s t h a t b e s t m e e t t h e i r i n d i v i d u a l n e e d s . T h e P l a n i s i n t e n d e d t o
p r o v i d e b e n e f i t s i n a c c o r d a n c e w i t h S e c t i o n s 1 2 5 , 1 0 5 a n d 1 2 9 o f t h e I n t e r n a l R e v e n u e C o d e , a s
a m e n d e d , a n d t h e R e g u l a t i o n s i s s u e d t h e r e u n d e r , s o t h a t t h e B e n e f i t s t h a t a n E m p l o y e e e l e c t s t o
r e c e i v e u n d e r t h e P l a n a r e e l i g i b l e f o r e x c l u s i o n f r o m t h e E m p l o y e e ' s i n c o m e f o r F e d e r a l I n c o m e
T a x p u r p o s e s .
T h e P l a n i s a l s o i n t e n d e d t o q u a l i f y u n d e r S e c t i o n s 1 0 5 ( b ) a n d 1 2 9 ( d ) o f t h e
I n t e r n a l R e v e n u e C o d e w i t h r e g a r d t o t h e w r i t t e n d o c u m e n t a t i o n r e q u i r e m e n t s f o r s e l f - f u n d e d
m e d i c a l r e i m b u r s e m e n t a n d d e p e n d e n t c a r e a s s i s t a n c e p l a n s .
A R T I C L E I I
C O M P O N E N T P L A N S
T h e B e n e f i t s o f f e r e d u n d e r t h i s P l a n a r e p r o v i d e d t h r o u g h s e p a r a t e C o m p o n e n t
P l a n s w h i c h a r e s e t f o r t h i n s e p a r a t e p l a n d o c u m e n t s , g r o u p i n s u r a n c e p o l i c i e s o r a d m i n i s t r a t i v e
s e r v i c e c o n t r a c t s a n d a r e i n c o r p o r a t e d h e r e i n a n d i d e n t i f i e d i n S c h e d u l e " A " a t t a c h e d h e r e t o .
N o t w i t h s t a n d i n g , t h e p r o v i s i o n s o f t h e s e p a r a t e M e d i c a l R e i m b u r s e m e n t P l a n a n d D e p e n d e n t
C a r e P l a n C o m p o n e n t P l a n s a r e s e t f o r t h i n t h i s P l a n d o c u m e n t .
ARTICLE III
DEFINITIONS
The following words and phrases, when used herein, shall have the following
meanings, unless a different meaning is clearly required by the context:
3.1 Administrator. "Administrator" shall mean the Employer or any person or
entity appointed by the Employer to administer this Plan on its behalf, as provided in Article XI.
3.2 Benefit. `Benefit" shall mean any of the qualified benefits which may be
purchased under this Plan. `Benefits" shall also mean any amounts paid to a Participant in the
Plan as reimbursement under the Medical Reimbursement Plan (see Article VIII) or the
Dependent Care Plan (see Article VII).
3.3 Code. "Code" shall mean the Internal Revenue Code of 1986, as
amended. References to any section of the Code include references to any comparable or
succeeding provision of any legislation which amends, supplements or replaces such section.
3.4 Component Plan. "Component Plan" shall mean any plan offering
Benefits available under this Plan, as set forth in the separate plan documents, except for the
Medical Reimbursement Plan (see Article VIII) and the Dependent Care Plan (see Article VII).
3.5 Dependent. "Dependent" includes the spouse or dependent of a
Participant who is eligible to receive benefits under a Component Plan and who is specifically
defined as a legal dependent under Section 152 of the Code. Dependent shall also mean, as to
health benefits offered under the Plan, a dependent eligible under Code Section 152, determined
without regard to Code Section 152(b)(1), (bx2), or (d)(l)(B).
Notwithstanding the preceding, if Component Plan permits a Participant
to cover an individual other than the Participant's spouse or Dependent (including a Participant's
registered domestic partner as recognized by the State of California), the term Dependent as used
throughout the Plan document shall also include such individual provided the benefit is treated as
a taxable benefit in accordance with Section 6.7.
3.6 Effective Date. "Effective Date" shall mean the date this Plan first
became effective, which is September 11, 2002.
3.7 Eligible Dependent Care Expense. "Eligible Dependent Care Expense"
means substantiated expenses incurred by the Participant during the Plan Year or grace period
described in Section 7.7 for Qualifying Dependent Care Services or for the cost of sending a
child of the Participant to a Qualifying Day Care Center. Expenses relating to nonrefundable
fees charged by a Qualified Day Care Center shall not be eligible for reimbursement unless the
child care services directly related to the fee are provided.
3.8 Eligible Medical Care Expense. "Eligible Medical Care Expense" means
substantiated expenses submitted by the Participant for reimbursement of medical and/or dental
services incurred by the Participant, or the Participant's Spouse during the Plan Year or during
the grace period defined in Section 8.7. "Eligible Medical Care Expenses" shall include amounts
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p a i d f o r p r e s c r i p t i o n a n d o v e r - t h e - c o u n t e r d r u g s a n d m e d i c i n e s , a n d s u c h o t h e r e x p e n s e s w h i c h
a r e n o t c o v e r e d b y i n s u r a n c e a n d w h i c h a r e p e r m i t t e d t o b e r e i m b u r s e d u n d e r a m e d i c a l f l e x i b l e
s p e n d i n g a c c o u n t p u r s u a n t t o S e c t i o n 2 1 3 ( d ) o f t h e C o d e , a s a m e n d e d , o r a s a u t h o r i z e d b y t h e
I R S f r o m t i m e t o t i m e . E l i g i b l e M e d i c a l C a r e E x p e n s e d o e s n o t i n c l u d e p r e m i u m s p a i d o n
a c c i d e n t o r h e a l t h i n s u r a n c e o r p r e m i u m s o n l o n g - t e r m c a r e i n s u r a n c e , w h e t h e r o r n o t s u c h
i n s u r a n c e i s p a i d f o r b y t h e E m p l o y e r .
3 . 9 E m p l o y e e . " E m p l o y e e " s h a l l m e a n a l l r e g u l a r a n d p r o b a t i o n a r y
e m p l o y e e s o f t h e E m p l o y e r a n d , t o t h e e x t e n t n e c e s s a r y , f o r m e r e m p l o y e e s w h o a r e e n t i t l e d t o
r e c e i v e b e n e f i t p a y m e n t s u n d e r t h i s P l a n . T e m p o r a r y o r c o n t r a c t e m p l o y e e s a r e n o t e l i g i b l e t o
p a r t i c i p a t e . " E m p l o y e e " s h a l l a l s o m e a n a n y i n d i v i d u a l w h o i s t r e a t e d a s e m p l o y e d b y a s i n g l e
e m p l o y e r u n d e r S e c t i o n s 4 1 4 ( b ) , ( c ) a n d ( m ) o f t h e C o d e . " E m p l o y e e " s h a l l n o t i n c l u d e a n y s e l f -
e m p l o y e d i n d i v i d u a l d e s c r i b e d i n S e c t i o n 4 0 1 ( c ) o f t h e C o d e .
3 . 1 0 E m p l o y e r . " E m p l o y e r " s h a l l m e a n R I V E R S I D E C O U N T Y
T R A N S P O R T A T I O N C O M M I S S I O N , a n y o t h e r o r g a n i z a t i o n w h i c h a d o p t s t h i s P l a n w i t h t h e
c o n s e n t o f E m p l o y e r , a n d a n y s u c c e s s o r o f s u c h E m p l o y e r .
3 . 1 1 E n t r y D a t e . " E n t r y D a t e " s h a l l m e a n , f o r a l l n e w l y h i r e d E m p l o y e e s , t h e
n e x t p a y r o l l p e r i o d i m m e d i a t e l y f o l l o w i n g c o m p l e t i o n a n d s u b m i s s i o n o f t h e e n r o l l m e n t f o r m s .
I n a l l o t h e r c a s e s , t h e " E n t r y D a t e " s h a l l m e a n t h e f i r s t d a y o f e a c h P l a n Y e a r .
3 . 1 2 E R I S A . " E R I S A " s h a l l m e a n t h e E m p l o y e e R e t i r e m e n t I n c o m e S e c u r i t y
A c t o f 1 9 7 4 .
3 . 1 3 F M L A . " F M L A " s h a l l m e a n t h e F a m i l y M e d i c a l L e a v e A c t o f 1 9 9 3 , a s
a m e n d e d a n d i n c l u d i n g a l l r e g u l a t i o n s i s s u e d t h e r e u n d e r ,
3 . 1 4 H i g h l y C o m p e n s a t e d P a r t i c i p a n t . " H i g h l y C o m p e n s a t e d P a r t i c i p a n t " s h a l l
m e a n a P a r t i c i p a n t w h o i s ( i ) a d i r e c t o r o f t h e E m p l o y e r , ( i i ) h i g h l y c o m p e n s a t e d , o r ( i i i ) a
s p o u s e o r d e p e n d e n t o f a H i g h l y C o m p e n s a t e d P a r t i c i p a n t . T h e c l a s s i f i c a t i o n o f a P a r t i c i p a n t a s
h i g h l y c o m p e n s a t e d f o r t h i s p u r p o s e s h a l l b e m a d e o n t h e b a s i s o f t h e f a c t s a n d c i r c u m s t a n c e s o f
e a c h c a s e .
3 . 1 5 K e y E m p l o y e e . " K e y E m p l o y e e " m e a n s a n y E m p l o y e e d e f i n e d a s s u c h i n
S e c t i o n 4 1 6 ( i x 1 ) o f t h e C o d e a n d t h e r e g u l a t i o n s i s s u e d t h e r e u n d e r .
3 . 1 6 L e a v e o f A b s e n c e . " L e a v e o f A b s e n c e " s h a l l m e a n a n y a b s e n c e o f a n
E m p l o y e e w h i c h i s a u t h o r i z e d b y t h e E m p l o y e r u n d e r t h e E m p l o y e r ' s p e r s o n n e l p o l i c i e s ,
i n c l u d i n g a n y l e a v e d e s i g n a t e d a s F M L A L e a v e . A d d i t i o n a l l y , a n E m p l o y e e s h a l l b e s u b j e c t t o
s u c h r i g h t s a n d b e n e f i t s f o r F a m i l y o r M e d i c a l L e a v e , a s d e f i n e d i n t h e F a m i l y a n d M e d i c a l
L e a v e A c t o f 1 9 9 3 , a s a r e p r o v i d e d u n d e r t h e A c t , a n d t h e C a l i f o r n i a F a m i l y R i g h t s A c t o f 1 9 9 1 .
3 . 1 7 O p e n E n r o l l m e n t P e r i o d . " O p e n E n r o l l m e n t P e r i o d " s h a l l m e a n t h e
p e r i o d b e g i n n i n g a t l e a s t t h i r t y ( 3 0 ) d a y s b e f o r e t h e b e g i n n i n g o f t h e n e x t P l a n Y e a r a n d e n d i n g
o n a n y d a t e p r e c e d i n g t h e c o m m e n c e m e n t o f t h e P l a n Y e a r , a s d e t e r m i n e d b y t h e A d m i n i s t r a t o r .
F o r a n e w E m p l o y e e , " O p e n E n r o l l m e n t P e r i o d " s h a l l m e a n t h e p e r i o d b e g i n n i n g t h e
E m p l o y e e ' s e f f e c t i v e d a t e o f e m p l o y m e n t a n d e n d i n g 3 1 d a y s l a t e r .
3
3.18 Participant. "Participant" shall mean an Employee who becomes enrolled
in the Plan pursuant to Article IV. "Participant" shall also mean a former Employee who elects
to continue health coverage under the Plan.
3.19 Plan. "Plan" shall mean the RIVERSIDE COUNTY
TRANSPORTATION COMMISSION FLEXIBLE BENEFITS PLAN, set forth herein,
including all subsequent amendments and modifications hereto.
3.20 Plan Year. "Plan Year" shall mean the twelve (12) consecutive month
period commencing July 1 and ending on June 30. Effective January 1, 2007, the Plan Year shall
commence on January 1 and end on December 31.
3.21 Qualifying Day Care Center. "Qualifying Day Care Center" means a day
care center which —
(a) provides full-time or part-time care for more than six individuals
(other than individuals who reside at the day care center) on a regular basis during the
Eligible Employee's taxable year, and
(b) which complies with all applicable laws and regulations of the
state and town, city or village in which it is located; and receives a fee, payment or grant
for services for any of the individuals to whom it provides services (regardless of whether
such facility is operated for a profit).
3.22 Qualifying Individual. "Qualifying Individual" means a Dependent of the
Participant, as defined in Code Section 152(a)(1), who is under the age of 13. "Qualifying
Individual" shall also mean a Dependent or Spouse of the Participant who is physically or
mentally incapable of caring for himself or herself and who has the same principal place of
residence as the Participant for more than one-half of the Plan Year, provided such individual
regularly spends at least eight hours a day in the Participant's home during such period.
3.23 Qualifying Dependent Care Services. "Qualifying Dependent Care
Services" or "Qualifying Services" means services performed to enable a Participant or his
Spouse to remain gainfully employed and which are relevant to the care of a Qualifying
Individual. Qualifying Services may be performed either in the home or outside the home of the
Participant. Such an expense shall be an Eligible Dependent Care Expense only if it is payable
to a person who is not (1) a Dependent of the Participant; (2) the Participant's Spouse; or (3) a
child of the Participant under the age of 19 as of the close of the Plan Year in which the services
are rendered.
3.24 Salary Reduction. "Salary Reduction" shall mean the amounts paid into
the Plan pursuant to elections made by the Participant to reduce his or her compensation for the
purchase of Benefits elected by the Participant.
3.25 Short Plan Year. "Short Plan Year" shall mean a Plan Year which is less.
than twelve (12) months and which ends on the last day of the Plan Year. This Short Plan Year
shall arise only in the following circumstances: (i) the initial Plan Year did not begin on July 1;
or (ii) the Employer changes the Plan Year for a valid business purpose resulting in a Short Plan
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Y e a r . I n t h e e v e n t t h a t a S h o r t P l a n Y e a r i s i n e f f e c t , a l l r e f e r e n c e s t o " P l a n Y e a r " s h a l l b e
r e p l a c e d b y " S h o r t P l a n Y e a r " i n a l l i n s t a n c e s w h e r e i t i s a p p r o p r i a t e .
3 . 2 6 S p o u s e . " S p o u s e " m e a n s t h e p e r s o n t o w h o m t h e P a r t i c i p a n t i s l e g a l l y
m a r r i e d b u t s h a l l n o t i n c l u d e a n i n d i v i d u a l l y l e g a l l y s e p a r a t e d f r o m a P a r t i c i p a n t u n d e r a d e c r e e
o f l e g a l s e p a r a t i o n . N o t w i t h s t a n d i n g , a P a r t i c i p a n t ' s r e g i s t e r e d d o m e s t i c p a r t n e r s h a l l b e e n t i t l e d
t o a n d r e c e i v e t h e s a m e r i g h t s a n d c o v e r a g e a t t r i b u t a b l e t o m e d i c a l a n d h e a l t h b e n e f i t s o f f e r e d
u n d e r t h e P l a n p u r s u a n t t o t h e C a l i f o r n i a D o m e s t i c P a r t n e r R i g h t s a n d R e s p o n s i b i l i t i e s A c t o f
2 0 0 3 .
3 . 2 7 S t u d e n t . " S t u d e n t " m e a n s a n i n d i v i d u a l w h o d u r i n g e a c h o f f i v e c a l e n d a r
m o n t h s d u r i n g a P l a n Y e a r i s e n r o l l e d a s a f u l l - t i m e s t u d e n t a t a n " e d u c a t i o n a l i n s t i t u t i o n . " F o r
t h i s p u r p o s e , " e d u c a t i o n a l i n s t i t u t i o n " m e a n s a n y i n s t i t u t i o n w h i c h n o r m a l l y m a i n t a i n s a r e g u l a r
f a c u l t y a n d c u r r i c u l u m a n d n o r m a l l y h a s a r e g u l a r l y e n r o l l e d b o d y o f p u p i l s o r s t u d e n t s i n
a t t e n d a n c e a t t h e p l a c e w h e r e i t s e d u c a t i o n a l a c t i v i t i e s a r e r e g u l a r l y c a r r i e d o n .
3 . 2 8 U n i f o r m e d S e r v i c e s . " U n i f o r m e d S e r v i c e s " s h a l l m e a n t h e A r m e d F o r c e s ,
t h e A r r n e d N a t i o n a l G u a r d , a n d t h e A i r N a t i o n a l G u a r d w h e n e n g a g e d i n a c t i v e d u t y f o r t r a i n i n g ,
i n a c t i v e d u t y t r a i n i n g , o r f u l l - t i m e N a t i o n a l G u a r d d u t y , t h e c o m m i s s i o n e d c o r p s o f t h e P u b l i c
H e a l t h S e r v i c e , a n d a n y o t h e r c a t e g o r y o f p e r s o n s d e s i g n a t e d b y t h e P r e s i d e n t o f t h e U n i t e d
S t a t e s i n t i m e o f w a r o r e m e r g e n c y .
3 . 2 9 P e r i o d o f C o v e r a g e . " P e r i o d o f C o v e r a g e " g e n e r a l l y m e a n s t h e P l a n Y e a r
b e g i n n i n g o n J a n u a r y 1 a n d e n d i n g o n D e c e m b e r 3 1 . A P a r t i c i p a n t ' s P e r i o d o f C o v e r a g e m a y b e
l e s s t h a n 1 2 m o n t h s i f a n e w P a r t i c i p a n t e n t e r s t h e P l a n d u r i n g t h e y e a r o r a P a r t i c i p a n t
c o m p l e t e s a p e r m i t t e d e l e c t i o n c h a n g e i n a c c o r d a n c e w i t h A r t i c l e V . A P a r t i c i p a n t ' s P e r i o d o f
C o v e r a g e s h a l l a l s o i n c l u d e c o n t i n u a t i o n c o v e r a g e e l e c t e d b y a t e r m i n a t e d P a r t i c i p a n t o r
Q u a l i f i e d B e n e f i c i a r y . A P a r t i c i p a n t ' s P e r i o d o f C o v e r a g e u n d e r t h e m e d i c a l s p e n d i n g a c c o u n t
o r d e p e n d e n t c a r e s p e n d i n g a c c o u n t s h a l l n o t b e l e s s t h a n t w e l v e ( 1 2 ) m o n t h s u n l e s s t h e P l a n
Y e a r i s S h o r t P l a n Y e a r .
A R T I C L E I V
E L I G I B I L I T Y A N D P A R T I C I P A T I O N
4 . 1 E l i g i b i l i t y . E a c h E m p l o y e e s h a l l b e e l i g i b l e t o p a r t i c i p a t e i n t h e P l a n a s o f
h i s o r h e r E n t r y D a t e .
4 . 2 P a r t i c i p a t i o n . A n E m p l o y e e m a y b e c o m e a P a r t i c i p a n t b y c o m p l e t i n g a n d
e x e c u t i n g a n e l e c t i o n f o r m a n d S a l a r y R e d u c t i o n A g r e e m e n t a n d b y p r o v i d i n g s u c h o t h e r
i n f o r m a t i o n a s i s r e a s o n a b l y r e q u i r e d b y t h e E m p l o y e r a s a c o n d i t i o n o f s u c h p a r t i c i p a t i o n . A
P a r t i c i p a n t ' s e l e c t i o n t o p a r t i c i p a t e i n t h e P l a n s h a l l c o n t i n u e t o b e v a l i d u n t i l e x p r e s s l y r e v o k e d
o r a l t e r e d , a s s e t f o r t h i n A r t i c l e V . T h e A d m i n i s t r a t o r s h a l l c o n t i n u e t o m a k e S a l a r y R e d u c t i o n s
a n d t h e P a r t i c i p a n t s h a l l b e d e e m e d t o h a v e s e l e c t e d t h e B e n e f i t s p r e v i o u s l y e l e c t e d b y
P a r t i c i p a n t i n s u b s e q u e n t P l a n Y e a r s c o n s i s t e n t w i t h t h e P a r t i c i p a n t ' s m o s t r e c e n t e l e c t i o n f o r m .
4 . 3 R e c o m m e n c e m e n t o f P a r t i c i p a t i o n . A f o r m e r a c t i v e P a r t i c i p a n t m a y
r e c o m m e n c e p a r t i c i p a t i o n i n t h e P l a n o n h i s d a t e o f r e e m p l o y m e n t a s a n e l i g i b l e E m p l o y e e .
H o w e v e r , a r e e m p l o y e d f o r m e r a c t i v e P a r t i c i p a n t m a y n o t m a k e a n e w e l e c t i o n t o p a r t i c i p a t e i n a
5
medical spending account and/or dependent care spending account which is effective during the
same Plan Year in which he or she separated from service with the Employer. If a former active
Participant is rehired by the Employer within 30 days of his or her date of termination, such
Participant shall not be permitted to submit a new election and his or her prior election shall be
reinstated for the remainder of the Plan Year.
Any employee who returns to active employment within ninety (90) days
of. completing a period of absence from employment for duty in the Uniformed Services shall
reenter the Plan upon reemployment. A Participant whose health coverage under the Plan is
terminated on account of his being in "uniformed service," and is later reinstated, shall not be
subject to a new exclusion or waiting period requirement imposed by such group health plan
and/or medical spending account, provided that such requirements would not have been imposed
if coverage had not been terminated as a result of the "uniformed service."
4.4 Leave of Absence. An Employee shall not be disqualified from
participating in the Plan during the period in which the Employee is on an authorized Leave of
Absence; however, that Employee shall continue to have an employment relationship with the
Employer and Employee shall pay the required costs of coverage as provided in Section 6.2.
A Participant who takes an unpaid leave of absence under FMLA ("FMLA
Leave") shall pay the required costs of coverage as provided in Section 6.2; however, the
Employee may revoke his or her election to participate under any group health insurance benefit
offered under this Plan, for the remainder of the Plan Year in which such leave of absence
commences. Such revocation shall take effect in accordance with such procedures as prescribed
by the Plan Administrator. Upon such Participant's return from his or her FMLA Leave, the
Participant may then elect to be immediately reinstated in the Plan, on the same terms that
applied to the Participant prior to the FMLA Leave, and with such other rights to revoke or
change elections as are provided to the Participants under the Plan. Notwithstanding the
foregoing, a Participant on FMLA Leave shall have no greater rights to benefits for the
remainder of the Plan Year in which the FMLA Leave commences as other Participants.
4.5 Cessation of Participation. An Employee shall cease to be a Participant
under this Plan and therefore, under each Component Plan, as of the earliest of:
(a) the date on which the Participant separates from service with the
Employer; or
(b) the date on which the Administrator, on a consistent and uniform
basis, deems the Participant has failed to make the required premium payments, including
the Salary Reduction, for the elected benefits, as provided in Section 4.6; or
(c) the date on which the Participant is not eligible to participate in.
any of the Component Plans for which he or she wishes to make an election; or
(d) the date on which the Participant dies; or
6
"
"
( e ) t h e d a t e o n w h i c h t h e P l a n t e r m i n a t e s .
4 . 6 C e s s a t i o n o f R e q u i r e d C o n t r i b u t i o n s . A P a r t i c i p a n t ' s e l e c t i o n t o
p a r t i c i p a t e i n t h e P l a n m a y b e t e r m i n a t e d i n a c c o r d a n c e w i t h S u b s e c t i o n 4 . 5 ( b ) i f t h e P a r t i c i p a n t
f a i l s t o m a k e t h e r e q u i r e d p r e m i u m p a y m e n t s w i t h r e s p e c t t o t h e B e n e f i t . I n s u c h c a s e , t h a t
i n d i v i d u a l m a y n o t m a k e a n e w b e n e f i t e l e c t i o n f o r t h e r e m a i n i n g p o r t i o n o f t h e P l a n Y e a r .
4 . 7 E l i g i b i l i t y U n d e r C o m p o n e n t P l a n s . T h e e l i g i b i l i t y o f a P a r t i c i p a n t u n d e r
a C o m p o n e n t P l a n s h a l l b e t h e s a m e a s s e t f o r t h i n t h i s A r t i c l e , u n l e s s o t h e r w i s e s p e c i f i e d i n t h e
C o m p o n e n t P l a n u n d e r w h i c h a P a r t i c i p a n t h a s e l e c t e d t o r e c e i v e b e n e f i t s . E a c h C o m p o n e n t
P l a n m a y p r o v i d e m o r e r i g o r o u s e l i g i b i l i t y r e q u i r e m e n t s w h i c h m a y c a u s e a P a r t i c i p a n t t o b e
i n e l i g i b l e t o p a r t i c i p a t e i n a p a r t i c u l a r C o m p o n e n t P l a n , b u t c o n t i n u e t o b e e l i g i b l e t o p a r t i c i p a t e
i n t h i s P l a n .
A R T I C L E V
E L E C T I O N S A N D P R O C E D U R E S .
5 . 1 I n i t i a l E l e c t i o n . P r i o r t o t h e a n n u a l E n t r y D a t e ( o r m i d - y e a r E n t r y D a t e
f o r n e w l y h i r e d E m p l o y e e s ) , t h e r e s h a l l b e a n O p e n E n r o l l m e n t P e r i o d d u r i n g w h i c h t h e
E m p l o y e e m a y e l e c t t o p a r t i c i p a t e i n t h i s P l a n . T h e A d m i n i s t r a t o r s h a l l p r o v i d e e a c h E m p l o y e e
d u r i n g e a c h O p e n E n r o l l m e n t P e r i o d w i t h a n e l e c t i o n f o r m a n d S a l a r y R e d u c t i o n A g r e e m e n t
w h i c h s h a l l i n c l u d e , a t a m i n i m u m , t h e f o l l o w i n g i n f o r m a t i o n :
( a ) t h a t t h e e l e c t i o n f o r m s h a l l b e c o m p l e t e d a n d r e t u r n e d t o t h e
A d m i n i s t r a t o r d u r i n g t h e O p e n E n r o l l m e n t P e r i o d ; a n d
( b ) t h a t t h e e l e c t i o n s h a l l b e e f f e c t i v e o n t h e E n t r y D a t e a n d c o n t i n u e
i n e f f e c t u n t i l t h e l a s t d a y o f t h e P l a n Y e a r f o r w h i c h t h e e l e c t i o n i s m a d e , o r u n t i l t h e
P a r t i c i p a n t p r o v i d e s t h e A d m i n i s t r a t o r w i t h a n e w e l e c t i o n f o r m m o d i f y i n g o r t e r m i n a t i n g
h i s o r h e r e x i s t i n g e l e c t i o n ; a n d
( c ) t h a t t h e e l e c t i o n s h a l l b e i r r e v o c a b l e , u n l e s s t h e P a r t i c i p a n t i s
e n t i t l e d t o c h a n g e h i s o r h e r e l e c t i o n a s p r o v i d e d i n t h i s A r t i c l e V ; a n d
( d ) t h a t t h e P a r t i c i p a n t ' s S a l a r y R e d u c t i o n s h a l l b e c o n s i d e r e d a s
e m p l o y e r c o n t r i b u t i o n s u s e d t o p a y f o r B e n e f i t s u n d e r t h e P l a n .
5 . 2 S a l a r y R e d u c t i o n . E a c h P a r t i c i p a n t s h a l l a u t h o r i z e t h e E m p l o y e r t o r e d u c e
h i s c o m p e n s a t i o n b y t h e a m o u n t n e e d e d f o r t h e p u r c h a s e o f B e n e f i t s , a s e l e c t e d b y t h a t
P a r t i c i p a n t . T h e A d m i n i s t r a t o r , m a y , i n i t s d i s c r e t i o n , e s t a b l i s h a l i m i t o n t h e a m o u n t o f S a l a r y
R e d u c t i o n s w h i c h a P a r t i c i p a n t m a y e l e c t f o r t h e P l a n Y e a r , f o r p u r p o s e s o f c o m p l y i n g w i t h t h e
n o n d i s c r i m i n a t i o n r e q u i r e m e n t s o f A r t i c l e X . S a l a r y R e d u c t i o n s s h a l l b e c o n t r i b u t e d t o t h e P l a n
b y t h e E m p l o y e r o n b e h a l f o f a P a r t i c i p a n t o n a l e v e l a n d p r o r a t a b a s i s f o r e a c h p a y r o l l p e r i o d .
I n t h e e v e n t t h a t a n E m p l o y e e c e a s e s t o b e a P a r t i c i p a n t i n t h i s P l a n , a P a r t i c i p a n t s h a l l h a v e n o
o b l i g a t i o n t o c o n t i n u e t o m a k e p a y m e n t s e q u a l t o t h e S a l a r y R e d u c t i o n .
5 . 3 E l e c t i o n o f B e n e f i t s . E a c h P a r t i c i p a n t s h a l l s u b m i t t o t h e E m p l o y e r o n t h e
e l e c t i o n f o r m p r o v i d e d b y t h e P l a n A d m i n i s t r a t o r h i s o r h e r e l e c t i o n a s t o t h e B e n e f i t s t o b e
7
provided by the Employer and the portion of his or her Salary Reductions which are to be
applied to provide each Benefit.
5.4 Participant .Makes Incorrect Election. If a Participant does not elect the
correct amount under his or her Salary Reduction to pay for coverage of the Benefits elected
under the Plan, the Administrator is authorized to increase or decrease a Participant's election by
the amount necessary to provide the Participant's elected coverage under the Plan.
5.5 Cost of Coverage Increased or Decreased. If the cost of any Benefit
offered under the Component Plans (except a Component Plan which provides for the
reimbursement of expenses) increases or decreases during the Plan Year, the Administrator may,
on a reasonable and consistent basis, automatically increase or decrease a Participant's election
by a corresponding amount of Salary Reduction to ensure that the Participant continues to
receive the elected coverage under the Component Plans; provided, however, that if the increase
or decrease is a significant change in cost, that the Participant shall be given the option to not
elect to change his or her benefits.
5.6 Administrator's Adiustment of Salary Reduction. The Administrator
maintains the right to adjust any Salary Reduction election made under the Plan to ensure that the
Plan complies with the nondiscrimination provisions of Article X.
5.7 Failure to Make Initial Election. If an Employee who is first eligible to
participate in the Plan fails to return the election form prior to the end of the Open Enrollment
Period, the Employee shall be deemed to have elected not to participate in the Plan.
5.8 Elections for Subsequent Plan Years.
(a) Open Enrollment Period. An Open Enrollment Period shall occur
prior to the beginning of each Plan Year. During the Open Enrollment Period, a
Participant who wishes to change his existing election, shall have the opportunity to elect
new or different coverage under the Plan effective for the subsequent Plan Year subject to
the terms and conditions of the Component Plans.
(b) Failure to Reelect. If a Participant fails to reelect coverage but
remains eligible to participate, the Participant shall be deemed to have elected the
Benefits selected on the election for the preceding Plan Year and a Salary Reduction
amount necessary to provide the same coverage. However, elections to contribute to the
Medical Reimbursement Plan or Dependent Care Plan must be affirmatively elected each
year by the Participant and a failure to reelect shall result in nonparticipation under the
Medical Reimbursement Plan or Dependent Care Plan.
5.9 Continuation Coverage. During an Open Enrollment Period, any
Participant, or a Qualified Beneficiary thereof, that has elected continuation of health coverage
under the Plan, shall have the opportunity to elect new or different coverage under the Plan
effective for the subsequent Plan Year. However, any such election shall be limited to health
care options under the Plan.
8
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5 . 1 0 S p e c i a l . E n r o l l m e n t P e r i o d . I n a c c o r d a n c e w i t h t h e C o d e S e c t i o n 9 8 0 1 ( 0
a n d t h e r e g u l a t i o n s i s s u e d b y t h e D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s , a n e l i g i b l e
E m p l o y e e o r D e p e n d e n t w h o e i t h e r i n c u r s a l o s s o f h e a l t h c o v e r a g e o r b e c o m e s o t h e r w i s e
e l i g i b l e f o r h e a l t h c o v e r a g e u n d e r t h i s P l a n s h a l l b e p e r m i t t e d t o e n r o l l f o r h e a l t h c o v e r a g e u n d e r
t h e P l a n i n a c c o r d a n c e w i t h o n e o f t h e s p e c i a l e n r o l h m e n t p e r i o d s d e s c r i b e d i n p a r a g r a p h s ( a ) a n d
( b ) b e l o w .
( a ) L o s s o f H e a l t h C o v e r a g e . A n E m p l o y e e w h o i s o t h e r w i s e e l i g i b l e
t o e n r o l l i n t h e P l a n b u t h a s n o t e l e c t e d t o p a r t i c i p a t e i n t h e P l a n , o r a D e p e n d e n t o f
E m p l o y e e t h a t i s n o t e n r o l l e d b u t o t h e r w i s e e l i g i b l e u n d e r t h e P l a n , s h a l l b e p e r m i t t e d t o
e n r o l l f o r c o v e r a g e u n d e r t h e P l a n p r o v i d e d :
( 1 ) T h e E m p l o y e e o r D e p e n d e n t w a s c o v e r e d u n d e r a n o t h e r
g r o u p h e a l t h p l a n o r h a d a l t e r n a t e h e a l t h i n s u r a n c e c o v e r a g e ( " P r i o r H e a l t h C o v e r a g e " ) a t
t h e t i m e c o v e r a g e u n d e r t h i s P l a n w a s p r e v i o u s l y o f f e r e d t o t h e E m p l o y e e .
( 2 ) T h e E m p l o y e e s t a t e d i n w r i t i n g a t s u c h t i m e t h a t P r i o r
H e a l t h C o v e r a g e w a s t h e r e a s o n f o r d e c l i n i n g e n r o l l m e n t .
( 3 )
w a s e i t h e r :
T h e E m p l o y e e ' s o r D e p e n d e n t ' s P r i o r H e a l t h C o v e r a g e
( i ) u n d e r a c o n t i n u a t i o n c o v e r a g e p r o v i s i o n a n d
t h e c o v e r a g e p e r i o d w a s e x h a u s t e d ; o r
( i i ) w a s t e r m i n a t e d a s a r e s u l t o f l o s s o f
e l i g i b i l i t y ( i n c l u d i n g a r e s u l t f r o m a c h a n g e i n f a m i l y s t a t u s ) o r e m p l o y e r
c o n t r i b u t i o n s t o w a r d s u c h c o v e r a g e w e r e t e r m i n a t e d .
U n d e r t h e t e r m s o f t h e P l a n , t h e e m p l o y e e r e q u e s t s s u c h e n r o l l m e n t n o t l a t e r t h a n 3 0 d a y s a f t e r
t h e d a t e o f a s p e c i a l e n r o l l m e n t e v e n t o r t h e d a t e a c e r t i f i c a t e o f g r o u p h e a l t h c o v e r a g e i s
p r o v i d e d f o l l o w i n g a t e r m i n a t i o n o f h e a l t h c o v e r a g e _
( b ) D e p e n d e n t S p e c i a l E n r o l l m e n t P e r i o d . A n y E m p l o y e e , r e g a r d l e s s
o f w h e t h e r s a i d E m p l o y e e i s c u r r e n t l y e n r o l l e d f o r h e a l t h c o v e r a g e u n d e r t h e P l a n , w h o
e x p e r i e n c e s a n i n c r e a s e i n t h e n u m b e r o f D e p e n d e n t s w h e t h e r t h r o u g h m a r r i a g e , b i r t h ,
a d o p t i o n o r p l a c e m e n t f o r a d o p t i o n , s h a l l b e p e r m i t t e d t o e n r o l l f o r h e a l t h c o v e r a g e u n d e r
t h e P l a n . D u r i n g t h e " d e p e n d e n t s p e c i a l e n r o l l m e n t p e r i o d , " E m p l o y e e s h a l l h a v e t h e
o p p o r t u n i t y t o e n r o l l a l l o t h e r D e p e n d e n t s w h o a r e o t h e r w i s e e l i g i b l e f o r c o v e r a g e ,
i n c l u d i n g t h e E m p l o y e e i f n o t e n r o l l e d , p r o v i d e d t h e E m p l o y e e e l e c t s e n r o l l m e n t w i t h i n
t h i r t y ( 3 0 ) d a y s c o m m e n c i n g o n t h e t a t e r o f : ( i ) t h e d a t e d e p e n d e n t c o v e r a g e i s m a d e
a v a i l a b l e ; o r ( i i ) t h e d a t e o f t h e m a r r i a g e , b i r t h , a d o p t i o n , p l a c e m e n t _ f o r a d o p t i o n , o r o t h e r
e v e n t w h i c h r e s u l t s i n t h e c h a n g e o f D e p e n d e n t s o f E m p l o y e e _
( c ) M e d i c a l S p e n d i n g A c c o u n t . N o t w i t h s t a n d i n g t h e f o r e g o i n g , t h e
s p e c i a l e n r o l l m e n t r i g h t s c o n v e y e d u n d e r t h i s S e c t i o n s h a l l n o t e x t e n d t o i n c l u d e a n
e l e c t i o n t o c o n t r i b u t e t o t h e M e d i c a l R e i m b u r s e m e n t P l a n o f f e r e d u n d e r t h e P l a n .
9
5.11 Revocability of Elections. The Administrator shall permit a Participant to
make a new election outside of the Open Enrollment Period for the remainder of a Plan Year
only if the new election is for one of the following reasons:
(a) both the revocation and new election are made on account of and
are consistent with a change in the Participant's family status, as set forth in Section 5.12;
(b) there is a significant change in the cost or coverage of the benefits
previously elected by the Participant, as set forth in Section 5.13;
(c) both the revocation and new election are made on account of and
pursuant to the terms of a "qualified medical child support order" as defined in ERISA
Section 609, as set forth in Section 5.15; or
(d) the Participant, spouse or dependent becomes eligible for
continuation coverage under Article IX and the Participant desires to elect to increase the
amount of his or her Salary Reduction in order to pay for the continuation coverage.
5.12 Change in Family Status. A Participant may make a change in coverage
during a Plan Year due to a change in family status, as set forth in this Section. A Participant
must notify the Administrator and must complete a new election form to change coverage. The
Participant's election shall only be deemed valid if the requested change in coverage is
necessitated by and corresponds with the change in family status and is consistent with the terms
and conditions of the affected Component Plan. This election shall be effective as of the first
day of the month following the date the Participant provides the Administrator with a new
election form reflecting the change in coverage due to a change in family status.
A change in family status shall include the following:
(a) a change in the Participant's marital status, including marriage,
death of spouse, divorce, legal separation, or annulment;
(b) a change in the number of dependents of a Participant (as defined
in Code Section 152), including a birth of a child, adoption, placement for adoption, or
death of a dependent;
(c) any change in the employment status of the Participant, spouse or
dependent which results in that individual becoming or ceasing to be eligible under this
Plan or other employee benefit plan maintained by the employer of the Participant,
spouse or dependent, including a termination or commencement of employment; a strike
or lockout; a commencement or return from an unpaid leave of absence (including leave
taken under FMLA); a change in work site; or a reduction or increase in hours of
employment (including a switch between part-time and full-time);
(d) a dependent satisfies or ceases to satisfy the eligibility
requirements for coverage due to attainment of age, student status, or any similar
circumstances as provided under the Component Plan under which the employee receives
coverage;
10
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(e) a change in the place of residence of the Participant, spouse, or
dependent; and
(f) a Participant, spouse, or dependent becoming or ceasing to be
entitled to coverage under MediCare or Medicaid.
To the extent the Code, and regulations issued thereunder, alters this
definition of change in family status, this Section 5.12 is intended to be interpreted in accordance
with any revised definition or interpretation.
5.13 Significant Change in Cost of Benefit. If the cost of a Benefit option
(other than a Component Plan which provides for the reimbursement of expenses) significantly
increases during a coverage period, all affected Participants may make a corresponding change in
their benefit election under the Plan. Changes that may be made include the following:
(1) In the case of a Benefit option which has experienced a
significant decrease in cost, a Participant may make a prospective change to an election
to commence participation in that Benefit option.
(2) In the case of a Benefit option what has experienced a
significant increase in cost, a Participant may change an election to terminate such
coverage and either, elect prospective coverage under another Benefit option providing
similar coverage or drop coverage if no other Benefit option providing similar coverage
is available.
For purposes of this Section, a "cost of increase or decrease" refers to an increase or decrease in
the amount of the Salary Reductions contributed by a Participant under the Plan, whether than
increase or decrease results from an action taken by the Employee (such as switching between
full-time and part-time status) or from an action taken by the Employer (such as reducing the
amount of Employer contributions for a class of Employees).
In the case of an election for a Benefit option under the Plan which provides for the
reimbursement of qualified dependent care expenses, a Participant's prior election may be
changed only if the cost change is imposed by a dependent care provider who is not a relative of
the employee.
5.14 Significant Change in Covera_ge of Component Plan Benefit.
(a) Significant Curtailment Without Loss of Coverage. If.a Participant
or a Participant's spouse or dependent experiences a "significant curtailment of coverage"
under a Benefit option that is not a loss of coverage, including a significant increase in
the deductible, co -payment, or the out-of-pocket cost sharing limit under a group health
plan; the Participant may revoke his or her election for such coverage and prospectively
elect to receive coverage under another Benefit option providing similar coverage. For
this purpose, coverage under a Component Plan is "significantly curtailed" only if there is
an overall reduction in coverage provided under the Component Plan so as to constitute
reduced coverage generally. In this regard, the loss of one particular physician in a health
11
4-7
care provider network in most cases will not qualify for a significant curtailment of
coverage under this Section.
(b) Significant Curtailment With Loss of Coverage. If a Participant or
a Participant's spouse or dependent experiences a significant curtailment of coverage that
is a "loss of coverage" under a Benefit option, the Participant may revoke his or her
election for such coverage and elect either to receive coverage under another Benefit
option providing similar coverage or to drop coverage if no other Benefit option
providing similar coverage is available under the Plan. For this purpose, a "loss of
coverage" means a complete loss of coverage under a benefit package option or other
coverage option, including the elimination of a benefits package option, an HMO ceasing
to be available in the area where the individual resides, or the individual losing all
coverage under. the option by reason of an overall lifetime or annual Iimitation under a
group health plan. In this regard, each of the following is considered to be a "loss of
coverage" under this Section:
(1) a substantial decrease in the medical care providers
available under the Benefit option (such as a major hospital ceasing to be a member of a
preferred provider network or a substantial decrease in the physicians participating in a
preferred provider network or an HMO;
(2) a reduction in the benefits for a specific type of medical
condition or treatment with respect to which a Participant or the Participant's spouse or
dependent is currently in a course of treatment; or
(3) any other similar fundamental loss of coverage;
(c) Addition or Improvement of Benefit Option. If during the Plan
Year, a Component Plan adds a new benefit package option or other coverage option, or
if coverage under an existing option is significantly improved, any Participant or
Employee, who is otherwise eligible to participate in the Plan, may revoke his or her
election under the Plan for the Plan Year and make an election on prospective basis for
coverage under the new or improved benefit option.
(d) Change In Coverage Under Another Employer Plan. A
Participant, or an Employee who is otherwise eligible to participate in the Plan but has
elected not to participate, may make a prospective election change that is on account of
and consistent with a change made under another employer plan (including a plan of the
Employer or another employer) by the Employee or the Employee's spouse or dependent,
provided the other employer plan allows participants to make an election change that
would be permitted under the rules of IRS Reg. § 1.125-4(c) and as provided in this Plan.
5.15 Oualified Medical Child Support Order. A Participant may make a change
in coverage during a Plan Year to provide health coverage under the Plan for Participant's child
or legal dependent pursuant to the terms of a judgment, decree, or order resulting from a family
law proceeding, including a "qualified child support order" as defined under ERISA Section 609,
requiring Participant to provide health coverage for the child. The Participant may also make a
12
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•
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"
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c h a n g e w h i c h c a n c e l s h e a l t h c o v e r a g e f o r t h e P a r t i c i p a n t ' s c h i l d o r d e p e n d e n t p r o v i d e d t h e o r d e r
r e q u i r e s t h e s p o u s e , f o r m e r s p o u s e , o r o t h e r i n d i v i d u a l t o p r o v i d e h e a l t h c o v e r a g e f o r t h e c h i l d :
5 . 1 6 U s e o f E l e c t r o n i c M e d i u m f o r P a r t i c i p a n t N o t i c e s a n d E l e c t i o n s .
( a ) D e f i n i t i o n o f E l e c t r o n i c M e d i u m . " E l e c t r o n i c M e d i u m "
m e a n s a n e l e c t r o n i c m e t h o d o f c o m m u n i c a t i o n b e t w e e n t h e P l a n A d m i n i s t r a t o r ( o r i t s
d e s i g n a t e d r e p r e s e n t a t i v e ) a n d E m p l o y e e t h e r e b y a l l o w i n g e a c h p a r t y t o s e n d a n d r e c e i v e
n o t i c e a n d e l e c t i o n s t h r o u g h t h e s a m e m e d i u m . T h e o n l y f o r m o f e l e c t r o n i c
c o m m u n i c a t i o n p e r m i t t e d b y t h e P l a n s h a l l b e v i a e l e c t r o n i c m a i l o n t h e E m p l o y e r ' s
n e t w o r k o r i n t r a n e t , t h r o u g h a n i n t e r a c t i v e w e b s i t e , o r t o a p r i v a t e e - m a i l a d d r e s s
s u p p l i e d t o t h e E m p l o y e r b y t h e E m p l o y e e f o r c o m m u n i c a t i o n p u r p o s e s . T h e e l e c t r o n i c
m e d i u m m u s t b e d e s i g n e d s o t h a t t h e i n f o r m a t i o n p r o v i d e d i s n o l e s s u n d e r s t a n d a b l e t o
t h e r e c e i v i n g p a r t y t h a n a w r i t t e n p a p e r d o c u m e n t . T h e e l e c t r o n i c m e d i u m s h a l l b e
d e s i g n e d t o a l e r t t h e E m p l o y e e , a t t h e t i m e a n o t i c e i s p r o v i d e d , t o t h e s i g n i f i c a n c e o f t h e
i n f o r m a t i o n i n t h e n o t i c e ( i n c l u d i n g i d e n t i f i c a t i o n o f t h e s u b j e c t m a t t e r o f t h e n o t i c e ) , a n d
p r o v i d e a n y i n s t r u c t i o n s n e e d e d t o a c c e s s t h e n o t i c e , i n a m a n n e r t h a n i s r e a d i l y
u n d e r s t a n d a b l e . T h e e l e c t r o n i c m e d i u m s h a l l b e d e s i g n e d t o p r e c l u d e a n y p e r s o n , o t h e r
t h a n t h e a p p r o p r i a t e i n d i v i d u a l , f r o m m a k i n g a P a r t i c i p a n t e l e c t i o n , s u c h a s S a l a r y
R e d u c t i o n A g r e e m e n t , o r a c c e s s i n g i n d i v i d u a l p a r t i c i p a n t a c c o u n t i n f o r m a t i o n .
( b ) D i s c l o s u r e a n d C o n s e n t R e q u i r e m e n t s .
( 1 ) D i s c l o s u r e S t a t e m e n t . P r i o r t o e l e c t r o n i c a l l y
t r a n s m i t t i n g a n y c o n s e n t o r n o t i c e t o t h e E m p l o y e e , t h e P l a n A d m i n i s t r a t o r s h a l l
p r o v i d e a s t a t e m e n t w h i c h c o n t a i n s t h e f o l l o w i n g : ( i ) i n f o r m s t h e E m p l o y e e o f
t h e r i g h t t o r e c e i v e a p a p e r d o c u m e n t o f t h e n o t i c e o r o t h e r P l a n - r e l a t e d m a t e r i a l
e i t h e r p r i o r t o o r a f t e r g i v i n g c o n s e n t t o e l e c t r o n i c t r a n s m i s s i o n ; ( i i ) i n f o r m s t h e
E m p l o y e e o f t h e r i g h t t o w i t h d r a w h i s o r h e r c o n s e n t a t a n y t i m e a n d t h e
p r o c e d u r e s f o r w i t h d r a w a l , i n c l u d i n g a n y c o n d i t i o n s o r c o n s e q u e n c e s a r i s i n g f r o m
s u c h w i t h d r a w a l ; ( i i i ) d e s c r i b e s t h e s c o p e a n d d u r a t i o n o f t h e c o n s e n t a s i t r e l a t e d
t o v a r i o u s p l a n t r a n s a c t i o n s ; ( i v ) d e s c r i b e s t h e p r o c e d u r e s f o r u p d a t i n g E m p l o y e e
c o n t a c t i n f o r m a t i o n ; a n d ( v ) d e s c r i b e s t h e h a r d w a r e o r s o f t w a r e r e q u i r e m e n t s
n e e d e d t o a c c e s s a n d r e t a i n t h e n o t i c e .
( 2 ) C o n s e n t . T h e P l a n A d m i n i s t r a t o r s h a l l b e
e x e m p t f r o m t h e c o n s e n t r e q u i r e m e n t s o f S e c t i o n 1 0 1 ( c ) o f t h e E l e c t r o n i c
S i g n a t u r e s i n G l o b a l a n d N a t i o n a l C o m m e r c e A c t ( E - S I G N ) p r o v i d e d t h e
E l e c t r o n i c M e d i u m u s e d t o p r o v i d e n o t i c e s a n d P l a n - r e l a t e d m a t e r i a l i s a m e d i u m
t h a t t h e E m p l o y e e h a s t h e e f f e c t i v e a b i l i t y t o a c c e s s a n d t h e E m p l o y e e i s a d v i s e d ,
e a c h t i m e a n o t i c e i s t r a n s m i t t e d , t h a t h e o r s h e c a n r e q u e s t t o r e c e i v e t h e n o t i c e i n
p a p e r f o r m a t n o c h a r g e . T h e f o r m o f E l e c t r o n i c M e d i u m u t i l i z e d b y t h i s P l a n
s h a l l b e t h r o u g h a n i n t e r a c t i v e w e b s i t e r e q u i r i n g t h e E m p l o y e e t o r e g i s t e r a n e -
m a i l a d d r e s s f o r c o m m u n i c a t i o n p u r p o s e s .
( 3 ) C h a n g e s i n H a r d w a r e o r S o f t w a r e
R e q u i r e m e n t s . I n t h e e v e n t o f a n y c h a n g e s i n t h e h a r d w a r e o r s o f t w a r e
1 3
requirements needed to access the Electronic Medium, the Plan Administrator, or
its designated representative, shall provide a statement to each Employee of the
revised requirements and the right to withdraw consent to receive electronic
delivery of Plan -related materials without consequence.
(c) Participant Elections. The Plan Adminishator, or its
designated representative, shall be permitted to electronically distribute participant
elections by Electronic Medium. Each Employee who is provided with enrollment or
Election information via Electronic Medium will also be informed by the Plan
Administrator that he or she may receive a paper copy of the relevant documents upon
request. A participant election will not be treated as being made available to an
individual if such individual cannot effectively access the Electronic Medium for
purposes of making the election. An election completed by an Employee via Electronic
Medium shall be deemed as being provided in written form so long as the following
requirements are satisfied:
(i) The Employee has a reasonable opportunity
review, confirm, modify or rescind the terms of the election before the election
becomes effective
(ii) The Employee receives, within a reasonable
time, a confirmation of the election either through written paper form or by
electronic mail (e-mail).
(d) Timing and Content of Elections and Notices. The
provisions of this Section 4.10 shall in no way affect or alter the timing or content
requirements applicable to each individual notice or document.
ARTICLE VI
FUNDING AND AVAILABLE BENEFITS
6.1 Funding. The Benefits provided herein shall be paid by the Employer;
provided, however, that the Employer's payments under the Plan shall be limited to such
amounts of compensation as a Participant elects to forego pursuant to his or her Salary Reduction
election. Amounts contributed through Salary Reduction shall be used to purchase the Benefits
offered under this Plan.
6.2 Payment of Contributions While on FMLA Leave. Upon a Participant
taking an unpaid FMLA leave of absence ("FMLA Leave"), each health care benefit elected by
the Participant shall continue during the FMLA Leave for a period not longer than twelve (12)
weeks, unless otherwise revoked by the Participant. During the unpaid FMLA Leave, the
Participant shall be responsible for making the required contributions for such benefits during the
period of the FMLA Leave. The Participant may select among the Prepayment Option, Catch -
Up Option, and Pay -As -You -Go Option to pay the contributions during FMLA Leave.
(a) Prepayment. The Participant may elect to prepay the contributions
prior to commencing the FMLA Leave. The prepaid contributions may be made from
14
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s a l a r y , v a c a t i o n p a y o r s i c k p a y , t o t h e e x t e n t p e r m i t t e d b y a p p l i c a b l e l a w a n d i n a
m a n n e r w h i c h w i l l n o t d e f e r c o m p e n s a t i o n t o a s u b s e q u e n t P l a n Y e a r . I n t h e e v e n t , a
P a r t i c i p a n t ' s F M L A L e a v e w i l l s p a n t w o P l a n Y e a r s , t h e P a r t i c i p a n t m a y o n l y p r e p a y
c o n t r i b u t i o n s f o r t h e r e m a i n d e r o f t h e P l a n Y e a r a n d s h a l l b e r e q u i r e d t o u t i l i z e a n o t h e r
p a y m e n t o p t i o n h e r e u n d e r t o m a k e t h e c o n t r i b u t i o n s f o r t h e s u b s e q u e n t P l a n Y e a r . T h e
P r e p a y m e n t O p t i o n m a y n o t b e r e q u i r e d a s a c o n d i t i o n t o r e m a i n i n g i n t h e P l a n , a n d
p r e p a y m e n t m a y n o t b e t h e s o l e m e t h o d o f m a k i n g c o n t r i b u t i o n s h e r e u n d e r .
( b ) P a y - A s - Y o u - G o . T h e P a r t i c i p a n t m a y e l e c t t o p a y t h e
c o n t r i b u t i o n s o n a n a f t e r - t a x b a s i s a s d u e . P a y m e n t s s h a l l b e m a d e o n t h e s a m e s c h e d u l e
a s p a y m e n t s w o u l d h a v e b e e n d u e i f t h e P a r t i c i p a n t h a d n o t b e e n o n F M L A L e a v e , o n t h e
s a m e s c h e d u l e a s p a y m e n t s r e q u i r e d f o r c o n t i n u a t i o n c o v e r a g e u n d e r A r t i c l e V I I I
h e r e u n d e r a r e m a d e , u n d e r t h e E m p l o y e r ' s e x i s t i n g r u l e s f o r p a y m e n t b y e m p l o y e e s o n
l e a v e w i t h o u t p a y , o r o n a n y o t h e r s c h e d u l e v o l u n t a r i l y a g r e e d u p o n b y t h e P l a n
A d m i n i s t r a t o r a n d t h e P a r t i c i p a n t t h a t i s n o t c o n s i s t e n t w i t h F M L A .
C o n t r i b u t i o n s u n d e r t h e P a y - A s - Y o u - G o O p t i o n m a y a l s o b e p a i d
o n a p r e - t a x b a s i s f r o m t a x a b l e c o m p e n s a t i o n s u c h a s v a c a t i o n p a y o r s i c k p a y p r o v i d e d
s u c h p a y m e n t w i l l n o t d e f e r c o m p e n s a t i o n t o a s u b s e q u e n t P l a n Y e a r .
( c ) C a t c h - U p O p t i o n . T h e E m p l o y e r m a y a s s u m e r e s p o n s i b i l i t y f o r
a d v a n c i n g t h e c o n t r i b u t i o n s o n b e h a l f o f t h e P a r t i c i p a n t , a n d m a y r e c o u p s u c h
c o n t r i b u t i o n s u p o n t h e P a r t i c i p a n t ' s r e t u r n t o e m p l o y m e n t . T h e c o n t r i b u t i o n s m a y b e
m a d e o n a p r e - t a x s a l a r y r e d u c t i o n b a s i s f r o m s a l a r y , v a c a t i o n p a y o r s i c k p a y w h e n t h e
P a r t i c i p a n t r e t u r n s f r o m F M L A L e a v e . T h e " C a t c h - U p O p t i o n " s h a l l b e a p p l i e d i n a
m a n n e r c o n s i s t e n t w i t h P r o p . T r e a s u r y R e g u l a t i o n s S e c t i o n 1 . 1 2 5 - 3 .
T h e P r e p a y m e n t O p t i o n a n d C a t c h - U p O p t i o n m a y n o t b e o f f e r e d
w i t h o u t a l s o o f f e r i n g t h e P a y - A s - Y o u - G o O p t i o n .
6 . 3 U n i f o r m e d S e r v i c e U n d e r U S E R R A . I n a c c o r d a n c e w i t h t h e U n i f o r m e d
S e r v i c e s E m p l o y m e n t a n d R e e m p l o y m e n t R i g h t s A c t o f 1 9 9 4 ( " U S E R R A " ) , a P a r t i c i p a n t w h o i s
a b s e n t f r o m e m p l o y m e n t w i t h t h e E m p l o y e r o n a c c o u n t o f b e i n g i n t h e U n i f o r m e d S e r v i c e s a s
d e f i n e d i n S e c t i o n 3 . 2 3 , m a y e l e c t t o c o n t i n u e p a r t i c i p a t i o n i n t h e P l a n . T h e c o v e r a g e p e r i o d
s h a l l e x t e n d f o r t h e l e s s e r o f e i g h t e e n ( 1 8 ) m o n t h s o r u n t i l t h e P a r t i c i p a n t f a i l s t o a p p l y f o r
r e i n s t a t e m e n t o r t o r e t u r n t o e m p l o y m e n t w i t h t h e E m p l o y e r . T h e P a r t i c i p a n t s h a l l b e
r e s p o n s i b l e f o r m a k i n g t h e r e q u i r e d c o n t r i b u t i o n s t o p a y f o r b e n e f i t s e l e c t e d d u r i n g t h e p e r i o d
d u r i n g w h i c h h e o r s h e i s i n " u n i f o r m e d s e r v i c e . " T h e m a n n e r i n w h i c h s u c h p a y m e n t s a r e m a d e
s h a l l b e d e t e r m i n e d b y t h e P l a n A d m i n i s t r a t o r , i n a m a n n e r s i m i l a r t o t h e p a y m e n t o f
c o n t r i b u t i o n s w i t h r e s p e c t t o F M L A L e a v e .
6 . 4 P r o v i s i o n o f B e n e f i t s . T h e E m p l o y e r s h a l l p r o v i d e s u c h B e n e f i t s a s t h e
P a r t i c i p a n t h a s e l e c t e d u n d e r t h e P l a n , i n s u c h a m o u n t s a s d o n o t e x c e e d t h e a m o u n t a l l o c a t e d
u n d e r t h e P a r t i c i p a n t ' s e l e c t i o n . T h e B e n e f i t s s h a l l b e p r o v i d e d p u r s u a n t t o t h e t e r m s a n d
c o n d i t i o n s o f t h e C o m p o n e n t P l a n s , w h e r e a p p l i c a b l e , a s s h a l l b e s e t f o r t h f r o m t i m e t o t i m e i n
t h e i n d i v i d u a l C o m p o n e n t P l a n d o c u m e n t s ; p r o v i d e d , h o w e v e r , t h a t t h e t e r m s a n d c o n d i t i o n s o f
t h e C o m p o n e n t P l a n s a r e n o t i n c o n s i s t e n t w i t h t h e t e r m s a n d c o n d i t i o n s o f t h i s P l a n . N o B e n e f i t
1 5
under the Plan shall be paid in any manner that defers the receipt of compensation beyond the
last day of the Plan Year.
6.5 Spending Accounts. The amounts designated by Participant in his Salary
Reduction Agreement to be applied for medical reimbursement or dependent care assistance
shall be credited to a separate ledger account in the Participant's name. Such amounts credited
to a Participant's spending account for any Plan Year shall be used only toward the payment of
or reimbursement for Participant's Eligible Expenses incurred for such Plan Year, as determined
under Article VII and Article VIII.
6.6 Reimbursements. Except as otherwise provided in this Plan or any
Component Plan, contract or arrangement established to provide Benefits, reimbursement of
Expenses shall be made at such time and in such amounts as shall be determined by the
Employer in accordance with Treasury Regulations Section 1.125-2 Q&A 7(b)(2). The amount
credited to a Participant's spending account(s) under any Component Plan for any Plan Year
shalI be used only to reimburse the Participant for expenses incurred for such Plan Year, and
only if the Participant applies for reimbursement during the reimbursement time limits (including
any extended grace period) set forth by the Component Plan.
6.7 Taxable Benefits. If offered by the Employer, Employees shall be
permitted to elect to receive certain permitted taxable benefits. An employee receiving such
benefits shall be treated as having received, at the time that the benefit is received, cash
compensation equal to the full value of the benefits and then as having purchased the benefits
with after-tax employee contributions.
The Employer shall also be permitted to allow Participants to elect health
coverage under the Plan for an individual who is not the spouse or Dependent of the Participant;
provided, however, that the fair market value of such health coverage is included in the
Participant's W-2 income.
ARTICLE VII
DEPENDENT CARE SPENDING ACCOUNTS
7.1 Component PIan. This Article VII shall set forth the provisions for the
RIVERSIDE COUNTY TRANSPORTATION COMMISSION DEPENDENT CARE
REIMBURSEMENT PLAN ("Dependent Care Plan'). Benefits under the Dependent Care Plan
shall take the form of reimbursement by the Employer for Eligible Dependent Care Expenses
incurred by a Participant during the Plan Year. A Participant shall only be entitled to
reimbursement of Eligible Dependent Care Expenses incurred after electing to participate in the
Dependent Care Plan.
7.2 Annual Election. For each Plan Year, a Participant shall affirmatively
specify the amount of the Participant's Salary Reduction to be allocated to the Dependent Care
Plan. The maximum annual amount which may be allocated by a Participant may not exceed the
least of the following:
16
•
"
"
"
( a ) $ 5 , 0 0 0 ( o r $ 2 , 5 0 0 i n t h e c a s e o f a m a r r i e d P a r t i c i p a n t f i l i n g a
f e d e r a l i n c o m e t a x r e t u r n s e p a r a t e f r o m t h i s S p o u s e ) ;
( b ) I f t h e P a r t i c i p a n t i s u n m a r r i e d a t t h e c l o s e o f t h e P l a n Y e a r , h i s
C o m p e n s a t i o n f o r s u c h P l a n Y e a r , o r
( c ) I f t h e P a r t i c i p a n t i s m a r r i e d a t t h e c l o s e o f a P l a n Y e a r , h i s
C o m p e n s a t i o n f o r s u c h P l a n Y e a r .
N o t w i t h s t a n d i n g t h e a b o v e , t h e m a x i m u m e l e c t i o n a m o u n t m u s t a l s o b e
r e d u c e d b y t h e a m o u n t o f a n y t a x - e x e m p t d e p e n d e n t c a r e a s s i s t a n c e b e n e f i t s r e c e i v e d b y t h e
P a r t i c i p a n t o r h i s S p o u s e f r o m a n y o t h e r e m p l o y e r d u r i n g t h e P l a n Y e a r .
F o r p u r p o s e s o f t h i s S e c t i o n 7 . 2 , " C o m p e n s a t i o n " m e a n s a l l e a r n i n g s o f a
P a r t i c i p a n t r e p o r t a b l e o n F o r m W - 2 f o r t h e P l a n Y e a r , b u t d o e s n o t i n c l u d e a n y a m o u n t s r e c e i v e d
f r o m a d e p e n d e n t c a r e a s s i s t a n c e p l a n , a n y p e n s i o n o r a n n u i t y , o r a s u n e m p l o y m e n t o r w o r k e r ' s
c o m p e n s a t i o n i n a c c o r d a n c e w i t h S e c t i o n 1 2 9 ( e ) ( 2 ) o f t h e C o d e .
F o r p u r p o s e s o f c a l c u l a t i n g t h e m a x i m u m a n n u a l b e n e f i t f o r a P l a n Y e a r ,
C o m p e n s a t i o n s h a l l b e t h e l e s s e r o f t h e P a r t i c i p a n t ' s C o m p e n s a t i o n d e t e r m i n e d u n d e r t h e
p r e c e d i n g p a r a g r a p h o r t h e P a r t i c i p a n t ' s S p o u s e ' s C o m p e n s a t i o n , i f t h e P a r t i c i p a n t i s m a r r i e d a t
t h e c l o s e o f t h e P l a n Y e a r . I f d u r i n g a n y t a x a b l e m o n t h t h e P a r t i c i p a n t ' s S p o u s e i s a S t u d e n t o r
i s p h y s i c a l l y o r m e n t a l l y i n c a p a c i t a t e d , t h e S p o u s e ' s C o m p e n s a t i o n f o r s u c h m o n t h s h a l l b e
d e e m e d t o b e $ 2 0 0 i f t h e r e i s o n e Q u a l i f y i n g I n d i v i d u a l f o r w h o m t h e P a r t i c i p a n t i n c u r s E l i g i b l e
D e p e n d e n t C a r e E x p e n s e s d u r i n g t h e P l a n Y e a r , o r $ 4 0 0 i f t h e r e a r e t w o o r m o r e Q u a l i f y i n g
I n d i v i d u a l s , i n a c c o r d a n c e w i t h S e c t i o n 2 1 ( d ) o f t h e C o d e .
7 . 3 S p e n d i n g A c c o u n t . T h e s o l e s o u r c e f o r p a y m e n t o f D e p e n d e n t C a r e
B e n e f i t s u n d e r t h i s A r t i c l e V I I s h a l l b e t h e u n f u n d e d a c c o u n t s e s t a b l i s h e d f o r e a c h P a r t i c i p a n t
p u r s u a n t t o h i s a n n u a l e l e c t i o n u n d e r S e c t i o n 5 . 4 . T h e P l a n A d m i n i s t r a t o r s h a l l r e i m b u r s e e a c h
P a r t i c i p a n t f o r h i s E l i g i b l e D e p e n d e n t C a r e E x p e n s e s a n d h i s s p e n d i n g a c c o u n t s h a l l b e d e b i t e d
a c c o r d i n g l y . T h e a g g r e g a t e r e i m b u r s e m e n t s m a d e a t a n y t i m e d u r i n g t h e P l a n Y e a r s h a l l n o t
e x c e e d t h e P a r t i c i p a n t ' s t o t a l c o n t r i b u t i o n s t o t h e D e p e n d e n t C a r e P l a n f o r t h e P l a n Y e a r .
7 . 4 R e i m b u r s e m e n t o f E l i g i b l e E x p e n s e s . A P a r t i c i p a n t s h a l l o n l y b e e n t i t l e d
t o r e i m b u r s e m e n t o f s u b s t a n t i a t e d E l i g i b l e D e p e n d e n t C a r e E x p e n s e s i n c u r r e d d u r i n g t h e P l a n
Y e a r . A n E l i g i b l e D e p e n d e n t C a r e E x p e n s e s h a l l b e c o n s i d e r e d i n c u r r e d w h e n t h e s e r v i c e s
g i v i n g r i s e t o s u c h e x p e n s e a r e p r o v i d e d , i r r e s p e c t i v e o f w h e n P a r t i c i p a n t i s f o r m a l l y b i l l e d o r
p a y s f o r s u c h e x p e n s e s . T h e a m o u n t o f r e i m b u r s e m e n t r e c e i v e d b y a P a r t i c i p a n t s h a l l a t n o t i m e
e x c e e d t h e b a l a n c e o f h i s d e p e n d e n t c a r e s p e n d i n g a c c o u n t . A n e x p e n s e i n e x c e s s o f t h e a c c o u n t
b a l a n c e s h a l l n o t b e r e i m b u r s e d . A n e x p e n s e m u s t b e i n c u r r e d d u r i n g t h e P l a n Y e a r t o b e
e l i g i b l e f o r r e i m b u r s e m e n t ; h o w e v e r , s u c h r e i m b u r s e m e n t m a y b e m a d e a f t e r t h e P a r t i c i p a n t ' s
c e s s a t i o n o f p a r t i c i p a t i o n o r a f t e r t h e P l a n Y e a r a s p r o v i d e d i n S e c t i o n 7 . 7 . I f a P a r t i c i p a n t
c e a s e s p a r t i c i p a t i o n i n t h e P l a n p r i o r t o t h e e n d o f t h e P l a n Y e a r , w h e t h e r d u e t o t e r m i n a t i o n o f
e m p l o y m e n t o r o t h e r w i s e , a n d h a s u n r e i m b u r s e d c o n t r i b u t i o n s r e m a i n i n g i n h i s o r h e r d e p e n d e n t
c a r e s p e n d i n g a c c o u n t s u c h P a r t i c i p a n t m a y r e c e i v e r e i m b u r s e m e n t f o r c l a i m s f o r p o s t -
1 7
termination Eligible Dependent Care Expenses incurred during the remaining Plan Year or the
Grace Period in Section 7.7, immediately following that Plan Year.
7.5 Limitations on Reimbursement/Forfeiture. The Employer's payment of
Dependent Care Benefits for any Plan Year will be limited to the lesser of (I) the Participant's
Eligible Dependent Care Expenses for the year, or (2) the amount of the Participant's election for
Dependent Care Benefits for the year. A Participant shall receive no reimbursement for
Dependent Care Benefits which are elected but unused during a Plan Year, for any reason. Any
balance remaining in the Participant's spending account after all Eligible Dependent Care
Expenses have been paid shall be forfeited by the Participant and the account balance reduced to
zero.
7.6 Claim for Benefits. Each Participant who desires to receive
reimbursement under the Plan for Eligible Dependent Care Expenses shall submit to the Plan
Administrator or the designated claims representative at the times indicated in Section 7.7, a
form provided by the Employer, or responses to other supplementary factual requests, containing
the following information:
(a) the name, age, and relationship to the Participant of the Qualifying
Individual for whom the Eligible Dependent Care Expenses were incurred;
(b) if any of the Qualifying Dependent Care Services were performed
outside the Participant's home for a Qualifying Individual incapable of caring for
himself, a statement as to whether said Qualifying Individual regularly spends at least
eight (8) hours a day in the Participant's home;
(c) if any of the Qualifying Dependent Care Services are performed
for a Qualifying Individual who is physically or mentally incapable of caring for himself,
a statement to that effect;
(d) the nature and dates of performance of the Qualifying Dependent
Care Services subject to reimbursements;
(e) the relationship, if any, to the Participant of the person(s) providing
the Qualifying Dependent Care Services;
(f) a statement indicating that the Participant will include on his
federal income tax return the name, address, and (except in the case of a tax-exempt
Qualifying Day Care Center) the taxpayer identification number of the provider of the
Qualifying Dependent Care Services;
(g) if the Participant is married and his Spouse is employed, a
statement of the Spouse's Compensation; or if the Spouse is not employed, a statement
that the Spouse is incapacitated or the Spouse is a student, indicating the months of the
year during which the Spouse attends an Educational Institution on a foil -time basis;
18
"
( h ) a s t a t e m e n t a s t o t h e a m o u n t , i f a n y , o f t a x - e x e m p t d e p e n d e n t c a r e
a s s i s t a n c e b e n e f i t s r e c e i v e d f r o m a n y o t h e r e m p l o y e r b y t h e P a r t i c i p a n t o r h i s S p o u s e
d u r i n g t h e P l a n Y e a r ; a n d
( i ) e v i d e n c e o f i n d e b t e d n e s s o r p a y m e n t b y t h e P a r t i c i p a n t t o t h e t h i r d
p a r t y w h o p e r f o r m e d t h e Q u a l i f y i n g S e r v i c e s .
A s s o o n a s a d m i n i s t r a t i v e l y f e a s i b l e f o l l o w i n g t h e e n d o f e a c h m o n t h , t h e P l a n A d m i n i s t r a t o r
s h a l l r e v i e w a l l t h e f o r m s s u b m i t t e d b y P a r t i c i p a n t s d u r i n g t h a t m o n t h i n a c c o r d a n c e w i t h t h e
f o r e g o i n g p r o c e d u r e s a n d s h a l l p a y e a c h P a r t i c i p a n t t h e D e p e n d e n t C a r e B e n e f i t s w h i c h e a c h
P a r t i c i p a n t i s e n t i t l e d t o r e c e i v e , i n a c c o r d a n c e w i t h t h i s A r t i c l e V I I . N o a m o u n t s s h a l l b e
r e i m b u r s e d b y t h e P l a n A d m i n i s t r a t o r u n t i l a f t e r t h e e x p e n s e h a s b e e n p r o p e r l y s u b s t a n t i a t e d i n
a c c o r d a n c e w i t h S e c t i o n 7 . 6 .
7 . 7 T i m e L i m i t ; G r a c e P e r i o d . N o e x p e n s e s s h a l l b e r e i m b u r s e d f o r a n y P l a n
Y e a r u n l e s s t h e P a r t i c i p a n t a p p l i e s f o r s u c h r e i m b u r s e m e n t w i t h i n t h r e e ( 3 ) m o n t h s a f t e r t h e e n d
o f s u c h P l a n Y e a r . H o w e v e r , a n y P a r t i c i p a n t w h o h a s u n r e i m b u r s e d c o n t r i b u t i o n s r e m a i n i n g i n
h i s o r h e r s p e n d i n g a c c o u n t a t t h e e n d o f a P l a n Y e a r m a y s u b m i t c l a i m s f o r E l i g i b l e D e p e n d e n t
C a r e E x p e n s e s i n c u r r e d d u r i n g t h e p e r i o d t h a t b e g i n s i m m e d i a t e l y f o l l o w i n g t h e c l o s e o f t h e P l a n
Y e a r a n d e n d s o n t h e d a y t h a t i s t w o m o n t h s p l u s f i f t e e n ( 1 5 ) d a y s f o l l o w i n g c l o s e o f t h a t P l a n
Y e a r ( " G r a c e P e r i o d " ) u n d e r t h e f o l l o w i n g c o n d i t i o n s :
( a ) A p p l i c a b i l i t y I n o r d e r f o r a P a r t i c i p a n t t o b e r e i m b u r s f o r
E l i g i b l e D e p e n d e n t C a r e E x p e n s e s i n c u r r e d d u r i n g a . G r a c e P e r i o d f r o m a m o u n t G
r e m a i n - a i n h i s o r h e r d e p e n d e n t c a r e s p e n d i n g a c c o u n t a t t h e e n d o f t h e P l a n Y e a r t o
w h i c h t h a t G r a c e P e r i o d r e l a t e s h e o r s h e m u s t b e e i t h e r f 1 } a P a r t i c i p a n t w i t h D e p e n d e n t
C a r e R e i m b u r s e m e n t P l a n c o v e r a g e t h a t i s i n e f f e c t o n t h e l a s t d a y o f t h a t P l a n Y e a r o r
( 2 ) a n E m p l o y e e s u b j e c t t o S e c t i o n 7 4 .
( b ) N o C a s h - O u t o r C o n v e r s i o n . P r i o r P l a n Y e a r D e p e n d e n t
C a r e R e i m b u r s e m e n t P l a n a m o u n t s m a y n o t b e c a s h e d o u t o r c o n v e r t e d t o a n o e r
t a x a b l e o r n o n t a x a b l e b e n e f i t . F o r e x a m p l e , p r i o r P l a n Y e a r D e p e n d e n t C a r e
R e i m b u r s e m e n t P l a n a m o u n t s m a y n o t b e u s e d t o r e i m b u r s e E l i g i b l e M e d i c a l C a r e
E x p e n s e s .
��c R e i m b u r s e m e n t o f G r a c e P e r i o d E x p e n s e s : E l i g i b l e
D e p e n d e n t C a r e E x p e n s e s i n c u r r e d d u r i n g a G r a c e P e r i o d a n d a p p r o v e d f o r
r e i m b u r s e m e n t i n a c c o r d a n c e w i t h t h e P l a n ' s c l a i m s p r o c e d u r e f o r t h e D e p e n d e n t C a r e
R e i m b u r s e m e n t P l a n w i l l b e r e i m b u r s e d a n d c h a r m e d f i r s t a g a i n s t a n a v a i l a b l e P r i o r P l a n
Y _ e a r ��D p e n d e n t C a r e R e i m b u r s e m e n t P l a n a m o u n t s a n d t h e n a a i n s t a n v a m o u n t s t h a t
a r e a v a i l a b l e t o r e i m b u r s e e x n e n a t h a t a r e i n c u r r e d d u r i n m t h e c u r r e n t P l a n Y e a r A l l
c l a i m s f o r r e i m b u r s e m e n t u n d e r t h e D e p e n d e n t C a r e R e i m b u r s e m e n t P l a n w i l l b e p a i d i n
t h e o r d e r i n w h i c h t h e y a r e a p p r o v e d .
/ d l R u n - O u t P e r i o d a n d F o i t t i r P s C l a i m s f o r e x e n u s e s
i n c u r r e d d u r i n t h e G r a c e P e r i o d m u s t b e s u b m i t t e d f o r r e i m b u r s e m e n t w i t h i n t h r e e ( 3 )
m o n t h s a f t e r t h e e n d o f t h e G c e P e r i o d . A n y p r i o r P l a n Y e a r D e p e n d e n t C a r e
1 9
,E-
Reimbursement Plan amounts that remain after all reimbursements have been made for
the Plan Year and its related Grace Period shall not be carried over to reimburse the
Partici ant for expenses incurred after the Grace Period ends. The Participant will forfeit
all rights with respect to such balance.
7.8 No Reversion to Employer. At no time shall any part of Plan assets be
used for, diverted to, purposes other than for the exclusive benefit of Participants or their
beneficiaries, or for defraying reasonable expenses of administering the Plan.
ARTICLE VIII
MEDICAL SPENDING ACCOUNTS
8.1 Component Plan. This Article VIII shall set forth the provisions for the
RIVERSIDE COUNTY TRANSPORTATION COMMISSION MEDICAL
REIMBURSEMENT PLAN ("Medical Reimbursement Plan"). Benefits under the Medical
Reimbursement Plan shall take the form of reimbursement by the Employer for Eligible Medical
Care Expenses incurred by a Participant during the Plan Year. A Participant shall only be
entitled to reimbursement of Eligible Medical Care Expenses incurred after electing to
participate in the Medical Reimbursement Plan.
8.2 Annual Election. For each Plan Year, a Participant shall affirmatively
specify the amount of the Participant's Salary Reduction to be allocated to the Medical
Reimbursement Plan. The maximum annual Medical Reimbursement Benefit elected by a
Participant may not exceed Two Thousand Five Hundred Dollars ($2,500.00).
8.3 Spending Account. The sole source for payment of Medical
Reimbursement Benefits under this Article VIII shall be the unfunded accounts established for
each Participant pursuant to his annual election under Section 5.3. The Plan Administrator shall
reimburse each Participant for his Eligible Medical Care Expenses and his spending account
shall be debited accordingly. The aggregate reimbursements made at any time during the Plan
Year shall not exceed the Participant's total contributions to the Medical Reimbursement Plan
for the Plan Year. A Participant's Medical Reimbursement Benefits shall be uniformly available
throughout the Plan Year.
8.4 Reimbursement of Eligible Expenses. A Participant shall be entitled to
reimbursement of Eligible Medical Care Expenses in an amount that does not exceed his total
contribution to the Medical Reimbursement Plan for the Plan Year. Each payment hereunder
shall be a charge to the Participant's medical care spending account. Reimbursement shall be
provided to any individual only for Eligible Medical Care Expenses incurred while that
individual is a Participant; however, such reimbursement may be made after such participation
ceases. An Eligible Medical Care Expense shall be considered incurred when the services giving
rise to such expense are provided, irrespective of when such expenses are billed to the
Participant. Reimbursement shall not be made for any amount that does not qualify as an
Eligible Medical Care Expense or exceeds the annual contribution.
8.5 Limitations on Reimbursement/Forfeiture_ The Employer's payment of
Benefits from the Medical Reimbursement Plan for any Plan Year will be limited to the lesser of
20
•
"
( 1 ) t h e P a r t i c i p a n t ' s E l i g i b l e M e d i c a l C a r e E x p e n s e s f o r t h e P l a n Y e a r ( i n c l u d i n g t h e g r a c e
p e r i o d d e s c r i b e d i n S e c t i o n 8 . 7 ) , o r ( 2 ) t h e a m o u n t o f t h e P a r t i c i p a n t ' s a n n u a l e l e c t i o n t o t h e
M e d i c a l R e i m b u r s e m e n t P l a n . A P a r t i c i p a n t s h a l l r e c e i v e n o r e i m b u r s e m e n t f o r a m o u n t s w h i c h
a r e e l e c t e d b u t u n u s e d d u r i n g a P l a n Y e a r , f o r a n y r e a s o n . A n y b a l a n c e r e m a i n i n g i n t h e
P a r t i c i p a n t ' s m e d i c a l c a r e s p e n d i n g a c c o u n t a f t e r a l l E l i g i b l e M e d i c a l C a r e E x p e n s e s h a v e b e e n
p a i d s h a l l b e f o r f e i t e d b y t h e P a r t i c i p a n t a n d t h e a c c o u n t b a l a n c e r e d u c e d t o z e r o .
8 . 6 C l a i m s f o r B e n e f i t s . T o r e c e i v e r e i m b u r s e m e n t f o r E l i g i b l e M e d i c a l C a r e
E x p e n s e s , a P a r t i c i p a n t m u s t s u b m i t a w r i t t e n c l a i m f o r b e n e f i t s t o t h e P l a n A d m i n i s t r a t o r o r t h e
d e s i g n a t e d c l a i m s r e p r e s e n t a t i v e a t t h e t i m e s i n d i c a t e d i n S e c t i o n 8 . 7 . S a i d c l a i m s h a l l i n c l u d e
t h e f o l l o w i n g :
( a ) t h e n a m e o f t h e p e r s o n o r p e r s o n s o n w h o s e b e h a l f E l i g i b l e
M e d i c a l C a r e E x p e n s e s h a v e b e e n i n c u r r e d ;
i n c u r r e d ;
( 1 a d e s c r i p t i o n o f t h e n a t u r e a n d d a t e s o f s e r v i c e o r e x p e n s e s o
( c ) a s t a t e m e n t i n d i c a t i n g t h a t s u c h e x p e n s e o r e x p e n s e s h a v e n o t
o t h e r w i s e b e e n p a i d t h r o u g h i n s u r a n c e o r r e i m b u r s e d f r o m a n y o t h e r s o u r c e ; a n d
( d ) a r e c e i p t o r o t h e r e v i d e n c e o f i n d e b t e d n e s s o r p a y m e n t b y t h e
P a r t i c i p a n t o f t h e s e r v i c e o r e x p e n s e .
T h e P l a n A d m i n i s t r a t o r w i l l r e v i e w t h e c l a i m a s s o o n a s a d m i n i s t r a t i v e l y f e a s i b l e
f o l l o w i n g t h e e n d o f e a c h m o n t h , a n d w i l l a d v i s e t h e P a r t i c i p a n t o f a n y r e i m b u r s e m e n t a m o u n t s
t o w h i c h h e i s e n t i t l e d . I f a P a r t i c i p a n t b e l i e v e s b e h a s b e e n i n c o r r e c t l y d e n i e d r e i m b u r s e m e n t o r
h a s n o t b e e n a d v i s e d o f h i s B e n e f i t s u n d e r t h e M e d i c a l R e i m b u r s e m e n t P l a n , h e m a y s u b m i t a
w r i t t e n r e q u e s t t o t h e P l a n A d m i n i s t r a t o r t o p r o v i d e e i t h e r a n e x p l a n a t i o n o f h o w E l i g i b l e
M e d i c a l C a r e E x p e n s e s a r e r e i m b u r s e d o r f u r t h e r i n f o r m a t i o n o f h i s B e n e f i t s . T h e P l a n
A d m i n i s t r a t o r m u s t r e s p o n d t o s u c h a r e q u e s t w i t h i n a r e a s o n a b l e t i m e . N o a m o u n t s s h a l l b e
r e i m b u r s e d b y t h e P l a n A d m i n i s t r a t o r u n t i l a f t e r t h e e x p e n s e h a s b e e n p r o p e r l y s u b s t a n t i a t e d i n
a c c o r d a n c e w i t h S e c t i o n 8 . 6 .
A d d i t i o n a l l y , t h e P l a n A d m i n i s t r a t o r w i l l p r o v i d e t o e v e r y c l a i m a n t , w h o i s
d e n i e d a c l a i m f o r r e i m b u r s e m e n t , a w r i t t e n n o t i c e s t a t i n g i n a f o r m a t d e t e r m i n e d t o b e
u n d e r s t o o d b y t h e c l a i m a n t : ( I ) t h e s p e c i f i c r e a s o n o r r e a s o n s f o r t h e d e n i a l ; ( 2 ) s p e c i f i c
r e f e r e n c e t o p e r t i n e n t p l a n p r o v i s i o n s o n w h i c h t h e d e n i a l i s b a s e d ; ( 3 ) a d e s c r i p t i o n o f a n y
a d d i t i o n a l m a t e r i a l o r i n f o r m a t i o n n e c e s s a r y f o r t h e c l a i m a n t t o p e r f e c t t h e c l a i m ; a n d ( 4 ) a n
e x p l a n a t i o n o f t h e c l a i m r e v i e w p r o c e d u r e s e t f o r t h b e l o w .
W i t h i n 6 0 d a y s o f r e c e i p t b y a c l a i m a n t o f a n o t i c e d e n y i n g a c l a i m u n d e r t h i s
S e c t i o n , t h e c l a i m a n t o r h i s d u l y a u t h o r i z e d r e p r e s e n t a t i v e m a y r e q u e s t i n w r i t i n g a f u l l a n d f a i r
r e v i e w o f t h e c l a i m b y t h e P l a n A d m i n i s t r a t o r o r b y t h e A d m i n i s t r a t o r w h i c h m a y b e a p p o i n t e d
b y t h e E m p l o y e r f o r t h a t p u r p o s e . T h e P l a n A d m i n i s t r a t o r m a y e x t e n d t h e 6 0 - d a y p e r i o d w h e r e
t h e n a t u r e o f t h e b e n e f i t i n v o l v e d o r o t h e r a t t e n d a n t c i r c u m s t a n c e s m a k e s u c h e x t e n s i o n
a p p r o p r i a t e . I n c o n n e c t i o n w i t h s u c h r e v i e w , t h e c l a i m a n t o r h i s d u l y a u t h o r i z e d r e p r e s e n t a t i v e
m a y r e v i e w p e r t i n e n t d o c u m e n t s a n d m a y s u b m i t i s s u e s a n d c o m m e n t s i n w r i t i n g . T h e P l a n
2 1
Administrator or Administrator shall make a decision promptly, and not later than 60 days after
the Plan Administrator's receipt of a request for review, unless special circumstances (such as
the notice to hold a hearing, if the Administrator deems one necessary) require an extension of
time for processing, in which case a decision shall be rendered as soon as possible, but not later
than 120 days after receipt of a request for review. The decision on review shall be in writing
and shall include specific references for the decision, written in a manner calculated to be
understood by the claimant, and specific references to the pertinent Plan provisions on which the
decision is based. If the decision on review is not made within such period, the claim will be
considered denied.
8.7 Time Limit; Grace Period. No expenses shall be reimbursed for any Plan
Year unless the Participant applies for such reimbursement within three (3) months after
the end of such Plan Year. However, any Participant who has unreimbursed
contributions remaining in his or her spending, account at the end of ar the Pla�yemaX
submit claims for Eligible Medical Care Expenses incurred durine the period thatbegim
immediately foll+win the close of that Plan Year and ends on the day that is two months
plus fi ts2 (151 daf that Plan Year ("Grace Period' under the
following conditions:
(a) Applicability In order for a Participant to be reimbursed
f F1iQible Medical are Expenses incurred during a Grace Period from amounts
remaining in his or her medical spe din account at the end of the Plan Year to yvbich
that Grace Period relates, he or she must be either (1) a Partic• ant with Medi
Reimbursement Plan coverage that is in effect on the last day of that Plan Year: or (2) a
ua tied Beneficia who has COBRA coverage under the Medical Reimbursement Plan
on the last day of that Plan Year.
(b) No Cash -Out or Conversion. Prior Plan Year Medical
Reimbursement Plan amounts may not be cashed out or converted to any other taxable or
nontaxable benefit. For example. prior Plan Year Medical Reimbursement Plan amounts
may not be used to reimburse Eligible Denendent Care Expenses
(c) Reimbursement of Grace Period Expenses. Eli 'ble
Expenses incurred during a_Grace Period and approved for reimbursement
in accordance with the Plan's claims procedure for the Medical Reimbursement Plan will
be reimbursed and charged first again t nv available Prior Plan Year Medical
Reimbursement Plan amoupts_and then agai
0
at are available to
reimburse expenses that are incurred during the current Plan Year. All claims for
reimbursement under the Medical Reimbursement Plan will be paid in the order in which
they are approved.
(d) Run -Out Period and Forfeitures. Claims for expenses
incurred during the Grace Period must be submitted for reimbursement within three (3)
months after the end of the Grace Period. Any gdior Plan Year Medical Reimbursement
Plan amounts that remain after all reimbursements have been made for the Plan Year and
22
"
"
i t s r e l a t e d G r a c e P e r i o d s h a l l n o t b e c a r r i e d o v e r t o r e i m b u r s e t h e P a r t i c i p a n t f o r e x p e n s e s
i n c u r r e d a f t e r t h e G r a c e P e r i o d e n d s T h e P a r t i c i p a n t w i l l f o r f e i t a l l r i g h t s w i t h r e s p e c t t o
s u c h b a l a n c e .
8 . 8 N o R e v e r s i o n t o E m p l o y e r . A t n o t i m e s h a l l a n y p a r t o f P l a n a s s e t s b e
u s e d f o r , d i v e r t e d t o , p u r p o s e s o t h e r t h a n f o r t h e e x c l u s i v e b e n e f i t o f P a r t i c i p a n t s o r t h e i r
b e n e f i c i a r i e s , o r f o r d e f r a y i n g r e a s o n a b l e e x p e n s e s o f a d m i n i s t e r i n g t h e P l a n .
A R T I C L E I X
C O N T I N U A T I O N C O V E R A G E
9 . 1 I n G e n e r a l . T h e f o l l o w i n g p r o v i s i o n s s h a l l a p p l y t o B e n e f i t s p r o v i d e d t o
e l i g i b l e E m p l o y e e s a n d t o t h e i r e l i g i b l e d e p e n d e n t s u n d e r t h e P l a n , b u t o n l y t o t h e e x t e n t t h a t t h e
B e n e f i t s s e l e c t e d p e r t a i n t o h e a l t h c a r e c o v e r a g e p r o v i d i n g m e d i c a l , s u r g i c a l , o r h o s p i t a l b e n e f i t s
a n d t o p l a n s p r o v i d i n g a n c i l l a r y m e d i c a l c o v e r a g e s u c h a s d e n t a l , v i s i o n , o r p r e s c r i p t i o n d r u g
b e n e f i t s . T h i s c o v e r a g e s h a l l b e c o n t i n u e d p u r s u a n t t o t h e f e d e r a l c o n t i n u a t i o n c o v e r a g e
p r o v i s i o n s o f t h e C o n s o l i d a t e d O m n i b u s B u d g e t R e c o n c i l i a t i o n A c t o f 1 9 8 5 ( " C O B R A " ) , a s
c o d i f i e d u n d e r C o d e S e c t i o n 4 9 8 0 B , a n d t h e r e g u l a t i o n s p r o m u l g a t e d t h e r e u n d e r .
9 . 2 D e f i n i t i o n s . F o r p u r p o s e s o f t h i s A r t i c l e I X , t h e f o l l o w i n g w o r d s a n d
p h r a s e s a r e i n t e n d e d t o s u p p l e m e n t , a n d i n s o m e i n s t a n c e s r e p l a c e , t h e d e f i n e d t e r m s l i s t e d
g e n e r a l l y i n A r t i c l e I I I a n d t o t h e e x t e n t o f a n y c o n f l i c t b e t w e e n t h e t e r m s s e t f o r t h h e r e i n a n d
t h o s e o f A r t i c l e I I I , t h e d e f i n e d t e r m s s e t f o r t h h e r e i n s h a l l c o n t r o l :
( a ) " D e p e n d e n t " m e a n s a n i n d i v i d u a l w h o m e e t s t h e d e f m i t i o n o f
d e p e n d e n t u n d e r t h e p a r t i c i p a t i n g E m p l o y e r p r o v i d e d h e a l t h p l a n c o v e r i n g t h e e l i g i b l e
E m p l o y e e . F o r t h e p u r p o s e s o f a n y m e d i c a l r e i m b u r s e m e n t p l a n , d e p e n d e n t s w i l l a l s o
i n c l u d e i n d i v i d u a l s w h o a r e d e p e n d e n t s w i t h i n t h e m e a n i n g o f S e c t i o n 1 5 2 ( a ) o f t h e
C o d e .
N o p e r s o n s h a l l b e c o n s i d e r e d a d e p e n d e n t o f m o r e t h a n
o n e E m p l o y e e .
I f b o t h a n E m p l o y e e a n d a n E m p l o y e e ' s s p o u s e a r e
e m p l o y e d b y t h e E m p l o y e r , d e p e n d e n t c h i l d r e n m a y b e c o v e r e d b y e i t h e r s p o u s e ,
b u t n o t b y b o t h .
( b ) " E l e c t i o n p e r i o d " m e a n s t h e s i x t y ( 6 0 ) d a y p e r i o d d u r i n g w h i c h a
Q u a l i f i e d B e n e f i c i a r y w h o w o u l d l o s e c o v e r a g e a s a r e s u l t o f a Q u a l i f y i n g E v e n t m a y
e l e c t c o n t i n u a t i o n c o v e r a g e . T h i s s i x t y ( 6 0 ) d a y p e r i o d b e g i n s n o t l a t e r t h a n t h e d a t e o f
t e r m i n a t i o n o f c o v e r a g e a s a r e s u l t o f a Q u a l i f y i n g E v e n t a n d e n d s n o t e a r l i e r t h a n t h e
s i x t y ( 6 0 ) d a y s a f t e r t h e l a t e r o f s u c h d a t e o f t e r m i n a t i o n o f c o v e r a g e o r t h e r e c e i p t o f
n o t i c e o f t h e r i g h t t o e l e c t c o n t i n u a t i o n c o v e r a g e u n d e r t h i s P l a n .
( c ) " F u l l - t i m e s t u d e n t " m e a n s a d e p e n d e n t c h i l d w h o i s e n r o l l e d i n ,
r e g u l a r l y a t t e n d s a n d i s r e c o g n i z e d b y t h e R e g i s t r a r o f a n a c c r e d i t e d s e c o n d a r y s c h o o l ,
c o l l e g e o r u n i v e r s i t y , i n s t i t u t i o n f o r t h e t r a i n i n g o f r e g i s t e r e d n u r s e s ( R . N . ) , o r a n y o t h e r
2 3
accredited or.licensed school for the minimum number of credit hours required by that
institution in order to maintain full-time student status.
(d) "Medicare" means the Health Insurance for the Aged and Disabled
Act, Title XVIII of Public Law 89-97, Social Security, as amended.
(e) "Qualified Beneficiary" means an individual who, on the day
before the Qualifying Event, is covered under this Plan as the covered Employee, the
spouse of the covered Employee or dependent child of the covered Employee. Qualified
Beneficiary shall include a child who is bom to (or placed for adoption with) a covered
Employee during the coverage period. The term Qualified Beneficiary does not include
APa': an individual whose status as a covered Employee is attributable to a period in which
such individual is a nonresident alien who received no earned income from the employer
which constituted income from sources within the United States (within the meaning of
Code Section 911(d)(2) and Section 861(a)(3)). The term Qualified Beneficiary also
does not include a Covered Employee's domestic partner regardless of whether such
person was a covered dependent under the Plan prior to the Qualifying Event. If an
individual is not a Qualified Beneficiary pursuant to this paragraph, a spouse or
dependent child of such individual shall not be considered a Qualified Beneficiary by
virtue of the relationship to such individual.
(f) "Qualifying Event" means with respect to a covered Employee,
any of the following events which, but for the continuation coverage under this provision,
would result in the loss of coverage of a Qualified Beneficiary_
(1) the death of the covered Employee;
(2) the termination (except by reason of such covered
Employee's gross misconduct) or reduction in hours of the covered Employee's
employment;
(3) the divorce or legal separation of the covered Employee
from such covered Employee's spouse;
(4) the covered Employee becoming entitled to benefits under
Title XVIII of the Social Security Act (Medicare);
(5)
the terms of this Plan;
a dependent child who ceases to be a dependent child under
(6) the Employer's filing for Chapter 11 reorganization as it
would affect retiree coverage.
(g) "University/college" means an accredited institution listed in the
current publication of accredited institutions of higher education.
9.3 Continuation Coverage. To the extent required by Section 9.1 above, a
Qualified Beneficiary who would lose health coverage under this Plan as a result of a Qualifying
24
"
E v e n t i s e n t i t l e d t o e l e c t c o n t i n u a t i o n c o v e r a g e w i t h i n t h e e l e c t i o n p e r i o d u n d e r t h i s P l a n .
C o v e r a g e p r o v i d e d u n d e r t h i s p r o v i s i o n i s o n a c o n t r i b u t o r y b a s i s . N o e v i d e n c e o f g o o d h e a l t h
w i l l b e r e q u i r e d .
E x c e p t a s o t h e r w i s e s p e c i f i e d i n a n e l e c t i o n , a n y e l e c t i o n b y a Q u a l i f i e d
B e n e f i c i a r y w h o i s a c o v e r e d e m p l o y e e o r s p o u s e o f t h e c o v e r e d e m p l o y e e w i l l b e d e e m e d t o
i n c l u d e a n e l e c t i o n f o r c o n t i n u a t i o n c o v e r a g e u n d e r t h i s p r o v i s i o n o n b e h a l f o f a n y o t h e r
Q u a l i f i e d B e n e f i c i a r y w h o w o u l d l o s e c o v e r a g e b y r e a s o n o f a Q u a l i f y i n g E v e n t .
I f t h i s P l a n p r o v i d e s a c h o i c e a m o n g t h e t y p e s o f c o v e r a g e u n d e r t h i s P l a n ,
e a c h Q u a l i f i e d B e n e f i c i a r y i s e n t i t l e d t o m a k e a s e p a r a t e s e l e c t i o n a m o n g s u c h t y p e s o f c o v e r a g e
( i . e . , s i n g l e , f a m i l y , e t c . ) .
9 . 4 T y p e o f C o v e r a g e .
( a ) C o n t i n u a t i o n c o v e r a g e u n d e r t h i s p r o v i s i o n i s c o v e r a g e w h i c h i s
i d e n t i c a l t o t h e c o v e r a g e p r o v i d e d u n d e r t h i s P l a n t o s i m i l a r l y s i t u a t e d b e n e f i c i a r i e s u n d e r
t h i s P l a n w i t h r e s p e c t t o w h o m a Q u a l i f y i n g E v e n t h a s n o t o c c u r r e d a s o f t h e t i m e
c o v e r a g e i s b e i n g p r o v i d e d . I f c o v e r a g e u n d e r t h i s P l a n i s m o d i f i e d f o r a n y g r o u p o f
s i m i l a r l y s i t u a t e d b e n e f i c i a r i e s , t h e c o v e r a g e s h a l l a l s o b e m o d i f i e d i n t h e s a m e m a n n e r
f o r a l l q u a l i f i e d b e n e f i c i a r i e s u n d e r t h i s P l a n i n c o n n e c t i o n w i t h s u c h g r o u p .
C o n t i n u a t i o n c o v e r a g e a v a i l a b l e t o a Q u a l i f i e d B e n e f i c i a r y u n d e r
t h i s p r o v i s i o n s h a l l a p p l y o n l y t o t h e t y p e a n d l e v e l o f h e a l t h c o v e r a g e u n d e r t h e P l a n t h a t
a Q u a l i f i e d B e n e f i c i a r y w a s a c t u a l l y r e c e i v i n g o n t h e d a y b e f o r e t h e Q u a l i f y i n g E v e n t .
T h e Q u a l i f i e d B e n e f i c i a r y m a y n o t c h a n g e h i s o r h e r e l e c t i o n e x c e p t a s o t h e r w i s e
p r o v i d e d u n d e r S e c t i o n s 5 . 9 a n d 5 . 1 1 ( d ) .
( b ) M e d i c a l S p e n d i n g A c c o u n t . N o t w i t h s t a n d i n g S e c t i o n 9 . 4 ( a )
a b o v e , a n E m p l o y e e t h a t w a s p a r t i c i p a t i n g i n t h e P l a n p r i o r t o t h e Q u a l i f y i n g E v e n t m a y
b e e l i g i b l e t o e l e c t c o n t i n u a t i o n c o v e r a g e u n d e r t h e m e d i c a l s p e n d i n g a c c o u n t , s u b j e c t t o
s u b s e c t i o n ( c ) .
( c ) U n a v a i l a b i l i t y o f C o n t i n u a t i o n C o v e r a g e . C o n t i n u a t i o n c o v e r a g e
u n d e r a m e d i c a l s p e n d i n g a c c o u n t s h a l l n o t b e o f f e r e d i f a l l o f t h e f o l l o w i n g t h r e e
c o n d i t i o n s a r e s a t i s f i e d ;
( i ) E m p l o y e r p r o v i d e s o t h e r h e a l t h c o v e r a g e
o p t i o n s w h i c h a r e a v a i l a b l e t o t h e E m p l o y e e ;
( i i ) T h e m a x i m u m a m o u n t r e q u i r e d u n d e r t h e
P l a n f o r a y e a r o f c o n t i n u a t i o n c o v e r a g e u n d e r t h i s A r t i c l e I X e q u a l s o r e x c e e d s
t h e m a x i m u m b e n e f i t a v a i l a b l e u n d e r t h e p l a n f o r t h e y e a r ; a n d
( i i i ) T h e c o n t r i b u t i o n p r e m i u m f o r t h e r e m a i n d e r
o f t h e P l a n Y e a r i n w h i c h t h e Q u a l i f y i n g E v e n t o c c u r r e d w i l l e x c e e d t h e
m a x i m u m b e n e f i t s t i l l a v a i l a b l e t o t h e P a r t i c i p a n t u n d e r t h e P l a n a s o f t h e d a t e o f
t h e Q u a l i f y i n g E v e n t . T h e d e t e r m i n a t i o n o f w h e t h e r t h i s c o n d i t i o n h a s b e e n
2 5
satisfied will be made by the Plan Administrator on a case by case basis at the
time of the Qualifying Event.
(d) Limited Continuation Coverage. In the event the Plan satisfies
only the first two conditions set forth in subparagraph (i and ii) above, the Employer shall
offer continuation coverage under the medical spending account for the remainder of the
Plan Year for the year in which the Qualifying Event occurred.
(e) Full Continuation Coverage. If the Plan Administrator finds that
the Plan does not satisfy the first two conditions set forth in subparagraph (i and ii)
above, the Employer must offer continuation coverage under the Plan to the Employee
for the duration of the coverage period required under Section 9.5.
9.5 Coverage Period. The coverage under this provision will extend for at
least the :period beginning on the date of a Qualifying Event and ending not earlier than the
earliest of the following:
(a) Initial 18-Month Coverage Period. If the Qualifying Event is a
termination of employment (other than for gross misconduct) or a reduction in
employment hours of a covered Employee, the coverage period for the Employee and his
or her dependents shall extend for eighteen (18) months after the date of the Qualifying
Event;
(b) Disability Extension. The initial eighteen (18) month coverage
period described in (a) above may be extended to twenty-nine (29) months after the date
of the Qualifying Event in the event the Qualified Beneficiary was disabled upon
termination of employment or during the first sixty (60) days of continuation coverage.
The Qualified Beneficiary must provide the Plan Administrator with notice of Social
Security disability determination within sixty (60) days of the disability determination
and prior to the expiration of the initial eighteen (18) month continuation period provided
in (a) above to become eligible for this extension of continuation coverage.
(c) Extension of Coverage Period. The initial eighteen (18) month
coverage period described in (a) above may be extended to thirty-six (36) months after
the date of the Qualifying Event upon the occurrence of a second Qualifying Event prior
to the expiration of the initial eighteen (18) month coverage period. The Qualified
Beneficiary must notify the Plan Administrator of the second Qualifying Event within
sixty (60) days of the date of the second Qualifying Event and prior to the expiration of
the initial eighteen (18) month period. In no event shall continuation coverage extend for
a period greater than thirty-six (36) months.
(d) 36-Month Coverage Period. In the case of any Qualifying Event
causing the loss of coverage, except those Qualifying Events identified in (a) above, the
coverage period for the Employee and his or her dependents shall extend for thirty-six
(36) months after the date of the Qualifying Event.
9.6 Notification Requirements.
26
(a) Notification by Qualified Beneficiary. Each covered Employee or
Qualified Beneficiary must notify the Employer of the occurrence of a divorce or legal
separation of the covered Employee from such covered Employee's spouse and/or the
covered Employee's dependent child ceasing to be a dependent child under the terns of
this Plan within sixty (60) days after the date of such occurrence. This sixty (60) day
time limit shall only apply to those occurrences as described in this paragraph which
occur after the date of the enactment of the Tax Reform Act of 1986.
(b) Notification by Employer. The Employer shall notify the
Administrator within thirty (30) days of a Qualifying Event, as required by federal law.
(c) Notification to Qualified Beneficiary. The Administrator shall
provide written notice to each covered Employee and spouse of such covered Employee
of his or her right to continuation coverage under this provision upon commencement of
coverage under a Component Plan providing health coverage, as required by federal law.
The Administrator shall notify any Qualified Beneficiary of the
right to elect continuation coverage under this provision within fourteen (19) days of
receiving notice of the occurrence of a Qualifying Event, as required by federal law. If
the Qualifying Event is the divorce or legal separation of the covered Employee from the
covered Employee's spouse or a dependent child ceasing to be a dependent child under
the terms of this Plan, the Employer shall only be required to notify a Qualified
Beneficiary of his or her right to elect continuation coverage if the covered Employee or
the Qualified Beneficiary notifies the Employer of such Qualifying Event within sixty
(60) days after the date of such Qualifying Event.
Notification of the requirements of this provision to the spouse of a
covered Employee shall be treated as notification to all other qualified beneficiaries
residing with such spouse at the time notification is made.
9.7 Termination of Continuation Coverage. The continuation coverage
provided hereunder shall be terminated prior to the expiration of the coverage periods provided
in Section 9.5 above upon the earlier of the following:
(a) with respect to continuation coverage under a medical spending
account, the last day of the Plan Year in which the Qualified Beneficiary experiences the
Qualifying Event.
(b) the date on which the Employer ceases to provide any group health
plan to any Employee;
(c) the date on which the Qualified Beneficiary fails to make timely
payment of the required contribution pursuant to this provision provided the deficiency
is not an "insignificant amount" as described in Section 9.8;
(d) the date on which the Qualified Beneficiary first becomes, after the
date of the election, covered under any other group health plan as an employee or
dependent. However, if the other group health plan has a preexisting condition
27
limitation, continuation coverage under the Plan will not cease while such preexisting
condition limitation under the group plan remains in effect (taking into account prior
creditable coverage under the portability rules of the Health Insurance Portability and
Accountability Act of 1996); or
(e) the date on which the Qualified Beneficiary becomes entitled to
benefits under Title XVIII of the Social Security Act (Medicare).
9.8 Contribution.
(a) A Qualified Beneficiary shall only be entitled to continuation
coverage provided such Qualified Beneficiary pays the applicable premium required by
the Employer in full and in advance, except as provided in (b) below. Such premium
shall not exceed the requirements of applicable federal law. A Qualified Beneficiary may
elect to pay such premium in installments as indicated by the Employer.
(b) Except as provided in (c) below, the payment of any premium shalt
be considered to be timely if made within thirty (30) days after the date due, or within
such longer period of time as applies to or under this Plan.
(c) Notwithstanding (a) or (b) above, if an election is made after a
Qualifying Event during the election period, this Plan will permit payment of the required
premium for continuation coverage during the period preceding the election to be made
within forty-five (45) days of the date of the election.
A premium payment received by the Employer which is deficient by an
insignificant amount shall be treated as full payment of the premium amount. For purposes of
this section, an insignificant amount is an amount not greater than the lesser of (i) ten percent
(10%) of the required amount; or (ii) fifty dollars ($50.00). Alternatively, in the event an
Employer receives an insufficient payment premium, the Employer retains the option of taking
steps to collect the deficient insignificant amount by notifying the Qualified Beneficiary of the
deficiency and allowing thirty (30) days after date of the notice for payment of the deficiency.
9.9 Coordination with State Continuation Coverage. In the event a Qualified
Beneficiary is entitled to less than 36 months of federal continuation coverage as a result of a
Qualifying Event, the Qualified Beneficiary will be notified prior to the expiration of federal
continuation coverage if he or she is eligible to elect an extension of continuation coverage under
the Plan for an additional period of up to 36 months from the date of the Qualifying Event
pursuant to the Section 1366.20 et. seq. of the California Health and Safety Code (the "California
Continuation Benefits Replacement Act" or "Cal -COBRA Program").
A covered employee's dependent who, (1) on the day before the
Qualifying Event, is covered under this Plan as the registered domestic partner of the covered
Employee and (2) loses health coverage under this Plan as a result of a Qualifying Event shall be
entitled to state continuation coverage subject to the eligibility, election and contribution
requirements set forth under the Cal -COBRA Program.
•
28
ARTICLE X
DISCRIMINATION
10.1 Nondiscrimination Requirements.
(a) Nondiscriminatory Class. The Employer shall not provide benefits
to a classification of Employees which the Secretary of the Treasury finds to be
discriminatory under Section 125 of the Code and the Regulations issued thereunder.
(b) Key Employees. The Employer shall not provide qualified
Benefits to Key Employees in amounts that exceed twenty-five (25%) of the aggregate of
such benefits provided for all eligible Employees under the Plan. For purposes of this
subsection, qualified Benefits shall not include benefits which are includible in gross
income.
10.2 Avoid Discrimination.
(a) Ability to Reject Election. If the Administrator deems it necessary
to avoid discrimination or possible taxation to Key Employees or a group of Employees
in whose favor discrimination may not occur in violation of Section 125 of the Code or
the Regulations issued thereunder, it may, but shall not be required to, reject any election
or reduce contributions or non-taxable benefits to assure compliance with Section 125 of
the Code. Any act taken by the Administrator pursuant to this Section shall be in a
nondiscriminatory and uniform manner.
(b) Manner of Rejecting Election to Avoid Discrimination. In the
event the Administrator determines that it is necessary to reject an election or reduce
contributions or non-taxable benefits, the rejection shall be carved out as forth in this
subsection. Non-taxable benefits of the affected Key Employee or Highly Compensated
Participant who has elected the highest amount of non-taxable benefits shall be reduced
until the discrimination tests set forth in this subsection are satisfied or until the amount
of his or her non-taxable benefit equals the non-taxable benefit of the affected Participant
who has elected the second highest amount of non-taxable benefits. This process shall
continue until the discrimination tests are satisfied. Any reduction made pursuant to this
subsection shall be made proportionately among non-insured benefits and once all non-
insured benefits are expended, proportionately among insured benefits. Contributions
which are not utilized to provide benefits to any Participant by virtue of any
administrative act under this subsection shall be forfeited and deposited into the general
account containing all Flexible Benefit Dollars.
10.3 Reimbursement Plans. The Plan is intended not to discriminate in favor of
"highly compensated individuals" (as defined in Section 414(q) of the Code with respect to the
Dependent Care Plan and as defined in Section 105(h) of the Code with respect to the Medical
Reimbursement Plan) as to eligibility to participate, contributions, and/or Benefits under the
Medical Reimbursement Plan and Dependent Care Plan (the "Reimbursement Plans"). If the
Plan Administrator determines the operation of either Reimbursement Plan in any Plan Year
would result in such discrimination, then the Plan Administrator shall select and exclude from
29
coverage under the applicable Reimbursement Plan such Participants and/or reduce such
contributions and/or Benefits to ensure compliance with the nondiscrimination requirements of
Section 129 and 105 of the Code.
ARTICLE XI
ADMINISTRATION
11.1 Allocation of Responsibility for Administration.
(a) Designated Representatives. The Employer may appoint an
individual or an administrative committee to serve at its discretion as Administrator. The
Administrator shall have only those powers, duties, responsibilities and obligations as are
specifically given to the Administrator under the Plan.
(b) Employer Responsibilities. The Employer shall have the sole
responsibility for making the contributions provided for under Article VI and shall have
the sole authority to amend or terminate, in whole or in part, the Plan at any time.
(e) Administrator's Responsibilities. The Administrator shall have the
sole responsibility for the administration of the Plan, as set forth herein. The
Administrator warrants that any directions given, information furnished, or action taken
by it shall be in accordance with the provisions of the Plan authorizing or providing for
such direction, information or action. The Administrator shall be responsible for the
proper exercise of its own powers, duties, responsibilities and obligations under this Plan
and shall not be responsible for any act or failure to act of another Employee. Neither the
Administrator, nor the Employer malces any guarantee to any Participant in any manner
for any Ioss or other event because of the Participant's participation in the Plan.
11.2 Transfer of Duties. The Employer may, at any time, assign all or any
portion of the Administrator's duties to a contracting third party.
11.3 Powers and Duties of Administrator.
(a) Powers and Duties Delegated to Administrator. The Administrator
shall supervise the administration of the Plan. The Administrator shall be responsible for
ensuring that the terms and conditions of the Plan are carried out for the exclusive benefit
of persons entitled to participate in the Plan without discrimination. The Administrator
shall have full power to administer the Plan, subject to the applicable requirements of the
law and any Administration Agreement executed by and between the Employer and the
Administrator. For this purpose, the Administrator's powers shall include the following:
(1) to construe and interpret the Plan, decide all questions of
eligibility and determine the amount, manner and time of payment of any benefits
hereunder;
(2) to prescribe the procedures for the Participants to follow in
filing applications for benefits and to prepare forms to be used by the Participants;
30
•
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"
"
( 3 ) t o p r e p a r e a n d d i s t r i b u t e , i n s u c h m a n n e r a s t h e
A d m i n i s t r a t o r d e t e r m i n e s a p p r o p r i a t e , i n f o r m a t i o n e x p l a i n i n g t h e P l a n ;
( 4 ) t o r e c e i v e f r o m t h e E m p l o y e r , P a r t i c i p a n t s , P a r t i c i p a n t ' s
s p o u s e s a n d D e p e n d e n t s , a n d o t h e r p e r s o n s s u c h i n f o r m a t i o n a s s h a l l b e n e c e s s a r y f o r t h e
p r o p e r a d m i n i s t r a t i o n o f t h e P l a n ;
( 5 ) t o f u r n i s h t o t h e E m p l o y e r a n d t h e P a r t i c i p a n t s , u p o n
r e q u e s t , a n n u a l r e p o r t s d e t a i l i n g t h e a d m i n i s t r a t i o n o f t h e P l a n ;
( 6 ) t o r e c e i v e , r e v i e w a n d k e e p o n f i l e r e c o r d s p e r t a i n i n g t o t h e
P l a n , a s t h e A d m i n i s t r a t o r d e e m s c o n v e n i e n t a n d p r o p e r ;
( 7 )
t o a l l o c a t e i t s a d m i n i s t r a t i v e r e s p o n s i b i l i t i e s ;
( 8 ) t o a p p o i n t o r e m p l o y i n d i v i d u a l s a n d a n y o t h e r a g e n t s t h e
A d m i n i s t r a t o r d e e m s a d v i s a b l e , i n c l u d i n g l e g a l a n d a c t u a r i a l c o u n s e l , t o a s s i s t i n t h e
a d m i n i s t r a t i o n o f t h e P l a n ;
( 9 ) t o a d o p t s u c h r u l e s a s t h e A d m i n i s t r a t o r d e e m s n e c e s s a r y ,
d e s i r a b l e o r a p p r o p r i a t e , s u b j e c t t o a p p l i c a b l e l a w . A l l r u l e s a n d d e c i s i o n s o f t h e
A d m i n i s t r a t o r s h a l l b e u n i f o r m l y a n d c o n s i s t e n t l y a p p l i e d t o . a l l P a r t i c i p a n t s i n s i m i l a r
c i r c u m s t a n c e s ; a n d
( 1 0 ) t o t a k e a l l o t h e r s t e p s n e c e s s a r y t o p r o p e r l y a d m i n i s t e r t h e
P l a n i n a c c o r d a n c e w i t h i t s t e r m s a n d c o n d i t i o n s a n d t h e r e q u i r e m e n t s o f t h e a p p l i c a b l e
l a w .
1 1 . 4 P o w e r s a n d D u t i e s N o t D e l e g a t e d t o A d m i n i s t r a t o r . T h e A d m i n i s t r a t o r
s h a l l h a v e n o p o w e r t o a d d t o , s u b t r a c t f r o m o r m o d i f y a n y o f t h e t e r m s o f t h e P l a n , o r t o c h a n g e
o r a d d t o a n y b e n e f i t s p r o v i d e d b y t h e P l a n , o r t o w a i v e o r f a i l t o a p p l y a n y r e q u i r e m e n t s o f
e l i g i b i l i t y f o r a b e n e f i t u n d e r t h e P l a n , e x c e p t a s m a y b e e x p r e s s l y p r o v i d e d h e r e i n .
I n t e r p r e t a t i o n s o f t h e p r o v i s i o n s o f t h e P l a n s h a l l n o t b e d e e m e d t o b e a d d i t i o n s , s u b t r a c t i o n s , o r
m o d i f i c a t i o n s o f t h e P l a n .
1 1 . 5 N o n d i s c r i m i n a t o r y E x e r c i s e o f A u t h o r i t y . W h e n e v e r i n t h e a d m i n i s t r a t i o n
o f t h e P l a n a n y d i s c r e t i o n a r y a c t i o n b y t h e A d m i n i s t r a t o r i s r e q u i r e d , t h e A d m i n i s t r a t o r s h a l l
e x e r c i s e i t s a u t h o r i t y i n a n o n d i s c r i m i n a t o r y m a n n e r s o t h a t a l l p e r s o n s s i m i l a r l y s i t u a t e d s h a l l
r e c e i v e s u b s t a n t i a l l y t h e s a m e t r e a t m e n t
1 1 . 6 i n c a p a c i t y o f P a r t i c i p a n t . W h e n e v e r , i n t h e A d m i n i s t r a t o r ' s o p i n i o n , a
p e r s o n e n t i t l e d t o r e c e i v e a n y p a y m e n t o f a b e n e f i t h e r e u n d e r o r a n i n s t a l h n e n t t h e r e o f i s u n d e r a
l e g a l d i s a b i l i t y o r i s i n c a p a c i t a t e d i n a n y w a y s o a s t o b e u n a b l e t o m a n a g e t h e p e r s o n ' s f i n a n c i a l
a f f a i r s , t h e A d m i n i s t r a t o r m a y d i r e c t t h e E m p l o y e r t o m a k e p a y m e n t s t o s u c h P a r t i c i p a n t o r t o
s u c h p e r s o n o r t o t h e p e r s o n ' s l e g a l r e p r e s e n t a t i v e o r t o a r e l a t i v e o r f r i e n d o f s u c h p e r s o n o n
s u c h p e r s o n ' s b e h a l f , o r t h e A d m i n i s t r a t o r m a y a p p l y t h e p a y m e n t f o r t h e b e n e f i t o f s u c h
P a r t i c i p a n t i n s u c h m a n n e r a s t h e A d m i n i s t r a t o r c o n s i d e r s a d v i s a b l e . A n y p a y m e n t o f a b e n e f i t
3 1
or installment in accordance with the provisions of this Section shall be a complete discharge of
any liability for the making of such payment under the provisions of the Plan.
11.7 Indemnification of Administrator. The Employer agrees to indemnify any
Employee serving as Administrator (including any Employee or former Employee who formerly
served as Administrator), against any and all liabilities, damages, costs and expenses (including
attorneys' fees and amounts paid in settlement of any claims approved by the Employer)
occasioned by any act or omission to act in connection with the Plan, if such act or omission is
made in good faith pursuant to the provisions of the Plan and not as a result of the
Administrator's gross negligence or willful misconduct.
ARTICLE XII
CLAIMS PROCEDURE
Except as provided under Article VII with respect to payment of dependent care
assistance benefits and under Article VIII with respect to payment of eligible medical expenses,
all claims for benefits that are provided through insurance contracts, whether such contracts are
between the insurer and the Employer or the insurer and the Participant, shall be made by filing a
claim for benefits in accordance with the claims procedure set forth under the insurance contract.
The Employer does not have the authority or responsibility for processing, reviewing or paying
such claims. All disputes regarding those claims shall be resolved in accordance with the
procedure set forth in the separate Component Plan document concerning those benefits.
ARTICLE XIII
AMENDMENTS TERMINATION AND ACTION BY EMPLOYER
13.1 Action by Employer. Any action by the Employer under this Plan,
including but not limited to, termination of this Plan, shall be by action of the Employer, or by
any person or persons duly authorized by action of the Employer to act on its behalf.
13.2 Amendments. The Employer reserves the right to make, from time to
time, any amendment or amendments to this Plan as it deems necessary or desirable, without
retroactive effect, unless specifically permitted to comply with the law.
13.3 Right to Terminate. The Employer may terminate this Plan at any time..
In the event of the dissolution, merger, consolidation or reorganization of the Employer, the Plan
shall terminate unless the PIan is continued by a successor to the Employer in accordance with
the Employer's procedures.
13.4 Plan Termination. Upon the termination of the Plan, the Administrator
may determine the best method to make payments to the effected Participants.
32
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A R T I C L E X I V
H I P A A P R I V A C Y S T A N D A R D S
1 4 . 1 P r o t e c t i o n o f I n d i v i d u a l l y I d e n t i f i a b l e H e a l t h I n f o r m a t i o n . T h e E m p l o y e r
a n d t h e P l a n h a v e a d o p t e d p o l i c i e s a n d p r o c e d u r e s ( " P r i v a c y P o l i c y " ) f o r t h e s o l e a n d l i m i t e d
p u r p o s e o f c o m p l y i n g w i t h t h e S t a n d a r d s f o r P r i v a c y o f I n d i v i d u a l l y I d e n t i f i a b l e H e a l t h
I n f o r m a t i o n , 4 5 C F R � 1 6 4 . 1 0 2 e t s e q . , a s a m e n d e d ( t h e " P r i v a c y R u l e " ) . T h e ' m a n n e r i n w h i c h
t h e s e p r o v i s i o n s w i l l b e a d m i n i s t e r e d s h a l l i n n o w a y a f f e c t , o r b e t a k e n i n t o a c c o u n t i n
d e t e r m i n i n g , t h e b e n e f i t s u n d e r t h e P l a n w i t h r e s p e c t t o a n y i n d i v i d u a l .
1 4 . 2 D e f i n i t i o n s . T h e d e f i n e d t e r m s a n d p h r a s e s u s e d i n t h i s A r t i c l e s h a l l c a r r y
t h e . s a m e m e a n i n g a n d i n t e n t s e t f o r t h u n d e r t h e P r i v a c y R u l e ; a n d i n s o m e i n s t a n c e s m a y r e p l a c e
t h e d e f i n e d t e r m s l i s t e d g e n e r a l l y i n A r t i c l e I I I a n d t o t h e e x t e n t o f a n y c o n f l i c t b e t w e e n t h e
t e r m s s e t f o r t h h e r e i n a n d t h o s e o f A r t i c l e I I I , t h e d e f i n e d t e r m s s h a l l c a r r y t h e m e a n i n g
p r e s c r i b e d u n d e r t h e P r i v a c y R u l e .
1 4 . 3 I d e n t i t y o f P l a n S p o n s o r . T h e E m p l o y e r s h a l l b e t h e P l a n S p o n s o r f o r
p u r p o s e s o f t h e P r i v a c y R u l e w h e n p e r f o r m i n g P l a n A d m i n i s t r a t i o n f u n c t i o n s o r P l a n S p o n s o r
f u n c t i o n s , w h e n a c t i n g o n b e h a l f o f t h e P l a n w i t h r e s p e c t t o i t s o b l i g a t i o n s u n d e r t h e P r i v a c y
R u l e , a n d w h e n a c t i n g o n b e h a l f o f t h e P l a n ' s p a r t i c i p a n t s a n d b e n e f i c i a r i e s w i t h r e s p e c t t o
P a r t i c i p a t i o n a n d E n r o l l m e n t I n f o r m a t i o n . T h e P r i v a c y O f f i c i a l s h a l l a c t f o r t h e P l a n S p o n s o r
a n d s h a l l b e e n t i t l e d t o d e l e g a t e i t s p o w e r s a n d r e s p o n s i b i l i t i e s i n a c c o r d a n c e w i t h i t s u s u a l
p r a c t i c e s .
1 4 . 4 R e s p o n s i b i l i t i e s a n d U n d e r t a k i n g s . T h e P l a n S p o n s o r s h a l l b e r e s p o n s i b l e
f o r m a k i n g a n y n e c e s s a r y c e r t i f i c a t i o n s t o t h e P l a n . S u c h c e r t i f i c a t i o n s s h a l l b e d e l i v e r e d t o t h e
P l a n ' s P r i v a c y O f f i c i a l . T h e P l a n S p o n s o r a l s o u n d e r t a k e s a n d a g r e e s t h a t i t :
( a ) S h a l l n o t u s e o r d i s c l o s e P r o t e c t e d H e a l t h I n f o r m a t i o n ( " P H I " )
e x c e p t a s t o t h o s e u s e s s p e c i f i c a l l y p e r m i t t e d u n d e r t h e P r i v a c y R u l e .
( b ) S h a l l r e q u i r e a n y a g e n t s o r s u b c o n t r a c t o r s t o w h o m i t d i s c l o s e s
P H I t o a g r e e t o t h e s a m e r e s t r i c t i o n s o n t h e u s e a n d d i s c l o s u r e o f P H I a s a p p l y t o t h e P l a n
S p o n s o r ;
( c ) S h a l l n o t u s e o r d i s c l o s e P H I f o r a n y e m p l o y m e n t - r e l a t e d a c t i o n s
o f E m p l o y e r ;
( d ) S h a l l n o t u s e o r d i s c l o s e P H I i n c o n n e c t i o n w i t h a n y o t h e r b e n e f i t s
o r b e n e f i t p l a n , p r o g r a m , o r a r r a n g e m e n t o f E m p l o y e r .
( e ) S h a l l r e p o r t t o t h e P r i v a c y O f f i c i a l a n y u s e s o r d i s c l o s u r e s o f P H I
i n c o n s i s t e n t w i t h t h e P l a n ' s P r i v a c y P o l i c y o f w h i c h i t b e c o m e s a w a r e .
( f ) S h a l l m a k e P H I a v a i l a b l e i n a c c o r d a n c e w i t h a n i n d i v i d u a l ' s r i g h t
o f a c c e s s i n a c c o r d a n c e w i t h t h e P l a n ' s P r i v a c y P o l i c y .
3 3
(g) Shall make PHI available for amendment and shall incorporate
amendments in accordance with the Plan's Privacy Policy.
(h) Shall make information available to provide any required
accounting of disclosures of PHI in accordance with the Plan's Privacy Policy.
(i) Shall make available to the Secretary of Health and Human
Services its internal practices, books, and records relating to the use and disclosure of
PHI from the Plan for purposes of determining the Plan's compliance with the Privacy
Rule.
(j) Shall, if feasible, retum to the Plan or destroy any PHI from the
Plan that it maintains in any form, and shall retain no copies of the PHI when the PHI is
no longer needed for the purpose for which disclosure was originally made. If it is not
feasible to return or destroy the PHI, the Plan Sponsor agrees that it shall further limit any
uses and disclosures to those purposes that make the return or the destruction of the
information not feasible.
(k) Shall ensure that adequate separation between the Plan Sponsor
and the Plan is established.
14.5 Uses and Disclosures of Protected Health Information.
(a) Certification. The Plan, and any Health Insurance Issuer or Health
Maintenance Organization with respect to the Plan, may disclose PHI to the Plan Sponsor
only following receipt of the Plan Sponsor's certification that the Plan has been amended
in accordance with the requirements of the Privacy Rule.
(b) Plan Administration. The Plan Sponsor shall be permitted to the
limited use and disclosure of PHI for purposes of plan administration, including all
Payment Activities and Health Care Operations, as permitted under the Plan's Privacy
Policy.
(c) Compliance with Privacy Rule. The Plan Sponsor shall be entitled
to those uses and disclosures of PHI as permitted by the Privacy Rule to the extent
necessary for compliance, including but not limited to any uses and disclosures permitted
(1) without permission from an individual; (2) only with explicit or implicit
authorization; or (3) because the PHI has been cleansed.
(d) Participation and Enrollment Information. Participation and
Enrollment Information may be disclosed as necessary to the Plan Sponsor.
(e) Summary Health Information. Summary Health Information may
be disclosed to the Plan Sponsor for the limited purpose of performing Plan Sponsor
functions.
(f) Individuals With Access to PHI. The Privacy Official and his or
her delegates, if any, are permitted to have access to PHI disclosed to or by the Plan. In
34
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a d d i t i o n , t h e P l a n S p o n s o r s h a l l d e s i g n a t e t h e i n d i v i d u a l ( s ) o r g r o u p ( s ) o f i n d i v i d u a l s
u n d e r t h e d i r e c t c o n t r o l o f t h e P l a n S p o n s o r w h o a r e p e r m i t t e d t o h a v e a c c e s s t o P H I
d i s c l o s e d b y o r t o t h e P l a n .
( g ) L i m i t a t i o n s o n D i s c l o s u r e s o f , A c c e s s t o , a n d U s e s o f P H I . P H I
m a y b e d i s c l o s e d f r o m t h e P l a n o n l y f o r P l a n A d m i n i s t r a t i o n F u n c t i o n s p e r f o r m e d o n
b e h a l f o f t h e P l a n , a n d t h e o t h e r p u r p o s e s i d e n t i f i e d i n t h e P l a n ' s P r i v a c y P o l i c y .
1 4 . 6 H y b r i d E n t i t y . T h e p r o v i s i o n s o f t h i s S e c t i o n s h a l l a p p l y o n l y t o t h e
h e a l t h c a r e c o m p o n e n t o f t h e P l a n .
A R T I C L E X V
G E N E R A L P R O V I S I O N S
1 5 . 1 W r i t t e n P l a n . T h e A d m i n i s t r a t o r s h a l l , u p o n r e q u e s t , p r o v i d e e a c h
P a r t i c i p a n t w i t h a c o p y o f t h e w r i t t e n P l a n ( s ) d e t a i l i n g t h e b e n e f i t s a v a i l a b l e t o t h e P a r t i c i p a n t .
1 5 . 2 N o T r u s t F u n d R e q u i r e d . T h e E m p l o y e r s h a l l h a v e n o o b l i g a t i o n , b u t
s h a l l h a v e t h e r i g h t , t o i n s u r e a n y b e n e f i t s u n d e r t h e P l a n o r t o e s t a b l i s h a n y f u n d o r t r u s t f o r t h e
p a y m e n t o f b e n e f i t s u n d e r t h e P l a n .
1 5 . 3 I n s u r e d B e n e f i t s , T h e E m p l o y e r s h a l l h a v e n o r e s p o n s i b i l i t y f o r t h e
p a y m e n t o f a n y b e n e f i t s c o v e r e d u n d e r t h e C o m p o n e n t P l a n s p r o v i d e d b y p o l i c i e s o f i n s u r a n c e .
1 5 . 4 R i g h t s t o E m p l o y e r ' s A s s e t s . N o E m p l o y e e o r b e n e f i c i a r y s h a l l h a v e a n y
r i g h t t o , o r i n t e r e s t i n , a n y a s s e t s o f t h e E m p l o y e r u p o n t e r m i n a t i o n o f e m p l o y m e n t o r o t h e r w i s e ,
e x c e p t a s p r o v i d e d f r o m t i m e t o t i m e u n d e r t h i s P l a n , a n d t h e n o n l y t o t h e e x t e n t o f t h e b e n e f i t s
p a y a b l e u n d e r t h e P l a n t o s u c h E m p l o y e e o r b e n e f i c i a r y . A l l p a y m e n t s o f b e n e f i t s a s p r o v i d e d
f o r i n t h i s P l a n s h a l l b e m a d e s o l e l y o u t o f t h e a s s e t s o f t h e E m p l o y e r a n d t h e A d m i n i s t r a t o r s h a l l
n o t b e l i a b l e t h e r e f o r e i n a n y m a n n e r .
1 5 . 5 N o n a l i e n a t i o n o f B e n e f i t s . B e n e f i t s p a y a b l e u n d e r t h i s P l a n s h a l l n o t b e
s u b j e c t i n a n y m a n n e r t o a n t i c i p a t i o n , a l i e n a t i o n , s a l e , t r a n s f e r , a s s i g n m e n t , p l e d g e ;
e n c u m b r a n c e , c h a r g e , g a r n i s h m e n t , e x e c u t i o n , o r l e v y o f a n y k i n d , e i t h e r v o l u n t a r y o r
i n v o l u n t a r y , i n c l u d i n g a n y s u c h l i a b i l i t y w h i c h i s f o r a l i m o n y o r o t h e r p a y m e n t s f o r t h e s u p p o r t
o f a s p o u s e o r f o r m e r s p o u s e , o r f o r a n y o t h e r r e l a t i v e o f t h e E m p l o y e e , p r i o r t o a c t u a l l y b e i n g
r e c e i v e d b y t h e p e r s o n e n t i t l e d t o t h e b e n e f i t u n d e r t h e t e r m s o f t h e P l a n ; a n d a n y a t t e m p t t o
a n t i c i p a t e , a l i e n a t e , s e l l , t r a n s f e r , a s s i g n , p l e d g e , e n c u m b e r , c h a r g e o r o t h e r w i s e d i s p o s e o f a n y
r i g h t t o b e n e f i t s p a y a b l e h e r e u n d e r , s h a l l b e v o i d . T h e E m p l o y e r s h a l l n o t i n a n y m a r i n e r b e
l i a b l e f o r , o r s u b j e c t t o , t h e d e b t s , c o n t r a c t s , l i a b i l i t i e s , e n g a g e m e n t s o r t o r t s o f a n y p e r s o n
e n t i t l e d t o b e n e f i t s h e r e u n d e r .
1 5 . 6 D i v e s t m e n t o f B e n e f i t s . S u b j e c t o n l y t o t h e s p e c i f i c p r o v i s i o n s o f t h i s
P l a n , n o t h i n g s h a l l b e d e e m e d t o d i v e s t a P a r t i c i p a n t o f a r i g h t t o t h e b e n e f i t t o w h i c h t h e
P a r t i c i p a n t b e c o m e s e n t i t l e d i n a c c o r d a n c e w i t h t h e p r o v i s i o n s o f t h i s P l a n .
3 5
15.7 Discontinuance of Contributions. In the event of a permanent
discontinuance of contributions to the Plan, all Participants shall receive any and all benefits to
which they were entitled as of the date the discontinuance of contributions occurred.
15.8 Plan Interpretation. This Plan, the Summary Plan Description and the
various Component Plans are intended to be read in conjunction with one another. However, to
the extent of any conflict, the provisions of the Plan shall control, unless otherwise provided by
Sections 125, 129 or 105(b)of the Code or the Regulations issued thereunder..
15.9 Governing Law. The Plan shall be administered in the State of California
and its validity, construction, and all rights hereunder shall be governed by the laws of the State
of California.
15.10 Severability. If any provision of the Plan shall be held invalid or
unenforceable, the remaining provisions shall continue to be fully effective.
15.11 Gender and Number. Words used in the masculine, feminine, or neuter
gender shall each be deemed to refer to the other whenever the context so requires. Words used
in the singular or plural number shall each be deemed to refer to the other whenever the context
so requires.
15.12 Headings. Headings used in the Plan are intended solely for reference and
are not intended to explain, modify or place any construction on any of the provisions of the
Agreement. Any conflict between such headings and the text shall be resolved in favor of the
text.
15.13 Successors and Assigns. The Plan shall inure to the benefit of and be
binding upon the parties hereto, their successors and assigns.
15.14 Discharge of Employee. The adoption and maintenance of the Plan shall
not be deemed to be a contract between the Employer and the Employee. Nothing herein
contained shall be deemed to give any Employee the right to be retained in the employ of the
Employer or to interfere with the right of the Employer to discharge any Employee at any time.
15.15 Consolidation With Other Plan Documents. In the event the Plan merges
or consolidates with, or transfers the assets and liabilities to, any other plan, no Participant herein
shall, solely on account of such consolidation or transfer, be entitled to a benefit on the day
following such event which is less than the benefit to which he or she was entitled on the day
preceding such event. For the purpose of this Section, the benefit to which a Participant is
entitled shall be calculated and based upon the assumption that a Plan termination and
distribution of assets occurred on the day as of which the amount of the Participant's entitlement
is being determined.
15.16 Counterparts. The Plan may be executed in an original and any number of
counterparts by the Employer, each of which shall be deemed an original of one and the same
instrument.
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I N W I T N E S S W H E R E O F , t h e E m p l o y e r h a s c a u s e d t h i s A m e n d m e n t t o b e
e x e c u t e d o n S e p t e m b e r 1 0 , 2 0 0 8 .
E M P L O Y E R :
R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N
C O M M I S S I O N
B y :
I t s : C h a i r m a n
A P P R O V E D A S T O F O R M A N D C O N T E N T :
B E S T B E S T & K R I E G E R L L P
B y :
A t t o r n e y s f o r E m p l o y e r
3 7
SCHEDULE "A"
The following Schedule, which may be . amended from time to time by the
Employer, specifies the Benefits and the Component Plans which set forth the terms, conditions
and limitations of the Benefits offered to Participants. The periods of coverage for the
Component Plans shall be the same as the Plan Year of the Flexible Benefits Plan, unless
specified otherwise.
BENEFIT
PROVIDER
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
Medical
Ca1PERS Health Benefits
Program
Plan Year
N/A
Medical Reimbursement
Plan
Self -insured
Plan Year
$2,500.00 annually
Dependent Care
Reimbursement Plan
Self -insured
Plan Year
$5,000.00 annually
$2,500.00 annually for married
Participant filing separate
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C E R T I F I C A T I O N O F E M P L O Y E R T O
R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N
F L E X I B L E B E N E F I T S P L A N
R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N , i s t h e s p o n s o r o f
t h e R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N F L E X I B L E B E N E F I T S
P L A N . T h e P l a n i s a h y b r i d e n t i t y w i t h i n t h e m e a n i n g o f t h e H e a l t h I n s u r a n c e P o r t a b i l i t y a n d
A c c o u n t a b i l i t y A c t o f 1 9 9 6 ( " H I P A A " ) w h i c h i n c l u d e s n o n - h e a l t h c a r e a n d h e a l t h c a r e
c o m p o n e n t s . T h e h e a l t h c a r e c o m p o n e n t s o f t h e P l a n i n c l u d e t h e f o l l o w i n g s e p a r a t e g r o u p
h e a l t h p l a n s :
R i v e r s i d e C o u n t y T r a n s p o r t a t i o n C o m m i s s i o n M e d i c a l R e i m b u r s e m e n t P l a n
T h e P l a n ( e x c l u d i n g t h e n o n - h e a l t h c a r e c o m p o n e n t s ) a n d t h e h e a l t h c a r e
c o m p o n e n t s i n c l u d e d i n t h e P l a n a r e g r o u p h e a l t h p l a n s w i t h i n t h e m e a n i n g o f H I P A A
( c o l l e c t i v e l y , t h e " P l a n " ) . T h e P l a n a n d R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N
C O M M I S S I O N d e s i r e t o e x c h a n g e h e a l t h i n f o r m a t i o n p r o t e c t e d u n d e r H I P A A f o r p u r p o s e s
r e l a t e d t o a d m i n i s t r a t i o n o f t h e P l a n . R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N
C O M M I S S I O N , a c t i n g i n i t s c a p a c i t y a s p l a n s p o n s o r o f t h e P l a n ( " P l a n S p o n s o r " ) m a k e s t h e
f o l l o w i n g c e r t i f i c a t i o n s f o r p u r p o s e s o f a d m i n i s t e r i n g t h e P l a n a s r e q u i r e d b y t h e " S t a n d a r d s f o r
P r i v a c y o f I n d i v i d u a l l y I d e n t i f i a b l e H e a l t h I n f o r m a t i o n , " 4 5 C F R � 1 6 4 . 1 0 2 e t s e q . ( t h e " P r i v a c y
R u l e " ) :
T h e p l a n d o c u m e n t o f t h e P l a n h a s b e e n a m e n d e d t o i n c o r p o r a t e t h e f o l l o w i n g
p r o v i s i o n s a n d P l a n S p o n s o r a g r e e s t o :
1 . n o t u s e o r f u r t h e r d i s c l o s e a n y p r o t e c t e d h e a l t h i n f o r m a t i o n ( " P H I ' )
r e c e i v e d f r o m t h e P l a n ( i n c l u d i n g a n y h e a l t h i n s u r a n c e i s s u e r o r H M O w i t h r e s p e c t t o t h e g r o u p
h e a l t h p l a n ) e x c e p t a s p e r m i t t e d o r r e q u i r e d b y t h e p l a n d o c u m e n t s o r r e q u i r e d b y l a w ;
2 . e n s u r e t h a t a n y a g e n t s o r s u b c o n t r a c t o r s t o w h o m i t d i s c l o s e s a n y P H I
a g r e e t o t h e s a m e r e s t r i c t i o n s a n d c o n d i t i o n s t h a t a p p l y t o t h e P l a n S p o n s o r w i t h r e s p e c t t o s u c h
i n f o r m a t i o n ;
3 . n o t u s e o r d i s c l o s e P H I f o r e m p l o y m e n t - r e l a t e d a c t i o n s a n d d e c i s i o n s ;
4 . n o t u s e o r d i s c l o s e P H I i n c o n n e c t i o n w i t h a n y o t h e r b e n e f i t p l a n ,
p r o g r a m , o r a r r a n g e m e n t o f R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N
e x c e p t t o t h e e x t e n t s u c h o t h e r b e n e f i t p l a n , p r o g r a m o r a r r a n g e m e n t i s p a r t o f a n o r g a n i z e d
h e a l t h c a r e a r r a n g e m e n t o f w h i c h t h e P l a n a l s o i s a p a r t ;
5 . r e p o r t t o t h e P l a n a n y u s e o r d i s c l o s u r e o f P H I t h a t i s i n c o n s i s t e n t w i t h t h e
u s e s a n d d i s c l o s u r e s s p e c i f i e d i n t h e P l a n o f w h i c h i t b e c o m e s a w a r e ;
6 . g i v e i n d i v i d u a l s a c c e s s r i g h t s t o P H I i n i t s p o s s e s s i o n i n a c c o r d a n c e w i t h
t h e p o l i c i e s a n d p r o c e d u r e s o f t h e P l a n ;
7. permit individuals to request amendment of their PHI in the Plan
Sponsor's possession, and to make any necessary amendments, in accordance with the policies
and procedures of the Plan;
8. make information available to provide any necessary accounting of
disclosures of PHI in accordance with the policies and procedures of the Plan;
9. make its internal practices, books, and records relating to the use and
disclosure of PHI from the Plan available to the Secretary of the Department of Health and
Human Services for purposes of determining the Plan's compliance with the Privacy Rule;
10. if feasible, to return to the Plan or destroy any PHI from the Plan that it
maintains in any foray and shall retain no copies of the PHI when the PHI is no longer needed
for the purpose for which disclosure was originally made. If it is not feasible to return or destroy
the PHI, the Plan Sponsor agrees that it shall further limit any uses and disclosures to those
purposes that make the return or the destruction of the information not feasible; and
11. agrees to ensure that adequate separation between the Plan Sponsor and
the Plan is established.
PLAN SPONSOR PLAN
RIVERSIDE COUNTY TRANSPORTATION RIVERSIDE COUNTY TRANSPORTATION
COMMISSION COMMISSION FLEXIBLE BENEFITS
PLAN
By= By:
Print Name: Jeff Stone Print Name: Anne Mayer
Title: Chairman Title: Privacy Official
Dated: Dated:
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R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N
F L E X I B L E B E N E F I T S P L A N
F R E Q U E N T L Y A S K E D Q U E S T I O N S
I N T R O D U C T I O N
A s o f S e p t e m b e r 1 1 , 2 0 0 2 , R I V E R S I D E C O U N T Y T R A N S P O R T A T I O N C O M M I S S I O N
( " R C T C " ) h a s e s t a b l i s h e d t h e R i v e r s i d e C o u n t y T r a n s p o r t a t i o n C o m m i s s i o n F l e x i b l e B e n e f i t s
P l a n ( " P l a n ' ) w h i c h a l l o w s i t s e m p l o y e e s t o e l e c t t o p u r c h a s e c e r t a i n q u a l i f i e d b e n e f i t s b a s e d
o n t h e i r i n d i v i d u a l n e e d s w i t h p r e - t a x d o l l a r s . T h e b e n e f i t s d e s c r i b e d i n t h i s b o o k l e t c o n s t i t u t e
t h e b e n e f i t s a v a i l a b l e u n d e r t h e P l a n a n d a r e r e f e r r e d t o c o l l e c t i v e l y i n t h i s b o o k l e t a s t h e
" B e n e f i t s . "
P l a n M o d i f i c a t i o n / T e r m i n a t i o n
T h e P l a n i s b a s e d o n R C T C ' s u n d e r s t a n d i n g o f t h e c u r r e n t p r o v i s i o n s o f t h e I n t e r n a l R e v e n u e
C o d e . R C T C i n t e n d s t o p r o v i d e b e n e f i t s u n d e r t h e P l a n i n d e f i n i t e l y . H o w e v e r , R C T C m a y
c h a n g e o r t e r m i n a t e t h e b e n e f i t s p r o v i d e d o r t h e c o n t r i b u t i o n s y o u m u s t p a y f o r s u c h b e n e f i t s .
R C T C h a s t h e r i g h t t o m a k e t h e s e c h a n g e s o r t o t e r m i n a t e b e n e f i t s a t a n y t i m e . I f t h i s o c c u r s i t
w i l l n o t a f f e c t a n y b e n e f i t t o w h i c h y o u w e r e e n t i t l e d p r i o r t o t h e d a t e o f t h e a m e n d m e n t o r
t e r m i n a t i o n .
P l a n A d m i n i s t r a t i o n
R C T C ' s A c c o u n t i n g D e p a r t m e n t w i l l m a n a g e t h e P l a n a n d w i l l h a v e f u l l d i s c r e t i o n t o d e t e r m i n e
e l i g i b i l i t y , i n t e r p r e t t h e P l a n a n d d e t e r m i n e w h e t h e r a c l a i m s h o u l d b e p a i d o r d e n i e d i n
a c c o r d a n c e w i t h t h e p r o v i s i o n s o f t h e P l a n a n d w i t h g o v e r n m e n t a l r e g u l a t i o n s .
B E N E F I T S & C O V E R A G E
T h e P l a n i s m a d e p o s s i b l e b y S e c t i o n 1 2 5 o f t h e I n t e r n a l R e v e n u e C o d e . S e c t i o n 1 2 5 e n a b l e s
E m p l o y e e s t o s e t a s i d e m o n e y o n a p r e - t a x b a s i s t o c o v e r :
f& P r e m i u m s f o r g r o u p h e a l t h i n s u r a n c e
" A l l o w a b l e M e d i c a l E x p e n s e s
f& D e p e n d e n t C a r e E x p e n s e s
C o n t r i b u t i o n s f o r a n y g r o u p h e a l t h i n s u r a n c e c o v e r a g e o f f e r e d u n d e r t h e P l a n a r e d e d u c t e d f r o m
y o u r p a y c h e c k o n a p r e - t a x b a s i s .
I n a d d i t i o n , y o u m a y a l s o e l e c t t o p a r t i c i p a t e i n t h e M e d i c a l S p e n d i n g A c c o u n t a n d / o r t h e
D e p e n d e n t C a r e S p e n d i n g A c c o u n t ( c o l l e c t i v e l y , t h e " F l e x i b l e B e n e f i t A c c o u n t s " ) , w h e r e b y
R C T C t a k e s a n a n n u a l a m o u n t , d e t e r m i n e d b y y o u , f r o m y o u r g r o s s p a y . T h e a n n u a l a m o u n t
t h a t m a y b e d e d u c t e d f r o m y o u r g r o s s p a y f o r e i t h e r o f t h e F l e x i b l e B e n e f i t A c c o u n t s i s s u b j e c t
R V B U S U W A H L I N 1 6 9 9 6 6 3 . 4 1
to threshold limitations which are discussed later in this booklet. This money is held in a
spending account for reimbursement of your eligible medical and/or dependent care expenses.
After you incur eligible medical or dependent care expenses, simply submit a claim, with the
required substantiating information as further described in Q-23 and Q-31, to be reimbursed
from the appropriate account.
Q-1. What Benefits are Available under the Plan?
You may purchase benefits under the Plan for yourself, your spouse and your eligible
dependents. You may pay for these benefits using pre-tax dollars that are automatically
deducted each pay period. Details relative to the cost per pay period for each benefit and the
minimum and maximum amounts you may contribute to the Flexible Benefit Accounts are listed
on the enrollment form.
The benefits from which you may choose include:
�► Premium Payment Component. Permits an Employee to pay for his or her share of
premiums under the several different health insurance plan offered through CaIPERS.
• Medical Spending Account. Also called the Medical Reimbursement Plan. It permits
an Employee to pay for his or her Allowable Medical Expenses (See Q-21) that are not
otherwise reimbursed by insurance with pre-tax dollars.
• Dependent Care Spending Account. Also called the Dependent Care Plan. It permits
an Employee to pay for his or her Employment -Related Dependent Care Expenses (See
Q-25) with pre-tax dollars.
Each benefit under the Plan has separate rules governing benefits and plan administration to
comply with various federal tax laws. These rules are explained in more detail in the plan
documents, copies of which are available from RCTC's Human Resources Department.
Q-2. May I Elect to Purchase Health Insurance Coverage for My Domestic Partner?
Yes, group health coverage, including medical and dental benefits, is available for Domestic
Partners that meet (i) the requirements of Section 297(b) of the California Family Code
("Domestic Partner'', and (ii) the eligibility requirements of the applicable health insurance
plan. However, please note that purchasing group health coverage for your Domestic Partner
may have federal tax consequences.
Under federal tax law, if your Domestic Partner does not qualify as your tax dependent for health
coverage purposes, the value of your Domestic Partner's health coverage is considered a taxable
benefit under the Plan. In this case, the fair market value of your Domestic Partner's coverage
for the Plan Year will be included in your gross income, subject to federal income tax
withholding and employment taxes, and will be reported on your Form W-2. The fair market
value of Domestic Partner health coverage is determined based upon the monthly premium for
single person coverage multiplied by the number of months of coverage. Although your salary
reduction amounts taken from your compensation on a pre-tax basis will be used to purchase
health coverage for your Domestic Partner, the value of such additional coverage will be taxable
RVBUSUWIWLIN S996B3A 2
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t o y o u a s e x p l a i n e d a b o v e . Y o u w i l l a l s o b e u n a b l e t o c l a i m e x p e n s e s f o r y o u r D o m e s t i c P a r t n e r
u n d e r t h e M e d i c a l S p e n d i n g A c c o u n t .
I f y o u r D o m e s t i c P a r t n e r q u a l i f i e s a s y o u r t a x d e p e n d e n t f o r h e a l t h c o v e r a g e p u r p o s e s , t h e n t h e
f a i r m a r k e t v a l u e o f y o u r D o m e s t i c P a r t n e r ' s h e a l t h c o v e r a g e w i l l n o t b e i n c l u d e d i n y o u r
i n c o m e o r b e s u b j e c t t o f e d e r a l w i t h h o l d i n g o r e m p l o y m e n t t a x e s . Y o u w i l l a l s o b e a b l e t o c l a i m
A l l o w a b l e M e d i c a l E x p e n s e s f o r y o u r D o m e s t i c P a r t n e r u n d e r t h e M e d i c a l S p e n d i n g A c c o u n t .
C a l i f o r n i a e x c l u d e s D o m e s t i c P a r t n e r c o v e r a g e f r o m g r o s s i n c o m e f o r s t a t e i n c o m e t a x p u r p o s e s ,
e v e n i f t h e D o m e s t i c P a r t n e r i s n o t a t a x d e p e n d e n t f o r h e a l t h c o v e r a g e p u r p o s e s .
Q - 3 . H o w D o I K n o w W h e t h e r M y D o m e s t i c P a r t n e r i s M y T a x D e p e n d e n t f o r H e a l t h
C o v e r a g e P u r p o s e s ?
T h e f o l l o w i n g c o n d i t i o n s m u s t b e m e t i n o r d e r f o r y o u r D o m e s t i c P a r t n e r t o q u a l i f y a s y o u r t a x
d e p e n d e n t f o r h e a l t h c o v e r a g e p u r p o s e s u n d e r f e d e r a l t a x l a w :
I . Y o u a n d y o u r D o m e s t i c P a r t n e r h a v e t h e s a m e p r i n c i p a l p l a c e o f a b o d e f o r t h e
e n t i r e c a l e n d a r y e a r ;
2 . Y o u r D o m e s t i c P a r t n e r i s a m e m b e r o f y o u r h o u s e h o l d f o r t h e e n t i r e c a l e n d a r y e a r
( t h e r e l a t i o n s h i p m u s t n o t v i o l a t e l o c a l l a w ) ;
3 . D u r i n g t h e c a l e n d a r y e a r y o u p r o v i d e m o r e t h a n h a l f o f y o u r D o m e s t i c P a r t n e r ' s
t o t a l s u p p o r t ;
4 . Y o u r D o m e s t i c P a r t n e r i s n o t y o u r ( o r a n y o n e e l s e ' s ) " q u a l i f y i n g c h i l d " u n d e r
S e c t i o n 1 5 2 ( c ) o f t h e I n t e r n a l R e v e n u e C o d e ; a n d
I f y o u r D o m e s t i c P a r t n e r q u a l i f i e s a s y o u r t a x d e p e n d e n t f o r h e a l t h c o v e r a g e p u r p o s e s , y o u c a n
a v o i d h a v i n g t h e v a l u e o f y o u r D o m e s t i c P a r t n e r ' s h e a l t h c o v e r a g e t r e a t e d a s t a x a b l e i n c o m e .
T o a v o i d t a x a t i o n , y o u m u s t c o m p l e t e a n d r e t u r n t h e a t t a c h e d C e r t i f i c a t i o n o f D e p e n d e n t
D o m e s t i c P a r t n e r S t a t u s , i n d i c a t i n g t h a t y o u r D o m e s t i c P a r t n e r q u a l i f i e s a s y o u r f e d e r a l t a x
d e p e n d e n t f o r h e a l t h c o v e r a g e p u r p o s e s . B e c a u s e t h e d e t e r m i n a t i o n o f w h e t h e r a p e r s o n i s a t a x
d e p e n d e n t f o r h e a l t h c o v e r a g e p u r p o s e s t o m s o n f a c t s s o l e l y w i t h i n y o u r k n o w l e d g e , R C T C
c a n n o t m a k e t h i s d e t e r m i n a t i o n f o r y o u . Y o u w i l l b e a s k e d t o c o m p l e t e a C e r t i f i c a t i o n e a c h y e a r
a t o p e n e n r o l l m e n t . F o r a n y y e a r i n w h i c h R C T C d o e s n o t r e c e i v e a C e r t i f i c a t i o n f r o m y o u ,
R C T C w i l l a s s u m e t h a t y o u r D o m e s t i c P a r t n e r d o e s n o t q u a l i f y a s y o u r f e d e r a l t a x d e p e n d e n t f o r
h e a l t h c o v e r a g e p u r p o s e s f o r t h a t y e a r .
E L I G I B I L I T Y & E N R O L L M E N T
Q 4 . W h o M a y P a r t i c i p a t e i n t h e P l a n ?
T o b e e l i g i b l e f o r p a r t i c i p a t i o n u n d e r t h e P l a n , y o u m u s t :
" B e a r e s i d e n t o f t h e U n i t e d S t a t e s .
f& N o t b e a t e m p o r a r y o r c o n t r a c t E m p l o y e e .
f& B e a r e g u l a r o r p r o b a t i o n a r y E m p l o y e e .
R V B U S l 1 W A H 1 J M 6 9 9 6 6 3 . 4 3
Q-5. How Do I Enroll in the Plan?
All Participants must enroll or re -enroll during the designated Open Enrollment. Period.
However, if you first become eligible after January 1 of a Plan Year you may enroll within 30
days of the date you become eligible. Enrollment forms are available from RCTC's Accounting
Department or the intranet.
To select the benefits you would like to purchase under the Plan, you must complete a Flexible
- Benefits Enrollment Form ("Election Form") prior to the beginning of each Plan Year.
For newly eligible employees, if you fail to complete an Election Form, then you will be
considered as having elected not to participate in the Plan. If you are already a participant in the
Plan and you fail to complete a new Election Form for the upcoming Plan Year, then you will be
deemed to have elected the same benefit options and salary reduction amounts that you elected
for the prior Plan Year; however, you will not be eligible to participate in the Flexible Benefit
Accounts.
Q-6. What are the "Open Enrolhnent Period" and the "Plan Year"?
The Open Enrollment Period is the period during which you have an opportunity to participate
under the Plan by signing and returning an individual Election Form. See Q-5. You will be
notified of the timing and duration of the Open Enrollment Period, which for a Plan Year
generally will be from November 1 through December 15 of the previous Plan Year.
The Plan Year is the 12 months beginning on each January 1 and ending on December 31.
Q-7. Can I Change My Elections?
During each annual Open Enrollment Period, you may change all of your benefit elections with
respect to the upcoming Plan Year. Your choices are in effect for the entire Plan Year. Only
under special circumstances may you apply to change an election after a Plan Year has started
and make new elections for the rest of that Plan Year. These special circumstances include the
following:
Change in Status
♦ Marital Status. Change in marital status (such as marriage, divorce, legal separation or
annulment);
♦ Number of Dependents. Change in the number of your dependents (such as the death of
your spouse or a child; the birth, adoption of or placement for adoption of a child);
♦ Employment. Change in your employment status or the status of your spouse or
dependent which results in that person becoming or ceasing to be eligible under this Plan
RVBUSV WAHLIM699663.4 4
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o r o t h e r b e n e f i t p l a n ( s u c h a s t h e s w i t c h i n g f r o m p a r t - t i m e t o f u l l - t i m e e m p l o y m e n t
s t a t u s o r f r o m f u l l - t i m e t o p a r t - t i m e s t a t u s b y y o u o r y o u r s p o u s e ; t e r m i n a t i o n o r
c o m m e n c e m e n t o f e m p l o y m e n t ; a s t r i k e o r l o c k o u t ; t h e t a k i n g o f o r r e t u r n f r o m a n
u n p a i d l e a v e o f a b s e n c e ; o r a c h a n g e i n w o r k s i t e ) ; h o w e v e r , a c h a n g e i n s t a t u s w i l l n o t
b e d e e m e d t o h a v e o c c u r r e d i n c a s e s w h e r e a f o r m e r e m p l o y e e i s r e h i r e d w i t h i n 3 0
d a y s o f h i s o r h e r t e r m i n a t i o n ;
f& D e p e n d e n t S t a t u s . C h a n g e i n d e p e n d e n t s t a t u s ( y o u r d e p e n d e n t s a t i s f i e s o r c e a s e s t o
s a t i s f y t h e e l i g i b i l i t y r e q u i r e m e n t s u n d e r t h e P l a n ) ;
" R e s i d e n c y . C h a n g e i n r e s i d e n c e c a u s i n g y o u t o b e o u t s i d e t h e P l a n ' s c o v e r a g e a r e a ( i f
a p p l i c a b l e ) ; o r
f& M e d i c a r e o r M e d i c a i d . E n t i t l e m e n t t o o r c e a s i n g t o b e e n t i t l e d t o M e d i c a r e o r M e d i c a i d .
C h a n g e s i n e l e c t i o n m u s t b e c o n s i s t e n t w i t h t h e c h a n g e i n f a m i l y s t a t u s . F o r e x a m p l e ,
t h e b i r t h o f a c h i l d m a y n e c e s s i t a t e a n i n c r e a s e i n t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t ,
b u t n o t a d e c r e a s e .
C h a n g e s i n C o s t o r C o v e r a g e
S p e c i a l c i r c u m s t a n c e s a l s o i n c l u d e c o s t a n d c o v e r a g e c h a n g e s t o t h e g r o u p h e a l t h p l a n i n
w h i c h y o u p a r t i c i p a t e , s u c h a s a s i g n i f i c a n t i n c r e a s e i n t h e c o s t o f y o u r g r o u p h e a l t h
c o v e r a g e , a s i g n i f i c a n t d e c r e a s e i n o r c e s s a t i o n o f y o u r g r o u p h e a l t h c o v e r a g e o r a
s i g n i f i c a n t c h a n g e i n y o u r g r o u p h e a l t h c o v e r a g e o r y o u r s p o u s e ' s a t t r i b u t a b l e t o y o u r
s p o u s e ' s e m p l o y m e n t . F o r t h e s e i n s t a n c e s , h o w e v e r , o n l y a c h a n g e t o a n o t h e r h e a l t h
p l a n w i t h s i m i l a r c o v e r a g e i s p e r m i t t e d .
T o c h a n g e y o u r e l e c t i o n , c o m p l e t e a n e w E l e c t i o n F o r m a v a i l a b l e a t R C T C ' s A c c o u n t i n g
D e p a r t m e n t o r t h e i n t r a n e t .
P A R T I C I P A T I O N I N T H E P L A N
Q - 8 . W h a t A r e t h e A d v a n t a g e s o f a S e c t i o n 1 2 5 P l a n ?
O n e o f t h e a d v a n t a g e s o f a S e c t i o n 1 2 5 P l a n i s t h a t t h e e m p l o y e e , r a t h e r t h a n t h e e m p l o y e r ,
d e c i d e s w h i c h b e n e f i t s h e o r s h e s h o u l d r e c e i v e . C o n s e q u e n t l y , a w i d e r r a n g e o f c h o i c e s i s
o f f e r e d a l l o w i n g y o u t o m a k e t h e c h o i c e s a s t o t h e p a r t i c u l a r b e n e f i t s w h i c h f i t y o u r s i t u a t i o n . A
S e c t i o n 1 2 5 P l a n c a n s i g n i f i c a n t l y l o w e r y o u r t a x b u r d e n , b e c a u s e y o u p a y n o f e d e r a l i n c o m e t a x
o n c o m p e n s a t i o n a l l o c a t e d t o t h e P l a n f o r q u a l i f i e d b e n e f i t s . F u r t h e r m o r e , y o u d o n o t h a v e t o
p a y s t a t e i n c o m e t a x e s o n t h i s m o n e y . H o w e v e r , p l e a s e s e e Q - 2 f o r a d i s c u s s i o n o n w h e n c e r t a i n
b e n e f i t s p r o v i d e d u n d e r t h e P l a n m a y g i v e r i s e t o f e d e r a l i n c o m e t a x .
Q - 9 . H o w D o I P a y f o r B e n e f i t s u n d e r t h e P l a n ?
A n E m p l o y e e ' s e l e c t i o n t o p a y f o r B e n e f i t s o n a p r e - t a x o r a f t e r - t a x b a s i s i s m a d e b y s u b m i t t i n g
a n E l e c t i o n F o r m a n d a S a l a r y R e d u c t i o n A g r e e m e n t w i t h t h e E m p l o y e r ( a s k t h e R C T C
A c c o u n t i n g D e p a r t m e n t f o r a c o p y i f y o u h a v e n o t r e c e i v e d o n e ) . U n d e r t h a t S a l a r y R e d u c t i o n
R V B U S U W A H L I M 6 9 9 6 6 3 . 4 5
Agreement, if you elect to pay for Benefits on a pre-tax basis, you agree to a salary reduction to
pay for your share of the cost of coverage (also known as contributions) with pre-tax funds
instead of receiving a corresponding amount of your regular pay that would otherwise be subject
to taxes. From then on, you must pay contributions for such coverage by having that portion
deducted from each paycheck on a pre-tax basis (generally an equal portion from each paycheck,
or an amount otherwise agreed to or as deemed appropriate by the Administrator). Please see Q-
2 for an exception to the preceding.
Q-10. How Long Can i Participate in the Plan?
You can participate in the Plan as long as you remain eligible. See Q-4. To participate in the
Medical Spending Account and Dependent Care Spending Account you must elect to participate
in the Flexible Benefit Accounts before the beginning of each Plan Year.
Q-11. What Happens if My Employment Terminates or the Plan Terminates?
If your employment terminates or the Plan is terminated, then, unless you elect to continue your
participation under the Plan's group health coverage, no further additions will be made to your
Flexible Benefit Accounts.
However, benefits for expenses incurred prior to termination will be paid until the earlier of
• The end of the Plan Year•, or
♦ The account balance in your Flexible Benefit Accounts has been reduced to zero.
PREMIUM PAYMENT COMPONENT
Q-12. How Does the Premium Payment Component Work?
You may choose group health coverage from one of the several different health insurance plans
offered through CaIPERS. You share the cost of your health coverage with RCTC and your
share of the premium is deducted from each paycheck. Except as discussed at Q-2, when you
participate in the Premium Payment Component your share of the premium is deducted from
your paycheck on a pre-tax basis. Because contribution costs are deducted from gross pay
before taxes are calculated, you save tax dollars.
If the cost of medical and prescription drug coverage increases or decreases, then your payroll
deduction will be automatically adjusted to reflect the change.
RveusuwAHLIN1699663.4
"
G E N E R A L I N F O R M A T I O N R E G A R D I N G
F L E X I B L E B E N E F I T A C C O U N T S
Q - 1 3 . H o w D o t h e F l e x i b l e B e n e f i t A c c o u n t s W o r k ?
Y o u m a y e s t a b l i s h s p e c i a l a c c o u n t s f o r t w o s e p a r a t e c a t e g o r i e s o f p r e d i c t a b l e e x p e n s e s : m e d i c a l
a n d d e p e n d e n t c a r e . Y o u s p e c i f y o n y o u r E l e c t i o n F o r m h o w m u c h y o u w a n t t o c o n t r i b u t e t o
e a c h a c c o u n t f o r t h e P l a n Y e a r . T h i s i s y o u r a n n u a l c o n t r i b u t i o n w h i c h w i l l b e d e d u c t e d f r o m
y o u r p a y t h r o u g h o u t t h e y e a r . T h e I n t e r n a l R e v e n u e S e r v i c e s t a t e s t h a t t h e b a l a n c e s o f t h e s e
F l e x i b l e S p e n d i n g A c c o u n t s c a n n o t b e c o m b i n e d o r u s e d f o r p u r p o s e s o t h e r t h a n f o r w h i c h t h e y
w e r e o r i g i n a l l y i n t e n d e d . T h a t m e a n s t h a t i f y o u h a v e m o n e y l e f t o v e r i n y o u r D e p e n d e n t C a r e
S p e n d i n g A c c o u n t a t t h e e n d o f t h e y e a r , y o u c a n n o t u s e i t f o r m e d i c a l e x p e n s e s o r v i c e v e r s a .
Q - 1 4 . W h a t A r e t h e A d v a n t a g e s o f E l e c t i n g t h i s B e n e f i t ?
T h e r e a r e s o m e e x p e n s e s y o u k n o w y o u w i l l h a v e t o p a y f o r i n t h e c o m i n g y e a r ; f o r e x a m p l e ,
n e w e y e g l a s s e s , o r t h o d o n t i a s e r v i c e s n o t c o v e r e d b y i n s u r a n c e o r d a y c a r e f o r a c h i l d o r a n
i n c a p a c i t a t e d d e p e n d e n t a d u l t w h i l e y o u a r e a t w o r k . N o r m a l l y , y o u w o u l d p a y f o r t h e s e
e x p e n s e s w i t h a f t e r - t a x i n c o m e . H o w e v e r , w h e n y o u p a r t i c i p a t e i n t h e M e d i c a l S p e n d i n g
A c c o u n t o r D e p e n d e n t C a r e S p e n d i n g A c c o u n t , y o u m a y s e t a s i d e p r e - t a x e a r n i n g s i n s p e c i a l
a c c o u n t s t o p a y f o r t h e s e e x p e n s e s .
Q - 1 5 . H o w M u c h S h o u l d I C o n t r i b u t e t o M y F l e x i b l e B e n e f i t A c c o u n t s ?
T h e r e a r e c e r t a i n f e d e r a l r e g u l a t i o n s t o c o n s i d e r b e f o r e e n r o l l i n g i n e i t h e r o f t h e F l e x i b l e B e n e f i t
A c c o u n t s .
f& F e d e r a l r e g u l a t i o n s r e q u i r e t h a t y o u d e s i g n a t e h o w m u c h m o n e y y o u w i s h t o c o n t r i b u t e
a n n u a l l y t o e a c h a c c o u n t a t t h e b e g i n n i n g o f t h e P l a n Y e a r .
f& Y o u m a y c h a n g e y o u r a n n u a l c o n t r i b u t i o n o n l y i f y o u e x p e r i e n c e a c h a n g e i n f a m i l y
s t a t u s , s u c h a s m a r r i a g e , d i v o r c e o r t h e a d d i t i o n o r l o s s o f a s p o u s e ' s i n c o m e . S e e Q - 7
f o r a c o m p l e t e l i s t o f c i r c u m s t a n c e s t h a t q u a l i f y a s a c h a n g e i n s t a t u s ) .
" D u e t o I R S r e g u l a t i o n s , y o u m u s t h a v e i n c u r r e d e l i g i b l e e x p e n s e s f o r w h i c h y o u m a y
r e c e i v e r e i m b u r s e m e n t f r o m t h e F l e x i b l e B e n e f i t A c c o u n t s b y t h e e n d o f t h e " g r a c e
p e r i o d " ( S e e Q - 1 6 ) , a n d m a k e a c l a i m f o r s u c h r e i m b u r s e m e n t s w i t h i n 3 m o n t h s a f t e r t h e
e n d o f s u c h " g r a c e p e r i o d " , o r y o u w i l l l o s e t h e m . A n y m o n e y l e f t i n y o u r M e d i c a l
S p e n d i n g A c c o u n t o r y o u r D e p e n d e n t C a r e S p e n d i n g A c c o u n t a f t e r a l l c l a i m s h a v e b e e n
p r o c e s s e d f o r t h a t P l a n Y e a r m u s t b e f o r f e i t e d . I R S r e g u l a t i o n s p r o h i b i t R C T C f r o m
r e t u r n i n g t h e s e f o r f e i t u r e s d i r e c t l y t o t h e E m p l o y e e s w h o f o r f e i t e d t h e f u n d s . A n y
f o r f e i t e d a m o u n t s w i l l b e a p p l i e d t o w a r d p l a n e x p e n s e s .
f& M o n e y s e t a s i d e f o r m e d i c a l e x p e n s e s c a n n o t b e u s e d f o r d e p e n d e n t c a r e e x p e n s e s , o r
v i c e v e r s a . T h e r e f o r e , i f y o u h a v e m o n e y l e f t o v e r i n o n e a c c o u n t t h a t y o u w o u l d
o t h e r w i s e f o r f e i t , y o u c a n n o t u s e t h a t m o n e y f o r o t h e r t y p e s o f e x p e n s e s . T h a t i s w h y i t
i s i m p o r t a n t t o e s t i m a t e y o u r e x p e n s e s c a r e f u l l y .
R V B U S U W A H U N 1 6 9 9 6 6 3 A 7
f& O n c e y o u m a k e a n e l e c t i o n , y o u c a n n o t c h a n g e i t u n t i l t h e e n d o f t h e P l a n Y e a r u n l e s s
y o u h a v e a c h a n g e i n s t a t u s .
f& I f y o u d o n o t e n r o l l i n t h e P l a n d u r i n g t h e a n n u a l O p e n E n r o l l m e n t P e r i o d , y o u m u s t w a i t
u n t i l t h e n e x t a n n u a l O p e n E n r o l l m e n t P e r i o d t o e n r o l l u n l e s s y o u h a v e a c h a n g e i n
s t a t u s . S e e Q - 7 f o r a d d i t i o n a l i n f o r m a t i o n .
H e r e a r e a f e w q u e s t i o n s t h a t m i g h t h e l p y o u d e c i d e h o w m u c h m o n e y t o s e t a s i d e i n y o u r
F l e x i b l e B e n e f i t A c c o u n t s :
f& W h a t i s y o u r h e a l t h i n s u r a n c e p l a n d e d u c t i b l e ? D o y o u t h i n k y o u w i l l i n c u r e n o u g h
e x p e n s e s t o m e e t i t d u r i n g t h e P l a n Y e a r ?
" A t w h a t p e r c e n t a g e d o e s y o u r h e a l t h i n s u r a n c e p l a n p a y b e n e f i t s ? Y o u c a n p a y t h e
r e m a i n i n g p o r t i o n w i t h p r e - t a x d o l l a r s .
" W h a t m e d i c a l , p r e s c r i p t i o n d r u g , d e n t a l o r v i s i o n c a r e e x p e n s e s d o y o u e x p e c t t o i n c u r
t h a t m a y n o t b e c o v e r e d u n d e r y o u r p l a n ? A r e y o u o r a n y o f y o u r d e p e n d e n t s o n l o n g -
t e r m m e d i c a t i o n ?
f& H o w m u c h d o y o u e x p e c t t o p a y f o r d e p e n d e n t c a r e d u r i n g t h i s P l a n Y e a r ? B e s u r e t o
c o n s i d e r e x p e n s e s f o r c h i l d c a r e , e l d e r c a r e a n d c a r e f o r a d i s a b l e d d e p e n d e n t .
Q - 1 6 . W h a t i s t h e ` G r a c e P e r i o d " ?
W i t h r e s p e c t t o b o t h t h e M e d i c a l S p e n d i n g A c c o u n t a n d t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t ,
y o u m a y b e r e i m b u r s e d f r o m u n u s e d a m o u n t s r e m a i n i n g i n y o u r M e d i c a l S p e n d i n g A c c o u n t o r
t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t a t t h e e n d o f t h e P l a n Y e a r f o r A l l o w a b l e M e d i c a l
E x p e n s e s o r E m p l o y m e n t - R e l a t e d D e p e n d e n t C a r e E x p e n s e s , r e s p e c t i v e l y , i n c u r r e d d u r i n g t h e
G r a c e P e r i o d . T h e " G r a c e P e r i o d " i s t h e p e r i o d o c c u r r i n g t w o m o n t h s a n d f i f t e e n d a y s a f t e r
t h e e n d o f t h e P l a n Y e a r .
Q - 1 7 . H o w D o I G e t R e i m b u r s e d ?
R e i m b u r s e m e n t p a y m e n t s u n d e r t h e M e d i c a l S p e n d i n g A c c o u n t o r D e p e n d e n t C a r e S p e n d i n g
A c c o u n t w i l l b e m a d e d i r e c t l y t o y o u . S i m p l y c o m p l e t e a F l e x i b l e B e n e f i t A c c o u n t
R e i m b u r s e m e n t R e q u e s t F o r m ( " R e i m b u r s e m e n t R e q u e s t ' ) a v a i l a b l e f r o m R C T C ' s
A c c o u n t i n g D e p a r t m e n t o r t h e i n t r a n e t , a t t a c h a c o p y o f y o u r r e c e i p t s , a n d s e n d i t t o R C T C ' s
A c c o u n t i n g D e p a r t m e n t . P l e a s e s e e Q - 2 3 a n d Q - 3 1 f o r a d d i t i o n a l r e q u i r e m e n t s .
Q - 1 8 . W h e n W i l l I R e c e i v e M y R e i m b u r s e m e n t s ?
R e i m b u r s e m e n t R e q u e s t s a r e u s u a l l y p r o c e s s e d t w i c e a w e e k . C u r r e n t l y , t h e " c u t o f f ' i s
M o n d a y / W e d n e s d a y 1 2 : 0 0 p . m . f o r T u e s d a y / T h u r s d a y c h e c k s , r e s p e c t i v e l y . C l a i m s f o r
"
R V B U S U W A H L I N 1 6 9 9 6 6 3 . 4 8
"
e x p e n s e s i n c u r r e d d u r i n g t h e G r a c e P e r i o d w i l l b e p r o c e s s e d i n t h e o r d e r r e c e i v e d ; f i r s t t o t h e
p r i o r P l a n Y e a r b a l a n c e , i f a n y , a n d t h e n t o t h e c u r r e n t P l a n Y e a r b a l a n c e .
A l l c l a i m s f o r p a y m e n t i n a n y P l a n Y e a r m u s t b e m a d e n o l a t e r t h a n 3 m o n t h s a f t e r t h e e n d o f t h e
G r a c e P e r i o d f o l l o w i n g t h e p r i o r P l a n Y e a r . E m p l o y e e s w h o t e r m i n a t e e m p l o y m e n t d u r i n g t h e
P l a n Y e a r w i l l b e g i v e n 3 m o n t h s f r o m t h e i r d a t e o f t e r m i n a t i o n i n w h i c h t o s u b m i t e x p e n s e s
i n c u r r e d p r i o r t o t h e i r t e r m i n a t i o n .
A n y q u e s t i o n s r e g a r d i n g t h e a d m i n i s t r a t i o n o f t h e F l e x i b l e B e n e f i t A c c o u n t s s h o u l d b e d i r e c t e d
t o t h e A c c o u n t i n g D e p a r t m e n t a n d H u m a n R e s o u r c e s M a n a g e r .
, E Q - 1 9 . H o w W i l l I K n o w H o w M u c h I H a v e i n M y A c c o u n t s ?
F o r e a c h E m p l o y e e , a d e t a i l s t a t e m e n t i s m a i n t a i n e d t h a t c l e a r l y s t a t e s t h e b a l a n c e i n e a c h
a c c o u n t . I t l i s t s t h e y e a r - t o - d a t e d e p o s i t s , c l a i m s s u b m i t t e d a n d c l a i m s p a i d , a s w e l l a s a n y
c a r r y - o v e r a m o u n t s . I t m a y b e r e q u e s t e d f r o m R C T C ' s A c c o u n t i n g D e p a r t m e n t . I n a d d i t i o n ,
t h r e e m o n t h s p r i o r t o t h e e n d o f t h e P l a n Y e a r , e a c h p a r t i c i p a t i n g E m p l o y e e w i l l r e c e i v e a n
E m p l o y e e A c c o u n t S t a t u s R e p o r t . T h i s r e p o r t i s y o u r r e m i n d e r t o s u b m i t a n y r e m a i n i n g c l a i m s
y o u m a y h a v e t o a v o i d p l a n f o r f e i t u r e s .
"
T H E M E D I C A L S P E N D I N G A C C O U N T
Q - 2 0 . W h a t A r e t h e A d v a n t a g e s o f C o n t r i b u t i n g t o a M e d i c a l S p e n d i n g A c c o u n t ?
Y o u c h o o s e t h e a m o u n t t o b e d e d u c t e d f r o m y o u r g r o s s p a y , u p t o a m a x i m u m o f $ 2 , 5 0 0 . 0 0 i n
a n y o n e P l a n Y e a r . T h i s a m o u n t w i l l b e :
f& T r a n s f e r r e d t o a m e d i c a l s p e n d i n g a c c o u n t i n e q u a l a m o u n t s e a c h p a y p e r i o d ; a n d
f& U s e d t o r e i m b u r s e y o u f o r a l l o w a b l e m e d i c a l e x p e n s e s i n c u r r e d d u r i n g a P l a n Y e a r . T h i s
i n c l u d e s a n y d e d u c t i b l e s a n d c o - p a y m e n t p e r c e n t a g e s y o u m u s t p a y .
Q - 2 1 . W h a t A r e A l l o w a b l e M e d i c a l E x p e n s e s ?
" A l l o w a b l e M e d i c a l E x p e n s e s " m e a n s t h o s e e x p e n s e s d e f i n e d i n S e c t i o n 2 1 3 o f t h e I n t e r n a l
R e v e n u e C o d e f o r d i a g n o s i s , t r e a t m e n t , o r p r e v e n t i o n o f d i s e a s e t h a t a r e n o t o t h e r w i s e u s e d a s a
t a x d e d u c t i o n b y y o u a n d t h a t a r e i n c u r r e d o n o r a f t e r t h e d a t e y o u b e c o m e c o v e r e d u n d e r t h e
P l a n . T h i s i n c l u d e s e x p e n s e s s u c h a s d e d u c t i b l e s a n d c o p a y m e n t s , u n i n s u r e d m e d i c a l a n d d e n t a l
e x p e n s e s , v i s i o n c a r e a n d h e a r i n g c a r e . G e n e r a l l y , t h e e x p e n s e s c o v e r e d m u s t b e " m e d i c a l l y
n e c e s s a r y , " o r p r e s c r i b e d b y a l i c e n s e d p h y s i c i a n t o q u a l i f y .
E x a m p l e s o f A l l o w a b l e M e d i c a l E x p e n s e s :
f& A c u p u n c t u r e ;
" A l c o h o l i s m a n d d r u g a b u s e t r e a t m e n t ;
" A m b u l a n c e s e r v i c e s ;
f& A r t i f i c i a l l i m b o r t e e t h ;
" C h i r o p r a c t o r ;
f& C o n t a c t l e n s e s ;
R v s u s 1 J w A H L W A 6 9 9 6 6 3 . 4 9
f& C o s m e t i c s u r g e r y n e c e s s a r y t o i m p r o v e a d e f o r m i t y c a u s e d b y c o n g e n i t a l a b n o r m a l i t y ,
a c c i d e n t o r t r a u m a , o r d i s f i g u r i n g d i s e a s e ;
f& C r u t c h e s ;
f& D e n t a l t r e a t m e n t ( n o n - c o s m e t i c ) ;
f& D e d u c t i b l e s o r c o - p a y m e n t s f o r m e d i c a l , d e n t a l , o r v i s i o n p l a n s ;
f& E y e g l a s s e s ;
" E y e s u r g e r y ;
f& F e r t i l i t y e n h a n c e m e n t ;
" G u i d e d o g o r o t h e r a n i m a l ;
f& H e a r i n g a i d s ;
" H o s p i t a l s e r v i c e s ;
f& L a b o r a t o r y f e e s ;
f& N u r s i n g h o m e a n d n u r s i n g d e v i c e s ;
" O x y g e n ;
" P r e s c r i p t i o n o r e l i g i b l e o v e r - t h e - c o u n t e r d r u g s o r i n s u l i n ;
f& P s y c h i a t r i c c a r e , p s y c h o a n a l y s i s , a n d p s y c h o l o g i s t s e r v i c e s ;
" S t o p - s m o k i n g p r o g r a m s , i n c l u d i n g p r e s c r i b e d d r u g s ;
f& T r a n s p o r t a t i o n e x p e n s e s f o r , a n d e s s e n t i a l t o , m e d i c a l c a r e ;
f& V a c c i n a t i o n s o r I m m u n i z a t i o n s ;
" W e i g h t - l o s s p r o g r a m s r e l a t e d t o s p e c i f i c d i s e a s e d i a g n o s e d b y p h y s i c i a n ; a n d
f& W h e e l c h a i r s .
F o r a m o r e c o m p r e h e n s i v e l i s t , c o n t a c t R C T C ' s A c c o u n t i n g D e p a r t m e n t .
Q - 2 2 . W h a t M e d i c a l E x p e n s e s A r e I n e l i g i b l e ?
Y o u w i l l n o t b e r e i m b u r s e d f o r i n e l i g i b l e e x p e n s e s . E x a m p l e s o f i n e l i g i b l e e x p e n s e s a r e :
f& A n y i l l e g a l o p e r a t i o n s o r t r e a t m e n t ;
f& U n n e c e s s a r y c o s m e t i c s u r g e r y ;
f& B a b y s i t t i n g , c h i l d c a r e a n d n u r s i n g s e r v i c e s f o r a n o r m a l , h e a l t h y c h i l d ;
f& C o s t o f s p e c i a l f o o d s t a k e n a s a s u b s t i t u t e f o r a r e g u l a r d i e t , w h e r e t h e s p e c i a l d i e t i s n o t
m e d i c a l l y n e c e s s a r y o r t h e t a x p a y e r c a n n o t s h o w c o s t i n e x c e s s o f c o s t o f a n o r m a l d i e t ;
f& C o s t o f t o i l e t r i e s , c o s m e t i c a n d s u n d r y i t e m s ( e . g . s o a p , t o o t h b r u s h e s ) ;
" D i a p e r s e r v i c e ;
f& F e e s f o r e x e r c i s e , a t h l e t i c o r h e a l t h c l u b m e m b e r s h i p w h e r e t h e r e i s n o s p e c i f i c h e a l t h
r e a s o n f o r n e e d i n g t h e m e m b e r s h i p ;
f& F u n e r a l e x p e n s e s ;
f& H a i r r e m o v a l ( e l e c t r o l y s i s ) o r h a i r t r a n s p l a n t s ;
" . P r e m i u m s p a i d f o r l o n g t e r n c a r e i n s u r a n c e ;
f& M a t e r n i t y c l o t h e s ;
f& M e c h a n i c a l e x e r c i s e d e v i c e n o t s p e c i f i c a l l y p r e s c r i b e d b y a d o c t o r ;
f& N u t r i t i o n a l s u p p l e m e n t s f o r g e n e r a l w e l l - b e i n g ;
f& T e e t h w h i t e n i n g ; a n d
f& W e i g h t - l o s s p r o g r a m f o r g e n e r a l w e l l - b e i n g .
R V B U S W W A H L I H 1 6 9 9 6 6 3 . 4 1 0
"
"
F o r a c o m p l e t e l i s t o f e l i g i b l e a n d i n e l i g i b l e e x p e n s e s , r e v i e w t h e I R S P u b l i c a t i o n 5 0 2 a v a i l a b l e
a t h t t p : / / w w w . i r s . g o v / p u b / i r s - p d F p 5 0 2 . p d f o r c o n t a c t R C T C ' s A c c o u n t i n g D e p a r t m e n t .
Q - 2 3 . W h a t S h o u l d I K n o w A b o u t R e q u e s t i n g a R e i m b u r s e m e n t f r o m t h e M e d i c a l
S p e n d i n g A c c o u n t ?
A l l o w a b l e M e d i c a l E x p e n s e s i n c u r r e d d u r i n g a P l a n Y e a r w i l l b e r e i m b u r s e d , u p t o t h e a m o u n t
y o u h a v e e l e c t e d f o r t h e P l a n Y e a r , e v e n i f y o u h a v e n o t y e t a c c u m u l a t e d t h a t a m o u n t i n y o u r
a c c o u n t .
C o p i e s o f r e c e i p t s f r o m s e r v i c e p r o v i d e r s o r t h e E x p l a n a t i o n o f B e n e f i t s F o r m f r o m a n i n s u r a n c e
c a r r i e r m u s t b e s u b m i t t e d w i t h t h e c o m p l e t e d R e i m b u r s e m e n t R e q u e s t . T h e d o c u m e n t a t i o n f r o m
t h e s e r v i c e p r o v i d e r s m u s t c o n t a i n t h e f o l l o w i n g i n f o r m a t i o n :
f& N a m e o f t h e p r o v i d e r ;
" P a t i e n t n a m e ;
" D a t e o f s e r v i c e ;
" D e s c r i p t i o n o f s e r v i c e ; a n d
" A m o u n t c h a r g e d .
T H E D E P E N D E N T C A R E S P E N D I N G A C C O U N T
Q - 2 4 . W h a t A r e t h e A d v a n t a g e s o f C o n t r i b u t i n g t o a D e p e n d e n t C a r e S p e n d i n g A c c o u n t ?
T h e c o s t o f d e p e n d e n t c a r e c a n b e a m a j o r e x p e n s e f o r t o d a y ' s w o r k i n g p a r e n t s . W h e n y o u
p a r t i c i p a t e i n t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t , y o u m a y s e t a s i d e p r e - t a x e a r n i n g s t o p a y
f o r d e p e n d e n t c a r e e x p e n s e s i n c u r r e d t o e n a b l e y o u o r y o u r s p o u s e t o w o r k .
W h e n y o u e n r o l l a t t h e b e g i n n i n g o f e a c h P l a n Y e a r , y o u c h o o s e t h e a m o u n t t o b e d e d u c t e d f r o m
y o u r g r o s s p a y . T h e m a x i m u m t h a t c a n b e s e t a s i d e f o r d e p e n d e n t c a r e i n a n y o n e P l a n Y e a r i s :
f& $ 5 , 0 0 0 . 0 0 f o r a s i n g l e E m p l o y e e , o r a m a r r i e d E m p l o y e e f i l i n g a j o i n t f e d e r a l i n c o m e t a x
r e t u r n ; o r
f& $ 2 , 5 0 0 . 0 0 f o r a m a r r i e d E m p l o y e e f i l i n g a s e p a r a t e f e d e r a l i n c o m e t a x r e t u r n .
T h e a m o u n t d e d u c t e d f r o m y o u r p a y w i l l b e t r a n s f e r r e d t o y o u r D e p e n d e n t C a r e S p e n d i n g
A c c o u n t i n e q u a l a m o u n t s e a c h p a y p e r i o d a n d u s e d t o r e i m b u r s e y o u f o r E m p l o y m e n t - R e l a t e d
D e p e n d e n t C a r e E x p e n s e s i n c u r r e d d u r i n g t h e P l a n Y e a r .
Q - 2 5 . W h a t A r e E m p l o y m e n t - R e l a t e d D e p e n d e n t C a r e E x p e n s e s ?
" E m p l o y m e n t - R e l a t e d D e p e n d e n t C a r e E x p e n s e s " m e a n s e x p e n s e s i n c u r r e d f o r t h e c a r e o f a
Q u a l i f y i n g D e p e n d e n t t o e n a b l e y o u o r y o u r s p o u s e t o b e g a i n f u l l y e m p l o y e d . T h i s i n c l u d e s :
R V B U S U W A H L I N t 6 9 9 6 6 3 . 4 j j
f& C h a r g e s f o r d a i l y c a r e o f a n y o f y o u r c h i l d r e n w h o a r e u n d e r t h e a g e o f 1 3 . C a r e m a y b e
p r o v i d e d e i t h e r i n o r o u t s i d e y o u r h o m e b y a n y p e r s o n e x c e p t :
o A c h i l d o f y o u r s w h o i s u n d e r a g e 1 9 ; o r
o A p e r s o n f o r w h o m y o u c l a i m a f e d e r a l i n c o m e t a x d e d u c t i o n .
I f c a r e i s p r o v i d e d o u t s i d e t h e h o m e b y a f a c i l i t y t h a t c a r e s f o r m o r e t h a n 6
f a c i l i t y m u s t b e l i c e n s e d .
C h a r g e s f o r d a i l y c a r e o f a n y m e m b e r o f y o u r i m m e d i a t e f a m i l y w h o i s
m e n t a l l y i n c a p a b l e o f s e l f - c a r e .
c h i l d r e n , t h e
p h y s i c a l l y o r
I n c l u d e d a r e p a y m e n t s t o c h i l d c a r e c e n t e r s , n u r s e r y s c h o o l s , k i n d e r g a r t e n a n d s c h o o l s
f o r c h i l d r e n u p t o b u t n o t i n c l u d i n g f i r s t g r a d e . E l i g i b l e e x p e n s e s a l s o i n c l u d e p a y m e n t
f o r s u m m e r d a y c a m p s , a f t e r - s c h o o l c a r e a n d e l d e r l y c a r e p r o v i d e d t h i s c a r e i s r e q u i r e d
t o e n a b l e y o u ( o r y o u r s p o u s e ) t o w o r k . H o w e v e r , e x p e n s e s r e l a t i n g t o n o n r e f u n d a b l e
f e e s c h a r g e d b y a d a y c a r e f a c i l i t y w i l l n o t b e e l i g i b l e f o r r e i m b u r s e m e n t u n l e s s c h i l d
c a r e s e r v i c e s d i r e c t l y r e l a t e d t o t h e f e e a r e p r o v i d e d .
T h e e x p e n s e s m u s t b e i n c u r r e d o n o r a f t e r t h e d a t e y o u b e c o m e c o v e r e d u n d e r t h e P l a n .
Q - 2 6 . W h a t i f I I n c u r E m p l o y m e n t - R e l a t e d D e p e n d e n t C a r e E x p e n s e s A f t e r M y
P a r t i c i p a t i o n i n t h e P l a n h a s b e e n T e r m i n a t e d b u t I S t i l l H a v e a R e m a i n i n g B a l a n c e
i n M y D e p e n d e n t C a r e S p e n d i n g A c c o u n t ?
E f f e c t i v e a s o f
i f y o u c e a s e p a r t i c i p a t i o n i n t h e P l a n p r i o r t o t h e e n d o f t h e P l a n Y e a r , w h e t h e r d u e t o t e r m i n a t i o n
o f e m p l o y m e n t o r o t h e r w i s e , a n d y o u h a v e u n r e i m b u r s e d c o n t r i b u t i o n s r e m a i n i n g i n y o u r
D e p e n d e n t C a r e S p e n d i n g A c c o u n t y o u m a y r e c e i v e r e i m b u r s e m e n t f o r c l a i m s f o r p o s t -
t e r m i n a t i o n E m p l o y m e n t - R e l a t e d D e p e n d e n t C a r e E x p e n s e s i n c u r r e d d u r i n g t h e r e m a i n i n g P l a n
Y e a r o r t h e G r a c e P e r i o d ( S e e Q - 1 6 ) i m m e d i a t e l y f o l l o w i n g t h a t P l a n Y e a r .
Q - 2 7 . W h o i s a Q u a l i f y i n g D e p e n d e n t ?
" Q u a l i f y i n g D e p e n d e n t " f o r p u r p o s e s o f t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t m e a n s :
f& a p e r s o n u n d e r a g e 1 3 w h o i s y o u r " q u a l i f y i n g c h i l d " u n d e r t h e I n t e r n a l R e v e n u e C o d e
( i n g e n e r a l , t h e p e r s o n m u s t : ( 1 ) h a v e t h e s a m e p r i n c i p a l a b o d e a s y o u f o r m o r e t h a n h a l f
t h e y e a r ; ( 2 ) b e y o u r c h i l d o r s t e p c h i l d ( b y b l o o d o r a d o p t i o n ) , f o s t e r c h i l d , s i b l i n g o r
s t e p s i b l i n g , o r a d e s c e n d a n t o f o n e o f t h e m ; a n d ( 3 ) n o t p r o v i d e m o r e t h a n h a l f o f h i s o r
h e r o w n s u p p o r t f o r t h e y e a r ) ; o r
f& y o u r s p o u s e w h o i s p h y s i c a l l y o r m e n t a l l y i n c a p a b l e o f c a r i n g f o r h i m s e l f o r h e r s e l f a n d
h a s t h e s a m e p r i n c i p a l p l a c e o f a b o d e a s y o u f o r m o r e t h a n h a l f o f t h e y e a r ; o r
R V B U S I J W A H L I M 6 9 9 6 6 3 . 4 1 2
"
"
"
" a p e r s o n w h o i s p h y s i c a l l y o r m e n t a l l y i n c a p a b l e o f c a r i n g f o r h i m s e l f o r h e r s e l f , h a s t h e
s a m e p r i n c i p a l p l a c e o f a b o d e a s y o u f o r m o r e t h a n h a l f o f t h e y e a r , a n d i s y o u r t a x
d e p e n d e n t u n d e r t h e I n t e r n a l R e v e n u e C o d e o r w o u l d q u a l i f y a s y o u r d e p e n d e n t e x c e p t
t h a t : ( 1 ) h e o r s h e h a s i n c o m e t h a t e q u a l s o r e x c e e d s t h e e x e m p t i o n a m o u n t ; ( 2 ) h e o r s h e
i s m a r r i e d a n d f i l e s a j o i n t r e t u r n w i t h h i s o r h e r s p o u s e ; o r ( 3 ) y o u ( o r y o u r S p o u s e , i f
f i l i n g j o i n t l y ) c o u l d b e c l a i m e d a s a t a x d e p e n d e n t o f a n o t h e r t a x p a y e r .
U n d e r a s p e c i a l r u l e f o r c h i l d r e n o f d i v o r c e d o r s e p a r a t e d p a r e n t s , a c h i l d i s a Q u a l i f y i n g
D e p e n d e n t w i t h r e s p e c t t o t h e n o n c u s t o d i a l p a r e n t w h e n t h e n o n c u s t o d i a l p a r e n t i s e n t i t l e d t o
c l a i m t h e d e p e n d e n c y e x e m p t i o n f o r t h e c h i l d . S e e t h e A d m i n i s t r a t o r f o r m o r e i n f o r m a t i o n o n
w h i c h i n d i v i d u a l s w i l l q u a l i f y a s y o u r Q u a l i f y i n g D e p e n d e n t s .
Q - 2 8 . C a n I S t i l l T a k e t h e F e d e r a l I n c o m e T a x C r e d i t f o r D e p e n d e n t C a r e E x p e n s e s ?
Y o u m a y n o t c l a i m a n y o t h e r t a x b e n e f i t f o r t h e a m o u n t o f y o u r p r e - t a x s a l a r y r e d u c t i o n s u n d e r
t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t , a l t h o u g h y o u r E m p l o y m e n t - R e l a t e d D e p e n d e n t C a r e
E x p e n s e s i n e x c e s s o f t h a t a m o u n t m a y b e e l i g i b l e f o r t h e D e p e n d e n t C a r e T a x C r e d i t ( s e e Q -
2 9 ) . F o r e x a m p l e , i f y o u e l e c t $ 3 , 0 0 0 i n c o v e r a g e u n d e r t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t
a n d a r e r e i m b u r s e d $ 3 , 0 0 0 , b u t y o u h a d E m p l o y m e n t - R e l a t e d D e p e n d e n t C a r e E x p e n s e s t o t a l i n g
$ 5 , 0 0 0 , t h e n y o u c o u l d c o u n t t h e e x c e s s $ 2 , 0 0 0 w h e n c a l c u l a t i n g t h e D e p e n d e n t C a r e T a x C r e d i t
i f y o u h a v e t w o o r m o r e Q u a l i f y i n g D e p e n d e n t s .
Q - 2 9 . W h a t i s t h e D e p e n d e n t C a r e T a x C r e d i t ?
T h e D e p e n d e n t C a r e T a x C r e d i t i s a c r e d i t a g a i n s t y o u r f e d e r a l i n c o m e t a x l i a b i l i t y u n d e r t h e
I n t e r n a l R e v e n u e C o d e . I t i s a n o n - r e f u n d a b l e t a x c r e d i t , w h i c h m e a n s t h a t a n y p o r t i o n o f i t t h a t
e x c e e d s y o u r f e d e r a l i n c o m e t a x l i a b i l i t y w i l l b e o f n o v a l u e t o y o u . T h e c r e d i t i s c a l c u l a t e d a s a
p e r c e n t a g e o f y o u r a n n u a l E m p l o y m e n t - R e l a t e d D e p e n d e n t C a r e E x p e n s e s . F o r m o r e
i n f o r m a t i o n a b o u t h o w t h e D e p e n d e n t C a r e T a x C r e d i t w o r k s , s e e I R S P u b l i c a t i o n N o . 5 0 3
( " C h i l d a n d D e p e n d e n t C a r e E x p e n s e s " ) . Y o u m a y a l s o w i s h t o c o n s u l t a t a x a d v i s o r .
Q - 3 0 . W h a t S h o u l d I C o n s i d e r W h e n D e t e r m i n i n g i f a n d t o W h a t E x t e n t t o P a r t i c i p a t e i n
t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t ?
W h e n d e c i d i n g w h e t h e r t o s e t a s i d e p a r t o f y o u r p a y f o r d e p e n d e n t c a r e , y o u n e e d t o c o n s i d e r
h o w t h e t a x b r e a k f o r t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t c o m p a r e s w i t h t h e D e p e n d e n t C a r e
T a x C r e d i t .
T h e D e p e n d e n t C a r e T a x C r e d i t i s s u b t r a c t e d f r o m y o u r i n c o m e t a x , w h i l e t h e D e p e n d e n t C a r e
S p e n d i n g A c c o u n t r e d u c e s y o u r t a x a b l e i n c o m e . T h e m e t h o d t h a t g i v e s y o u t h e g r e a t e s t t a x
s a v i n g s d e p e n d s o n y o u r i n d i v i d u a l s i t u a t i o n . I n s o m e c a s e s , e i t h e r t h e D e p e n d e n t C a r e T a x
C r e d i t o r t h e D e p e n d e n t C a r e S p e n d i n g A c c o u n t m a y b e b e t t e r . h i o t h e r c a s e s , u s i n g a
c o m b i n a t i o n o f t h e t w o m a y p r o v i d e t h e m o s t t a x s a v i n g s .
R V B U S U W A H U N 1 6 9 9 6 6 3 . 4 1 3
Q-31. What Should I Know about Requesting a Reimbursement from the Dependent Care
Spending Account?
Employment -Related Dependent Care Expenses incurred during a Plan Year will be reimbursed
when you have a positive, or funded, balance in your Dependent Care Spending Account for that
Plan Year.
Submit an itemized receipt or canceled check, along with a completed Reimbursement Request,
to RCTC's Accounting Department. The Tax ID Number (or Social Security Number) of the
care provider must be included on the Reimbursement Request. The tax law requires you to give
this number, and your dependent care provider is required by law to give you this number.
OTHER RIGHTS THAT YOU SHOULD KNOW
COBRA and HIPAA Rights. Under the Health Insurance Portability and Accountability Act of
1996, you. have certain rights to the reduction or elimination of exclusionary periods of coverage
for preexisting conditions under your group health plan, if you have creditable coverage from
another plan. You should be provided a certificate of creditable coverage, free of charge, from
your group health plan or health insurance issuer when you lose coverage under the Plan, when
you become entitled to elect continuation coverage, when your continuation coverage ceases, if
you request it before losing coverage, or if you request it up to 24 months after losing coverage.
Without evidence of creditable coverage, you may be subject to a preexisting condition
exclusion for 12 months (18 months for late enrollees) after your enrollment date in your
coverage.
Family Medical Leave Act. As an Employee, you may be entitled under the federal Family and
Medical Leave Act (FMLA) to up to 12 work -weeks of unpaid, job -protected leave in any 12-
month period. You may be eligible if you have worked for RCTC for at least one year, and for
1,250 hours during the previous 12 months. Such leave may be available for the birth and care
of a newborn child, placement of a child for adoption or foster care, a serious health condition of
a family member (child, spouse, or parent) or a personal serious health condition.
As a participant in the health care part of the Plan, you have, while on FMLA leave, the option to
continue your health benefits on the same terms and conditions as immediately prior to your
taking FMLA leave. You and your eligible dependents shall remain covered under the Plan
while you are on FMLA leave as if you still were at work. Your coverage will be maintained
until you retum to work or, if earlier, you notify RCTC that you will not retum to work. If you
choose not to remain covered under the Plan while on FMLA leave, and subsequently return to
work before or at the end of FMLA leave, you and your eligible dependents shall immediately
become covered under the Plan without proof of insurability and without regard to pre-existing
conditions that arise while on FMLA leave.
Continuation Coverage Following Termination of Employment. Continued health care
coverage may be available to you under the temis of the component health plans. If you are
covered under one of the Plan's group health plans, you have the right to choose continuation
coverage if you lose health coverage for any reason other than termination due to gross
misconduct. Your spouse or eligible dependent covered under a health plan shall have a separate
RVBUSUNAH IM699663.4 14
•
"
r i g h t t o c o n t i n u a t i o n c o v e r a g e f o r t h e m s e l v e s i f t h e y l o s e g r o u p h e a l t h p l a n c o v e r a g e f o r a n y o f
t h e f o l l o w i n g r e a s o n s :
f& y o u r d e a t h ;
f& t h e t e r m i n a t i o n o f y o u r e m p l o y m e n t ( f o r a n y r e a s o n s o t h e r t h a n g r o s s m i s c o n d u c t ) o r
r e d u c t i o n i n y o u r h o u r s o f e m p l o y m e n t ;
f& y o u r d i v o r c e o r l e g a l s e p a r a t i o n ; -
f& y o u b e c o m e e n t i t l e d t o M e d i c a r e ; o r
f& t h e d e p e n d e n t c e a s e s t o b e a " d e p e n d e n t c h i l d " u n d e r t h e t e r m s o f a g r o u p h e a l t h p l a n .
T h e t e r m s o n w h i c h c o n t i n u a t i o n c o v e r a g e i s a v a i l a b l e a r e e x p l a i n e d i n t h e i n f o r m a t i o n p r o v i d e d
. � t o y o u i n c o n n e c t i o n w i t h y o u r e n r o l l m e n t i n t h e p a r t i c u l a r h e a l t h p l a n s .
I f y o u h a v e a b a l a n c e i n e i t h e r o f y o u r F l e x i b l e S p e n d i n g A c c o u n t s u p o n y o u r t e r m i n a t i o n o f
e m p l o y m e n t , y o u m a y e l e c t t o c o n t i n u e y o u r p a r t i c i p a t i o n u n d e r t h e P l a n ' s g r o u p h e a l t h
c o v e r a g e u n t i l t h e e n d o f t h e P l a n Y e a r . Y o u r c o n t i n u e d p a r t i c i p a t i o n i s s u b j e c t t o p a y m e n t o f
r e q u i r e d c o n t r i b u t i o n s o n a n a f t e r - t a x b a s i s . I f y o u i n c u r A l l o w a b l e M e d i c a l E x p e n s e s d u r i n g
t h e p e r i o d o f c o n t i n u e d p a r t i c i p a t i o n , y o u w i l l b e r e i m b u r s e d f o r t h o s e e x p e n s e s a c c o r d i n g t o Q -
1 7 . H o w e v e r , i n n o e v e n t w i l l y o u r e c e i v e b e n e f i t s i n e x c e s s o f t h e e l e c t e d s a l a r y r e d u c t i o n f o r
t h a t P l a n Y e a r .
O T H E R I N F O R M A T I O N T O K N O W
Q u a l i f i e d M e d i c a l C h i l d S u p p o r t O r d e r s . G e n e r a l l y , y o u r P l a n b e n e f i t s m a y n o t b e a s s i g n e d
o r a l i e n a t e d . H o w e v e r , a n e x c e p t i o n a p p l i e s i n t h e c a s e o f a " q u a l i f i e d m e d i c a l c h i l d s u p p o r t
o r d e r . " B a s i c a l l y , a q u a l i f i e d m e d i c a l c h i l d s u p p o r t o r d e r i s a c o u r t - o r d e r e d j u d g m e n t , d e c r e e ,
o r d e r o r p r o p e r t y s e t t l e m e n t a g r e e m e n t i n c o n n e c t i o n w i t h s t a t e d o m e s t i c r e l a t i o n s l a w w h i c h
e i t h e r ( 1 ) c r e a t e s o r e x t e n d s t h e r i g h t s o f a n " a l t e r n a t e r e c i p i e n t " t o p a r t i c i p a t e i n a g r o u p h e a l t h
p l a n , i n c l u d i n g t h i s P l a n , o r ( 2 ) e n f o r c e s c e r t a i n l a w s r e l a t i n g t o m e d i c a l c h i l d s u p p o r t . A n
" a l t e r n a t e r e c i p i e n t " i s a n y c h i l d o f a P a r t i c i p a n t w h o i s r e c o g n i z e d b y a m e d i c a l c h i l d s u p p o r t
o r d e r a s h a v i n g a r i g h t t o e n r o l l m e n t u n d e r a P a r t i c i p a n t ' s g r o u p h e a l t h p l a n . A m e d i c a l c h i l d
s u p p o r t o r d e r m u s t s a t i s f y c e r t a i n s p e c i f i c c o n d i t i o n s t o b e q u a l i f i e d . Y o u w i l l b e n o t i f i e d b y t h e
P l a n A d m i n i s t r a t o r i f i t r e c e i v e s a m e d i c a l c h i l d s u p p o r t o r d e r t h a t a p p l i e s t o y o u a n d t h e P l a n ' s
p r o c e d u r e s f o r d e t e r m i n i n g w h e t h e r t h e m e d i c a l c h i l d s u p p o r t o r d e r i s q u a l i f i e d .
M a t e r n i t y a n d N e w b o r n C o v e r a g e . G r o u p h e a l t h p l a n s a n d h e a l t h i n s u r a n c e c a r r i e r s g e n e r a l l y
m a y n o t , u n d e r F e d e r a l l a w , r e s t r i c t b e n e f i t s f o r a n y h o s p i t a l l e n g t h o f s t a y i n c o n n e c t i o n w i t h
c h i l d b i r t h f o r t h e m o t h e r o r n e w b o r n c h i l d t o l e s s t h a n 4 8 h o u r s f o l l o w i n g a n o r m a l v a g i n a l
d e l i v e r y , o r l e s s t h a n 9 6 h o u r s f o l l o w i n g a c e s a r e a n s e c t i o n . H o w e v e r , F e d e r a l l a w g e n e r a l l y
d o e s n o t p r o h i b i t t h e m o t h e r ' s o r n e w b o r n ' s a t t e n d i n g p r o v i d e r , a f t e r c o n s u l t i n g w i t h t h e m o t h e r ,
f r o m d i s c h a r g i n g t h e m o t h e r o r h e r n e w b o r n e a r l i e r t h a n 4 8 h o u r s ( o r 9 6 h o u r s a s a p p l i c a b l e ) . I n
a n y c a s e , p l a n s a n d i s s u e r s m a y n o t , u n d e r F e d e r a l l a w , r e q u i r e t h a t a p r o v i d e r o b t a i n
a u t h o r i z a t i o n f r o m t h e p l a n o r t h e i n s u r a n c e i s s u e r f o r p r e s c r i b i n g a l e n g t h o f s t a y n o t i n e x c e s s
o f 4 8 h o u r s ( o r 9 6 h o u r s ) .
C o n f i d e n t i a l i t y o f Y o u r P r i v a t e H e a l t h i n f o r m a t i o n . A f e d e r a l l a w , t h e H e a l t h I n s u r a n c e
P o r t a b i l i t y a n d A c c o u n t a b i l i t y A c t o f 1 9 9 6 , o r H I P A A , r e q u i r e s t h a t h e a l t h p l a n s p r o t e c t t h e
R V B U S U W A H L I M 6 9 9 6 6 3 . 4 1 5
confidentiality of your private health information. Because this Plan offers certain health plan
benefits, such as a medical plan, dental plan, vision plan, and medical spending account, it is
required by HIPAA to safeguard your private health information. The section of the Plan
relating to HIPAA will apply only to those health plan benefits provided under the Plan.
The Plan and RCTC will not use or further disclose information that is protected by HIPAA
except as necessary for treatment, payment, health plan operations and plan administration, or as
permitted or required by law. By law, the Plan has required all of its business associates (those
entities that perform functions on behalf of the Plan and need access to private health
information) to also observe HIPAA's privacy rules. In particular, the Plan will not, without
authorization, use or disclose protected health information for employment -related actions and
4-2 decisions or in connection with any other benefit or employee benefit plan of RCTC.
Under HIPAA, you have certain rights with respect to your protected health information,
including certain rights to see and copy the information, receive an accounting of certain
disclosures of the information and, under certain circumstances, amend the information. You
also have the right to file a complaint with the Plan or with the U.S. Department of Health and
Human Services if you believe your rights under HIPAA have been violated.
A complete description of your rights under HIPAA can be found in the Plan's privacy notice,
which was either distributed to you upon enrollment or prior to June 15, 2006. For a copy of this
notice, if you have questions about the privacy of your health information or if you wish to file a
complaint under HIPAA, please contact the Privacy Official and Complaint Manager for RCTC.
Examination of Records. RCTC will makeavailable to each Employee such records as pertain
to the Employee, for examination at reasonable times during normal business hours.
Amendment or Termination of the Plan. RCTC, at any time or from time to time, may amend
any or all of the provisions of the Plan without your consent. No amendment will have the effect
of reducing any of your benefit elections in effect at the time of such amendment, unless such
amendment is made to comply with federal law or local statute or regulations. RCTC reserves
the right to terminate this Plan, in whole or in part, at any time.
Non -Alienation of Benefits. Except for Qualified Medical Child Support Orders received by
RCTC, no benefit, right or interest of any person under this Plan will be subject to anticipation,
alienation, sale, transfer, assignment, pledge, encumbrance or charge, seizure, attachment or
legal, equitable or other process or be liable for, or subject to, the debts, liabilities or other
obligations of such person, except as otherwise required by law.
Limitation on Employee Rights. Nothing appearing in or done pursuant to this Plan will be
held or construed:
♦ To give any person any legal or equitable right against RCTC, except as expressly
provided herein or provided by law; or
RVBUSUWAHLIN1699663.4 16
" thereunder (as they might be amended from time to time).
♦ To create a contract of employment with any Employee, to obligate RCTC to continue
the service of any employee or to affect or modify his or her terms of employment in any
way.
Other Salary -Related Plans. It is not intended that any other salary -related employee benefit
plans that are maintained or sponsored by RCTC will be affected by this Plan. Any
contributions or benefits under such other plans with respect to you will, to the extent permitted
by law, be based on your compensation from RCTC, including any amounts by which your
salary or wages may be reduced.
Jurisdiction. The Plan is governed by the Internal Revenue Code and the regulations issued
GENERAL INFORMATION
Name and Identification Number of Plans
Riverside County Transportation Commission Flexible Benefits Plan (501), Riverside
County Transportation Commission Dependent Care Reimbursement Plan (502) and
Riverside County Transportation Commission Medical Reimbursement Plan (503).
Participants
The plans provide benefits for all employees of RCTC who meet the eligibility requirements
described herein.
Plan Administrator
Riverside County Transportation Commission
4080 Lemon Street, 3h Floor
Riverside, CA 92501
(951)787-7141
Contact: Michele Cisneros, Accounting and Human Resources Manager
If you have a question about the Plan, then contact RCTC's Finance Department:
Chief Financial Officer
Accounting Human Resources Manager
Accounting Technicians
Senior Accounting Assistant
Employer Identification Number (EIN)
33-0072823
RVBUSLIWAHUM699663A 17
(951)787-7926
(951)787-7941
(951)787-7925 or787-7959
(951)787-7930
Agent for Service of Legal Process
Clerk of the Board
Riverside County Transportation Commission
4080 Lemon Street, 3n1 Floor
Riverside, CA 92501
Plan Year
The Plan Year is based on the calendar year beginning on January 1 and ending on December
31.
.E Plan Definition and Funding
This is a Section 125 flexible benefits plan classified as a "cafeteria" plan by the Internal
Revenue Code. It includes a Section 105 health flexible spending account, classified by the
Department of Labor as a "welfare" plan, and a Section 129 dependent care flexible spending
account. The Plan is funded through salary reduction contributions.
Health Insurance Issuer
The name and address of the health insurance agent is:
CaIPERS
Office of Employer & Member Health Service
P.O. Box 942714
Sacramento, CA 94229-2714
(888) CaIPERS (225-7377)
Not a Contract of Employment
No provision of the Plan is to be considered a contract of employment between you and
RCTC. RCTC's rights with regard to disciplinary action and termination of any Employee,
if necessary, are in no manner changed by any provision of the Plan.
GLOSSARY
The following defined terms have a special meaning with respect to the benefits outlined in this
booklet.
"Employee" refers to a person in the Service of RCTC, and only includes a. person who is a
resident of the United States.
"RCTC" refers to Riverside County Transportation Commission, as the employer.
"Service" refers to work performed for RCTC on an active regular or probationary basis; and not
as a temporary or contract employee.
RVBUSUWAHLIN1699663.4 18
RIVERSIDE COUNTY TRANSPORTATION COMMISSION
DATE:
September 10, 2008
TO:
Executive Committee
FROM:
Jennifer Harmon, Office and Board Services Manager
THROUGH:
John Standiford, Deputy Executive Director
SUBJECT:
Adoption of Ordinance No. 08-001 to Amend the Administrative
Code to Reflect the Disbandment of the Transit Policy Committee
STAFF RECOMMENDATION:
This item is for the Committee to Adopt Ordinance 08-001, "An Ordinance
Amending the Riverside County Transportation Commission Administrative Code",
to reflect changes related to the disbandment of the Transit Policy Committee_
BACKGROUND INFORMATION:
Changes made to the Commission's Administrative Code require adoption through
Ordinance to reflect those changes. At its July 9, 2008 meeting, the Commission
approved the disbandment of the Transit Policy Committee as the Committee's
proscribed responsibilities in the triennial audit had been fulfilled and ongoing issues
regarding public transit service and funding issues can be addressed by the
Commission's Plans and Programs Committee. Therefore, under Article III,
Section H.1.(d) "The Transit Policy Committee" shall be removed from the
Administrative Code.
Attachments:
1) Proposed Revision to the Administrative Code
2) Ordinance No. 08-001
Agenda Item 7
ATTACHMENT 1
ORDINANCE NO.08-001
AN ORDINANCE AMENDING THE RIVERSIDE COUNTY
TRANSPORTATION COMMISSION ADMINIS fRATIVE CODE
WHEREAS, the Commission has determined that it is now necessary to amend its
Administrative Code to reflect changes related to the disbandment of the Transit Policy
Committee;
NOW, THEREFORE, the Riverside County Transportation Commission hereby ordains
as follows:
Section 1. Article III, Section H.1.(d) of the Administrative Code is hereby removed.
Section 2. This Ordinance shall be effective on September 10, 2008.
APPROVED AND ADOPTED this 10th day of September, 2008.
Jeff Stone, Chair
Riverside County Transportation Commission
• ATTEST:
Jennifer Harmon
Clerk of the Board
"
"
"
A T T A C H M E N T 2
H . C O M M I T T E E S O F T H E C O M M I S S I O N .
I . T h e f o l l o w i n g C o m m i t t e e s o f t h e C o m m i s s i o n a r e h e r e b y c r e a t e d :
( d ) T h e T r a n s i t P o l i c y C o m m i t t e e . T h i s C o m m i t t e e s h a l l b e
c w a r a p o s e . l o f , r � f& o / o . . . b e f s o f - t h e ! " , . . . . . . , ; . . , i o n . . , . l e e t e d 1 . . . t h e . . n L . _
r e
N . e a ' o f - t h e - C - o l r i - - b e
a s - f e l l o v i d e - p o l i e y - d i r e e t i o n - t o - t h e - p r e p a r a t i o n - o f - t h e - t r a n s i t - v i s i o n i t o f
t f a n s i t i m p l e m e n t a t i m i t f e v i e w t h e p e f f e m a n e e e f o p e F a t e s ; a n d b f i n g r e g i o n a l
o t h - 1 , . e t ; a . a t . . . t h e I " ` , . . . , m i t t e e a l n . n n . t h i r d m a . . . _ _ d a y a f - t h
f i a a a l - a f r e y a l _ b y t a G e m m i S E 6 m m t t t e e m e m b e r s S h a l l s o f y e - - a t - t i t @ - w i l l - a n d