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10-10-2022 Council Packet
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10-10-2022 Council Packet
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© Hitesman & Wold, P.A. 2019 <br />Cafeteria Plan <br />Summary Description (3-11) <br />6 <br />(4) an event causing a dependent to satisfy or cease to satisfy the eligibility <br />requirements applicable under a plan provided or paid for through this Cafeteria <br />Plan; or <br />(5) a change in place of residence for you, your spouse or your dependent. <br />A change or revocation shall be allowed in these circumstances only if such change or <br />revocation is made on account of, and corresponds with, the change in status and the <br />change in status affects eligibility for coverage under a plan sponsored by the Employer or <br />another employer (referred to as the general consistency requirement). The Plan <br />Administrator (in its sole discretion) shall determine, based on prevailing IRS guidance, <br />whether a requested change or revocation satisfies the general consistency requirement. <br />Example 1: An employee enrolls in single coverage under the Employer’s Group Medical <br />Plan and elects to pay the cost of that coverage through the Cafeteria Plan. The employee <br />also elects to participate in the Health Flexible Spending Account. During the Plan Year, <br />the employee gets married. If the employee enrolls his or her new spouse in the Group <br />Medical Plan, the employee may change his or her election to pay the increased cost of <br />that coverage through the Cafeteria Plan. In addition, the employee may increase his or <br />her election under the Health Flexible Spending Account. <br /> <br />Example 2: Employer has three medical plan options: an indemnity option, an HMO <br />option with a service area covering the location of on e of Employer’s operations, and an <br />HMO option with a service are covering the location of the other operation. An employee <br />enrolls in the HMO option with a service area covering the area in which employee works <br />and makes an election to pay the cost of the coverage through the Cafeteria Plan. <br />Employee also elects to participate in the Health Flexible Spending Account. If employee <br />is transferred to the other location, the employee may switch to the other HMO option or <br />the indemnity option and change his or her election to pay the cost of the new option. The <br />employee may also drop medical coverage and terminate his or h er election under the <br />Cafeteria Plan to pay the cost of medical coverage. The employee cannot change his or <br />her election under the Health Flexible Spending Account because the change in work <br />location does not affect his or her eligibility under the Health Flexible Spending Account. <br /> <br />A requested change or revocation must also satisfy the following specific consistency <br />requirements in order for you to be able to alter your election based on the change in <br />status: <br />(1) Loss of Dependent Eligibility. For a change in status involving your divorce, <br />annulment or legal separation from your spouse, the death of your spouse or <br />dependent, or your dependent ceasing to satisfy the eligibility requirements for <br />coverage, you may elect to change your election only to reflect the cancellation of <br />group health plan coverage for the affected spouse or dependent. Canceling <br />coverage for any other individual under these circumstances fails to correspond <br />with that change in status. For example, if you have elected group medical <br />coverage for you, your spouse, and your child, and you divorce during the Plan <br />Year, you may drop your ex-spouse from the coverage and make an election <br />change under this Cafeteria Plan to reflect the reduced cost of coverage. However, <br />you would not be allowed to change your election to reflect the reduced cost <br />attributable to dropping coverage for yourself or your child. <br />(2) Gain of Coverage Eligibility Under Another Employer's Plan. If you, your <br />spouse, or your dependent gains eligibility for coverage under another employer's
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