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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 />37 <br />modifications, or adjustments to the allocation of the account. In accordance <br />with this part (1), a claim incurred during the preceding Plan Year and submitted <br />during the Claims Run-out Period will be processed subsequent to a previously <br />submitted claim incurred during the Grace Period, even if the account from the <br />preceding Plan Year is exhausted by reimbursement of the claim incurred during <br />the Grace Period. <br />(3) Elections. No adjustment to a Participant’s election for the current Plan Year <br />shall be made or allowed based upon the amount of claims reimbursed from the <br />prior Plan Year’s account in accordance with part (1) hereof. <br />(b) Claims Run-Out Period. Except as otherwise provided in this Section 10.12, (i) <br />amounts attributed to a Participant’s DC Account f or any Plan Year shall be used only to <br />reimburse the Participant for eligible Dependent Care Expe nses incurred during such Plan <br />Year, and (ii) any balance remaining in a Participant’s DC Account for a Plan Year shall be <br />forfeited following the end of the Claim Run-Out Period and shall be forfeited in <br />accordance with Section 5.7. The Plan Administrato r may extend this period in the event <br />the Participant cannot obtain proper documentation until after the expiration of the <br />period. Such forfeited amount shall not be distributed in cash, carried over to the next <br />Plan Year or used by the Participant for any other purpose. <br />10.13 Dependent Care Limitations. <br />(a) Reimbursement or payment of eligible Dependent Care Expenses shall be made to the <br />Participant only in the event and to the extent that such reimbursement or payment is: <br />(1) not otherwise provided for under any insurance policy, whether the premium on such <br />policy is paid by the Employer or an individual, and (2) not provided for or reimbursable <br />under any other plan or policy. <br />(b) Other limitations, if any, shall be set forth in the Adoption Agreement. <br />10.14 Reporting and Disclosure. Each Participant must be furnished with a written statement <br />showing the amounts paid under this portion of the Plan by an Employer on behalf of the <br />Participant for a calendar year. The statement must be furnished before January 31st of the <br />following year. If the actual amount paid is not known by this deadline, the Employer may report <br />a reasonable estimate of the amounts paid under this portion of the Plan.