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<br />© 2019 Hitesman & Wold, P.A. MEDSURETY, LLC <br />Cafeteria Plan 1-888-816-4234, www.medsurety.com <br />Basic Plan Document <br />7 <br />Note: This provision applies to participation in this Plan. With respect to the Optional Benefits <br />that involve premium payments for other plans sponsored be the Employer, coverage under the <br />underlying plan may extend beyond the date on which a Participant ceases to be a Participant in <br />this Plan. <br /> <br />In the event the Plan does not learn that a Participant has automatically ceased to be a <br />Participant until a date after the date participation cease d, participation will be terminated <br />retroactively and the Plan shall be entitled to recover any amounts paid as benefits paid after the <br />date participation is terminated. Termination of participation in this Plan shall not prevent a <br />former Participant from continuation coverage, conversion coverage or benefits under the <br />respective Optional Benefit plans if and to the extent provided by such plans. <br />3.5 Conditions of Participation. As a condition of participation and receipt of benefits under this <br />Plan, the Participant agrees to: <br />(a) Observe all Plan rules and regulations; <br />(b) Consent to inquiries by the Plan Administrator with respect to any provider of services <br />involved in a claim under this Plan; <br />(c) Submit to the Plan Administrator all notifications, reports, bills, and other information <br />required by the Plan or which the Plan Administrator may reasonably require; and <br />(d) Repay any overpayments or incorrect payments received under the Plan. <br />Failure to do so relieves the Plan, Plan Administrator, and Claims Administrator from a ny and all <br />obligations under this Plan. <br />3.6 Participation in Optional Benefit Plans. In order to elect a particular Optional Benefit <br />provided under this Plan, a Participant must elect that Optional Benefit on such forms as the Plan <br />Administrator may require (unless the benefit is provided to all Participants) and, if the cost of <br />Optional Benefit is not fully paid by the Employer, shall be required to share the cost of the <br />Optional Benefit as provided in Article IV. Further, the Participant must meet any elig ibility, <br />participation, etc., requirements applicable to that Optional Benefit in accordance with the terms <br />of the underlying plan through which the Optional Benefit is provided.