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Benefit Plans Administrative Services 12/26/2018
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Benefit Plans Administrative Services 12/26/2018
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Last modified
1/17/2019 10:42:27 AM
Creation date
1/17/2019 10:40:55 AM
Metadata
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Template:
Contracts
Contractor's Name
Benefit Plans Administrative Services
Approval Date
12/26/2018
Council Approval Date
12/12/2018
Department
Human Resources
Department Project Manager
Sharon DeHaan
Subject / Project Title
HRA VEBA Account for LEOFF Trust Plan B
Tracking Number
0001615
Total Compensation
$0.00
Contract Type
Agreement
Contract Subtype
Professional Services
Retention Period
6 Years Then Destroy
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CITY OF EVERETT <br /> SECTION 125 CAFETERIA PLAN <br /> TABLE OF CONTENTS <br /> COMPANY INFORMATION 1 <br /> PLAN INFORMATION 2 <br /> A. GENERAL INFORMATION AND DEFINITIONS 2 <br /> B. ELIGIBILITY 3 <br /> Eligible Employees 3 <br /> Excluded Employees 3 <br /> Leave of Absence under FMLA 4 <br /> Non-FMLA 4 <br /> Termination of Participation 4 <br /> Reemployment 5 <br /> C. PARTICIPATION ELECTIONS 5 <br /> Failure to Elect (Default Elections) 5 <br /> Change in Status 5 <br /> D. PREMIUM CONVERSION ACCOUNT 6 <br /> Contracts for Reimbursement 6 <br /> Enrollment 6 <br /> Contributions 6 <br /> E. FLEXIBLE SPENDING ACCOUNTS 6 <br /> Employer Contributions 6 <br /> Eligible Expenses 8 <br /> Expenses Not Eligible for Reimbursement 8 <br /> Reimbursement 9 <br /> Grace Period 9 <br /> Run Out Period 9 <br /> Automatic Payment of Claims 9 <br /> Carryover 10 <br /> Termination of Employment 10 <br /> Qualified Reservist Distributions 10 <br /> F. HEALTH SAVINGS ACCOUNT(HSA Account) (Article 9) 10 <br /> Employer Contributions 10 <br /> B. FLEXIBLE BENEFIT CREDITS (Flex Credits) (Section 11.01) 11 <br /> Health Flex Contribution 11 <br /> Cash Outs 12 <br /> H. PURCHASE AND SALE OF PAID TIME OFF(PTO) (Section 11.02) 12 <br /> Purchase of PTO 12 <br /> Sale of PTO 13 <br /> Carryover of PTO 13 <br /> I. MISCELLANEOUS 13 <br /> Plan Administrator Information 13 <br /> SECTION J. EXECUTION PAGE 14 <br /> Copyright©2002-2018 <br /> Benefit Plans Administrative Services LLC <br />
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