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AMENDMENT TO <br /> CITY OF ELK RIVER FLEXIBLE BENEFITS PLAN <br /> BY THIS AMENDMENT, the City of Elk River Flexible Benefits Plan (herein referred to as the "Plan's is <br /> hereby amended as follows: <br /> 1. AUTHORITY AND SCOPE. This Amendment is being made pursuant to (a) the Plan sponsor's general <br /> authority to amend and modify the Plan, and (2) IRS Notice 2013-71, which authorizes limited carryovers <br /> under certain health flexible spending accounts that are part of a Section 125 cafeteria plan. <br /> 2. WORDS AND PHRASES. Unless specifically defined herein, the words and phrases used in this <br /> Amendment are intended to have their ordinary meaning and are not necessarily intended to have the <br /> same meaning as the same defined terms used in the Plan. <br /> 3. EFFECTIVE DATE. This Amendment first applies with respect to the plan year beginning on or after <br /> January 1, 2014. <br /> 4. LIMITED CARRYOVER UNDER HEALTH FSA. The health flexible spending account(s) (the 'health <br /> FSA(s)') that is part of the Plan is hereby amended to provide a limited carryover of account balances <br /> from plan year to plan year in accordance with the following conditions and restrictions: <br /> a. A participant of a health FSA may carry over the lesser of (i) $500, or (ii) the balance of his/her <br /> account. The balance of a participant's account at any point in time shall be equal to the amount <br /> credited to the account for the plan year minus claims paid to date with respect to that plan year. <br /> b. In general, the balance of a participant's account available for the carryover shall be determined <br /> upon expiration of the health FSA's claim run-out period. For purposes of this Amendment, the <br /> 'claim run-out period" refers to the period of time following a plan year during which claims for <br /> expenses incurred during that plan year may be submitted for reimbursement. Notwithstanding <br /> the foregoing, the balance of the participant's account as of midnight on the last day of the plan <br /> year, up to the amount specified in paragraph a. above, shall be available to reimburse expenses <br /> incurred on and after the first day of the new plan year. The claims administrator will administer <br /> claims submitted during the claim run out period (including allocating claims between the <br /> participant's carryover balance and the participant's election for the new plan year (if any)) in a <br /> manner consistent with applicable law (including regulatory guidance). <br /> C. In general, a carryover made in accordance with the provisions of this Amendment shall occur <br /> within the same health FSA. However, unless otherwise prohibited under applicable law <br /> (including regulatory guidance), a participant entitled to an account carryover in accordance <br /> herewith shall receive the carryover to an account under the Plan's limited scope health FSA (if <br /> one exists) if: (i) the participant enrolls in the limited scope health FSA for the following plan <br /> year, or (ii) the participant directs the Plan Administrator, by no later than the last day of the <br /> plan year from which the carryover is to be made and in accordance with procedures adopted by <br /> the Plan Administrator, to make the carryover to the limited scope health FSA. For purposes of <br /> this Amendment, the term 'limited scope health FSA" shall refer to the health FSA, if any, that is <br /> part of the Plan that is intended to be compatible with eligibility for contributions to a health <br /> savings account. <br /> d. In general, a carryover made in accordance with the provisions of this Amendment shall occur <br /> automatically. However, unless otherwise prohibited under applicable law (including regulatory <br /> guidance), if a participant entitled to an account carryover in accordance herewith elects to waive <br /> the carryover in accordance with procedures adopted by the Plan Administrator and the <br /> conditions contained in the applicable regulatory guidance, the carryover shall not occur, <br /> provided the election is made no later than the last day of the plan year from which the carryover <br /> is to be made. <br /> Flex Plan Amendment 1 <br /> Health FSA Carryover <br />