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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
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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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D.PREMIUM CONVERSION ACCOUNT <br /> D. PREMIUM CONVERSION ACCOUNT <br /> Contracts for Reimbursement <br /> NOTE:If Premium Conversion Account is not a selected Benefit under A.5a, Section D is disregarded. <br /> 1. If Premium Conversion Accounts are allowed under the Plan, select the types of Contracts with respect to which a <br /> Participant may contribute under Section 5.04: <br /> a. B Employer Health <br /> b. Q Employer Dental <br /> c. Q Employer Vision <br /> d. ❑ Employer Short-Term Disability <br /> e. 0 Employer Long-Term Disability <br /> f. 0 Employer Group Term Life <br /> g. ❑ Employer Accidental Death & Dismemberment <br /> h. 0 Individually-Owned Dental <br /> i. 0 Individually-Owned Vision <br /> j. 0 Individually-Owned Disability <br /> k. 0 COBRA continuation coverage under the Employer group health plan <br /> I. 0 Other: <br /> Enrollment <br /> 2. Q All Employees will automatically be enrolled in the Premium Conversion Account upon their date of hire and will <br /> be deemed to have elected to contribute the entire amount of any premiums payable by the Employee during the <br /> Plan Year for participation in Employer-sponsored Contract(s). <br /> NOTE:If D.2 is not selected, Eligible Employees may only elect to participate in the Premium Conversion Account <br /> pursuant to Section 4.02(b), 4.02(c)and Section 4.03 of the Plan. <br /> Contributions <br /> 3. Ed Participant elections will be automatically adjusted for changes in the cost of Employer-sponsored Contracts <br /> pursuant to the terms of Treas. Reg. 1.125-4(f)(2)(i). <br /> E. FLEXIBLE SPENDING ACCOUNTS <br /> NOTE:If Flexible Spending Accounts are not a permitted Benefit under A.Sb, Section E is disregarded. <br /> Employer Contributions <br /> 1. 0 Matching Contributions.The Plan permits Employer matching contributions to the applicable Benefits as <br /> follows: <br /> a. Health FSA: <br /> i. 0 None <br /> 6 Copyright©2002-2018 <br /> Benefit Plans Administrative Services LLC <br />
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