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© Hitesman & Wold, P.A. 2019 <br />Cafeteria Plan <br />Summary Description (3-11) <br />54 <br />PART VIII. <br />CASH PAYMENT <br />8.1 What benefits are provided? <br />The Plan permits you to receive a cash payment of all or a portion of the available Employer <br />contribution not allocated for the purchase of other benefits under the Cafeteria Plan. <br />8.2 How do I become a Participant? <br />To become a Participant in this portion of the Cafeteria Plan, you must first become a Participant <br />in the Cafeteria Plan. If you satisfy those requirements, you become a Participant in this portion of the <br />Cafeteria Plan by waiving coverage under the Group Medical Plan or enrolling in the Group Medical Plan <br />with coverage for Employee Only, Employee Plus Children or Employee Plus Spouse. If you enroll in <br />Employee Plus Family Group Medical you will cease to be eligible for cash payments under this portion of <br />the Plan. To waive coverage under the Group Medical Plan, you must complete and submit a “waiver of <br />coverage” form available from the Plan Administrator. <br />8.3 What amount of cash may I receive? <br />Employees waiving Group Medical: receive $180.16 monthly. <br />Employees selecting Employee Only Medical: receive $180.16 monthly. <br />Employee selecting Employee Plus Children Medical: You may receive $333.13 monthly <br />Employee selecting Employee Plus Spouse: receive up to $47.99 monthly <br />Employee selecting Employee Plus Family: receive no cash payment. <br /> <br />8.4 When is the cash payment made? <br />The cash payment will be pro-rated and made in substantially equal installments each month. The <br />payments will be made by a separate check or incorporated into the Participant's regular paycheck. All <br />cash payments constitute taxable income and are subject to withholding to the extent required by law. <br />8.5 What if I am no longer eligible? <br />If your employment terminates, or you otherwise ceas e to be eligible to participate in the Cafeteria <br />Plan, the cash payments cease. Only Participants are eligible to receive a cash payment. <br /> <br /> <br /> <br />