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© Hitesman & Wold, P.A. 2019 Cafeteria Plan Summary Description (3-11) 5 1.7 What is the maximum election I can make under the Cafeteria Plan? The maximum salary reduction election available under this Cafeteria Plan is the sum of your cost of coverage under the Group Medical Plan, Group Dental Plan, the maximum election permitted under the Health Flexible Spending Account, Limited Scope Health Flexible Spending Account, Dependent Care Flexible Spending Account, and the HSA Contribution Feature minus any Employer contribution. 1.8 Can I change my election during the Plan Year? Generally, you cannot change your election regarding participation in the Cafeteria Plan or the Optional Benefits you have selected under the Cafeteria Plan during the Plan Year. You may change your elections only during the annual enrollment period, and then, only for the coming Plan Year. However, your elections will terminate automatically if you cease to be eligible to participate in the Cafeteria Plan. In addition, there are several other exceptions to this general rule. Caution: The circumstances in which you are allowed to change your election, as further described below, are based upon the facts and circumstances of each particular situation. The descriptions of the r ules below are general in nature. If you have questions regarding the application of the rules to your specific fact situation, please contact the Plan Administrator immediately. Any request to change your election must be within the deadline described below. NOTE: The exceptions to the general rule that elections are irrevocable for the Plan Year are determined under regulations issued by the IRS. NOTE: The IRS recognizes only marriages that are valid under applicable state law. Accordingly, a reference to marital status or spouse in this Section 1.8 is applicable only if you are married to an individual and the marriage is valid under applicable state law. NOTE: For purposes of this Section 1.8, if the election relates to an Optional Benefit involving health benefits (e.g., Group Medical Plan, Group Dental Plan, Health Flexible Spending Account, Limited Purpose Flexible Spending Account), the term “dependent” means a “tax dependent” as defined below in Section 1.16. If the election relates to the Dependent Care Flexible Spending Account, the term “dependent” means a “qualifying individual” as defined below in Section 3.5. (a) Change in Status. You may change or revoke your previous election during the Plan Year if one or more of the following changes in status occur: (1) a change in your legal marital status, including marriage, divorce, death of your spouse, legal separation or annulment; NOTE: A change in the status of a domestic partnership is not a change in status. (2) a change in the number of your dependents, including birth of a child, adoption or placement for adoption of a dependent, or death of a dependent ; (3) any of the following events that change your employment status or the employment status of your spouse or dependent: termination or commencement of employment, a reduction or increase in hours worked, a switch between part- time and full-time, a strike or lockout, a change in worksite, commencement or return from an unpaid leave of absence, a switch between hourly and salaried, a switch between union and non-union, or any similar event;