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