Benefit Plans Administrative Services BPAS 3/9/2020

the excess, unreimbursed portion of a claim will not be pended if the HC Account has been exhausted and no further contributions will be made to the Participant's HC Account under Article V. 4.7 Death of a Participant. (a) Notwithstanding anything herein to the contrary, unless specifically provided otherwise in the Adoption Agreement, in the event a Participant's participation in the Plan terminates because of the Participant's death,the Participant has no surviving Spouse or Dependents, and the former Participant incurred a Eligible Expense prior to the Participant's death that would have been reimbursable out of the Participant's HC Account but that has not been submitted for reimbursement, the deceased Participant's estate may submit such Eligible Expense for reimbursement in accordance with Section 4.3. A certified copy of the deceased Participant's death certificate and proof that the person acting upon behalf of such Participant's estate has authority to do so must be submitted with such claims. (b) Notwithstanding anything herein to the contrary, unless specifically provided otherwise in the Adoption Agreement,the deceased Participant's surviving Spouse,if any,may continue to access the Participant's HC Account for purposes of obtaining reimbursement of Eligible Expenses until the earlier of: (1)the date on which the HC Account balance reaches zero; or (2) the date on which the surviving Spouse dies. No claim shall be paid to a surviving Spouse pursuant to this subsection(ii) unless a certified copy of the deceased Participant's death certificate has been provided to the Claims Administrator. If continuation coverage is required by applicable law, the access described in this Section 4.7(b) shall be provided only if offered as and selected in lieu of such continuation coverage. (c) Notwithstanding anything herein to the contrary, unless specifically provided otherwise in the Adoption Agreement, the deceased Participant's surviving Dependents, if any, may continue to access the Participant's HC Account for purposes of obtaining reimbursement of Eligible Expenses until the earlier of: (1) the date on which the HC Account balance reaches zero; or(2)the date the last surviving Dependent dies. No claim shall be paid to a surviving Dependent pursuant to this subsection (iii) unless a certified copy of the deceased Participant's death certificate has been provided to the Claims Administrator. If continuation coverage is required by applicable law, the access described in this Section 4.7(c) shall be provided only if offered as and selected in lieu of such continuation coverage. (d) Notwithstanding anything herein to the contrary, if provided in the Adoption Agreement, upon a Participant's death,the Participant's Designated Beneficiary may continue to access the Participant's HC Account for purposes of obtaining reimbursement of Eligible Expenses incurred by the Designated Beneficiary if the Participant is not survived by a Spouse or Dependent. Such access shall be provided until the earlier of: (1) the date on which the HC Account balance reaches zero; or (2) the date on which the Designated Beneficiary dies. No claim shall be paid to a Designated Beneficiary unless a certified copy of the deceased Participant's death certificate has been provided to the Claims Administrator and the Designated Beneficiary has certified that the Participant does not have a surviving Spouse or Dependent. Reimbursements paid to a Designated Beneficiary shall be reported as taxable income to the Designated Beneficiary to the extent required by law. For purposes of the Plan, a "Designated Beneficiary" is a person designated by a Participant as his/her beneficiary in accordance with the procedures established by the Claims Administrator for doing so. A Participant may designate one or more contingent Designated Beneficiaries who will become a Designated Beneficiary if the primary Designated Beneficiary predeceases the Participant. An individual who is the Participant's ©2017 Hitesman&Wold,P.A. 12 Funded Post-Employment HRA Basic Plan Document(Single Employer Non-ERSA)