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<br />© 2012 Hitesman & Wold, P.A. City of Elk River <br />Flexible Benefits Plan <br />39 <br />(c) not be claimed as another person’s dependent for purposes of such person’s federal <br />income tax return; <br />(d) not be actually covered by Medicare; and <br />(e) not have any health coverage other than Permitted Insurance, Permitted Coverage, or <br />coverage under a high deductible health plan (as defined under Section 223(c)(2) of the <br />Code), whether or not such coverage is sponsored by the Employer. <br />Participation in this HSA Contribution Feature component shall cease upon the earlier of the date <br />upon which the Participant no longer satisfies the foregoing eligibility requirements or the date <br />determined under Section 3.4 of this Plan. <br />16.5 Contributions. <br />(a) Employer Contributions. Employer Contributions, if any, will be contributed to the <br />Participant’s HSA at the times established by the Employer. <br />(b) Employee Contributions. Amounts withheld from a Participant’s Compensation <br />pursuant to an agreement authorizing salary reduction with respect to this Optional <br />Benefit shall be contributed to the Participant’s HSA as soon as administratively feasible. <br />16.6 Limits on Contributions. Contributions made by a Participant and/or on a Participant’s behalf <br />(i.e., Employer Contributions) into the HSA under this Plan are limited in accordance with the <br />following rules. <br />(a) General Limit. During a taxable year, total contributions to all health savings account <br />owned by a Participant cannot exceed the indexed amount established under Section 223 <br />of the Code. <br />(b) Catch Up Contributions. An additional “catch-up” amount (determined on a monthly <br />basis) can be contributed for eligible individuals who attain age 55 before the close of the <br />taxable year. <br />(c) Pro-rated Limit if Not Eligible on December 1st. If a Participant is eligible for HSA <br />contributions during a taxable year but ceases to be eligible prior to December 1st of that <br />taxable year, the contribution limit for that taxable year shall be determined by <br />multiplying 1/12 of the applicable limit by the number of months the first day of which <br />the Participant was eligible for HSA contributions. This pro-rated limit shall apply to all <br />contributions made during the applicable taxable year, including those contributions <br />made prior to the date on which the Participant ceased to be eligible for HSA <br />contributions. <br />(d) Special Rule if Eligible on December 1st. If a Participant becomes eligible for HSA <br />contributions during the taxable year and is eligible on December 1st of such year, the <br />Participant shall be deemed to have been eligible for each month in such taxable year <br />and may make or receive HSA contributions up to the full annual limit. This special rule <br />applies to all contributions made during the applicable taxable year, including <br />contributions made prior to or after December 1st. <br />Example: An Eligible Employee becomes eligible for HSA contributions on July 1st and <br />remains eligible through December 1st. The Eligible Employee may begin making <br />contributions to his or her HSA through this Plan on July 1st at a rate pursuant to which <br />the full annual contribution will have been made by the end of the taxable year. <br /> <br />Page 132 of 254