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(5) Loss of Governmental or Educational Coverage. A Participant may <br /> prospectively change his or her Election to add group health coverage for the <br /> Participant or his or her Spouse or dependent, if such individual(s) loses <br /> coverage under any group health coverage sponsored by a governmental or <br /> educational institution including, but not limited to, the following: a medical care <br /> program of an Indian Tribal government (as defined in Code § 7701(a)(40)), the <br /> Indian Health Service, or a tribal organization; a state health Benefits risk pool; <br /> or a foreign government group health plan, subject to the terms and limitations <br /> of the applicable benefit package option(s). <br /> (g) Family and Medical Leave Act. A Participant taking a leave governed by the Family <br /> and Medical Leave Act of 1993 ("FMLA'� may revoke or change an Election as may be <br /> provided for under the FMLA and the Employer's FMLA policy required thereunder, <br /> provided the Employer is subject to FMLA. <br /> (h) Special Rule for HSA Contribution Feature. A Participant may change his or her <br /> Election with respect to the HSA Contribution Feature prospectively on at least a monthly <br /> basis. A Participant may also revoke his or her Election with respect to the HSA <br /> Contribution Feature prospectively if the Participant becomes ineligible to make or have <br /> made HSA contributions under the HSA Contribution Feature. <br /> (i) Other. The Plan Administrator shall have the discretion to allow a change to or <br /> termination of an Election to the extent such change or termination is the result of any <br /> other situation informally recognized by the IRS as providing an exception to the general <br /> rule that Elections are irrevocable (e.g., corrections of mistakes, changes to meet <br /> nondiscrimination requirements, failure to satisfy underwriting). <br /> A Participant entitled to make a new Election under this Section must do so within thirty (30) <br /> days of the event. An Employee who is eligible to elect benefits but declined to do so during the <br /> initial Election period, or during a subsequent Election period, may file a new Election within <br /> thirty (30) days of the occurrence of an event described above, but only if the new Election is <br /> made on account of and corresponds with the event. Subject to the provisions of the underlying <br /> group health plan, Elections made to add medical coverage for a newborn or newly adopted <br /> dependent child pursuant to a HIPAA special enrollment right may be retroactive for up to thirty <br /> (30) days. All other new Elections shall be effective prospectively immediately following the date <br /> the Participant files the new Election with the Plan Administrator. Elections made pursuant to <br /> this Section shall be effective for the balance of the Plan Year in which the Election is made <br /> unless a subsequent event (described above) allows a further Election change. <br /> 5.4 Rehire and Eligibility Loss. Termination of employment shall automatically revoke any <br /> Election. Former Participants who are rehired: <br /> (a) After thirty (30) days following a termination of employment, shall have two 'periods of <br /> coverage;" that period prior to the termination of employment and that period following <br /> the re-employment of the terminated Employee. Expenses incurred prior to the <br /> termination of employment shall be subject to the Election in effect upon termination; <br /> while the Employee shall have an opportunity to make a new Election and expenses <br /> incurred after re-employment shall be subject to the Election made upon re-employment. <br /> (b) Within thirty (30) days following a termination of employment, shall have the Election in <br /> effect prior to the termination of employment reinstated upon re-employment. <br /> 5.5 Benefit Descriptions. While an Election to receive one or more of the Optional Benefits may <br /> be made under this Plan, the benefits themselves may be provided in accordance with Plan <br /> documents or contracts which describe the types and amounts of benefits available, the <br /> requirements for participation, procedures for submitting claims, and the other terms and <br /> ©2012 Hitesman&Wold, P.A. 14 City of Elk River <br /> Flexible Benefits Plan <br />