1996-001-Adopting Amended Cafeteria Plan, Plan For Town Employees And Approving Summary Plan DescriptionsRESOLUTION 1996 - i
RESOLUTION OF THE TOWN OF LOS GATOS
ADOPTING AMENDED CAFETERIA PLAN (IRC SECTION 125) PLAN FOR TOWN
EMPLOYEES AND APPROVING SUMMARY PLAN DESCRIPTIONS
WHEREAS, the Town of Los Gatos has adopted a Cafeteria Plan under Internal
Revenue Code Section 125 to provide medical reimbursement, health insurance, and dependent
care reimbursement benefits to Town employees; and
WHEREAS, the Plan needs to be updated and clarified to ensure proper
administration,
RESOLVED, by the Town Council of the Town of Los Gatos, County of Santa
Clara, State of California, that the Town of Los Gatos adopts the amended Cafeteria Plan attached
hereto as Exhibit A, and the Town Manager is authorized and directed to execute the Adoption
Agreement by and on behalf of the Town.
BE IT FURTHER RESOLVED that the Summary Plan Description attached hereto
as Exhibit B is approved.
PASSED AND ADOPTED at a regular meeting of the Town Council of the Town
of Los Gatos, California, held on the 16th day of January, 1996 by the following vote:
COUNCIL MEMBERS:
AYES: Joanne Benjamin, Steven Blanton, Linda Lubeck, Patrick O'Laughlin
Mayor Randy Attaway
NAYS: None
ABSENT: None
ABSTAIN: None
SIGNED: —`
MAYOR THE TO OF LOS GATOS
LOS GATOS, CALIF IA
ATTEST:
CLERK OF THE TOWN OF LOS GATOS
LOS GATOS, CALIFORNIA
TOWN CLERK
4GR: �L 49-3
IHH:�
RECW_Z r
BID:
LIMITATION OF LEGAL LIABILITY
The Employer or Sponsor of this Plan understands and agrees that
HICKS & COMPANY is in no way liable for the legal and tax aspects
of this Plan. Full legal and tax responsibility is assumed by the
undersigned Organization establishing this Plan, which acknowledges
that it has reviewed the terms and conditions of the Plan with its
legal and tax advisors with respect to the adoption of this Plan
and the various options available under the Plan.
t
EMPLOYER:
ADOPTION AGREEMENT
I.R.C. SECTION 125 CAFETERIA PLAN
TOWN OF LOS GATOS
110 E. MAIN STREET
LOS GATOS, CA 95032
TRUST ID NUMBER 94- 6001435
PLAN ADMINISTRATOR:
TOWN OF LOS GATOS
110 E. MAIN STREET
LOS GATOS, CA 95032
(408) 354 -6829
THE UNDERSIGNED EMPLOYER DOES HEREBY ADOPT THE FOLLOWING CAFETERIA
PLAN FOR THE EXCLUSIVE USE AND BENEFIT OF ITS EMPLOYEES. IN
CONNECTION HEREWITH, THE EMPLOYER MAKES THE FOLLOWING STATEMENTS
AND SELECTIONS.
THE NAME OF THE PLAN SHALL BE:
TOWN OF LOS GATOS CAFETERIA PLAN
Plan Number 501
TERMS AND CONDITIONS OF
TOWN OF LOS GATOS CAFETERIA PLAN
ARTICLE I
GENERAL PROVISIONS
1.1 EFFECTIVE DATES. The Effective Date of this Plan shall be July 1, 1992 as
amended on July 1, 1995.
1.2 PLAN YEARS. The First Plan Year shall begin on the Effective Date and end
of June 30, 1993. Each subsequent Plan Year shall begin on July 1st and end of June 30th
of each successive Year.
1.3 ELIGIBILITY REQUIREMENTS. All employees who meet the participation
requirements are eligible to participate in this plan. To qualify as a participant under this ,
plan you must be:
a. An employee appointed to the competitive service, who is working at least 20
hours per week on a regular basis as a probationary or regular employee; or
b. A confidential or provisional employee, working at least 20 hours per week
on a regular basis; or
c. The Town Manager, the Town Attorney, a department head, or a
management employee, working at least 20 hours per week on a regular
basis.
1.4 ENTRY DATES. Each Employee shall begin participation on the first day of
the month following date of hire.
1.5 LEGAL CONSTRUCTION. This Plan shall be construed according to the
Laws of the State of California.
ARTICLE II
INTRODUCTION
2.1 PURPOSE OF THE PLAN. This document constitutes the Cafeteria Plan for
TOWN OF LOS GATOS pursuant to the Adoption Agreement. The purpose of the
Cafeteria Plan (hereinafter referred to as the Plan) is to allow the Employees of the
Employer to select among various taxable and nontaxable Benefit programs, as adopted
under the Adoption Agreement and described in Article X offered under this Plan to the
employees by the Employer; said Benefits may include (but are not limited to) Medical,
Disability, Dental and Group Term Life Insurance, Medical and Dependent Care
Assistance and Reimbursement Programs, and other Benefits as the Employer may offer
from time to time.
pursuant to the provisions of I.R.C. Section 125, and such other
Internal Revenue Code Sections as may apply at any given time.
2.2 PLAN ADMINISTRATION. The Administration of the Plan
shall be the sole responsibility of the Employer and /or the
appointed Plan Administrator. The Plan shall be administered on
the basis of the Plan Year.
2.3 TERM OF PLAN. This Plan is intended to be ongoing and
perpetual and for an indefinite period of time.
ARTICLE III
PARTICIPATION
3.1 ELIGIBILITY. Every Employee who has
requirements as set out in Section 1.3, shall
participate in the Plan as of his Entry Date,
Section 1.4. To participate in the Cafeteria
be required to file an Agreement to Participa
Section 4.3).
met the Eligibility
be eligible to
-as described in
Plan employees will
to (as described in
3.2 TERM OF COVERAGE OF PARTICIPANTS. Each Participant and
his Covered Dependents (as described in Section 3.3), if covered
under the Plan, shall be covered for the entire Plan Year (or
such portion of the Plan Year remaining after the Participant's
Entry Date, if later than the first day of the Plan Year). The
Benefits provided to any Participant or his Covered Dependents
for any Plan Year shall cease on the first date following the
occurrence of any of the following:
(a) The Participant ceases to be a participant under this
Plan due to his death, resignation or termination;
(b) The Participant fails to make his required
contributions, if any, under the Plan;
(c) The Participant ceases to be a member of a class of
employees who are eligible for benefits under this
Plan;
(d) With respect to a Covered Dependent, the date that
Covered Dependent ceases to be a Covered Dependent as
defined in Section 3.3;
(e) The date a specific Benefit provided under this Plan is
discontinued;or otherwise no longer provided; or
(f) The date this Plan is terminated.
F
3.3 COVERED DEPENDENT. A Covered Dependent is defined as
the spouse or any other dependent of the Participant. Any
dependent who has or could have been elected as a dependent of
the Participant on his Federal tax return shall qualify hereunder
as a Covered Dependent under this Plan.
3.4 EXCEPTION FOR CERTAIN HEALTH PLANS. Notwithstanding any
other provisions in this Article III, any Participant or Covered
Dependent who is eligible for Health Care Continuation Coverage
under the Consolidated Omnibus Budget Reconciliation Act of 1985,
commonly referred to as COBRA, shall be allowed to continue to
receive health benefits under this Plan, so long as such
Participant or Covered Dependent complies with the provisions set
out in COBRA. The Employer shall adopt rules relating to
continuation coverage, as provided under Code Section 4980(B), or
applicable state laws, as may be required from time to time, and
shall advise affected individuals of the terms and conditions of
such continuation coverage.
3.5 NOTICE OF ELIGIBILITY. The Employer, or the designated
Plan Administrator, shall notify the Employees of the Employer of
their eligibility to participate in the Plan, and shall inform
them of the terms and their rights under the Plan. Each
Participant shall be provided with a copy of the Summary Plan
Description.
ARTICLE IV
CONTRIBUTIONS
4.1 PARTICIPANT CONTRIBUTIONS. All Participant contributions
shall be derived from the Participants salary, either through
reduction of his present salary or by foregoing all or a part of
an increase in his salary, and shall be made pursuant to a Salary
Reduction Agreement, which is attached to and made a part of the
Employee's Agreement to Participate, as described in Section 4.3
below. All Participant contributions become the property of the
Employer, to be used for the exclusive benefit of each
Participant as set forth in Section 8.2.
4.2 FUND LIMITATIONS. All Participant contributions may, at
the Employer's (or the designated Plan Administrator's) election,
be placed in a fund, as described in Article VIII. At the end of
the Plan Year, any interest, income, or excess funds attributable
to Participants' contributions shall become the sole property of
the Employer, and the Employer shall use said funds as set forth
in Section 8.2.
4.3 AGREEMENT TO PARTICIPATE /SALARY REDUCTION AGREEMENT.
Before any Participant is allowed to participate in the Cafeteria
Plan, he must file with the Employer, or its designated Plan
Administrator, an Agreement to Participate. This Agreement shall
3
contain a Salary Reduction Agreement which will authorize, by
agreement of the parties, the Employer to reduce the
Participant's salary in an amount sufficient to pay the Benefit
the Participant elects on his own behalf. The Salary Reduction
Agreement shall specify the amount the Participant authorizes to
be reduced from his salary. Pursuant to the Salary Reduction
Agreement, the Employer shall withhold the agreed amount from the
Participant's paycheck for each pay period beginning with the
first pay period for which the Participant is participating in
the Plan. The Participant must, before his first Plan Year ends
and for every Plan year after his first Plan Year, execute a new
Salary Reduction Agreement with the Plan Administrator. Each new
Salary Reduction Agreement shall specify the benefit and the
amount of salary the Participant authorizes to be withheld from
his paycheck. Should the participant fail to return the Salary
Reduction Agreement for any Plan Year before the start of the
Plan Year, said Participant shall be ineligible to participate in
the Plan for that Plan Year.
4.4 CHANGE IN PARTICIPANT'S RATE OF CONTRIBUTION. No
Participant in the Plan shall be allowed to alter or discontinue
his contributions to the Plan during a Plan Year unless one of
the following events takes place:
(a) There is a change in the Participant's family status.
Such change may include, but is not limited to, the marriage
or divorce of the Participant; the adoption, birth or death
of a child or other Covered Dependent (as defined under
Section 3.3) of the Participant or his spouse; the
emancipation or coming of age of a child of the Participant
so that the child is no longer eligible as a Covered
Dependent under the Plan; the employment of the
Participant's spouse; etc. Upon the occurrence of any of
the aforementioned events, or such other event as may
qualify as a change in family status in the opinion of the
Plan Administrator, and in accordance with any applicable
Federal laws, the Participant may file a New Salary
Reduction Agreement, which will serve to revoke the
Participant's previous Salary Reduction Agreement. The New
Salary Reduction,Agreement shall be effective prospectively
and apply only to those Benefits accruing to the Participant
or his Covered Dependents after the effective date of the
New Salary Reduction Agreement.
(b) The Participant's Salary Reduction Agreement for a given
Plan Year shall terminate and contributions from the
Participant shall cease upon the date a Participant is no
longer eligible to participate under the terms of the Plan.
4.5 INCREASES OR DECREASES IN PREMIUMS. Should a third
party benefit provider, such as an Insurance Company, increase or
decrease premiums for any health benefits being offered under
4
this Plan during the Plan Year, any Participant participating in
such benefit shall have his Salary Reduction increased or
decreased automatically in an amount sufficient to pay for such
increase or decrease. However, in the case of an increase in
premium, if there is a similar benefit offered under the Plan at
the time of said increase, the Participant may select such
similar benefit rather than pay the increase.
4.6 LIMITATION ON REHIRED EMPLOYEES. Any Employee who is a
Participant under this Plan who separates from service from the
Employer shall terminate participation under this Plan. If such
Employee should later be rehired by the Employer in the same Plan
Year as the Plan Year in which he separated from service, such
Employee shall be barred from participating in the Plan for the
remainder of that Plan Year.
ARTICLE V
PARTICIPANT'S ACCOUNTS; PAYMENT OF BENEFITS
5.1 PARTICIPANT'S BENEFIT ACCOUNT. It shall be the duty of
the Plan Administrator to establish separate Benefit Accounts for
each Benefit option a Participant elects. Participant
Contributions which have been deferred by Salary Reduction shall
be deposited into the proper Benefit Account(s) of the
Participant in a timely fashion. Each Account shall be
designated as either a "Premium Account" or as a "Reimbursement
Account ". Deposits shall be made by the Employer as soon as is
possible after the pay period for which Participant Contributions
have been deducted from the Participant's paycheck, but in no
case longer than 90 days.
5.2 PREMIUM ACCOUNT. A "Premium Account" is an account
established with the intent to pay for Premium -type Benefits
selected by the Participant, which includes, but are not limited
to: Medical Insurance, Group Term Life Insurance, Dental
Insurance and Disability Insurance. In all cases, money
contributed to a Premium Account becomes the property of the
Employer to be used for the benefit of the Participants under the
Plan.
5.3 REIMBURSEMENT ACCOUNT. A "Reimbursement Account" is an
account used to reimburse a Participant for Qualified Expenses
that are not Premium -type expenses as defined by the appropriate
Benefit established under the Plan and so elected by the
Participant. Reimbursement Accounts are authorized only for
those expenses recognized under the Internal Revenue Code as
allowable Reimbursable Benefits, and may include, but are not
limited to, Unreimbursed Medical Expenses and Dependent Care
Assistance Expense Reimbursement. In all cases, money
5
contributed to a Reimbursement Account becomes the property of
the Employer to be used for the benefit of the Participants under
the Plan.
5.4 PAYMENT OF BENEFITS. It shall be the responsibility of
the Plan Administrator to pay the Benefits authorized under the
Plan other than insurance benefits administered by a third -party
benefit provider.
5.5 PAYMENT OF PREMIUM -TYPE BENEFITS. The Participant's
portion of Premium -type Benefit premiums shall be paid out of the
Participant's Premium Account. Payment shall be made by the
Employer, (or the designated Plan Administrator), in a timely
manner upon receipt of a Premium Notice from the Benefit Provider
providing such benefit.
5.6 PAYMENT OF REIMBURSABLE BENEFITS. It shall be the duty
of the Plan Administrator to construe what are and are not
Qualified Expenses subject to reimbursement from the
Reimbursement Accounts. Such determinations shall be made in
accordance with the applicable Federal laws that apply to the
expenses being considered. If the Plan Administrator determines
that an expense is a Qualified Expense subject to reimbursement,
the Plan Administrator shall reimburse the Participant for his
Qualified Expense as soon as is reasonably possible. The Plan
Administrator may require proper evidence that a Qualified
Expense has been incurred and that such expense is authorized
under applicable Federal law and that the expense was incurred
during the time the Participant was participating under the Plan.
The Plan Administrator shall be the sole arbiter of what
constitutes a Qualified Expense subject to reimbursement.
Payment shall be made directly to the Plan Participant.
5.7 QUALIFIED EXPENSE. A Qualified Expense is any expense
subject to reimbursement under the Plan and as authorized under
any applicable Federal law as a reimbursable expense not subject
to income taxation.
5.8 DESIGNATION OF BENEFICIARIES. Each Participant or
Covered Dependent shall be afforded the opportunity from time to
time to name any person as his beneficiary in case of death. Any
named beneficiary shall be entitled to any Benefits having
accrued to the Participant or Covered Dependent at the time of
death. The Participant or Covered Dependent may, in addition,
name concurrent, contingent and /or successive beneficiaries. Any
beneficiary designation must be filed with the Employer (or the
designated Plan Administrator) on a form approved by the
aforementioned party and must be filed prior to the Participant's
or Covered Dependent's death. In those cases where a Participant
or Covered Dependent fails to designate a beneficiary, or the
designated beneficiary predeceases the Participant or Covered
Beneficiary, the Plan, Administrator shall pay any Benefits due to
the deceased Participant or Covered Dependent to either:
6
(a) one or more of the Participant's or Covered Dependent's
relatives by blood, adoption or marriage, in such
proportions as the Plan Administrator sees fit; or
(b) the legal representative or representative of the estate
of the last to die of the Participant or Covered Dependent
and his designated beneficiary.
5.9 INCAPACITY OF PARTICIPANT. The Plan Administrator is
empowered to make payments directly to a Participant's legal
representative or blood relative in cases where the Plan
Administrator determines the Participant is under a legal
disability or is incapacitated in such a way as to be unable to
manage his own affairs in a competent manner.
ARTICLE VI
PLAN ADMINISTRATION
6.1 THE PLAN ADMINISTRATOR. The Employer or the designated
Plan Administrator (herein referred to as "the Plan
Administrator "), as named in the Adoption Agreement, shall be
responsible for the administration of the Plan.
6.2 THE PLAN ADMINISTRATOR'S DUTIES. In addition to any
rights duties or powers specified throughout the body of this
Plan, the Plan Administrator shall have the following rights,
duties, and powers:
(a) To interpret the Plan, to determine the amount, manner
and time for payment of any Benefits under the Plan, and to
construe or remedy any ambiguities, inconsistencies or
omissions under the Plan.
(b) To adopt and apply any rules or procedures to insure
the orderly and efficient administration of the Plan.
(c) To determine the rights of any Participant or Covered
Dependent or designated beneficiary to a Benefit under this
Plan.
(d) To develop appellate and review procedures for any
Participant, Covered Dependent or designated beneficiary who
is denied a Benefit under the Plan.
(e) To provide the Employer with such tax or other
information it may require in connection with the Plan.
(f) To employ any agents, attorneys, accountants or other
parties (who may also be employed by the Employer) and to
allocate or delegate to them such powers or duties as is
7
necessary to assist in the proper and smooth administration
of the Plan, provided that such allocation or delegation and
the acceptance thereof is in writing.
(g) To report to the Employer, or any party designated by
the Employer, after the end of each Plan year regarding the
administration of the Plan, and to report any significant
recommendations for modifications as to procedures, Benefits
or Benefit Providers or any other change which might insure
the smooth administration of the Plan. However, nothing in
this paragraph is meant to confer upon the Plan
Administrator any powers to amend the Plan or change any
administrative procedure or contract with Benefit Providers
or adopt any other procedure involving the Plan without the
express written approval of the Employer regarding any
amendment, change in administrative procedure, or Benefit
Provider. Notwithstanding the preceding sentence, the Plan
Administrator is empowered to take any actions he sees fit
to assure that the Plan complies with the nondiscrimination
requirements of Internal Revenue Code Section 125.
6.3 INFORMATION TO BE PROVIDED TO PLAN ADMINISTRATOR. The
Employer, or any of its agents, shall provide to the Plan
Administrator any employment records of any employee eligible to
participate under the Plan. Such records shall include, but will
not be limited to, any information regarding period of
employment, leaves of absence, salary history, termination of
employment, or any other information the Plan Administrator may
need for the proper administration of the Plan. Any Participant
or Covered Dependent or any other person entitled to Benefits
under the Plan shall furnish to the Plan Administrator his
correct post office address, his date of birth, the names,
correct addresses and dates of birth of any designated
beneficiaries, with proper proof thereof, or any other data the
Plan Administrator might reasonably request to insure the smooth
and proper administration of the Plan.
6.4 DECISION OF PLAN ADMINISTRATOR FINAL. Subject to
applicable State or Federal law, and the provisions of Section
6.5, below, any interpretation of any provision of this Plan made
in good faith by the Plan Administrator as to any Participant's
rights or benefits under this Plan is final and shall be binding
upon the parties. Any misstatement or other mistake of fact
shall be corrected as soon as reasonably possible upon
notification to the Plan Administrator and any adjustment or
correction attributable to such misstatement or mistake of fact
shall be made by the Plan Administrator as he considers equitable
and practicable.
6.5 REVIEW PROCEDURES. In cases where the Plan
Administrator denies a Benefit for any Participant or Covered
Dependent or any other person eligible to receive benefits under
8
the Plan, the Plan Administrator shall furnish in writing to said
party the reasons for the denial of benefits. The written denial
shall be provided to the party within 30 days of the date the
Benefit was denied by the Plan Administrator. The written denial
shall refer to any Plan or Internal Revenue Code Section upon
which the Plan Administrator relied in making such denial. The
denial may include a request for any additional data or material
needed to properly complete the claim and explain why such data
or material is necessary, and explain the Plan's claim review
procedures. If requested in writing, and within 30 days of the
claim denial, the Plan Administrator shall afford any claimant
whose request for claim was denied a full and fair review of the
Plan Administrator's decision, and within 30 days of the request
for review of the denied claim, the Plan Administrator shall
notify the claimant in writing of his final decision on the
reviewed claim. Claim review procedures under the Cafeteria Plan
apply except to the extent that claims and review procedures are
provided under Benefits administered by a third party Benefit
Provider.
6.6 EXTENSIONS OF TIME. In any case where the Plan
Administrator determines special circumstances apply, the Plan
Administrator may extend the amount of time any Participant,
Covered Dependent or designated beneficiary may need to appeal a
claim, upon proper application to the Plan Administrator.
6.7 RULES TO APPLY UNIFORMLY. The Plan Administrator shall
perform his duties on a reasonable and nondiscriminatory basis
and shall apply uniform rules to all Participants similarly
situated under the Plan.
6.8 INDEMNITY. Government Code 825 governs the rights
and obligations of the Employer with regard to indemnification of
its officers and employees for employee activities within the
course and scope of their employment, including administration of
this Plan. The Employer shall comply with the provisions of
Section 825 in determining whether to indemnify its officers and
employees in administering this Plan, unless Employer's
obligations are otherwise governed by a memorandum of
understanding adopted pursuant to Government Code 3500 and
following.
ARTICLE VII
FUNDING, AMENDMENT AND TERMINATION OF THE PLAN
7.1 FUNDING. This Plan shall be funded by Employer
contributions attributable to Participants' Salary Reductions.
7.2 AMENDMENT. The Employer shall have the right to amend
this Plan at any time, or from time to time, at its discretion,
and with the approval of the Board of Directors, subject to the
9
limitation that no Amendment shall change the terms and conditions of payment of any
Benefit a Participant, Covered Dependent or designated beneficiary was or might have
been entitled to under the Plan, except to the extent such Amendment is necessary to
comply with any Federal, State or local law or regulation. The Employer may also make
Amendments apply retroactively to the extent necessary so that the Plan remains in
compliance with Internal Revenue Code Section 125 or any other provision of the Internal
Revenue Code applicable to the Plan. The Employer may amend any Benefit available
under the Plan, may add Benefits or combine Benefits, so long as such amendment does
not eliminate any obligation owed to a Participant, Covered Dependent or designated
beneficiary that arose during the time the Plan was in force.
7.3 TERMINATION. The Employer shall have the right to terminate this Plan
at any time, so long as such termination does not eliminate any obligation owed to a
Participant, Covered Dependent or designated beneficiary that arose during the period the
Plan was in force.
ARTICLE VIII
ACCOUNTFUND
8.1 ACCOUNT FUND. The term "Account Fund" means all assets held under
the Plan by the Employer. The Employer shall receive, hold, distribute and administer the
assets of the Fund in accordance with the terms of the Plan as set forth in this Plan
document. The assets of this Account Fund shall be the Employer's for the sole benefit of
the Participants of the Plan.
8.2 REVERSION TO EMPLOYER. At the end of the Plan Year, any interest,
income, or excess funds attributable to Participant's contributions shall become the sole
property of the Employer, and the Employer shall use said funds in any way it sees fit. In
no case, however, shall the excess funds, or the income from the account, be used to reduce
Participant contributions for a future Plan Year. Should the Plan be terminated by the
Employer during or after the end of a Plan Year, the Employer shall have full right to any
assets in this Fund, after all obligations owed to Participants, Covered Dependents, or
designated beneficiaries under the Plan have been fulfilled.
8.3 RECORDS AND ACCOUNTS OF EMPLOYER. The employer shall
maintain accurate and complete record and accounts of all transactions under the Plan,
which shall be available at all reasonable times for inspection or audit by any person
designated by the Employer or the Plan Administrator, if different from Employer and by
any other person or entity to the extent required by law.
10
V
ARTICLE IX
GENERAL PROVISIONS
9.1 NON - ASSIGNABILITY. Any Benefits to any Participants
under this Plan shall be nonassignable and for the exclusive
benefit of Participants, Covered Dependents and designated
beneficiaries. No Benefit shall be voluntarily or involuntarily
assigned, sold or transferred.
9.2 NO EMPLOYMENT CONTRACT. By creating this Cafeteria
Plan, and the payment of Benefits under said Plan, the Employer
in no way guarantees employment for any Employee or Participant
under this Plan. Participation in this Plan shall in no way
assure continued employment with the Employer.
9.3 PARTICIPANT LITIGATION. In any action or proceeding
against the Plan, or the administration thereof, Employees or
former Employees of the Employer or any other Person having or
claiming to have an interest under the Plan shall not be
necessary parties to such action or proceeding. The Employer,
the Plan Administrator, or their registered representative shall
be the sole source for service of process against the Plan. Any
final judgment which is not appealed or appealable shall be
binding on the Employer and any interested party to the Plan.
9.4 GENDER AND NUMBER. Words in this document denoting the
masculine shall include the feminine and neutral genders and
words denoting the singular shall include the plural wherever by
context.
9.5 ADDRESSES, NOTICE, WAIVER OF NOTICE. Each Participant
shall furnish the Employer with his correct post office address.
Any communication, statement or notice addressed to a Participant
at his last post office address as filed with the Employer will
be binding on such person. The Employer or Plan Administrator
shall be under no legal obligation to search for or investigate
the whereabouts of any person benefiting under this Plan. Any
notice required under the Plan may be waived by such person
entitled to such notice.
9.6 REQUIRED INFORMATION. Each Participant or Covered
Dependent shall furnish to the Employer such documents, evidence
or information as the Employer considers necessary or desirable
to ensure the smooth operation and administration of the Plan and
for the protection of the Employer or any Benefit Providers under
the Plan.
9.7 MISTAKE OF FACT. Any mistake of fact or misstatement
of fact shall be corrected when it becomes known and any
adjustments due to such mistakes or misstatements shall be made
promptly.
it
9.8 WITHHOLDING OF TAXES. The Employer or any Benefit
Provider under the Plan may withhold from any payments to
Participants, Covered Dependents or designated beneficiaries any
amounts necessary to comply with any tax withholding provisions
of the Internal Revenue Code or any State's Income Tax Act or any
applicable similar laws.
9.9 SEVERABILITY. In any case where any provision of this
Plan is held to be illegal or invalid, such illegality or
invalidity shall apply only to that part of the Plan and shall
not apply to any remaining provisions of the Plan, and the Plan
shall be construed as if such illegal or invalid provision had
never existed under the Plan.
9.10 APPLICABLE LAW. This Plan shall be construed under the
Internal Revenue Code of 1986, as amended from time to time and
as construed, interpreted and modified by any regulations,
rulings, or court decisions affecting said Code. The Plan is
intended to constitute a Cafeteria Plan as provided under
Internal Revenue Code Section 125. This Plan shall be construed
under the laws of the State of CALIFORNIA.
ARTICLE X
BENEFITS PROGRAMS
10.1 INTRODUCTION. The following Benefit Programs shall be
available under this Plan. The Employer reserves the right to
amend, revoke or add any additional Benefit Programs from time to
time as it sees fit, subject to any applicable Federal laws. The
Participant shall file with the Plan Administrator before the
start of each Plan Year a Salary Reduction Agreement designating
the Benefit Programs he wishes to participate in. As part of the
Agreement, the Participant shall designate an amount necessary to
pay for each elected Benefit Program.
10.2 HEALTH INSURANCE PROGRAMS. These Programs are intended
to allow Participants to pay their portion of any Health
Insurance Policy offered under this Cafeteria Plan with
Participant Salary Reductions. The definition of "Health
Insurance Policy" includes, but is not limited to, any policy
covering Medical, Dental, Psychological or Psychiatric Services,
Vision Care or Prescription Drugs. Any Health Insurance Program
offered under this Plan shall be available on a nondiscriminatory
basis to any Participant and his dependents. Any Benefit
provided under this Program is to be considered a Premium type
Benefit, as describedunder Section 5.2 of this Plan, and shall
be paid from a Premium Account. The specific provisions of the
Health Insurance Programs as set forth in a contract(s) or
policy(s) issued by an Insurance Company and /or a(ny) Health
Maintenance Organization(s) are hereby incorporated herein by
reference.
12
10.3 DEPENDENT CARE ASSISTANCE PROGRAM. This Program is
intended to provide Participants and members of his family unit
reimbursement of certain dependent care assistance expenses
incurred during the course of the Plan Year. Claims may be made
up to 90 days following the end of the plan year for expenses
incurred during the plan year. Any monies paid to Participants
shall be paid from a Reimbursement Account, as described in
Section 5.3.
Each Participant shall elect, before the start of a Plan Year, or
before his Entry Date, if after the start of a Plan Year, a
specific amount to be placed in a Reimbursement Account for the
purpose of reimbursement of Dependent Care Assistance Expenses.
A Participant shall not be eligible for further Dependent Care
Assistance reimbursements once he has received reimbursements
equal to the amount he elected to defer for the Plan Year, or, if
he ceased to be a Participant during the Plan Year, the amount
actually deferred during the Plan Year, to the Dependent Care
Assistance Program.
This Program shall provide reimbursement for certain eligible
expenses incurred in the care of a dependent. Only those
expenses which are considered Dependent Care Assistance expenses
within the meaning of Internal Revenue Code Sections 129 and
21(b)(2) shall be eligible for reimbursement under this Program.
Funds for this Program shall be held in the Fund Account as
described in Article VIII, and payment shall be made from the
Account Fund, at the direction of the Plan Administrator.
No Participant shall be allowed to defer more than $5000, if
married filing jointly, or $2500 if married filing separately, in
income for any Calendar Year. If the participant has a working
spouse, the maximum amount that can be deferred under this
program shall be the lesser of $5000 or the earned income of the
participant's spouse.
The Plan Administrator shall only make reimbursement payments
under this Program when presented with satisfactory evidence that
the Participant actually incurred a reimbursable expense covered
under this Plan. A Participant who terminates employment or
otherwise ceases to be a Participant under this Plan prior to the
end of the Plan Year shall only be eligible for reimbursement of
expenses incurred during the term of his employment during his
last Plan Year. The Participant has three months in which to
file claims for reimbursement after termination of participation.
Any funds remaining in his Reimbursement Account after the three
month period shall revert to the Employer to be donated as stated
in Section 8.2 of this Plan.
10.4 MEDICAL REIMBURSEMENT PROGRAM. This program is intended
to provide Participants and members of their family unit
reimbursement of certain health expenses incurred during the
13
course of the Plan Year. Claims may be made up to 90 days
following the end of the plan year for expenses incurred during
the plan year. This program is separate from any Health
Insurance Program mentioned in Section 10.2. Any monies paid to
Participants shall be paid from a Reimbursement Account, as
described in Section 5.3.
Each Participant shall elect, before the start of a Plan Year, an
amount to be placed in a Reimbursement Account for reimbursement
of health expenses. A Participant will not be eligible for
further health reimbursements once he has received reimbursements
equal to the amount he elected to defer if he ceased to be a
Participant during the Plan Year, in the Medical Reimbursement
Program. Health expenses incurred by Covered Dependents of
Participants shall be considered expenses reimbursable under the
Plan. Funds for this Program shall be held in the fund account
as described in Article VIII, and payments shall be made from the
account, at the direction of the Plan Administrator.
The Plan Administrator shall only make reimbursement payments
under this Program when presented with satisfactory evidence that
the Participant or his Covered Dependents actually incurred a
reimbursable expense covered under this plan. Qualified
reimbursable expenses include, but are not limited to, deductible
amounts, co- payments, amounts not paid by a Health Insurance
Program because of an exclusion, etc. In no event shall a
reimbursable expense include any item which is not intended to be
a Medical Care expense within the meaning of I.R.C. Section 213
(d) for a Participant or a Covered Dependent. only health
expenses incurred during the Plan Year are eligible for
reimbursement.
A Participant who terminates employment or otherwise ceases to be
a Participant under this Plan prior to the end of the Plan Year
shall be eligible for reimbursement of expenses incurred during
the last Plan Year he was a Participant, without regard to the
date he ceased to be a Participant.
Although a Participant may elect to make his annual deferral on a
periodic basis, other than annually, the Plan shall be obligated
to pay out any amount up to the annual amount the Participant
agreed to defer under this Program at any time. Thus, should the
Participant incur an expense under this Program that is greater
than the amount in the Participant's account at the time the
expense is incurred, the Plan shall be obligated to pay the
actual amount incurred within a reasonable time, up to the amount
the Participant agreed to defer for the annum.
The Employer reserves the
Program for any Plan Year
for the next Plan Year to
Program for the next Plan
Section 8.2.
right to apply any excess in this
into the Medical Reimbursement Program
reduce Participant premiums under this
year notwithstanding the provisions of
14
Participants shall be limited to a maximum deferral of $2.500.00
per year to this Program.
ARTICLE XI
LIMITATIONS ON KEY EMPLOYEES
11.1 KEY EMPLOYEE DEFINED. A "Key Employee" is any
Employee who, at any time during the Plan Year, or any of the
four preceding Plan Years, is:
(a) an officer of the Employer who received compensation
from the employer greater than $45,000 for the Plan Year;
(b) one of the ten Employees having compensation from the
Employer greater than $30,000 and owning the largest
interests of the Employer;
(c) a shareholder owning (directly or indirectly) more than
five percent of the voting power or all classes of stock of
the Employer; or
(d) a shareholder owning (directly or indirectly) more than
one percent of the voting power or all classes of the stock
of the Employer and having an annual compensation from the
employer of more than $150,000.
11.2 LIMITATION OF BENEFITS FOR KEY EMPLOYEES.
Notwithstanding anything herein to the contrary, not more than
twenty five percent of the benefits provided hereunder during the
Plan Year to or on behalf of all Employees shall be provided to
Key Employees. Any payment to a Key Employee in excess of such
limitation shall not be treated as a payment pursuant to the
Plan.
11.3 HIGHLY COMPENSATED EMPLOYEES DEFINED.
As of 1995, a Highly Compensated Employee is one who is a 5%
(percent) or more owner, has an annual salary is excess of
$100,000, or an annual salary in excess of $66,000 AND in the top
20% (percent) of employees salary, or an annual salary in excess
of $60,000 AND an officer, or family members (spouse of lineal
descendant under the age of 19).
11.4 LIMITATION OF BENEFITS FOR HIGHLY COMPENSATED
EMPLOYEES.
Notwithstanding anything herein to the contrary, not more than
twenty five percent of the benefits provided hereunder during the
Plan Year to or on behalf of all Employees shall be provided to
Highly Compensated. Any payment to a Highly Compensated Employee
in excess of such limitation shall not be treated as a payment
pursuant to the plan.
15
BENEFITS AVAILABLE UNDER THE PLAN
As part of this Adoption Agreement, the Employer hereby elects
that the following Benefit Programs be available for the benefit
of the Employees of the Employer, herewith:
MEDICAL, AND DENTAL INSURANCE
DEPENDENT CARE REIMBURSEMENT PLAN
UNREIMBURSED MEDICAL EXPENSES
IN WITNESS THEREOF, The Parties affix their signatures this
day of
TOWN OF LOS GATOS
19
by,
Signature and Title
APPROVED AS TO FORM:
LARRY ANDERSON, TOWN ATTORNEY
ATTEST:
MARIAN V. COSGROVE, TOWN CLERK
- -- SUMMARY PLAN DESCRIPTION - --
TOWN OF LOS GATOS
CAFETERIA PLAN
PREPARED BY: HICKS & COMPANY
55 Independence Circle,
Suite 206
Chico, CA 95973
(916) 891 -4975
� s
TOWN OF LOS GATOS CAFETERIA PLAN
SUMMARY PLAN DESCRIPTION
I. INTRODUCTION TO YOUR PLAN
TOWN OF LOS GATOS has instituted a Cafeteria Plan as part of your
employee benefits' program. Your Cafeteria Plan will allow you to
pay your share of Medical and Dental Insurance Premiums, your
Dependent Care Expenses (ie. Childcare) and /or Unreimbursed Medical
Expenses on a pre -tax basis.
All premiums under this plan are paid for out of your salary
reductions. This is an agreement between you and your Employer
allowing the Employer to take money out of your paycheck each pay
period. This money is taken from your check before you pay taxes
on it. Thus, the government is giving you a tax incentive to
participate in this Cafeteria Plan. Your benefit costs are
substantially reduced by paying for your benefits this way. The
following example illustrates this principle:
EXAMPLE: Employer Z has a health insurance program,
under which all employees receiving Dependent Health
Insurance benefits must pay their own premiums. Employee
A's monthly take -home pay, before paying his Dependent
Health Insurance premium is $1661.87. The premium for
his Dependent Health Insurance is $150 per month. After
paying this, he is left with $1511.87.
Next January 1, Employer Z will install a Cafeteria Plan.
Let's assume Employee A makes the same salary and taxes
don't increase, but now Employee A can pay his premium
with before -tax dollars.
Employee A will get a $33.77 monthly raise! His take
home pay after paying for his Dependent Health Insurance
premium will be $1,545.64. The pay raise represents the
taxes he would have paid on the $150 per month Dependent
Health Insurance premiums.
2
If you elect to participate in the Reimbursement Program,
(Dependent Care Expenses and /or Unreimbursed Medical Expenses) on
the Salary Reduction Agreement, the money that is withheld from
your paycheck is then reimbursed to you when you submit
verification of expenses. Any money you contribute to pay for your
benefits is not subject to taxation. Thus, your benefit costs are
quite low, and in most cases, will result in a net increase in
spendable income to you. This can be illustrated by the following
example:
EXAMPLE: Employee B elects to participate in the
Cafeteria Plan and elects Dependent Care expenses. She
elects to have her salary reduced by $100 per month.
Then each month she is reimbursed $100 when she submits
her Dependent Care bill.
Before the Cafeteria Plan was installed, Employee B was
paying that same $100 per month, but on an after tax
basis. This meant Employee B had to earn about $125 to
pay her dependent care expenses of $100. Thus, by
participating in the Cafeteria Plan, Employee B will have
an extra $25 each month to spend.
II. PARTICIPATION IN YOUR PLAN
All employees who meet the participation requirements are eligible
to participate in this plan. To qualify as a participant under
this Plan you must work at least 20 hours per week on a regular
non - seasonal basis.
Your Entry Date, the date you may actually join the Plan, is on the
first day of the month following the date of hire.
AGREEMENT TO PARTICIPATE /SALARY REDUCTION AGREEMENT
You will be required to file an Agreement to Participate a few
weeks before your Entry Date. The Agreement to Participate is an
agreement between you and your Employer. It says that you agree to
be a participant in this Plan and states which benefits you've
selected under your Plan. It will also specify the amount you've
agreed to contribute towards the cost of these benefits. Any money
you contribute to this Plan will not be subject to state, federal
or social security income taxation.
3
Each year after your first Plan Year, you will be required to file
a new Salary Reduction Agreement. It must be filed with the Plan
Administrator before the start of the new Plan Year. It will state
the amount you wish to have your salary reduced by for the new Plan
Year.
If you do not file a new Agreement to Participate and a new Salary
Reduction Agreement with the Plan Administrator before the start of
the new Plan Year, it will be assumed that you elected not to
participate in the Plan for the new Plan Year.
CHANGE IN CONTRIBUTIONS /CHANGE IN FAMILY STATUS
The laws governing Cafeteria Plans DO NOT allow you to change your
contribution during the Plan Year. There are, however, a few
exceptions to this rule. You may change your contribution if there
is a change in your family status.
Change in Family Status includes:
Change in Premium Costs (automatic)
Marriage or Divorce
Birth, Death or Adoption of a Dependent
Child is no longer a Dependent
Change in a Spouse's Employment
Change of Employee's job status
This list is only a partial list of what might be considered a
change in family status. It is up to the Plan Administrator to
determine what is and isn't a change in family status, and his
judgment must be made in reliance with the laws governing Cafeteria
Plans.
Note that the new reductions can start only after your change in
family status has taken place and the New Salary Reduction
Agreement has been filed. To illustrate this principle, let's
assume you are engaged to be married. You want to cover your
spouse -to -be under the Medical Insurance program. You will not be
able to have additional salary reductions made and receive coverage
for your spouse -to -be until after your wedding takes place.
Also, you will not be required to make further contributions to the
Plan once you have died, retired, terminated employment or have a
change in job status so that you are no longer eligible to
participate under this Plan.
ONCE YOU'VE ELECTED TO DEFER MONEY TO ONE OF THE PROGRAMS BELOW,
YOU CANNOT CHANGE THAT ELECTION, SUBJECT TO THE EXCEPTION REGARDING
A CHANGE IN- FAMILY STATUS. ANY MONEY LEFT OVER AT THE END OF THE
PLAN YEAR IN THESE PROGRAMS BECOMES THE PROPERTY OF THE EMPLOYER.
SHOULD YOU FAIL TO SPEND ALL THE MONEY YOU DEFER TO A REIMBURSEMENT
PROGRAM BEFORE THE END OF A PLAN YEAR, YOU CANNOT CARRY THAT MONEY
4
OVER TO THE NEXT PLAN YEAR. IT IS, THEREFORE, VERY IMPORTANT THAT
YOU DETERMINE AS ACCURATELY AS POSSIBLE HOW MUCH YOU WISH TO DEFER
TO A REIMBURSEMENT PROGRAM. THE BENEFITS COORDINATOR WILL BE GLAD
TO ASSIST YOU IN MAKING AN ACCURATE ASSESSMENT OF YOUR NEEDS UNDER
THESE PROGRAMS.
III. BENEFITS UNDER YOUR CAFETERIA PLAN
HEALTH AND DENTAL CARE BENEFITS
Your Cafeteria Plan allows you to pay for your share of Health, and
Dental Care Insurance premiums on a pre -tax basis.
For specific coverage, consult the Summary Plan Description of the
basic health insurance policy, available from the Benefits
Coordinator.
PAYMENT OF PREMIUMS
Your net take home pay will INCREASE as a participant, because you
will no longer be paying your Insurance premiums on an after tax
basis.
REIMBURSEMENT PROGRAMS
CARE ASSISTANCE PROGRAM
Qualified expenses under the Dependent Care Assistance Program
include any expenses that you could take as a credit against tax on
your income tax form for the care of a dependent. A dependent
eligible for these expenses includes a child or any other relative
for whom you take a tax deduction on your tax form. A person is a
dependent of yours if you provide them with at least 50% of their
living expenses over the course of the year. Of course, the person
must be related to you by blood or marriage or adoption.
Dependents eligible under this program include children under the
age of 13, and physically or mentally incapacitated individuals who
are in need of supervised care. The government recognizes your need
to work to help support the household.
Before deciding to participate in the Dependent Care Assistance
Program, you should know that there is a provision in the Federal
Income Tax Code that allows you to take a credit against taxes for
Dependent Care Assistance Expenses. Internal Revenue Code Section
21 allows taxpayers to take a credit against tax of up to $2400 per
qualified dependent (up to a maximum of $4800 per year) for
dependent care assistance expenses. This allowable tax credit is
more advantageous for many lower -paid Participants in this Plan.
5
The Plan Administrator or a Tax Advisor will be glad to discuss
whether participating in this Program or taking the tax credit
under Internal Revenue Code Section 21 would be better for you.
Also, the tax laws further limit how much you can contribute to
this Program. Under the terms of the Plan, you can defer no more
than the lesser of your actual (or, if you are married and if less,
your spouse's) income for the year or $5000 per year to this
Program.
Generally, you can't receive reimbursements under this Program if
you are married and your spouse doesn't work (however, if your
spouse is a full -time student or unable to work, then your spouse
is deemed to have a monthly income of $200, if you have one
dependent, $400 if you have two or more dependents).
You can apply for reimbursement for household service expenses,
including payments to baby - sitters, maids, nurses and cooks who
work in your house, at least to the extent their services are for
the care of a qualified individual. Household service expenses
would not include payments to a gardener or chauffeur.
Out -of -home expenses would include payments for well -being and
protection of qualified individuals. This would include nursery
school, day -care centers, and certain summer camp expenses. This
does not include expenses for educational expenses for children in
first grade or beyond, or food, clothing and transportation
expenses.
Out -of -home care expenses for your spouse or dependents over the
age of 12 who are unable to care for themselves qualify under this
Program only if those individuals regularly spend at least eight
hours each day in your home. Therefore, nursing home expenses do
not qualify under this Program. However, in -house expenses for
these individuals would.
You cannot receive reimbursement to be paid to a child of yours
under the age of 19 as a provider of Dependent Care services, even
if that child is providing you with otherwise - qualified dependent
care assistance.
The law requires that you give the name, address and taxpayer
identification number for any person or organization that you use
for dependent care assistance on your tax return. If you fail to
get this information from any party who provided dependent care
assistance to you, you will have to include any amounts you paid
through reimbursement under the Dependent Care Assistance Program
to that party in your gross income for the year. Thus, it is very
important that you get this information as soon as possible from
those parties providing dependent care assistance to you or your
family. It is your responsibility to get this information. The Plan
Administrator will not be liable for any additional taxable income
3
to you that might have been avoided if the proper information had
been furnished.
MEDICAL EXPENSES
You can defer money under the Medical Reimbursement Program. This
money will be returned to you, tax free, to pay for any qualified
medical expenses that are not covered by medical insurance. You
have a maximum deferral of $2,500.00 per year.
Qualified expenses under the Medical Reimbursement Program would
include any viable medical expenses that are not covered under your
medical insurance program. Thus, co- payments, deductibles,
excluded coverage, expenses for prescriptions or medical supplies
that are not paid for by insurance are considered expenses that can
be reimbursed under your Medical Reimbursement Program.
Examples of expenses eligible for reimbursement under this Program
would include: membership fees in associations furnishing medical
services, hospitalization and clinical care; fees for health
institute memberships prescribed by a doctor as medically
necessary; transportation expenses (such as an ambulance) incurred
to get medical services; home improvement costs that are
recommended by a doctor and necessary for treatment or
rehabilitation, to the extent such improvement does not increase
the value of your home.
The following examples would not qualify as expenses eligible for
reimbursement, even though recommended by a doctor: expenses for
cosmetic items, maternity items or wigs (unless ordered by a doctor
as essential to health); vacation or travel expenses, even if for
rehabilitation or prescribed by a doctor; meals and lodgings
(unless included as part of a hospital bill or while traveling
between distant hospitals) at a location away from home, even if
prescribed by a doctor or received as an outpatient.
The Plan is required to pay you any benefits you incur, up to the
maximum you elected, at any time. For example, assume Sue elected
to have $1200 in medical reimbursement money put in her
reimbursement account, taken out of her pay at the rate of $100 per
month. The plan is on a calendar year. In February, Sue breaks
her leg, and has $600 of medical expenses that are not covered
under basic health insurance, but are eligible for reimbursement
under this program. The plan must pay her the $600 even though she
had deferred only $200 at that point in time. Should Sue quit her
job that month, the Plan cannot require that she pay the additional
$400. That risk is taken by the Plan.
ENDING PARTICIPATION BEFORE THE END OF A PLAN YEAR
Should you end participation in this Plan by either separating from
service or failing to make required contributions under this Plan,
you will not be allowed to rejoin the Plan until the following Plan
Year. For example, Joe works for the employer. The Plan Year is
the calendar year. Joe participates in the employer's Cafeteria
Plan, until May 1, when he starts a new job with another company.
On August 1, Joe is rehired by his old employer. Joe will not be
able to participate in the Cafeteria Plan until January 1 of the
next year, which is the first day of the new Cafeteria Plan Year.
IV. GENERAL INFORMATION
You may need the following information if you have any questions
about your Plan.
1. GENERAL PLAN INFORMATION
The name of this Plan is TOWN OF LOS GATOS CAFETERIA PLAN.
Your Employer has assigned Plan Number 501 to this Plan.
The provisions of your Plan became effective on July 1, 1992 as
amended on July 1, 1995.
This Plan's records are maintained on a 12 -month period known as
the Plan Year. The Plan Year for your Plan is July through June.
The assets of your Plan are held by the Employer.
Your Plan shall be governed by the Laws of the State of California.
2. EMPLOYER INFORMATION
Your Employer name, address and tax identification number are:
TOWN OF LOS GATOS
110 E. MAIN STREET
LOS GATOS, CA 95032
ID NUMBER 94- 6001435
3. PLAN ADMINISTRATOR INFORMATION
The name, address and telephone number of your Plan Administrator
are:
TOWN OF LOS GATOS
110 E. MAIN STREET
LOS GATOS, CA 95032
(408) 354 -6829
Your Plan Administrator is responsible for the administration of
Li
your Plan. Should you need to see any records or have any questions
regarding the Plan, contact the Plan Administrator.
4. BENEFITS COORDINATOR
Carla Turner has been named as the Plan's Benefits Coordinator. If
you need additional information about the plan or the benefits
offered, the Benefits Coordinator will be able to assist you.
5. LEGAL REPRESENTATIVE
The following entity has been named your Plan's agent for service
of legal process:
TOWN OF LOS GATOS
110 E. MAIN STREET
LOS GATOS, CA 95032
(408) 354 -6829
Service of process can also be made to the Employer or Plan
Administrator.
V. ADMINISTRATION OF YOUR PLAN
Hicks & Company, acting for the Plan Administrator, is responsible
for the administration of your Cafeteria Plan. Duties include
determining who is eligible to participate, interpreting laws and
regulations and how they apply to your Plan and whether or not
certain expenses should be allowed under the Plan.
After you've become a participant in the Plan, you'll file all of
your claims with the Plan Administrator. Hicks & Company will
determine, in accordance with the various laws that apply to
Cafeteria Plans, whether the expense is an allowable one. If it is,
you'll be reimbursed for that expense by the Plan Administrator.
The Plan Administrator can demand any documents or evidence deemed
necessary to properly administer your Plan. If it appears that
you've submitted insufficient data to make a determination, or if
Hicks & Company feels that the claim you've made is not allowed
under the Plan, the claim can by denied. After the claim has been
denied, you will be allowed an opportunity to appeal. You will be
given 30 days to appeal the decision. If your claim was denied due
to a lack of sufficient documentation, the Plan Administrator will
give you a Chance to get the necessary information.
If your claim was denied because the Plan Administrator felt your
claim was for an expense not covered under the Plan, you will be
given the chance to show why it should have been allowed under the
Plan. If the Plan Administrator rejects your reasons, you will not
be able to appeal again.
In addition to interpreting the plan and processing claims and
paying benefits, the Plan Administrator also keeps all the records
of the Plan. Should you need a copy of anything you've filed with
the Plan Administrator, contact them directly.
This Summary Plan Description is a brief description of the Plan
and your rights, benefits and obligations under the Plan. This
Summary Plan Description is not meant to interpret, extend or
change any provisions contained in the main Plan Document. The
provisions of TOWN OF LOS GATOS CAFETERIA PLAN can only be
accurately understood by reading the Plan Document. This Document
is on file with the Employer and may be read by you or your
dependents or your legal representative by contacting the Benefits
Coordinator. Hicks & Company will make the Document available to
you at any reasonable time. You may request a copy of the Plan
from the Plan Administrator. Hicks may charge you a fee for
copying the Plan for you.
VI. ACCOUNT PROVISIONS
All of your salary reduction money is in an account to pay for your
benefits. However, once placed in the account, that money becomes
the property of your Employer. This does NOT mean your Employer can
spend the money any way at all. The account assets must be used to
pay for your benefits.
The law does require that, if the account earns interest, that
money must remain the property of your Employer. Otherwise, this
Plan would become disqualified, and you would lose the special tax
advantages that your Cafeteria Plan offers you.
The account is managed by the Employer. it is the Employer's duty
to manage the assets for your benefit. Since the primary purpose of
this plan is to provide you benefits, and not to earn money for the
participants, the Employer's main purpose is to preserve assets.
RIE