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4.9. SR 12-16-2013
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4.9. SR 12-16-2013
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ARTICLE IX. <br /> GROUP MEDICAL BENEFITS <br /> 9.1 Purpose. The purpose of this Article is to provide for the pre-tax payment opportunity for Group <br /> Medical Benefits under this Plan as an Optional Benefit. The Employer provides Group Medical <br /> Benefits through one or more"plans"within the meaning of Sections 105 and 106 of the Code. <br /> 9.2 Separate Written Plan. For purposes of Sections 105 and 106 of the Code, this Article shall <br /> constitute a separate written plan providing for the reimbursement or direct payment of <br /> Insurance Premium expenses. To the extent necessary, other provisions of the Plan are <br /> incorporated by reference. <br /> 9.3 Definitions. <br /> (a) Dependent means an individual (e.g., Spouse, child, etc.) who qualifies as a <br /> "dependent" under the terms and conditions of the applicable plan document governing <br /> the Group Medical Benefits. <br /> (b) Group Medical Benefits means the medical coverage made available by the Employer <br /> through this Article to which the Insurance Premiums relate. It does not include <br /> individual insurance contracts. <br /> (c) HMO means a health maintenance organization authorized to do business in the state in <br /> which it operates with which an agreement has been entered for the purpose of <br /> providing benefits under the Plan. <br /> (d) Highly Compensated Individual means an individual who is highly compensated as <br /> defined in Section 105(h)(5) of the Code. <br /> (e) Insurance Contract means (1) any insurance contract secured from an insurance <br /> company or HMO authorized to do business in the state in which such contract is issued, <br /> which has been obtained for the purpose of providing benefits under this portion of the <br /> Plan; or (2) a self-insured plan administered by a third party. <br /> (f) Insurance Premiums means the amount that must be paid on a periodic basis in <br /> return for coverage under the Insurance Contract. <br /> 9.4 Terms, Conditions and Limitations. The Employer shall secure the necessary Insurance <br /> Contracts, as identified in Exhibit A. Coverage shall begin, benefits shall be provided, and <br /> coverage shall terminate in accordance with the applicable Insurance Contracts. Such Insurance <br /> Contracts, are expressly incorporated into and made part of this Plan. <br /> 9.5 Payments. The Plan Administrator shall make Insurance Premium payments for the Group <br /> Medical Benefits on behalf of the Participant in an amount necessary to provide the benefit <br /> applicable to the Participant under this portion of the Plan for the applicable Plan Year. Such <br /> payments shall be made from Employer Contributions, if any, provided by the Employer under <br /> the Plan and, if necessary, contributions made in accordance with the salary reduction <br /> arrangement and other arrangements applicable to the Participant under the terms of the Plan. <br /> The appropriate portions shall depend on the coverage elected by the Participant. The Plan <br /> Administrator shall also make such payments on behalf of the Participant's Dependents who are <br /> enrolled in the Group Medical Benefits. To the extent a Dependent is provided coverage under <br /> the Group Medical Benefits and that Dependent is not the Participant's Spouse or Tax Dependent, <br /> the tax consequence of such coverage shall be addressed as described in Section 4.2. <br /> 9.6 Nondiscrimination. To the extent the Group Medical Benefits are subject to Section 105(h) of <br /> the Code or Section 2716 of the Public Health Services Act, they shall not discriminate in favor of <br /> ©2012 Hitesman&Wold, P.A. 23 City of Elk River <br /> Flexible Benefits Plan <br />
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