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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 />13 <br />(2) Significant Cost Increases. If the Plan Administrator determines that the cost <br />of an Optional Benefit (other than the Health Flexible Spending Account or <br />Limited Scope Health Flexible Spending Account) significantly increases during a <br />Plan Year, the Participant may, on a prospective basis, either (a) make a <br />corresponding increase in his or her Election, (b) enroll in another benefit <br />package option providing similar coverage and make a correspond ing Election <br />change, or (c) revoke his or her Election if no other benefit package option <br />providing similar coverage is available. The Plan Administrator (in its sole <br />discretion) will decide, in accordance with prevailing IRS guidance, whether a <br />cost increase is significant and what constitutes “similar coverage” based upon all <br />the surrounding facts and circumstances. <br />(3) Significant Cost Decrease. If the Plan Administrator determines that the cost <br />of an Optional Benefit (other than the Health Flexible Spending Account or <br />Limited Scope Health Flexible Spending Account) significantly decreases during a <br />Plan Year: (i) an Eligible Employee or Participant may commence participation in <br />such Optional Benefit; and (ii) the Plan Administrator shall automatically <br />effectuate a prospective decrease in a Participant’s Election with respect to such <br />Optional Benefit in accordance with the cost decrease. <br />(f) Change in Coverage. <br />(1) Significant Curtailment. If the Plan Administrator determines that coverage <br />under an Optional Benefit (other than the Health Flexible Spending Account or <br />the Limited Scope Medical Reimbursement Plan) is significantly curtailed during a <br />Plan Year, the Participant may prospectively enroll in another benefit package <br />option providing similar coverage and make a corresponding Election change. <br />Coverage under an accident or health plan is deemed “significantly curtailed” <br />only if there is an overall reduction in coverage provided to Participants u so as <br />to constitute reduced coverage to Participants in general. The Plan Administrator <br />(in its sole discretion) will decide, in accordance with prevailing IRS guidance, <br />whether a curtailment is “significant”, and whether a substitute Optional Benefit <br />constitutes “similar coverage” based upon all the surrounding facts and <br />circumstances. <br />(2) Loss of Coverage. If the Plan Administrator determines that coverage under <br />an Optional Benefit (other than Health Flexible Spending Account or the Limited <br />Scope Medical Reimbursement Plan) is lost during a Plan Year, the Participant <br />may, on a prospective basis: (i) enroll in another benefit package option <br />providing similar coverage and make a corresponding Election change; or (ii) <br />revoke his or her Election if no other benefit package option providing similar <br />coverage is available. Coverage under an accident or health plan is deemed <br />“lost” only if there is a complete loss of coverage under the benefit package <br />option (e.g., due to elimination of the benefit package option or application of an <br />annual or lifetime maximum) or other fundamental loss of coverage. The Plan <br />Administrator (in its sole discretion) will decide, in accordance with prevailing IRS <br />guidance, whether a “loss” has occurred, and whether a benefit package option <br />constitutes “similar coverage” based upon all the surrounding facts and <br />circumstances. <br />(3) Addition or Improvement of an Optional Benefit. If during a Plan Year, <br />the Plan adds a new Optional Benefit or a new benefit package option under the <br />Optional Benefit (other than the Health Flexible Spending Account or Limited <br />Scope Health Flexible Spending Account), or if coverage under an existing <br />Optional Benefit is significantly improved: (i) an affected Participant may