4.13 SR 05-06-2024 - Laserfiche WebLink

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© 2012 Hitesman & Wold, P.A. City of Elk River Flexible Benefits Plan 14 (5) Loss of Governmental or Educational Coverage. A Participant may prospectively change his or her Election to add group health coverage for the Participant or his or her Spouse or dependent, if such individual(s) loses coverage under any group health coverage sponsored by a governmental or educational institution including, but not limited to, the following: a medical care program of an Indian Tribal government (as defined in Code § 7701(a)(40)), the Indian Health Service, or a tribal organization; a state health Benefits risk pool; or a foreign government group health plan, subject to the terms and limitations of the applicable benefit package option(s). (g) Family and Medical Leave Act. A Participant taking a leave governed by the Family and Medical Leave Act of 1993 (“FMLA”) may revoke or change an Election as may be provided for under the FMLA and the Employer’s FMLA policy required thereunder, provided the Employer is subject to FMLA. (h) Special Rule for HSA Contribution Feature. A Participant may change his or her Election with respect to the HSA Contribution Feature prospectively on at least a monthly basis. A Participant may also revoke his or her Election with respect to the HSA Contribution Feature prospectively if the Participant becomes ineligible to make or have made HSA contributions under the HSA Contribution Feature. (i) Other. The Plan Administrator shall have the discretion to allow a change to or termination of an Election to the extent such change or termination is the result of any other situation informally recognized by the IRS as providing an exception to the general rule that Elections are irrevocable (e.g., corrections of mistakes, changes to meet nondiscrimination requirements, failure to satisfy underwriting). A Participant entitled to make a new Election under this Section must do so within thirty (30) days of the event. An Employee who is eligible to elect benefits but declined to do so during the initial Election period, or during a subsequent Election period, may file a new Election within thirty (30) days of the occurrence of an event described above, but only if the new Election is made on account of and corresponds with the event. Subject to the provisions of the underlying group health plan, Elections made to add medical coverage for a newborn or newly adopted dependent child pursuant to a HIPAA special enrollment right may be retroactive for up to thirty (30) days. All other new Elections shall be effective prospectively immediately following the date the Participant files the new Election with the Plan Administrator. Elections made pursuant to this Section shall be effective for the balance of the Plan Year in which the Election is made unless a subsequent event (described above) allows a further Election change. 5.4 Rehire and Eligibility Loss. Termination of employment shall automatically revoke any Election. Former Participants who are rehired: (a) After thirty (30) days following a termination of employment, shall have two “periods of coverage;” that period prior to the termination of employment and that period following the re-employment of the terminated Employee. Expenses incurred prior to the termination of employment shall be subject to the Election in effect upon termination; while the Employee shall have an opportunity to make a new Election and expenses incurred after re-employment shall be subject to the Election made upon re-employment. (b) Within thirty (30) days following a termination of employment, shall have the Election in effect prior to the termination of employment reinstated upon re-employment. 5.5 Benefit Descriptions. While an Election to receive one or more of the Optional Benefits may be made under this Plan, the benefits themselves may be provided in accordance with Plan documents or contracts which describe the types and amounts of benefits available, the requirements for participation, procedures for submitting claims, and the other terms and Page 107 of 254