6.5. ERMUSR 01-15-2008 - Laserfiche WebLink

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ARTICLE IX. GROUP MEDICAL BENEFITS 9.1 Separate Written Plan. For purposes of Section 105 and 106 of the Code, this Article shall constitute a separate written plan, providing for the pre tax payment of Insurance Premiums for Group Medical Benefits to Participants. To the extent necessary, other provisions of the Plan are incorporated by reference. 9.2 Purpose. The Employer provides Group Medical Benefits through one or more "plans" within the meaning of Sections 105 and 106 of the Code. The purpose of this Article is to provide for the pre tax payment of Insurance Premiums for Group Medical Benefits to Participants. The DMO and/or Insurance Contracts and/or other health benefit agreements through which the Group Medical Benefits are provided are identified in Exhibit A. 9.3 Definitions. (a) Dependent means an individual who qualifies as a "dependent" under the terms and conditions of the applicable Insurance Contract, HMO agreement, or plan document governing the Group Medical Benefits. To the extent anon-tax Dependent is provided coverage, income shall be imputed to the Participant as described in Section 4.2. (b) Group Medical Benefits means the Medical coverage made available by the Employer to which the Insurance Premiums relate. It does not include individual Insurance Contracts. (c) Highly Compensated Employee means an individual who is highly compensated as defined in Section 105(h)(5) of the Code. (d) HMO means a Medical maintenance organization authorized to do business in the state in which an agreement has been entered for the purpose of providing benefits under this portion of the Plan. (e) Insurance Contract means any insurance contract secured from an insurance company authorized to do business in the State of Minnesota which has been obtained for the purpose of providing benefits under this portion of the Plan; or aself-insured plan administered by a third party. (f) Insurance Premiums means the amount that must be paid on a periodic basis in return for group coverage. Insurance Premiums includes amounts for insurance types of benefits, including but not limited to Insurance Contracts, HMO coverage and self-insured programs for which "premium equivalents" are charged. (g) Medical Plan means this Article of the Elk River Municipal Utilities Flexible Benefits Plan which constitutes a separate written plan as described in Section 9.1 above. 9.4 Terms, Conditions and Limitations. The Employer shall secure the necessary Insurance Contracks, HMO agreements, other health benefit agreements from third party providers with respect to the provision of Group Medical Benefits and/or establish the necessary self-insured program. Coverage shall begin, benefits shall be provided, and coverage shall terminate in accordance with the applicable Insurance Contracts, HMO agreements, other health benefit agreements, and/or self-insured plan documents described in Exhibit A. Such contracts, agreements, and plan documents are expressly incorporated into and made part of this Plan. 9.5 Payments. The Plan Administrator shall make Insurance Premium payments for the Group Medical Benefits on behalf of the Participant in an amount necessary to provide the benefit applicable to the Participant under this portion of the Plan for the applicable Plan Year. If the ©2007 Hitesman & Associates, P.A. 20 Elk River Municipal Utilities 122707 Flexible Benefits Plan