4.13 SR 05-06-2024 - Laserfiche WebLink

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© 2012 Hitesman & Wold, P.A. City of Elk River Flexible Benefits Plan 13 (f) Change in Coverage. (1) Significant Curtailment. If the Plan Administrator determines that coverage under an Optional Benefit (other than Health Care Expense Reimbursement Plan and Limited Scope Health Care Expense Reimbursement Plan) is significantly curtailed during a Plan Year, the Participant may prospectively enroll in another benefit package option providing similar coverage and make a corresponding Election change. Coverage under an accident or health plan is deemed “significantly curtailed” only if there is an overall reduction in coverage provided to Participants under the Plan so as to constitute reduced coverage to Participants in general. The Plan Administrator (in its sole discretion) will decide, in accordance with prevailing IRS guidance, whether a curtailment is “significant”, and whether a benefit package option constitutes “similar coverage” based upon all the surrounding facts and circumstances. (2) Loss of Coverage. If the Plan Administrator determines that coverage under an Optional Benefit (other than Health Care Expense Reimbursement Plan and Limited Scope Health Care Expense Reimbursement Plan) is lost during a Plan Year, the Participant may, on a prospective basis: (i) enroll in another benefit package option providing similar coverage and make a corresponding Election change; or (ii) revoke his or her Election if no other benefit package option providing similar coverage is available. Coverage under an accident or health plan is deemed “lost” only if there is a complete loss of coverage under the benefit package option (e.g., due to elimination of the benefit package option) or other fundamental loss of coverage. The Plan Administrator (in its sole discretion) will decide, in accordance with prevailing IRS guidance, whether a “loss” has occurred, and whether a benefit package option constitutes “similar coverage” based upon all the surrounding facts and circumstances. (3) Addition or Improvement of an Optional Benefit. If during a Plan Year, the Plan adds a new Optional Benefit or a new benefit package option under the Optional Benefit (other than the Health Care Expense Reimbursement Plan and Limited Scope Health Care Expense Reimbursement Plan), or if coverage under an existing Optional Benefit (other than the Health Care Expense Reimbursement Plan and Limited Scope Health Care Expense Reimbursement Plan) is significantly improved: (i) an affected Participant may prospectively change his/her Election with respect to the newly-added or improved Optional Benefit; and (ii) an Eligible Employee may commence participation in such Optional Benefit. The Plan Administrator (in its sole discretion) will decide, in accordance with prevailing IRS guidance, whether an Optional Benefit has been “significantly improved” based upon all the surrounding facts and circumstances. (4) Change Under Another Employer-Sponsored Plan. A Participant may make a prospective Election change (other than with respect to the Health Care Expense Reimbursement Plan and Limited Scope Health Care Expense Reimbursement Plan) that is on account of and corresponds with a change made under another employer-sponsored plan (including a plan of the Employer or a plan of another employer), provided (i) the other cafeteria plan or qualified benefits plan permits its participants to make an Election change that would be permitted under the Cafeteria Plan Regulations; or (ii) this Plan permits Participants to make an Election for a Plan Year period of coverage which is different from the plan year period of coverage under the other cafeteria plan or Optional Benefit. The Plan Administrator shall determine, based on prevailing IRS guidance, whether a requested change is on account of and corresponds with a change made under another employer-sponsored plan. Page 106 of 254