HomeMy WebLinkAbout3034_176-_ You will still be able to request reimbursement for
qualifying dependent care expenses for the remainder of the
Plan Year from the balance remaining in your dependent care
account at the time of termination of employment. However, no
further salary redirection contributions will be made on your
behalf after you terminate.
-- Your participation in the Health Care Reimbursement Plan
will cease, and no further salary redirection contributions
will be contributed on your behalf. However, you will be able
to submit claims for health care expenses incurred prior to
your date of termination.
Under Federal law, you, your spouse, and your dependents may be
entitled to continuation of health care coverage. The Administrator
will inform you of these rights if you terminate employment.
Generally, if we (and any related companies) employed twenty (20)
or more employees "on a typical business day" in the preceding
calendar year, health plan continuation must be made available for
a period not to exceed eighteen (18) months if a loss of benefits
occurs because of your termination of employment or reduction of
hours, or for a period not to exceed three (3) years for any of the
other reasons given in (b) and (c) below. Under certain
circumstances, persons who are disabled at the time of termination
of employment or reduction in hours may be eligible for
continuation of coverage for a total of 29 months (rather than 18) .
You should check with the Administrator for more details regarding
this extended coverage. However, in certain circumstances, this
continuation coverage may be terminated for reasons such as failure
to pay continuation coverage cost, coverage under another
employer's plan (whether as an employee or otherwise, provided the
other employer's health plan does not contain any exclusion or
limitation with respect to any pre-existing condition of the
beneficiary) , termination of our health plan, or ycu (or the person
entitled to continued coverage) become entitled to Medicare
benefits. However, if you become entitled to Medicare benefits,
your dependents may still qualify for continuation coverage. The
cost of continuation coverage must be paid by the individual
choosing such coverage; however, the cost may not exceed 102% of
the cost of the same coverage for a "similarly situated" employee
or family member. When the continuation coverage for a disabled
person is extended from 18 months to 29 months, the disabled person
may be charged 150*-. (rather than 102%) of the cost of the coverage
after expiration of the initial 18 -month period.
(a) If you would otherwise lose your health plan coverage
under this Plan because of a termination of employment or
reduction in hours, you may continue the health plan coverage
provided under this Plan. However, this will not be a
tax-deductible expense to you, absent unusual circumstances.
(b) Your spouse may choose continuation
ation coverage for
himself or herself if he or she loses group health coverage for
any of the following reasons: (1) your death; (2) your divorce
or legal separation; or (3) you become entitled to Medicare.
(c) Your dependent children may choose continuation
coverage for themselves if they lose group health coverage for
any of the following reasons: (1) death of a parent; (2) your
divorce or legal separation; (3) you become entitled to
Medicare; or (4) your dependent ceases to be a dependent child
under the Plan.
It is your responsibility to notify the Plan Administrator of
a divorce, legal separation or other change in marital status,
change in a spouse's address, or a child losing dependent status
under the plan, within sixty (60) days of the event. It is our
responsibility to notify the Plan Administrator of your death,
termination of employment or reduction in hours, or Medicare
eligibility.
4. What Happens If I Am A Retiree and My Sick Leave Deferred
Compensation Account Is Depleted?
If you participate in the Plan pursuant to the Retiree Health
Insurance Program and you no longer have sick leave available to
pay for benefits under the Plan, your right to current benefits
will be determined in the following -manner:
You will remain covered by insurance, but only for the
period for which premiums have previously been paid.
-_ Your participation in the Health Care Reimbursement Plan
will cease, and no further salary redirection contributions
will be contributed on your behalf. However, you will be able
to submit claims for health care expenses previously incurred.
5. Will My Social Security Benefits Be Affected?
Your Social Security benefits may be slightly reduced because
when you receive tax-free benefits under our Plan, it reduces the
amount of contributions that you make to the Federal Social
Security system as well as our contribution to Social Security on
your behalf.
VI
HIGHLY COMPENSATED AND KEY EMPLOYEES
1. Do Limitations Apply to Highly Compensated Employees?
Under the Internal Revenue Code, "highly compensated employees"
and "key employees" generally are Participants who are officers,
shareholders or highly paid. You will be notified by the
Administrator each Plan Year whether you are a "highly compensated
employee" or a "key employee."
If you are within these categories, the amount of contributions
and benefits for you may be limited so that the Plan as a whole
does not unfairly favor those who are highly paid, their spouses or
their dependents. Federal tax laws state that a plan will be
considered to unfairly favor the key employees if they as a group
receive more than 25-1; of all of the nontaxable benefits provided
for under our Plan.
Plan experience will dictate whether contribution limitations
on "highly compensated employees" or "key employees" will apply.
You will be notified of these limitations if you are affected.
VII
PLAN ACCOUNTING
1. Periodic Statements
The Administrator will provide you with a statement of your
account periodically during the Plan Year that shows your account
balance. It is important to read these statements carefully so you
understand the balance remaining to pay for a benefit. Remember,
you want to spend all the money you have designated for a
particular benefit by the end of the Plan Year.
VIII
GENERAL INFORMATION ABOUT OUR PLAN
This Section contains certain general information which you may
need to know about the Plan.
1. General Plan Information
Village of Mount Prospect Flexible Compensation Plan is the
name of the Plan.
Your Employer has assigned Plan Number 501 to your Plan.
The provisions of your amended Plan become effective on January
1, 1996. Your Plan was originally effective on July 1, 1985.
Your Plan's records are maintained on a twelve-month period of
time. This is known as the Plan Year. The Plan Year begins on
January 1st and ends on December 31st.
2. Employer Information
Your Employer's name, address, and identification number are:
Village of Mount Prospect
100 South Emerson Street
Mount Prospect, Illinois 60656
36-6006011
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3. Plan Administrator Information
The name, address and business telephone number of your Plan's
Administrator are:
Mr. David Jepson, Village of Mount Prospect
100 South Emerson Street
Mount Prospect, Illinois 60656
(708) 392-6000
The Administrator keeps the records for the Plan and is
responsible for the administration of the Plan. The Administrator
will also answer any,questions you may have about our Plan. You may
contact the Administrator for any further information about the
Plan.
4. Service of Legal Process
The name and address of the Plan's agent for service of legal
process are:
Village of Mount Prospect
100 South Emerson Street
Mount Prospect, Illinois 60656
5. Type of Administration
The type of Administration is Employer Administration.
Ix
ADDITIONAL PLAN INFORMATION
1. Claims Process
You should submit reimbursement claims during the Plan Year,
but in no event later than a reasonable time following each Plan
Year, subject to procedures established by the Plan Administrator.
Any claims submitted after that time will not be considered. Claims
for benefits that are insured or self-funded will be reviewed in
accordance with procedures contained in the policies. All other
general claims or requests should be directed to the Administrator
of our Plan. If a non-insured claim under the Plan is denied in
whole or in part, you or your beneficiary will receive written
notification. The notification will include the reasons for the
denial, with reference to the specific provisions of the Plan on
which the denial was based, a description of any additional
information needed to process the claim and an explanation of the
claims review procedure. If we fail to respond within 90 days, your
claim is treated as denied. Within 60 days after denial, you or
your beneficiary may submit a written request for reconsideration
of the application to the Administrator.
Any such request should be accompanied by documents or records
in support of your appeal. You or your beneficiary may review
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pertinent documents and submit issues and comments in writing. The
Administrator will review the claim and provide, within 60 days, a
written response to the appeal. (This period may be extended an
additional 60 days under certain circumstances.) In this response
the Administrator will explain the reason for the decision, with
specific reference to the provisions of the Plan on which the
decision is based. The Administrator has the exclusive right to
interpret the appropriate plan provisions. Decisions of the
Administrator are conclusive and binding.
X
SUMMARY
The money you earn is important to you and your family. You
need it to pay your bills, enjoy recreational activities and save
for the future. our flexible benefits plan will help you keep more
of the money you earn by lowering the amount of taxes you pay. The
Plan is the result of our continuing efforts to find ways to help
you get the most for your earnings.
If you have any questions, please contact the Administrator.
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