10-10-2022 Council Packet - Laserfiche WebLink

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© 2019 Hitesman & Wold, P.A. MEDSURETY, LLC Cafeteria Plan 1-888-816-4234, www.medsurety.com Basic Plan Document 12 (5) COBRA Coverage. If the Participant becomes eligible for COBRA (or similar health plan continuation coverage under state law) under an Optional Benefit, the Participant may increase the Election for that Optional Benefit to pay for such coverage provided the Participant remains eligible to participate in the Plan and still receives Compensation. (b) HIPAA Special Enrollment Rights. If a Participant, a Participant’s Spouse, and/or a Participant's dependent enrolls in a group health plan that is an Op tional Benefit of this Plan and subject to the HIPAA special enrollment rights provided by Code § 9801(f), the Participant may make a new election that corresp onds with the special enrollment. For purposes of this provision (1) an Election to add previously eligible dependents as a result of the acquisition of a new Spouse or dependent child (a/k/a the Tag -along Rule), shall be considered consistent with the special enrollment right; and (2) a HIPAA special enrollment Election attributable to the birth or adoption of a new dependent child may be effective retroactive (up to thirty (30) days), provided it applies to Compensation not yet currently available. (c) Certain Judgments, Decrees and Orders. If a judgment, decree, or order (an “Order”) resulting from a divorce, legal separation, annulment or change in legal custody (including a qualified medical child support order) requires accident or health coverage for a Participant's Dependent child (including a foster child who is a Dependent of the Participant), a Participant may: (1) change his or her Election to provide coverage for the Dependent child (provided that the Order requires the Participant to provide c overage and subject to the provisions of the underlying group health plan); or (2) change his or her Election to revoke coverage for the Dependent child if the Order requires that another individual (including the Participant’s Spouse or former Spouse) provide coverage under that individual's plan. (d) Medicare and Medicaid. If a Participant, a Participant’s Spouse, or a Participant’s Dependent who is enrolled in a health or accident benefit under this Plan becomes entitled to Medicare or Medicaid (other than coverage consisting solely of benefits under Section 1928 of the Social Security Act providing for pediatric vaccines), the Participant may prospectively reduce or cancel the health or accident coverage of the person becoming entitled to Medicare or Medicaid. Further, if a Participant, a Participant’s Spouse, or a Participant’s Dependent who has been entitled to Medicare or Medicaid loses eligibility for such coverage, then the Participant may prospectively elect to commence or increase the health or accident coverage provided under this Plan of the person losing entitlement to Medicare or Medicaid. (e) Change in Cost. (1) Automatic Increase or Decrease for Insignificant Cost Changes. If the cost of an Optional Benefit (other than the Health Flexible Spending Account or Limited Scope Health Flexible Spending Account) increases or decreases during a Plan Year by an insignificant amount, then the pre-tax contributions or after-tax contributions (as applicable) under each affected Participant Election shal l be prospectively increased or decreased to reflect such change. The Plan Administrator, on a reasonable and consistent basis, will automatically effectuate this prospective increase or decrease in Participant contributions in accordance with such cost changes. The Plan Administrator (in its sole discretion) will decide, in accordance with prevailing IRS guidance, whether increases or decreases in costs are “insignificant” based upon all the surrounding facts and circumstances (including, but not limited to, the dollar amount or percentage of the cost change).