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© Hitesman & Wold, P.A. 2019 <br />Cafeteria Plan <br />Summary Description (3-11) <br />58 <br />PART XII. <br />ADMINISTRATIVE INFORMATION <br />Plan: <br />Plan Name: City of Orono Cafeteria Plan <br />Plan Type: Section 125 Cafeteria Plan <br /> <br />Employer, Plan Administrator, and Agent for Service of Legal Process: <br />Name: City of Orono <br />Address: 2750 Kelley Parkway <br />City, State Zip: Orono, MN 55356 <br />Phone/Fax Number: 952-249-4600 / 952-249-4611 <br />EIN: 41-6008585 <br />Contact Person: Ronald Olson rolson@ci.orono.mn.us <br /> <br />Claims Administrator: <br />Name: MEDSURETY, LLC <br />Address: 18001 Hwy 7 <br />City, State Zip: Minnetonka, MN 55345 <br />Phone/Fax Number: 952-303-5700 / 952-856-2656 <br /> <br />PLAN NAME PLAN TYPE <br />City of Orono Cafeteria Plan <br />City of Orono Group Medical Plan <br />City of Orono Group Dental Plan <br />Section 125 Cafeteria Plan <br />Health and Accident <br />Health and Accident <br />City of Orono Dependent Care Flexible Spending <br />Account <br />Dependent Care Assistance Plan <br />City of Orono Health Flexible Spending Account Health and Accident <br />City of Orono Limited Scope Health Flexible <br />Spending Account <br />City of Orono HSA <br />Health and Accident <br /> <br />Health Savings Account Contribution Feature <br /> <br />This Plan does not have a trust; therefore, there are no trustees.