6.5. ERMUSR 01-15-2008 - Laserfiche WebLink

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(or another employer's qualified benefit plan) as a result of a change in marital status or a change in employment status, a Participant may elect to cease or decrease coverage only if that coverage becomes effective or is increased under the other employer's plan. (3) Dependent Care Expense Reimbursement Plan. With respect to the Dependent Care Expense Reimbursement Plan, a Participant may change or terminate his or her Election only if (i) such a change or termination is made on account of and corresponds with a Change in Status that affects eligibility for coverage under an employer's plan; or (ii) the Election change is on account of and corresponds with a Change in Status that affects eligibility of dependent care expenses for the tax exclusion available under Code § 129 of the Code. (b) HIPAA Special Enrollment Rights. If a Participant's Spouse or a Participant's Dependent is entitled to special enrollment rights under a group health plan, as required by Code § 9801(f), medical coverage was declined under the group health plan because of outside medical coverage, and eligibility for the outside medical coverage is subsequently lost due to legal separation, divorce, death, termination of employment, reduction in hours, or exhaustion of the maximum COBRA period, then a Participant may revoke a prior Election for health or accident coverage and make a new Election (including salary reduction Election), provided that the Election corresponds with the exercise of such special enrollment right. For purposes of this provision (1) an Election to add previously eligible Dependents as a result of the acquisition of a new Spouse or Dependent child, subject to the provisions of the underlying group health plan, shall be considered consistent with the special enrollment right (a/k/a the Tag-along Rule); and (2) a HIPAA special enrollment Election attributable to the birth or adoption of a new Dependent child may, subject to the provisions of the underlying group health plan, be effective retroactive (up to thirty (30) days). (c) Certain ]udgments, Decrees and Orders. If a judgment, decree, or order (an "Order") resulting from a divorce, legal separation, annulment or change in legal custody (including a qualified medical child support order) requires accident or health coverage for a Participant's Dependent child (including a foster child who is a Dependent of the Participant), a Participant may: (1) change his or her Election to provide coverage for the Dependent child (provided that the Order requires the Participant to provide coverage and subject to the provisions of the underlying group health plan); or (2) change his or her Election to revoke coverage for the Dependent child if the Order requires that another individual (including the Participant's Spouse or former Spouse) provide coverage under that individual's plan. (d) Medicare and Medicaid. If a Participant, a Participant's Spouse, or a Participant's Dependent who is enrolled in a health or accident benefit under this Plan becomes entitled to Medicare or Medicaid (other than coverage consisting solely of benefits under Section 1928 of the Social Security Act providing for pediatric vaccines), the Participant may prospectively reduce. or cancel the health or accident coverage of the person becoming entitled to Medicare or Medicaid. Further, if a Participant, a Participant's Spouse, or a Participant's Dependent who has been entitled to Medicare or Medicaid loses eligibility for such coverage, then the Participant. may prospectively elect to commence or increase the health or accident coverage. (e) Change in Cost. (1) Automatic Increase or Decrease for Insignificant Cost Changes. If the cost of an Optional Benefit (other than the Medical Expense Reimbursement Plan) increases or decreases during a Plan Year by an insignificant amount, then the pre-tax contributions or after-tax contributions (as applicable) under each ©2007 Hitesman & Associates, P.A. 10 Elk River Municipal Utilities 122707 Flexible Benefits Plan