2003-08 RESOLUTION NO. 2003- 08
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF GRAND
TERRACE, CALIFORNIA, IMPLEMENTING THE PREMIUM
CONVERSION PLAN FOR THE EMPLOYEES OF THE CITY OF
GRAND TERRACE, COMMENCING MAY 1,2003 AND RENEWING
ANNUALLY ON NOVEMBER 1
WHEREAS, on this date, the City Council of the City of Grand Terrace did meet to
discuss the implementation of The City of Grand Terrace Premium Conversion Plan to be
effective May 1, 2003;
NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF GRAND TERRACE_
does hereby resolve, declare determine, and order as follows:
SECTION 1. The form of Cafeteria Plan, as authorized under Section 125 of the
Internal Revenue Code of 1986, presented to this meeting is hereby adopted and approved
and that the proper officers of the Employer are hereby authorized and directed to execute
and deliver to the Plan Administrator one or more copies of the Plan;
- SECTION 2. The initial Plan Year shall be forthe period beginning May 1,2003 and
ending October 31, 2003. All subsequent Plan Years shall be for a 12 month period
beginning November 1.
SECTION 3. The Employer shall contribute to the Plan amounts sufficient to meet
- its obligation under the Cafeteria Plan, in accordance with the terms of the Plan Document
and shall notify the Plan Administrator to which periods said contributions shall be applied;
SECTION 4. The proper officers of the Employer shall act as soon as possible to
notify employees of the adoption of the Cafeteria Plan by delivering to each Employee a
copy of the Summary Plan Description presented to this meeting, which form is hereby
approved;
SECTION 5. Attached hereto as Exhibits A and B respectively are true copies of
The City of Grand Terrace Premium Conversion Plan Document, and Summary Plan
Description approved and adopted in this Resolution. .
PASSED, APPROVED AND ADOPTED this 24th day of April, 2003.
ayor of the City of Grand Terrace
ATTEST:
' City Clerk of the City ofZrand
Terrace
I, BRENDA STANFILL, City Clerk of the City of Grand Terrace, do hereby certify
that Resolution No. 2003- 08 was introduced and adopted at a regular meeting of the City
Council of the City of Grand Terrace held on the 24th day of April, 2003, by the following
vote:
AYES: Councilmember Hilkey, Mayor Pro Tem Ferre and Mayor Garcia
NOES: Done
ABSENT: Councilmembers Larkin and Cortes
ABSTAIN: None
Brenda Stanfill, City Cljdfk
Approved as to form:
City Attorney
� IBIT A
It
PREMIUM CONVERSION PLAN
FOR
City-of Grand Terrace
Prepared by:
`- Benefits Resource
May 1,2003
Advice of Legal Counsel should be obtained before amending or altering this plan document format.
r
TABLE OF CONTENTS
ARTICLE 1 -AMEND AND RESTATE
1.1 Creation and Title
1.2 Effective Date
1.3 Purpose
ARTICLE II-DEFINITIONS
ARTICLE III-PARTICIPATION
3.1 . Eligibility
3.2 Commencement to Participation
3.3 Term of Participation
3.4 Participation by Rehired Employees
3.5 COBRA Continuation Coverage
3.6 Family Medical Leave Act
ARTICLE IV-CONTRIBUTIONS
4.1 Source of Contributions
4.2 Change in Participant's Benefits Enrollment
4.3 Increases or Decreases in Premium
4.4 Maximum Contribution
4.5 Nondiscrimination
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ARTICLE V-PARTICIPANTS'ACCOUNTS AND PAYMENT OF BENEFITS
5.1 Participants'Benefit Accounts
5.2 Premium Account
. 5.3 Payment of Benefits
ARTICLE VI-PLAN ADMINISTRATION
6.1 Plan Administrator
6.2 Plan Administrator's Duties
6.3 Information to be Provided to Plan Administrator
6.4 Decision of Plan Administrator Final
6.5 Review Procedures
6.6 Extensions of Time
6.7 Rules to Apply Uniformly
6.8 Indemnity
ARTICLE VII-GENERAL PROVISIONS
7.1 Amendment and Termination
7.2 Nonassignability
7.3 Not an Employment Contract
7.4 Participant Litigation
7.5 Addresses,Notice and Waiver of Notice
7.6 Required Information
7.7 Severability
7.8 Applicable Law
tom,.
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City of Grand Terrace
.ti PREMIUM CONVERSION PLAN
ARTICLE 1
AMEND AND RESTATE
1.1 Amend and Restate. The Employer hereby Amends and Restates a cafeteria plan under the berths
and conditions set forth in this document The Plan is to be known as City of Grand Terrace
Premium Conversion Plan.
1.2 Effective Date. The provisions of the Plan shall be effective as of May 1,2003
1.3 Purpose. The purpose of the Plan is to allow employees to select among cash compensation and
certain nontaxable benefits,namely coverage under one or more benefits programs maintained by the
Employer. The Employer intends that the Plan qualify as a cafeteria plan under Section 125 of the
Code, and that the benefits provided under the Plan be eligible for exclusion from Federal and State
income tax.
ARTICLE II
DEFINITIONS
As used in this Plan document,the following terms shall have the following meanings:.
2.1 "Affiliated Employer"means any employer which adopts the Plan with the approval of City of
Grand Terrace.
2.2 "Benefits"mean cash and the various qualified benefits under Section 125(f)of the Code sponsored
by the Employer and made available by the Employer through the Plan,including,but not limited-to,
health insurance,group term life insurance,disability insurance,AD&D and vision.
2.3 "Benefit Accounts"mean the accounts established by the Plan Administrator under the Plan for
each Participant's Benefits for purposes of administering the Plan.
2.4 "Benefits Enrollment Form"means the form or forms,including a Salary Reduction Agreement,
evidencing an Eligible Employee's selections from among the various Benefits and the amount to be .
contributed towards various Benefits for a Plan Year or portion of a Plan Year.
2.5 "Code"means the Internal Revenue Code of 1986,as amended from time to time.
2.6 "ComBensation"means all of the earned income,salary,wages and other earnings paid by the
Employer to a Participant during a Plan Year,including the amounts contributed by the Employer
pursuant to a salary reduction agreement which are not includable in gross income under Sections
125,402(a)(8),403(b) or 457(b)of the Code.
2.7 "Dependent"means an individual who is a dependent within the meaning of Section 152(a)of the
Code of a Participant or a former Participant in the Plan.
2.8 "Effective Date" shall be May 1,2003.
2.9 "Eligible Employee"means an Employee who has met the Eligibility requirements of the Plait set
r out in Section 3.1.
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2.10 "Employee"means an individual employed by the Employer who regularly works at least 30 hours
per week,except for: (1)employees covered by a collective bargaining agreement,(2)employees who
are nonresident aliens who receive no earned income from the Employer which constitutes income
from other sources.within the United States,and(3)employees who are self-employed individuals in
Section 401 (c) of the Internal Revenue code.
2.11.. "Employer"means City of Grand Terrace or any of its affiliates,successors or assigns which adopt
the Plan.
2.12 "Entry Date"means for each Eligible Employee,the first of the month following 90 days of
consecutive full time employment.
2.13 "Participant" means any Employee who has met the eligibility requirements of Section 3.1 of the
Plan and has elected to participate in the Plan by providing the Plan Administrator with an executed
Benefits Enrollment Form.
2.14. "Plan"means City of Grand Terrace Premium Conversion Plan,as described herein.
2.15 "Plan Administrator"means the Employer or such other person or committee as may be appointed
by the Employer to administer the Plan.
2.16 "Plan Year"means the 12-consecutive month period beginning November 1 and ending on
October,31,except the first year which begins May 1 and ends October 31.
2.17 "Salary Reduction Agreement"means the agreement by an Employee authorizing the Employer to.
reduce the Employee's Compensation while a Participant during the Plan Year for purposes of
making contributions toward Benefits under the Plan.
- 2.18 "Spouse"means an individual who is legally married to a Participant but shall not include an
individual separated from a Participant under a decree of legal separation.
2.19 "Status Change"means a change as in one of the following.examples:
a. Change in Employee's legal marital status,including marriage,divorce,death of spouse,legal
separation,and annulment;however, the change can only be made for the coverage
consistent with the dependent causing the qualified change.
b. Change in the number of dependents including birth,adoption,placement for adoption and
death of a dependent;
c. . Change in employment status for.-
1- Employee
2. Spouse
3. Dependent that is claimed as such on your Federal Income Tax;
d. A Change in employment status will be considered as follows:
1. Termination or commencement of employment.
2. A strike or lockout.
3. A commencement or return from unpaid leave of absence.
4. Change in worksite that would affect the benefits offered by the employer.
5. A change in the employment status that would"affect either the Employee's benefit
eligibility,or,the eligibility of a dependent. (If there is no change in eligibility as a result
of a change,the allocated reduction cannot be modified).
6. A dependent satisfies (or ceases to satisfy) dependent eligibility requirements as a result
of a Dependent becoming ineligible for benefits due to the attainment of an ineligible
age,marriage,or loss/achieving of student status;
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7. Residence change where the change affects the eligibility of coverage for Employee
and/or eligible dependent;
8. Commencement or termination of adoption proceedings for a dependent
.9. Any change consistent with a qualifying event is eligible. The general uniform rule
applies so that changes can only be made that are consistent with the qualified status
change taking place.
10. Change in coverage in employer sponsored plans.
11. Addition or deletion of coverage option by employer.
12. Change in coverage affecting the Employee at their Dependent's place of employment
Gender and Number. Except when otherwise indicated by the context,any masculine terminology
shall also include the feminine and the definition of any term in the singular shall also include the
:plural.
ARTICLE III
PARTICIPATION
3.1 Eligibility. Each employee shall be eligible to participate on the first of the month following 90 days
of consecutive full time employment
Each Eligible Employee shall be eligible to become a Participant as of his or her
Entry Date,
3.2 Commencement of Participation. An Eligible Employee shall become a Participant in the Plan
after providing the Plan Administrator with an executed Benefits Enrollment Form setting forth the
Benefits to be made available to the Eligible Employee for the immediately following Plan Year or.
remaining portion of the Plan Year. As part of the Benefits,Enrollment Form,the Participant shall
also execute a Salary Reduction Agreement,which authorizes the Employer to withhold from the
Participant's Compensation an amount the Participant elects to have contributed to the Plan. The
Participant must,before the end of the first Plan Year of participation and,before the end of each
subsequent Plan Year,provide the Plan Administrator with a newly executed Benefits Enrollment
Form.. Each new Benefits Enrollment Form shall specify the type and amount of Benefits to be made
available to the Participant for the immediately following Plan Year or remaining portion of the Plan
Year..For the initial Plan Year only,if a Participant fails to execute a valid Benefits Enrollment Form
before the Plan's original Effective Date,the Participant shall be deemed to have elected to continue
to receive the same benefits that the Participant received under all plans sponsored by the Employer
which became available under the Plan as of the Effective Date. In addition,the Participant shall be
deemed to have executed a valid Benefits Enrollment Form for purposes of determining the source
and amount of contributions to the Plan pursuant to Article IV of the Plan. Should a Participant fail .
to execute a valid Benefit Enrollment Form for any Plan Year before the start of the Plan Year,the
Benefits Enrollment Form for the immediately preceding Plan Year shall be deemed to be effective
for the subsequent Plan Year.
3.3 Term of Participation. Each Participant shall be a Participant.in the Plan for the entire Plan Year or
the portion of the Plan Year remaining after the Participant's Entry Date,if later than the first day of
the Plan Year. A Participant shall cease to be a Participant in the Plan on the earliest of
a. the date the Participant dies, resigns or terminates employment with the Employer, subject
to the provisions of Section 3.4.
b. the date the Participant fails to make required contributions under the Plan.
C. the end of the plan year the Participant ceases to be an Employee;or
d. the date the Plan terminates.
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3.4 Participation by Rehired Employees. A Participant whose employment terminates and who is
subsequently re-employed more than 60 days from the initial termination date may not re-enter the.
f Plan as a Participant prior to the first day of the first Plan Year following the date of re-employment
3.5 COBRA Continuation Coveraee. Under COBRA,This section 3.5 shall not apply to any group health plan of
the Employer for any calendar year if all employers maintaining such plan normally employed fewer than 20
employees on a typical business day during the preceding calendar year.
Notwithstanding any other provisions in this Article III, any Participant, Spouse or Dependent eligible for
continuation of coverage under the Plan under the Consolidated Omnibus Budget Reconciliation Act of 1985
("COBRA')shall be allowed to continue to participate in the Plan,so long as such Participant,Spouse or Eligible
Dependent complies with the provisions set out in COBRA.
The Employer shall adopt rules relating to continuation coverage,as provided under Section 4980B of
the Code or applicable state law, as may be required from time to time, and shall advise affected
individuals of the terms and conditions of such continuation coverage.
3.6 Family Medical Leave Act. Under the FMLA, the provisions of this-section 3.6 shall not be
available to Employees for such Plan Years in which the Employer has 50 or fewer Employees. Plan
Years in which the Employer has more than 50 Employees, the Employer must make FULA leave
available to Employees for up to 12 weeks in connection with the birth or.adoption of a child, or to
care for a close relative,or because of a serious health condition of the Employee..
Payment Options for coverage while on unpaid Family Medical Leave Act leave for group plans:
a. Pre-pay before commencement of leave through pre-tag or after-tax Salary Reduction
Agreement from any taxable compensation,including cashing out of unused sick or vacation
days,provided all other plan requirements are met
b. Pay-as-you-go. Employees may pay their share of premium payments on the same schedule
as payments would be made if the employee were not on leave, or under another schedule
permitted under Department of Labor regulations.
The Employer shall not be required to continue the health coverage of an Employee who
fails to make required premium payments while on FMLA leave. However,if the Employer
chooses to continue the health coverage of an Employee who fails to make required
premium payment while on FMLA leave,the Employer is entitle_d to recoup those payments
after the Employee returns from FMLA leave.
C. Catch-up-option. Under this payment option the Employer shall.advance the Employee's
share of group health premiums while the Employee is on FMLA leave and thereafter shall
be entitled to recover such advanced amounts when the Employee Retums from FMLA
leave.
ARTICLE IV
CONTRIBUTIONS
4.1 Source of Contributions. The Employer shall contribute amounts deemed necessary to meet its
obligations under the Plan. Contributions to the Plan for the Plan Year shall be limited to the
amounts determined by the Benefits Enrollment Form entered into.by Participants.for the Plan
Year. Contributions to the Plan shall be made to, and all Plan assets shall be held in such accounts
or funds as the Employer deems appropriate.
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4.2 Change in Participant's Benefits Enrollment. No Participant shall.be allowed to alter or
discontinue the Participant's elected Benefits under the Plan Year unless there is a change in the
Participant.'s family status. A Change in Family Status means a change as in one of the following
examples:
a marriage,
b. divorce;
c. death of a spouse or.dependent;
d. birth or adoption of a child;
e. termination or commencement of a spouse's employment;
f. the employee's or spouse's taking of an unpaid leave of absence;
g. the employee's or spouse's change from part-time to full-time or full-time to part-tune
employment status;
h. a significant change in the health coverage of the employee or spouse attributable to the spouse's
employment;or
i. other similar events determined by the Employer in its sole discretion to be changes in family
status,but that do not affect ERISA regulations.
Upon the occurrence of any of the aforementioned events,or such other event as may
qualify as a change in,family status in the option of the Plan Administrator,the
Participant may file a new Benefits Enrollment Form,within 90 days of such change in
family status,which.will serve to revoke the Participant's previous Benefits Enrollment
Form. The new Benefits Enrollment Form shall be effective prospectively and apply only
to those Benefits accruing to the Participant,the Participant's Spouse or the Participant's
Dependents after the effective date of the new Benefits Enrollment Form. The
Participant's Benefits Enrollment Form for a given Plan Year shall terminate and Benefits
under the Plan shall cease upon the date a Participant is no longer eligible to participate
under the terms of the Plan:
4.3 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 this Plan during
the Plan Year,.any Participant participating in such benefit shall have his contributions increased or
decreased automatically in an amount sufficient to payfor 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. No new Benefits
Elections or termination of existing Benefits Elections may be elected as a result of an increase or
decrease in premium by a third party benefit provider.
4.4 Maximum Contribution. The Maximum Contribution any individual can make under this Plan is an
amount.equal to the sum of the costs for each of the highest cost premium-type Benefit Options
offered under the Plan in each Benefit Category. The term`Benefit Option"refers to any category of
Benefits offered under this Cafeteria Plan in which the Participant has the opportunity to choose one
benefit from several different Options in that category. The term "Benefit Category" refers to any
category of Benefits offered under this Plan and may include (but is not limited to)-Health Insurance,
Group Term Life Insurance or Disability Insurance.
4.5 Nondiscrimination.. The Plan is intended to not discriminate in favor of highly compensated
individuals as to eligibility to participate, contributions and benefits in accordance with applicable
provisions of the Code. The Plan Administrator may take such actions as excluding certain highly
compensated individuals from participation in the Plan or limiting the contributions made with
respect to certain highly compensated participants if, in the Plan Administrator's judgment, such
actions serve to assure that the Plan does not violate applicable nondiscrimination rules.
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ARTICLE V
PARTICIPANTS'ACCOUNTS AND PAYMENT OF BENEFITS
5.1 Participants'Benefit Accounts. The Plan Administrator shall establish separate Benefits Accounts
based on the Benefits selections made by each Participant Contributions shall be credited to the
proper Benefits Accounts of each Participant. Each Benefits Account shall be designated as a
"Premium Account".
5.2 Premium Account. A "Premium Account"is an account established with the intent of paying for
premium-type Benefits pursuant to an insurance policy issued by an insurance company to provide
medical, dental, vision, psychological or psychiatric, prescription drugs, group-term life insurance, .
disability insurance or other qualified benefits under Section 125. For purposes of City of Grand
Terrace Premium Conversion Plan,the following premiums are eligible: Medical,Dental,Vision.
5.3 Payment of Benefits. The Plan Administrator shall pay the Benefits authorized under the Plan other
an th insurance benefits administered by a third-party benefit provider. 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.
ARTICLE VI
PLAN ADMINISTRATION
6.1 Plan Administrator. The Plan Administrator shall be responsible for the administration of the Plan.
6.2 Plan Administrator's Duties. In addition to any rights, duties or powers specified throughout the
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, Spouse, Dependent or beneficiary.to benefits
under the Plan.
d. to develop appellate and review procedures for any Participant, Spouse, Dependent or
designated beneficiary denied benefits 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 necessary to
assist in the proper and efficient 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 problems as
to the administration of the Plan and to make recommendations for modifications as to
procedures and benefits,or any other change which might insure the efficient 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
adopt any other procedure involving the Plan without the express written approval of the
Employer regarding any amendment or 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
y r requirements of Section 125 of the Code.
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 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 reasonable request to insure the proper-and efficient 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 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 under this Plan for any
Participant,Spouse or Dependent or any other person eligible to receive benefits under the Plan,the
Plan Administrator shall famish in writing to said party the reasons for the denial of benefits. The
written denial shall refer to any Plan or section of the Code 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
With respect to the denial of any claim for benefits from an insurance company or other third-party
benefit provider, paid for as a premium-type Benefit under the Plan, the review procedures of the
insurance company or other thud-party benefit provider shall apply.
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,Spouse,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 in a reasonable manner
and on a nondiscriminatory basis and shall apply uniform rules to all Participants similarly situated
under the Plan.
6.8 Indemnity. The Employer does hereby agree to indemnify and hold harmless,to the extent allowed
by law and over and above any liability coverage contracts or directors and officers insurance, any
officer or director of the Employer, designated by the Employer or the Plan Administrator who has
been employed, hired or contracted to assist in the fulfillment of the administration of this Plan. In
addition, the Employer agrees to pay any costs of defense or other legal fees incurred by any of the
above parties over and above those paid by any liability or insurance contract.
ARTICLE VII
8
GENERAL PROVISIONS
7.1 Amendment and Termination. The Employer may amend or terminate this Plan at any time by
legal action of the authorized agents of the Employer, subject to the limitation that no amendment
shall change the terms and conditions of the payment of any benefit a Participant,Spouse,Dependent
or designated beneficiary was or might have been entitled to under the Plan at the.time of the
amendment or termination. The Employer may also make amendments apply retroactively to the
extent necessary so that the Plan remains incompliance with Section 125 of the Code or any other
provision of the Code applicable to the Plan.
7.2 NonassignahjUty. Any benefits to any Participants under this Plan shall be nonassignable and for
the exclusive benefit of Participants, Spouses,Dependents and designated beneficiaries. No benefit
shall be voluntarily or involuntarily assigned,sold or transferred.
7.3 Not an Employment Contract. By creating this Plan and providing benefits under the 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.
7.4 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 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 of 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.
7.5 Addresses. Notice and 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.
7.6 Required Information. Each Participant,Spouse or Dependent shall furnish to the Employer such
documents, evidence or information as the Employer considers necessary or desirable to ensure the
efficient operation and administration of the Plan and for the protection of the Employer.
. 7.7 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.
7.8 Applicable Law. The Plan shall be construed under the laws of the State of California, to the
extent not preempted by any Federal law.
Executed this day of ,20
EMPLOYER City of Grand Terrace
(Officer)
9
EXHIBIT
City of Grand Terrace
`i Premium Only Plan
SUMMARY PLAN DESCRIPTION
Your employer has established a Premium Only Plan within the meaning of Section .125 of the
Internal Revenue Code of 1986, designed to offer a choice among benefits to employees.. The
Premium Only Plan has been established with the intent that participants will not have to include
as taxable income the amount of compensation they have foregone to pay for their.contributions
to eligible benefits offered by your employer. This Summary Plan Description (SPD) describes the
benefits, terms, and conditions of the Plan as it applies to employees of your employer-on or
after their effective date(s) for participation.
This SPD is a summary of the Premium Only Plan and is not meant to interpret, extend or change
the Premium Only Plan in any way. We suggest you read the SPD carefully so that you may
understand the Premium Only Plan's operation and its benefit to you. However, the provisions of
the applicable Plans can be determined more precisely by consulting the -plan documents "
themselves, which are available from your benefits administrator. In the event of any
inconsistencies between this SPD and the actual provisions of the Plan(s), the.terns
of the applicable Plan Document will govern,
Plan Name: City of Grand Terrace Premium Only Plan
Plan Effective Date: May 1,2003
Plan Year: Shall be the 12 consecutive month period beginning November. 1 and
ending October 31, except the first year which begins May 1 and ends
October 31.
Plan Administrator/Sponsor:
Larry Ronnow
City of Grand Terrace
22795.Barton Rd.
Grand Terrace,California 92313
909-824-6621
Employer's Identification Number(EN): 95-3316135
Plan Identification Number: 501
Agent for Service of Legal Process:
City of Grand Terrace
22795 Barton Rd.
Grand Terrace;California 92313
909-824-6621
Summary of Benefits: Medical, Dental,Vision.
Who can participate in the Premium Only Plan?
An employee of the employer regularly performing services at least 30 hours per week shall
become eligible to participate following 90 days of consecutive employment.
What happens when I elect to contribute to the Pre-Tax .Premium portion of the
Premium Only Plan?
As a participant in the Premium Only Plan, you can make your insurance premium contributions
on a pre-tax basis, instead of after-tax. To do this, your regular insurance contribution is
deducted from your gross income for reach payroll period, and your employer pays your
insurance premiums. Your new gross income is your income less the pre-tax contributions to the
insurance plans.
Are there any other ways that my election can be modified in the middle of a plan
year?
The Premium Only" Plan is required to meet certain nondiscrimination provisions as outlined by
the Internal Revenue Code. Your employer reserves the right to modify the amount of any
benefit elections of the shareholders, officers, owners, and other highly compensated employees
by the amount necessary to allow the Plan to satisfy these nondiscrimination requirements.
What happens if I terminate'employment?
If you terminate employment,
y p yment, you will no longer be eligible to participate in the Premium Only
Plan. Typically, your pretax contributions will continue through your last regular payroll period.
Please contact your benefits administrator for more information regarding pre-tax contributions if
your employment terminates.
Termination of participation in the Premium Only Plan will not affect any rights you may have to
continue participation in. certain health plans. Your benefits administrator will give you
information on how to continue coverage under the health plans, if this is appropriate.
Can I change my decision to participate?
The decision to participate will be binding for the full Plan Year. You may change this election
only under the following circumstances:
a. You may change your participation election prior to the beginning of each new Plan Year.
The election you make will be binding for the new Plan Year.
b. You may change your election to participate during the Plan Year if you experience a`change
in family status". The election change should be consistent with and as a result of the
change in family status. Changes in family status include:
1. Change in Employee's.legal marital status, including marriage,
divorce, death of spouse, legal separation, and annulment;
however, the change can only be made for the coverage consistent
with the dependent causing the qualified change.
2. Change in the number of dependents including birth, adoption,
placement for adoption and death of a dependent,
3. Change in employment status for:
Employee
Spouse
Dependent that is claimed as such on your Federal Income
Tax;
A Change in employment status will be considered as follows: ,
a. Termination or commencement of employment.
b. A strike or lockout.
C. A commencement or return from unpaid leave of,absence. .
d. Change in worksite that would affect the benefits offered by the
employer.
e. A change in the employment status that would affect either the
Employee's benefit eligibility, or,the eligibility of a dependent.
(If there is no change in eligibility as a result of a change,the
allocated reduction cannot be modified).
4. A dependent satisfies(or ceases to satisfy).dependent eligibility
requirements as a,result of a Dependent becoming ineligible for.
benefits due to the attainment of an ineligible age, marriage, or
loss/achieving of student status;
S. Residence change where the change affects the eligibility of
coverage for Employee and/or eligible dependent;
6. Commencement or termination of adoption proceedings for a
,.' dependent.
.7. Any change consistent with a qualifying event are eligible. The
general uniform rule applies.so that,changes can only be made that
are consistent with the qualified status change taking place.
8. Change in coverage in employer sponsored plans.
9. Addition or deletion of coverage option by employer.
10. Change in coverage affecting the Employee at their Dependent's
place of employment.
If you experience a change in family status and would like to change your election, please
contact your benefits administrator as soon as possible.
Are there other ways that my partidpation in the Premium Only Plan can be
terminated?
If you no longer meet the eligibility provisions of.the Premium Only Plan or your employer
terminates the plan, your participation will be terminated.
Are the benefit contributions to the Premium Only Plan reported as income on my
Form W-2?
The amounts that are contributed to the Premium Only Plan are not considered taxable
wages by the IRS in most States. As a result"wages, tips and other compensation"reported
for federal income,'state income (except New Jersey and Pennsylvania), and FICA on your .
W-2 will be your gross income less any benefit contributions to the Premium Only Plan.
How do Premium Only Plan contributions affect my Social Security benefit?
Participation in the Premium Only Plan reduces your gross taxable income and may affect
your Social Security benefit by reducing the total taxable income used to calculate your Social
Security.benefit. In most instances,the current tax savings under the Premium Only Plan will
outweigh'the slight impact on future Social Security benefits.
Can my employer terminate or amend the Premium Only Plan?
The Premium Only Plan can be amended or terminated, in whole or in part at any time, by
your employer or its Board of Directors.(if applicable) in the same manner as.the plan was
adopted. Consent of any participant, employee or any other person referenced in the Plan is
not required to terminate the Plan.
How can.I appeal a claim decision made under the Premium Only Plan?
If you, as'a Participant in the Premium Only Plan, or your beneficiary believe you are entitled
to a benefit under the Premium Only Plan that is different from the amount that has been
paid, you may file an appeal with the Plan Administrator. This appeal must be made in
writing to the Plan Administrator and must contain the following information:
• The reason(s)for making the appeal;
The facts supporting the appeal;
• The amount claimed; and
• The name and address of the person filing the appeal (claimant).
-� The Plan Administrator will generally make a decision within 90 days after receiving the
appeal and must mail a copy of the decision to the claimant promptly. The decision must give
specific reasons and references to the Premium Only Plan provisions, which support the Plan
Administrator's decision.
If an appeal is denied, in whole or in part, the claimant may seek a review of the Plan
Administrator's decision. The request for review must be. submitted in writing to the Plan
Administrator within 60 days of the date the written denial was received. The Claimant will
be given an opportunity to review any Premium Only Plan documents involved and may
submit written comments. The review will be conducted by either the employer's Board of
.Directors or an officer of your employer. Unless special circumstances arise, a written
decision will be given to the claimant within 60 days of the date the request for a review was
received.
Are there special rules that apply if this plan is being offered as part of a
collectively bargained (union) agreement?
If this Plan is maintained in accordance with a collectively bargained agreement, you or your
beneficiaries have the right to examine or obtain a copy of the agreement upon written
request to the Plan Administrator.
Pre-Tax Premiums
What happens to my Pre-Tax Premium election if I drop my insurance during the
middle of the Plan Year?
The decision to elect to pay your insurance premiums pre-tax through the Premium Only Plan
is binding for the full Plan Year, unless you are eligible for a change allowed by the IRS. If
_ you drop your insurance coverage in the middle of the Premium Only Plan Year without an
allowable reason (i.e., change in family status), you may be required to continue to have the
premium amounts deducted from your gross income under the Premium Only Plan.
Can my employer modify my Pre-Tax Premium election under the Premium Only
Plan?
If the amount of your required premium contributions(s) increases or decreases as a result of
a rate adjustment required by an independent third party (such as an insurance company),
your employer will automatically increase or decrease the amount of your Pre-Tax Premium
election(s).
Can I change my Pre-Tax Premium election under the.Premium Only.Plan?
You may change your pre-tax premium election only under the following circumstances:
In coordination with each new plan year
If you experience a change in family status (as previously described)
If your coverage under the eligible insurance benefits is significantly modified or ceases,
or there is a.significant increase in premium costs, you may revoke your. election and
elect coverage under another insurance benefit with similar coverage,.if one is available
under the Premium Only Plan.
Statement of Rights
As a participant in the Premium Conversion Plan, you are entitled to certain rights and
protections under the Employee Retirement Income Security Act of 1974, ERISA provides that all
Plan participants shall be entitled to examine, without charge, at the Plan Administrator's office
and at other specified locations (such as work sites and union halls), all plan documents,
including insurance contracts, collective bargaining agreements and copies of all documents filed
by the Plan with the U.S. Department of. Labor (such as detailed annual, reports and Plan
descriptions); obtain copies. of all Plan documents and other Plan information upon written
request to the Plan Administrator. The Administrator may make a reasonable charge for the
copies. You are also entitled to receive a summary of the Plan's financial report, if applicable.
The Plan Administrator is required by law to furnish each participant with a copy of the summary
annual report,with certain exceptions.
In addition to creating rights for Plan participants, ERISA imposes duties upon the people who
are responsible for the operation of the Premium Only Plan. The people who operate your Plan,
called"fiduciaries"of the Plan have a duty to do so prudently and in the interest of you and other
Plan participants and beneficiaries. No one, including your employer or any other person, may
fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare
benefit or exercising your rights under ERISA. If your claim for a welfare benefit is denied in
whole or in part you must receive a written explanation of the reason for denial. You have the
right to have the Plan Administrator review and reconsider your claim.
Under ERISA, there are steps you can take to enforce the above rights. For instance, if you
request materials from the plan and do not receive them within 30 days, you may file a suit in
\�' federal court. In such a case, the court may require the plan administrator to provide the
t
materials and pay you up to $100 a day until you receive the materials, unless the materials were
not sent because of reasons beyond the control of the administrator. If you have a claim for
benefits which is denied or ignored, in whole or in part, you may. file suit in a state or federal
court. If it should happen that plan fiduciaries misuse the plan's money, or if you are
discriminated against for asserting your rights, you may file suit in a federal court. The court will
decide who should pay court_costs and legal fees. If you are successful the court may order the
person you have sued to pay these costs and fees. If you lose, the court may order you.to pay
these costs and fees, for example, if it.finds your claim frivolous.
If you have any questions about your plan, you should contact the plan administrator. If you
have any questions about this.statement or about your rights under ERISA, you should contact
the nearest Area Office of the U.S. Labor-Management Services Administration, U.S. Department
of Labor, listed in your telephone directory or the Division.of Technical Assistance Inquiries,
Pension and Welfare Benefit Administration, U.S. Department of Labor, 200 Constitution Avenue
N.W., Washington,.D.C. 20210.