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© Hitesman & Wold, P.A. 2019 Cafeteria Plan Summary Description (3-11) 16 (5) is a citizen, national, or resident of the United States, or a resident of Canada or Mexico; (6) is younger than you (unless he/she is permanently and totally disabled); and (7) does not file a joint tax return with his or her spouse. (c) An individual who: (1) is your child (or a descendant of a child), brother, sister, stepbrother, or stepsister, parent (or a parent’s ancestor), stepparent, brother or sister’s son or daughter, parent’s brother or sister, son-in-law, daughter-in-law, father-in-law, mother-in- law, brother-in-law, or sister-in-law or, if not such a relative, an individual who has the same principal place of abode as you and is a member of your household; (2) has received more than one-half of his/her support from you during the relevant year; (3) is not your qualifying child or the qualifying child of anyone else (i.e., does not satisfy the requirements of paragraph (a) above with respect to any person); and (4) is a citizen, national, or resident of the United States, or a resident of Canada or Mexico. NOTE: The definition “tax dependent” is different than the definition applicable under the Internal Revenue Code for purposes of identifying who you may claim as an exemption on your federal income tax return and is different than the definition of “qualifying individual” that applies under the Dependent Care Flexible Spending Account. Additional special rules apply in some cases. For additional information, please contact the Plan Administrator or your tax advisor. 1.17 How are claims determined? NOTE: This claims determination procedure applies only with respect to issues related to the Cafeteria Plan (e.g., the ability to pay for benefits on a pre-tax basis and the election of Optional Benefits) and claims for reimbursement under the Dependent Care Flexible Spending Account and Health Flexible Spending Account, Limited Scope Health Flexible Spending Account. Claims for other benefits (e.g., claims under the major medical and dental coverages) are handled through the claims determination procedures in those separate plans or policies. (a) Claim Submission. Unless a separate procedure is provided with respect to an Optional Benefit, a claim for benefits must be made in writing and submitted to the Claims Administrator. Please refer to the sections of this summary describing each Optional Benefit for additional information. (b) Benefits Denials. The Claims Administrator will decide your claim within a reasonable time not longer than thirty (30) days after it is received. This time period may be extended for an additional fifteen (15) days for matters beyond the control of the Claims Administrator, including when a claim is incomplete. You will receive written notice of any extension, indicating the reasons for the extension and the date by which a decision is expected to be made. If your claim is incomplete, and the Claims Administrator notifies you of that fact, the time period for deciding your claim will be suspended from the date the notice is provided through the date on which you respond or by which you are supposed to respond. You will be given at least forty-five (45) days in which to respond.