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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 />10 <br />the plan). The Plan Administrator (in its sole discretion) will decide, in accordance <br />with prevailing IRS guidance, whether a curtailment is "significa nt," and whether <br />a benefit package option constitutes "similar coverage" based upon all the <br />surrounding facts and circumstances. <br />(2) Loss of Coverage. If the Plan Administrator determines that your coverage, or <br />the coverage of your spouse or dependent, is lost during a Plan Year, you may: (i) <br />enroll in another option providing similar coverage and make a corresponding <br />election change to pay for that new coverage through the Cafeteria Plan, or (ii) if <br />no other option providing similar coverage is available, cancel the underlying <br />coverage and revoke your election to pay the cost of such coverage through this <br />Cafeteria Plan. Coverage is deemed "lost" only if there is a complete loss of <br />coverage (e.g., the benefit plan option is eliminated or an annual or lifetime <br />maximum is reached) or other fundamental loss of coverage (e.g., a substantial <br />decrease in the health care providers available under the option or a reduction in <br />benefits for a specific type of medical condition with respect to which you or your <br />spouse or dependent is currently receiving treatment . The Plan Administrator (in <br />its sole discretion) will decide, in accordance with prevailing IRS guidance, whether <br />a “loss" has occurred, and whether a benefit package option constitutes "similar <br />coverage" based upon all the surrounding facts and circumstances. <br />Application to Dependent Care Flexible Spending Account. This rule allows <br />you to change your election under the Dependent Care Flexible Spending Account <br />to reflect changes regarding your dependent care provider, including: (1) the <br />termination of one provider and the hiring of another provider, and (2) the <br />termination of a provider because a relative becom es available to care for your <br />child at no cost. You will need to notify the Plan Administrator of any such change <br />in coverage under the Dependent Care Flexible Spending Account. <br /> <br />(3) Addition or Improvement of an Optional Benefit. If during a Plan Year, a <br />new plan or plan option is offered, or if coverage under an existing plan or option <br />is significantly improved, you may enroll in the new or improved coverage and <br />make or change your election to pay the cost of such coverage through the <br />Cafeteria Plan. The Plan Administrator (in its sole discretion) will decide, in <br />accordance with prevailing IRS guidance, whether an Optional Benefit has been <br />“significantly improved” based upon all the surrounding facts and circumstances. <br />(4) Change Under Another Employer-Sponsored Plan. You may make an <br />election change that is on account of and corresponds with a change made under <br />another employer-sponsored plan (including a plan of the Employer or a plan of <br />another employer) if: (i) the other plan permits its participants to make an election <br />change that would be permitted under the prevailing IRS guidance, or (ii) the Plan <br />Year of this Cafeteria Plan is different from the plan year under the other plan. <br />For example, if your spouse drops your coverage during open enrollment under <br />his or her employer’s group medical plan and you enroll in the Employer’s Group <br />Medical Plan, you may make or change your election to pay for such coverage <br />through the Cafeteria Plan. <br />(5) Loss of Governmental or Educational Coverage. If you add coverage under <br />an Employer-sponsored group health plan (e.g., the Group Medical Plan or Group <br />Dental Plan) for yourself or your spouse or dependent because such individual has <br />lost coverage under any health coverage sponsored by a governmental or <br />educational institution (including, but not limited to, the following: a state
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