5.3. ERMUSR 02-09-2010 - Laserfiche WebLink

Home Browse Search

ARTICLE IX GROUP MEDICAL BENEFITS 9.1 Purpose. The purpose of this Article is to provide for the pre-tax payment opportunity for Group Medical Benefits under this Plan as an Optional Benefit. The Employer provides Group Medical Benefits through one or more ~~plans" within the meaning of Sections 105 and 106 of the Code. 9.2 Separate Written Plan. For purposes of Sections 105 and 106 of the Code, this Article shall constitute a separate written plan providing for the reimbursement or direct payment of Insurance Premium expenses. To the extent necessary, other provisions of the Plan are incorporated by reference. 9.3 Definitions. (a) Dependent means an individual (e.g., Spouse, child, domestic partner, etc.) who qualifies as a "dependent" under the terms and conditions of the applicable plan document governing the Group Medical Benefits. To the extent a Dependent is provided coverage under the Group Medical Benefits and that Dependent is not the Participant's Spouse or Tax Dependent, the tax consequence of such coverage shall be addressed as described in Section 4.2. (b) Group Medical Benefits means the medical coverage made available by the Employer through this Article to which the Insurance Premiums relate. It does not include individual Insurance Contracts. (c) Highly Compensated Individual means an individual who is highly compensated as defined in Section 105(h)(5) of the Code. (d) HMO means a health maintenance organization authorized to do business in the state in which it operates with which an agreement has been entered for the purpose of providing benefits under the Plan. (e) Insurance Contract means (1) any insurance contract secured from an insurance company or HMO authorized to do business in the state in which such contract is issued, which has been obtained for the purpose of providing benefits under this portion of the Plan; or (2) 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 coverage under the Insurance Contract. 9.4 Terms, Conditions and Limitations. The Employer shall secure the necessary Insurance Contracts, HMO agreements, or other health benefit agreements from third party providers, as identified in Exhibit A. 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. Such Insurance 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 25