HomeMy WebLinkAboutCC AG PKT 2007-10-22 #Y
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AGENDA REPORT
DATE:
October 22, 2007
TO:
Honorable Mayor and City Council
FROM:
David N. Carmany, City Manager
BY:
Andrew J. Tse, Personnel Manager
SUBJECT:
RESOLUTION NO. - A resolution of the City
Council of the City of Seal Beach approving the Plan
Document of the Full Flex Cafeteria Plan Section 125
effective January 1, 2008
SUMMARY OF REOUEST:
The purpose oftbis report is to request Council consideration to approve the Plan Document
of the Full Flex Cafeteria Plan Section 125 effective January 1,2008.
e BACKGROUND:
In 2006, the California State Legislature passed AB 2544 which required agencies to
increase their contribution towards the cost ofretiree (annuitant) health care coverage based
on the number of years participating in PEMHCA at a S% increment per year. The City of
Seal Beach became a member in 1988, which places the City at the 20th year mark or 100"10
contribution level on January 1,2008.
Agencies with a full flex cafeteria plan for its health care program and with an equal
contribution method are not impacted by AB 2544. The propose plan documents defines the
City's pIan.
FINANCIAL IMPACT:
The projected initial investment of implementing the Full Flex Cafeteria Plan is estimated
to be $30,000. The implementation of the full flex cafeteria plan and amending the
health care program; however will reduce the City's unfunded liability for health care
from the current actuarial projection ofS12.3 million by approximately 40%.
RECOMMENDATION:
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It is recommended that the City Council adopt the following resolution:
Agenda Item ... q
October 22, 2007
Agenda Report - Approving of Plan Document Full Flex Cafeteria Plan Section 125
Page 2
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1. Resolution No. . "A resolution of the City Council of the City ofSea1
Beach approving the Plan Document of the Full Flex Cafeteria Plan Section 125 effective
January 1, 2008"
APPROVED:
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David N. 'Carmany, City Manager
Attachments:
Resolution Number
Plan Document - Full Flex Cafeteria Plan Section 125
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RESOLUTION NUMBER
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A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF SEAL BEACH APPROVING THE PLAN
DOCUMENT OF THE FULL FLEX CAFETERIA
PLAN SECTION 125 EFFECTIVE JANUARY 1, 2008
WHEREAS, the City has COIIducted workshops and met in good faith with ils various
labor groups to implement a full flex cafeteria plan and amendmenls to the health
care program; and
WHEREAS, a plan document needs to be approved by the governing body to define the
plan and retained for official records.
SOW, THEREFORE, the City Council of the City of Seal Beach hereby resolves:
Section 1. The PIan Document of the Full Flex Cafeteria Plan Section 125 is hereby
approved and takes effcct on January I, 2008.
Scction 2. Except as provided for in SectiOll I, there are- no other corrections,
changes or amendmenls.
PASSED, APPROVED AND ADOPTED by the City Council of Seal Beach, at a regular
meeting held 011 the 22nd day of October. 2007 by the following vote:
AYES:
COUNCll.MEMBERS
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NOES: COUNCll.MEMBERS
ABSENT: COUNCll.MEMBERS
ABSTAIN: COUNCll.MEMBERS
Mayor
ATI"EST:
City Clerk
STATEOFCAL1FORNIA I
COUNTY OF ORANGE I SS
CITY OF SEAL BEACH }
I, Linda Devine, City Clerk for the City of Seal Beach, California, do hereby certify that
the foregoing resolution is the original copy of ResolutiOll Number on file in the
office of the City Clerk, passed, approved and adopted by the City Council of the City of
Seal Beacb at a regular meeting beld on the 22nd day of October , 2007.
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City Clerk
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Agenda Item *y
"Full Flex Cafeteria Plan Section 125"
Plan Document will be delivered under
separate cover
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Agenda Item *y
"Full Flex Cafeteria Plan Section 125"
Plan Document will be delivered under
separate cover
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CITY OF SEAL BEACH
FULL FLEX CAFETERIA PLAN
SECTION 125
PLAN DOCUMENT
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CITY OF SEAL BEACH
TABLE OF CONTENTS
STATEMENT OF PURPOSE
ARTICLE
I. DEFINITIONS
1.1 Administrator ......... ...... ...... ............... ...... ......... .............
1.2 Anniversary Date ... ............ ............ ............ ...... ......... .....
1.3 Benefits ............................ .............. .............................
1.4 City.. . ... ... ... ... ... ... ... ... .. . ... . .. . .. .. . ... . .. ... ... ... . .. .. . .. . ... ... ... ...
1.5 Code ... ......... ..................... ..................... ......... ............
1.6 Compensation ...............................................................
1.7 Council... ...... ...... ............ ............ ......... ......... ......... ......
1.8 Dependent ... ......................... ................................ .......
1.9 Dependent Premiums ........... ............ ............ .......... .......
1.10 Effective Date ................................................................
1.11 Election Periods ... .................................... ......... .............
1.12 Eligible Employee ...........................................................
1.13 Employee......................................................................
1.14 Employer...... ........................... .............................. ........
1.15 Flex Dollars ....................................................................
1.16 Highly Compensated Employee ..........................................
1.17 Insurance Company.........................................................
1.18 Optional Benefit Coverages............ ............... .....................
1.19 Participant... ...... ......... .................. ...... ...... ......... .............
1.20 Period of Coverage ......... ......... ...... ......... ............ ......... .....
1.21 Plan ........................ ......... .................. ............ ................
1.22 Plan Administrator ............ ............ ...... ............ ............... ....
1.23 Plan Year .........................................................................
1.24 Salary Reduction ......... ......... ...... ...... ......... ......... ...............
II. ELIGIBILITY AND PARTICIPATION
2.1 Eligibility .........................................................................
2.2 Entry Date ...... ..................... ............ ............... ...... ...........
2.3 Employee Election ............................................................
2.4 Election Periods ...............................................................
2.5 Termination of Participation......... ...... ...... ...... ................ .....
2.6 Termination of Employment ......... ......... ............ ......... .........
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III. OPTIONAL BENEFIT COVERAGES
3.1 Coverage Options ............................................................ 7
3.2 Description of Optional Benefit Coverages ..................... ....... 7
3.3 Election of Optional Benefit Coverages in Lieu of Cash............ 7
IV, ELECTIONS
4.1 Election Procedure ............................................................ 8
4.2 FilII Flex Cafeteria Election Forms............................................. 8
4.3 Initial Elections .................................................................. 9
4.4 Failure to Return Election Forms ........................................... 9
4.5 Irrevocable Nature of Salary Reduction Selected...................... 10
4.6 Status Change: Ability to Change Elections..................... .. .. .... 10
4.7 Consistency Rules .............................................................. 13
4.8 Changes by Administrator .................................................... 13
4.9 Adjustment of Compensation Reductions ................................. 13
4.10 Maximum Elective Contributions ............................................. 13
4.11 Cessation of Required Contributions ......................................... 14
4.12 Coordination with FMLA ........................................................ 14
V.
FLEX DOLLARS AND ADDITIONAL CASH BENEFITS
5.1 Flex Dollars ......................................................................... 15
5.2 Allocation of Flex Dollars ........................................................ 15
5.3 Waiver of Coverage Cash Option ............................................. 15
VI, NON-DISCRIMINATION
6.1 Intent ................................................................................. 16
6.2 Reduction of Benefits and/orContributions ................................ 16
6.3 Treatment of Contribution Reductions ....................................... 16
VII. ADMINISTRATION
7.1 Appointment of Administrator ............ ..................... ............ ..... 17
7.2 Duties of the Administrator ..................................................... 17
7.3 Reports and Records ............................................................ 18
7.4 Fiduciary Responsibilities ...................................................... 18
7.5 Administrator Limitations ........................................................ 18
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VIII. AMENDMENT AND TERMINATION OF THE PLAN
8.1 Amendment ......................................................................... 19
8.2 Termination ......................................................................... 19
8.3 Rights of Participants ............................................................. 19
IX. MISCELLANEOUS
9.1 Indemnification ...... ............ ............ ......... ......... ............... ..... 20
9.2 Tax Treatment of Plan................................. ............... ............ 20
9.3 Third Party Actions................................................................ 20
9.4 Funding............ ..................... ................... .................. ......... 20
9.5 No Effect on Other Employee Considerations............................. 20
9.6 Titles and Headings ............................................................... 20
9.7 Gender and Number .................. ........................... ............ ..... 20
9.8 Amendments in Writing ................................................ .......... 20
9.9 Separate Provisions ............................................................... 20
9.10 Plan Number ......... ..................... ...... ...... ......... ......... ............ 20
9.11 City Information ............................................................. 20
9.12 Service of Legal Process ............ ............................................. 20
X.
APPENDIX A - OPTIONAL BENEFIT COVERAGES ........ .......... ......... 22
XI. APPENDIX B- FLEX-DOllAR ALLOWANCE...................................... 23
XII. EXECUTION PAGE......... ......... ......... ...... ...... ............ ............ ...... .....24
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STATEMENT OF PURPOSE
This plan document amends and restates the City of Seal Beach Section 125 Plan originally
effective September 1, 1990. The purpose of this Plan is to provide Participants with a choice
between cash and optional benefit coverages.
This Plan is intended to qualify as a .Cafeteria Plan" under Section 125 of the Internal
Revenue Code of 1986, as amended, and is to be interpreted in a manner consistent with the
requirements of Section 125.
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ARTICLE I
DEFINITIONS
Whenever used here in, the following terms have the following meaning unless a different
meaning is clearly required by the context:
1.1 Administrator: The Administrator shall be the third party the Plan Administrator
appoints to perform all or some of its duties under the Plan.
1.2 Anniversary Date: The annual recurrence of the first day of the Plan Year.
1.3 Benefits: Benefits shall mean any benefit provided by the City of which a Participant
may choose to participate in.
1.4 City: City shall mean the City of Seal Beach.
1.5 Code: Code shall mean the Internal Revenue Code of 1986, as amended, and all
regulations issued thereafter, and replacements from time to time.
1.6 Comoensation: Compensation shall mean total remuneration received by a
Participant, including but not limited to wages, salary, overtime, bonuses,
commissions, any other payment which is not an advance, loan or expense
reimbursement. Each Participant's compensation shall be determined prior to taking
into account Participant's Salary Reduction Contributions under the Plan.
1.7 Council: Council shall mean members of the City Council of the City of Seal Beach, as
constituted from time to time.
1.8 Deoendent: Dependent shall mean the Participant's spouse, dependent child, or
qualifying relative of the employee as defined under Section 152 of the Code, as
amended from time to time, that is eligible to participate in the City's health plans.
1.9 Deoendent Premiums: Dependent premiums shall mean the amount of premium
charged for dependent coverage under the City's group insurance plans.
1.10 Effective Date: Effective date shall mean the date that this Plan becomes effective,
which is January 1, 2008.
1.11 Election Periods: Election periods shall mean the period of time as determined in the
Plan in which a Participant or employee may enter, change, or terminate from the
Plan. The Initial Election Period shall be the thirty (30) days after the date of hire to
complete the necessary forms to elect the benefits desired within the Plan. This Initial
Election Period may be extended by the Administrator, at its sole discretion upon
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written notice to employees. The annual election period shall be the period of time
coinciding with the CalPERS medical open enrollment period, time during which an
eligible employee may make an election pursuant to Section 3.3.
1.12
Eliaible Emolovee: Eligible employee shall mean an employee who has satisfied the
eligibility requirements under the Plan and the City's Personnel Rules and
Regulations. Independent contractors and part-time employees shall not be deemed
eligible employees.
1.13
Emolovee: Employee shall mean a person employed by the Employer under common
law rules applicable in determining employer/employee relationships. Independent
contractors shall not be deemed employees.
1.14 Emolover: Employer shall mean the City.of Seal Beach.
1.15 "Flex Dollars": Flex Dollars shall mean benefit dollars provided to a participant by his
or her Employer, which may be applied towards the cost of Optional Benefit Coverage
as described in Appendix A.
1.16 Hiahlv Comoensated Emolovee: Highly Compensated Employee means any employee
who is either: (1) an officer; (2) receiving compensation above the Section 414 limit for
the applicable year; (3) receiving compensation above the Section 414 limit for the
applicable year and in the highest 20% of all employees; (4) a spouse or dependent of
a highly compensated employee; or (5) meeting any other definition under Section
414(q) of the Code.
1.17 Insurance Comoanv: Insurance company, or insurance carrier, or insurer shall mean
any insurance company that underwrites and has a contract with the City for a benefit
under this Plan.
1.18 Ootional Benefit Coveraaes: Optional Benefit Coverages are coverages available to
the Participant under the Plan.
1.19 Particioant: Participant is any eligible employee who elects to participate in the plan.
1.20 Period of Coveraae: Period of Coverage shall mean a Plan Year.
1.21 Plan: Plan shall mean the City's Section 125 Plan.
1.22 Plan Administrator: The Plan Administrator shall be the City of Seal Beach or the
individual the City may appoint to act on its behalf.
1.23 Plan Year: Plan Year means the period beginning January 1 and ending December
31~ All Plan Years shall begin on January 1 and end on December 31, unless
otherwise changed by the City or the Administrator.
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1.24 Salarv Reduction Contributions: Salary reduction contributions shall mean the amount
that each Participant has authorized the City to reduce his or her compensation in
order for it to be contributed to the Plan to provide the benefits selected by
Participants. The amount of Salary Reduction Contributions shall be designated on
the Election Form.
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ARTICLE"
ELIGIBILITY AND PARTICIPATION
2.1 Eliaibilitv:
All employees shall become eligible to become a Participant under the Plan upon
satisfying the following requirements of Subsections (A) and (B) below:
(A) Emolovment Status:
Those eligible to participate in the Plan are full time employees as defined in the
City of Seal Beach Position Classification Plan, incorporated herein by
reference. Part-time employees and independent contractors shall not be
deemed eligible employees.
(B)
Service Conditions:
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An employee will become a Participant on the first day of the month following
thirty days of employment.
2.2 Entry Date:
The date a Participant satisfies eligibility provisions as defined in Section 2.1 (B).
2.3 Emolovee Election:
All eligible employees may then elect, during the appropriate Election Period, to
become a Participant by completing the City of Seal Beach Full Flex Cafeteria Plan
Election Fonn, the "Fonn". This fonn designates whether the employee desires to elect
the benefits of the Plan.
2.4 Election Periods:
(A) Initial Election Period:
All eligible employees have a thirty (30) day election period to select plans
offered by the City; and a thirty (30) day election period after their date of hire to
make an election under one of the plans offered by the City. Employees must
complete the necessary forms to elect the benefits that they desire within the
Plan. This Initial Election Period may be extended by the Administrator, at its
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(8) Annual Election Periods: After the Initial Election Period, Participants may elect
to change, modify, decrease, or increase their benefits or participation in the
Plan during only one Election Period, which shall be the period of time
coinciding with the CalPERS medical open enrollment period, which
immediately precedes the Anniversary Date of the Plan. Participants must
complete an election Form as described in Section 2.3 above, to have changes
become effective in the new Plan Year.
2.5 Tennination of ParticiDation:
A Participant shall remain a Participant in the Plan until the occurrence of one or more
of the following:
(A) Participant ceases to be eligible to participate in Plan;
(8) Participant's employment is tenninated;
(C) Participant's death;
(D) The tennination of this Plan;
(E) Participant elects not to participate under subsection 4.4(0).
2.6 Tennination of EmDlovment:
If a Participant's employment tenninates, all contributions to the Plan shall cease upon
the tennination date, the Participant shall no longer be considered a Participant
effective on the date of termination.
However, a fonner Participant may still be eligible for certain benefits in accordance
with the terms of the City's medical, dental, vision and other insurance plan for which
premiums have been paid on the former Participant's behalf. The continuation of any
benefits is governed solely by the tenns and provisions of the City's group insurance
plans and applicable law.
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ARTICLE III
OPTIONAL BENEFIT COVERAGES
3.1 Coveraae ootions: Each Participant may choose under this Plan to receive his or her
compensation in cash, and any additional cash benefits to the extent available under
Article V, or to have a portion of it applied by the City toward the cost of the Optional
Benefit Coverages available to the Participant. Notwithstanding anything herein to the
contraryr Optional Benefit Coverages shall be limited to coverages and benefits
available under the plans identified in Appendix A.
3.2 Descriotion of Ootional Benefit Coveraaes: While the election of one or more of the
Optional Benefit Coverages may be made under this Plan, the coverages and benefits
thereunder will be provided not by this Plan but by the plans identified in Appendix A,
the requirements for participating in such plans, and the other terms and conditions of
coverage and benefits under such plans are set forth from time to time in the plans
identified in Appendix A, and in any group insurance contracts and prepaid health plan
contracts that constitute (or are incorporated by reference in) those plans. The benefit
descriptions in such plans, as in effect from time to time, are hereby incorporated by
reference into this Plan.
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3.3 Election of Ootional Benefit Coveraaes in Lieu of Cash: A Participant may elect under
this Plan to receive one or more of the Optional Benefit Coverages described in
Section 3.2, to the extent available to the Participant under the applicable plans
identified on Appendix A, in accordance with the procedures described in Sections 4.1,
4.2 and 4.3.
(A) If a Participant elects coverage for a Period of Coverage under a plan identified
on Appendix A, and if the Participant is required under such plan to pay a share
of the cost of such coverage, such share shall be paid by the Participant.
Payment shall first be from the Participant's Flex Dollars, as provided in Section
5.2, and second by means of a reduction in the Participant's compensation for
the Period of Coverage for the balance of the cost of each coverage elected.
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(B) If any employee elects coverage for a Period of Coverage under a Flexible
Spending Arrangement identified on Appendix A 2., the employee's contribution
to the Arrangements shall first come from the Participant's Flex Dollars, when
applicable, if Flex Dollars are not available, the employee's compensation for
the Period of Coverage will be reduced by such amount as the employee elects
(subject to the limitations of that Plans), and the amount equal to the reduction
in compensation will be credited to the appropriate reimbursement account in
accordance with the applicable Flexible Spending Arrangements identified on
Appendix A numeral 2.
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ARTICLE IV
ELECTIONS
4.1 Election Procedure: Prior to the commencement of each Period of Coverage, the
Administrator shall provide an Election Form to each Participant and to each other
individual who is expected to become a Participant at the beginning of the applicable
Period of Coverage. The Election Form shall be effective as the first day of the Period
of Coverage. Each Participant who desires to elect an Optional Benefit Coverage
available for the Period of Coverage shall so specify on the appropriate Election Form,
and insurance carrier or vendor forms and agrees to a reduction in his or her
compensation, when applicable.
4.2
(A) The amount of the reduction in the Participant's compensation for the Period of
Coverage for coverage under a plan identified as an Optional Benefit Coverage
on Appendix A shall equal the Participant's share of the cost of such coverage,
reduced by the amounts paid from the Participant's Flex Dollars under Section
5.2
(B) The amount of the reduction in the Participant's compensation for the Period of
Coverage for coverage elected by the Participant under a Flexible Spending
Arrangement identified on Appendix A numeral 2. shall be the coverage amount
elected by the Participant, subject to the limitations of such Plans. The
Participant's election shall equal the Participant's share of the cost of such
coverage, reduced by the amounts paid from the Participant's Flex Dollars
under Section 5.2
(C) The amount of contributions shall change according to the schedule of
premiums for the City's group benefits. A Participant's election under the City's
full flex cafeteria plan could automatically increase or decrease, depending
upon the change in premiums of that particular benefit offered by the City, or
increase or decrease depending upon the amount of the Participant's required
contribution for benefits.
Each Election Form must be completed and returned to the Administrator on or before
such date as the Administrator shall specify, which date shall be no later than the
beginning of the first pay period for which the participant's benefit coverage will
become effective.
Full Flex Cafeteria Election Forms:
Each Participant shall complete a Full Flex Cafeteria Plan Election Form, the "Election
Form" at the Initial Election Period. In all following years, if a Participant desires to
change the amount of the election, enroll in the Plan, or terminate from the Plan, a
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4.3
new Election Form must be completed within thirty (30) days before the Anniversary
date of the Plan. This period of time shall be known as the Annual Election Period.
Initial Elections:
(A) An eligible employee, as defined in Sections 1.12 and 2.1 of this Plan, who is
not a Participant prior to the effective date of the Plan, has thirty (30) days from
the effective date of this Plan to elect their desired benefits for the Current Plan
Year. Such election is made by completing the Election Form and other
necessary forms as deemed by the Administrator. The Administrator may
choose to extend this period, at its sole discretion, in order to assist the City's
employees in determining whether to participate in this Plan.
(B) The initial election shall adhere to the Plan Year.
4.4 Failure to Return Election Forms:
(A) A new Participant's failure to return a completed Election Form under Section
4.1, 4.2, and 4.3 to the Administrator on or before the specified due date for the
Period of Coverage in which he or she becomes a Participant with respect to
the benefits available for that Period of Coverage shall be deemed to have
waived to participate in the City's medical plan and any Optional Benefit
Coverage for the duration of the Plan Year and elected to receive compensation
as taxable income as described in Appendix B, as long the Participant can
furnish the Plan Administrator with proof of coverage.
(B) An existing Participant's failure to retum a completed Election Form to the
Administrator relating to coverage under a plan identified as an Optional Benefit
Coverage on Appendix A 1. on or before the specified due date for any
subsequent Period of Coverage shall be deemed to constitute (1) a re-election
of the same coverage or coverages, if any, under such plans as were in effect
just prior to the end of the preceding Period of Coverage (to the extent such
coverage remains available as an Optional Benefit Coverage under the Plan),
and (2) an agreement to a reduction in the Participant's compensation for the
subsequent Period of Coverage equal to the Participant share of each such
coverage for the Period of Coverage, reduced by the amounts paid from the
Participant's Flex Dollars under Section 5.2.
(C) An existing Participant's failure to return a completed election form to the
Administrator under Section 4.1, 4.2, and 4.3 relating to coverage under a
Flexible Spending Arrangement Plan identified on Appendix A2. on or before
the specified due date for any Period of Coverage shall be deemed to constitute
(1) a waiver to participate under such plans as were in effect just prior to the
end of the preceding Period of Coverage, and (2) the renouncement to a
reduction in the Participant's compensation for the subsequent Period of
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Coverage equal to the Participant share of each such coverage for the Period of
Coverage.
Participants may voluntarily terminate their participation in the Plan, but only
during an Annual Election Period. If a Participant elects not to participate for
the Plan Year applicable for the Annual Election Period, then that Participant
cannot elect to reenter the Plan until the next Annual Election Period, unless a
Status Change as described in Sections 4.5. and 4.6 occurs or there is a mid-
plan year change in the benefits offered through this Plan.
4.5 Irrevocable Nature of Salary Reduction Selected:
(D)
(A) A Participant's election of benefit coverage and the amount of salary reduction
contributions shall be irrevocable during the Plan Year, unless a Participant has
experience a status a change as described in this section or Section 4.6.
(B) Participants can change, modify, decrease or increase their elections under the
Election Form, only if a Status Change as defined in Section 4.6 has occurred,
a change has occurred in the City's group benefits offered to its employees, or
a change has occurred in the amount of contribution for the plan's benefits as
required by the City during the Plan Year. If such a change has occurred, then
the Participant must submit to the Administrator a completed new Election Form
in order to have the change be effective at the beginning of the following payroll
period.
(C) The Employer and/or the Administrator cannot change any amount in the
Election Form selected by each Participant during the Plan Year, unless a
termination has occurred as defined under Section 2.5 or 2.6 of this Plan, or a
Status Change has occurred, or a change has occurred in the City's group
benefits offered to its employees, or a change has occurred in the amount of
contribution for the plan's benefits as required by the City.
4.6 Status Chanae: Ability to Chanae Elections
(A) A Participant's election made under the Plan (including an election made
through inaction under Section 4.4, shall be irrevocable by the Participant
during the Period of Coverage except as otherwise provided in Section 4.5,
subsections and 1 through 6 below. A Participant may revoke an election in
writing for the balance of the Period of Coverage and, if desired, file a new
election in writing if, under the facts and circumstances, a change in status
occurs, and the requested revocation and new election satisfies the applicable
consistency requirements in Section 4.7.
Application for such change must be made within thirty (30) days of the actual event.
For this purpose, a change in status includes the following events:
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1. Leaal Marital Status. Events that change a Participant's legal marital
status, including marriage, death of spouse, divorce, legal separation,
or annulment.
2. Number of Deoendents: Events that change the Participants number
of Dependents (as defined in Code Section 152), including birth,
adoption, placement for adoption (as defined in Regulations under
Code Section 9801), or death of a dependent.
3. Emolovment Status. Any of the following events that change the
employment status of the employee, employee's spouse, or the
employee's dependent: a termination or commencement of
employment; a strike or lockout; a commencement of or return from
an unpaid leave of absence; and a change in worksite. In addition, if
the eligibility conditions of the full flex cafeteria plan or other
employee benefit plan of the employer of the employee, spouse or
dependent depend on the employment status of that individual and
there is a change in that individual's employment status with the
consequence that the individual becomes (or ceases to be) eligible
under the plan, then that change constitutes a change of employment
under this paragraph.
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4. Reauirements for Unmarried Deoendents: An event that causes a
Participant's dependent to satisfy or cease to satisfy the requirements
for coverage due to attainment of age, student status, or any similar
circumstance as provided in any accident or health plan identified in
Appendix A under which the Participant received coverage.
5. Residence or Worksite. A change in the place of residence or work of
the Participant, or the Participant's spouse, or the Participant's
dependent.
6. Enrollment in Health Coveraae. A significant change in the health
coverage of the Participant or the Participant's spouse attributable to
the spouse's employment, and such other events that the
Administrator determines will permit the revocation of an election
(and, if applicable, the filing of a new election) during a Period of
Coverage under regulations and rulings of the Intemal Revenue
Service.
(B) In order to revoke an election or file a new election under this subsection, a
Participant must submit an Election Form within thirty (30) days of the change in
status.
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(C) In the case of coverage under a plan identified in Appendix A, a Participant may
revoke an Election Form for the balance of the Period of Coverage and file a
new Election Form in writing that corresponds with the special enrollment rights
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provided in Code Section 9801(f), whether or not the change in election is
permitted under Section 4.6.
(D)
In the case of a judgement, decree or order resulting from a divorce, legal
separation, annulment, or change in legal custody (including a Qualified
Medical Child Support Order) that requires accident or health coverage for a
Participant's child, a Participant may change his or her election (1) to provide
coverage for the child under a health plan identified in Appendix A, if the order
so requires, or (2) to cancel coverage under a health plan identified in Appendix
A, for the Participant's child if such order requires the Participant's former
spouse to provide coverage.
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(E) In the case of coverage under a health plan identified in Appendix A, a
Participant may revoke an Election Form for the balance of the Period of
Coverage and file a new Election Form in writing to effectively cancel such
health plan coverage for the Participant and/or the Participant's spouse or
dependent to the extent that such individual become entitled to coverage under
Part A or Part B of Title XVIII of the Social Security Act (Medicare) or Title XIX
of the Social Security Act (Medicaid), other than coverage consisting solely of
benefits under Section 1928 of the Social Security Act (the program for
distribution of pediatric vaccines). In addition, if an employee, spouse or
dependent who has been entitled to such coverage under Medicare, Medicaid,
or a state program under the State Children Health Insurance Program (SCHIP)
loses eligibility for such coverage, the full flex cafeteria plan may permit the
employee to make a prospective election to commence or increase coverage of
that employee, spouse, or dependent under the health plan. A Participant may
not revoke his election if he becomes eligible for SCHIP coverage during the
year.
(F) In the case of coverage under a health plan identified in Appendix A1., which is
provided by an independent third-party provider, if:
1. The Participant's share of the cost of such coverage significantly
increases or decreases as a result of a significant cost increase or
decrease by the independent third-party provider, the Administrator may
permit all Participants electing such coverage for the Period of Coverage,
to revoke their elections for the balance of the Period of Coverage, and
to complete a new Election Form, provided that similar coverage is
elected under a health plan identified in Appendix A1., for the balance of
the Period of Coverage. In the event that similar coverage is not
available to the Participant, the Participant may revoke his election for
the remainder ofthe Plan Year.
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2.
Such coverage ceases or is significantly curtailed, the Administrator may
permit all Participants electing such coverage for the Period of Coverage,
to revoke their elections for the balance of the Period of Coverage, and
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to complete a new Election Form, provided that similar coverage is
elected under a health plan identified in Appendix A1., for the balance of
the Period of Coverage. In the event that similar coverage is not
available to the Participant, the Participant may revoke his election for
the remainder of the Plan Year.
(G)
Any revocation and new election under this Section 4.6 shall be effective at
such time as the Administrator shall prescribe, but not earlier than the first pay
period beginning after the revocation and new election, unless otherwise
required by law.
4.7 Consistencv Rules:
A Participant's requested written revocation and new election will be consistent with a
change in status described in Section 4.6 if, and only if, (1) the change in status results
in the Participant, or the Participant's spouse or dependent, gaining or losing eligibility
for accident or health coverage under either the Plan or a plan of the spouse's or
dependent's employer, and (2) the election change corresponds with that gain or loss
of coverage.
Notwithstanding anything in this Section 4.7 to the contrary, if the Participant, or the
Participant's spouse or dependent, becomes eligible for continuation coverage under a
health plan identified in Appendix A as provided in Code Section 4980B or any similar
state law, the Participant may elect to reduce his or her compensation under the Plan
in order to pay for the continuation coverage.
4.8
Chanoes bv Administrator: If the Administrator determines, before or during any year,
that the Plan may fail to satisfy for such year any nondiscrimination or other
requirement imposed by the Code or any limitation on benefits provided to the Highly
Compensated Employees, the Administrator shall take such action as the
Administrator deems appropriate, under rules uniformly applicable to similarly situated
Participants, to assure compliance with such requirement or limitation. Such action
may include, without limitation, a modification of elections by Highly Compensated
Employees (as defined by the Code for purposes of the nondiscrimination requirement
in question) without the consent of such Employees.
4.9
Adiustment of Comoensation Reductions: If the cost of Optional Benefit Coverages
provided by an independent third-party provider under a medical, dental plan or vision
plan identified in Appendix A1., increases or decreases during a Period of Coverage, a
corresponding change shall be made in the Election Form of all Participants receiving
such coverage in an amount to be determined by the Administrator.
4.10 Maximum elective contributions: The maximum amount of elective contributions under
the Plan for any Participant shall be the total cost to the Participant for the Period of
Coverage of the most expensive Optional Benefit Coverages that any Participant could
elect.
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4.11 Cessation of reauired contributions: Nothing in this Plan shall prevent the cessation of
coverage or benefits under any plan identified on Appendix A, in accordance with the
terms of such plan, on account of a Participant's failure to pay the Participant's share
of the cost of such coverage or benefits, through compensation reduction or otherwise.
4.12 Coordination with FMLA: Notwithstanding any other provision of this Plan, the
Administrator may (a) permit a Participant to revoke (and subsequently reinstate) his
or her election of one or more Optional Benefit Coverages under the Plan, and (b)
adjust a Participant's compensation reduction as a result of a revocation or
reinstatement to the extent the Administrator deems necessary or appropriate to
assure the Plan's compliance with the provisions of the Family and Medical Leave Act
of 1993 and any regUlations pertaining thereto.
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ARTICLE V
FLEX DOLLARS AND ADDITIONAL CASH BENEFITS
5.1 Flex Dollars: A Participant will be eligible to receive Flex Dollars if, and to the extent
that, the City has elected to provide Flex Dollars under the Plan. Prior to the
commencement of each Period of Coverage the City shall determine the amount of
Flex Dollars available to each such Participant in accordance with the rules and
procedures adopted by the City and by the Plan Administrator, which shall not
discriminate in favor of Highly Compensated Employees. The Administrator shall
notifY such Participant in writing of the amount of Flex Dollars available to him or her
for the Period of Coverage (or for the balance of the Period of Coverage).
5.2 Allocation of Flex Dollars: Any Flex Dollars available to a Participant under this Article
V shall be applied proportionately each pay period toward the cost of the Optional
Benefit Coverages elected by the Participant. If for any Period of Coverage the cost of
the Optional Benefit Coverages elected by the participant exceeds the Participant's
Flex Dollars, then the Participant's compensation shall be reduced proportionately
each pay period in the amount of the excess, and an amount equal to the
compensation reduction shall be contributed by the Employer to cover the remaining
cost of the Optional Benefit Coverages elected by the Participant. However, if for any
Period of Coverage the cost of the Optional Benefit Coverages elected by the
Participant is less than the Participant's Flex Dollars, then the Participant shall receive
the value of any Flex Dollars not allocated to Optional Benefit Coverage and divert
them to the plans described on Appendix A.
5.3 Waiver of Coveraae Cash Ootion: A Participant who has elected to waive coverage
as described in Section 4.4.(A) or who has affirmatively elected to waive medical
coverage under the City's medical plan identified in Appendix A shall be deemed to
have elected the Waiver of Coverage Cash Option. Under this Option the Employer
will increase such Participant's cash compensation as a taxable refund of
contributions, for each pay period during which the Participant does not have in effect
any medical coverage or has elected any Optional Benefit Coverage. Determination of
the waiver amount available to Participants, and the manner in which it is paid, shall
be made in accordance with the rules and procedure adopted by the Employer and by
the Administrator, which shall not discriminate in favor of Highly Compensated
Employees. The Administrator shall notify such Participant in writing of the waiver
amount available to him or her for the Period of Coverage (or for the balance of the
Period of Coverage) under this Option. An eligible Participant may elect the Waiver of
Coverage Cash Option in writing in such form and manner as the Administrator shall
prescribe, at the same time or times that the Participant is permitted to elect Optional
Benefit Coverages under Article IV. Such election shall be irrevocable during each
Period of Coverage to the same extent as an election of Optional Benefit Coverages
identified in Appendix A.
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ARTICLE VI
NON-DISCRIMINATION
6.1 Intent:
It is the intent of this Plan not to discriminate between any classes of employees or
create s!]ch an action in part or whole of this Plan document that is in violation of Code
Sectjon 125 and Treasury regulations. The Administrator shall avoid all discretionary
acts that could be deemed to be discriminatory under any applicable Code section or
law.
6.2 Reduction of Benefits and/or Contributions:
The Administrator may reduce, modify, change or reject the benefits or amounts of
contribution of any Participant of the Plan if the Administrator deems it necessary to
make certain this Plan does not discriminate in favor of Highly Compensated
Employees as defined in Code Section 125 and any other applicable Code section or
law.
6.3 Treatment of Contributions:
Contributions that exceed the value of benefits under the Plan and contributions that
violate the nondiscrimination rules shall be returned to the Participant in the form of
taxable income.
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ARTICLE VII
ADMINISTRATION
7.1 Aooointment of the Plan Administrator:
The Council shall designate the Plan Administrator of the Plan. Such designation of
the Plan.Administrator will be for the full term of the Plan Year, unless otherwise noted
by Council. The name, address, and phone number of the Plan Administrator of the
Plan will be:
City Manager
City of Seal Beach
211 8th Street
Seal Beach, California 90740
Phone #: (562) 431-2527
The Plan Administrator shall be responsible for the complete management of the Plan,
and to undertake any action necessary to preserve the benefits of the Participants of
the Plan.
7.2
Duties of the Plan Administrator:
The Plan Administrator shall have all necessary power to carry out the full
administration and management of the Plan. The Plan Administrator's powers shall
include, but are not limited to:
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
(K)
To interpret the provisions of the Plan;
To enforce all provisions of the Plan;
To make changes in the Plan when necessary;
To decide all questions of eligibility;
To decide all questions of benefits;
To decide the proper management of benefit claims;
To obtain from every employee the necessary forms and documents that allow
participation in the Plan;
To obtain from every Participant the necessary forms and documents that allow
either continued participation or termination in the Plan;
To contract with any and all insurance companies or other suppliers to provide
benefits under the Plan;
To notify each Participant in writing of any amendment of the Plan, of any
proposed amendment of the Plan, of the termination of any benefit of the Plan,
and of the termination of the Plan;
To provide guidance for employees and Participants as to questions of
participation, benefits, or personal objectives in connection with the Plan;
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(L) To appoint an Administrator, agents, consultants and professionals to assist in
administering the Plan and completing necessary documentation and
reportings;
(M) To avoid discrimination under the Plan;
(N) To pay for any administrative costs of the Plan;
(0) To do any other acts as deemed necessary to administer and manage the plan
for the benefit of its Participants.
7.3 Reoorts and Records:
7.4
7.5
The Plan Administrator shall keep complete books, reports and records of all activities
under the Plan. The records of the Plan shall be open for inspection during normal
business hours, to the City and to each Participant, of only that Participant's individual
participation records. The Plan Administrator or the Administrator shall prepare and
submit to the City an annual report containing material, which the Administrator deems
necessary under Sections 125 and 129 or any other section of the Code.
Fiduciary Resoonsibilities:
The Plan Administrator shall conduct its duties of the Plan as a fiduciary for the
Participants and their beneficiaries. The Administrator must exercise proper
judgement and diligence in carrying out any action and in any capacity as Plan
Administrator. The Administrator shall act according to the Plan and the administrative
duties contained herein, and such actions must be for the benefit of the Participants or
potential Participants of the Plan.
Administrator Limitations:
The Plan Administrator is not responsible for the actual administration of group
insurance plans supplied by insurance carriers, as such plans shall be governed by
the terms of each such plan.
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ARTICLE VIII
AMENDMENT AND TERMINATION OF THE PLAN
8.1 Amendment:
The Plan Administrator can amend the Plan by providing written notice to all
Participants and potential Participants of the change or pending change. Such
amendment of the Plan shall not affect the rights of a Participant pertaining to all
clauses .contained in this Plan, or change any benefit of the Participant if such benefit
has not been subsequently changed by a carrier or the City, or change any right under
the City's group insurance plan.
8.2 Termination:
The City expects that this Plan will be maintained indefinitely, however, continuance is
not guaranteed. The City reserves the right to terminate the Plan at any time with
advance notice to Participants. Upon termination, no further contributions will be
made.
e 8.3 Riahts of Particioants:
If the Plan is terminated, the rights of Participants to receive benefits and
reimbursements under the City's group insurance plan for conditions prior to
termination are not affected in any manner.
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ARTICLE IX
MISCELLANEOUS
9.1 Indemnification:
The City agrees to indemnify the Plan Administrator, and any employee of the City
acting as the Plan Administrator, an assistant to the Plan Administrator, or agent of the
Plan Administrator, its employees, or any other person who performs duties of the
Plan, referred to as the Plan Administrator, to the fullest extent permitted by law
against any and all liabilities, claims, expenses, and damages stemming from the
actions or omissions of any such person in connection with administering the Plan for
the benefit of its Participants, as long as such actions and omissions were at the time
in good faith and carried forth with proper diligence and care.
9.2 Tax Treatment of the Plan:
The City specifically makes no claim as to the tax treatment of the Plan, the
qualification of the Plan as a taxable or tax-exempt entity, tax deductions of
contributions, or any other assurance of future tax treatments.
9.3 Third Party Actions:
The City shall not be directly responsible for any action taken by any insurance carrier
who offers benefits to the City, nor shall it be responsible to make payments to any
Participant if the insurance carrier fails to do so.
9.4 Fundina:
All contributions to the Plan do not have to be placed in trust accounts or specified for
certain benefits, nor is it required that the City or Administrator maintain separate
accounts for any or all Participants with regard to their contributions. The assets of the
Plan will be considered as general assets of the City to be used to timely pay for the
benefits selected.
9.5 No Effect on Other Emolovee Considerations:
Participation in this Plan by any employee of the City should not be construed as
anything but participation in one particular benefit offered by the City. Participation in
the Plan does not bind the City to any contractual obligation or employment obligation
with the employee, other than to the terms of the Plan documents.
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The title and headings within this document are for simplification or reference only, and
are not intended to be complete in any definition or meaning of the actual plan. The
entire text of this document shall govem rather than any specific title or heading.
9.7 Gender and Number:
Wherever any words are used in the masculine, feminine or neuter gender, they shall
be interpreted to be applicable to all cases where they would apply. Wherever used in
this document, the singular shall mean the plural and the plural shall mean the singular
except where context requires otherwise.
9.8 Amendments in Writina:
Any and all amendments to this Plan, qualifications of the Plan, and interpretations of
the Plan, need to be in writing in order to be valid.
9.9
Seoarate Provisions:
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If any provision of this Plan is deemed invalid or unenforceable, then only its validity or
enforceability shall be questioned or changed, and it will not affect in any manner any
other provision of the Plan or the Plan itself.
9.10 Plan Number:
The Plan Number shall be 502.
9.11 City Information:
The name, address, phone number, and employer identification number of the City is:
City of Seal Beach
211 8th Street
Seal Beach, California 90740
Phone #: (562) 431-2527
EIN# 95-6000794 .
9.12 Service of Leaal Process:
The name, address, and phone number of the agent for service of legal process is:
Quinn Barrow, City Attorney
Richard, Watson, and Gershon
355 S. Grand Avenue, 40th Floor
e Los Angeles, CA 90071
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APPENDIX A
OPTIONAL BENEFIT COVERAGES
Optional Benefit Coverages shall consist of the coverages(s) available to a Participant under
the following Plan (s) maintained by the City:
1. Optional BeRefit Coverages- Health Care Coverage
(A) Medical Plan through the Califomia Public Employees' Retirement System
(B) City of Seal Beach Dental Plan
(C) City of Seal Beach Vision Plan
(D) City of Seal Beach Voluntary Plans
2. Optional Benefit Coverages- Flexible Spending Accounts
The following Flexible Spending Arrangement Account Plan(s) will be maintained by
the City and made available to Participants under this Appendix, subject to the terms
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(A) The City of Seal Beach Health Care Spending Account Plan, as amended from
time to time and attached hereto as Enclosure 1.
(B) The City of Seal Beach Dependent Care Spending Account Plan, as amended
from time to time, and attached hereto as Enclosure 1.
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APPENDIX B
FLEX-DOLLAR ALLOWANCE
Flex Dollar Allowance Effective July 1, 2008:
SEAL BEACH MUNICIPAL EMPLOYEES
With Medical Coverage Total Monthly
Em 10 ee Benefit
Em $550.00
Em $850.00
$1100.00
$310.00
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EXECUTION PAGE
by
IN WITNESS WHEREOF, the City has caused this Plan to be signed
as of the _ day of ,.
CITY OF SEAL BEACH
BY:
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