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5.3. ERMUSR 02-09-2010
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5.3. ERMUSR 02-09-2010
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2/5/2010 4:08:14 PM
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City Government
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ERMUSR
date
2/9/2010
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(1) Significant Curtailment. If the Plan Administrator determines that <br />coverage under an Optional Benefit (other than Medical Expense <br />Reimbursement Plan) is significantly curtailed during a Plan Year, the <br />Participant may prospectively enroll in another benefit package option <br />providing similar coverage and make a corresponding Election change. <br />Coverage under an accident or health plan is deemed "significantly <br />curtailed" only if there is an overall reduction in coverage provided to <br />Participants under the Plan so as to constitute reduced coverage to <br />Participants in general. The Plan Administrator (in its sole discretion) <br />will decide, in accordance with prevailing IRS guidance, whether a <br />curtailment is "significant," and whether a benefit package option <br />constitutes "similar coverage" based upon all the surrounding facts and <br />circumstances. <br />(2) Loss of Coverage. If the Plan Administrator determines that <br />coverage under an Optional Benefit (other than Medical Expense <br />Reimbursement Plan) is lost during a Plan Year, the Participant may, <br />on a prospective basis: (i) enroll in another benefit package option <br />providing similar coverage and make a corresponding Election change, <br />or (ii) revoke his or her Election if no other benefit package option <br />providing similar coverage is available. Coverage under an accident or <br />health plan is deemed "lost" only if there is a complete loss of <br />coverage under the benefit package option (e.g., due to elimination of <br />the benefit package option or application of an annual or lifetime <br />maximum) or other fundamental loss of coverage. The Plan <br />Administrator (in its sole discretion) will decide, in accordance with <br />prevailing IRS guidance, whether a "loss' has occurred, and whether a <br />benefit package option constitutes 'similar coverage based upon all <br />the surrounding facts and circumstances. <br />(3) Addition or Improvement of an Optional Benefit. If during a Plan <br />Year, the Plan adds a new Optional Benefit or a new benefit package <br />option under the Optional Benefit (other than the Medical Expense <br />Reimbursement Plan), or if coverage under an existing Optional <br />Benefit (other than the Medical Expense Reimbursement Plan) is <br />significantly improved: (i) an affected Participant may prospectively <br />change his/her Election with respect to the newly-added or improved <br />Optional Benefit; and (ii) an Eligible Employee may commence <br />participation in such Optional Benefit. The Plan Administrator (in its <br />sole discretion) will decide, in accordance with prevailing IRS guidance, <br />whether an Optional Benefit has been "significantly improved" based <br />upon all the surrounding facts and circumstances. <br />(4) Change Under Another Employer-Sponsored Plan. A Participant <br />may make a prospective Election change (other than with respect to <br />the Medical Expense Reimbursement Plan) that is on account of and <br />corresponds with a change made under another employer-sponsored <br />plan (including a plan of the Employer or a plan of another employer), <br />provided (i) the other cafeteria plan or qualified benefits plan permits <br />its participants to make an Election change that would be permitted <br />under the Cafeteria Plan Regulations, or (ii) this Plan permits <br />Participants to make an Election fora Plan Year period of coverage <br />which is different from the plan year period of coverage under the <br />14 <br />
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