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HomeMy WebLinkAboutES06-271 - Amendment - ICMA Retirement Corp - Retirement Health Savings (RHS) Plan - 10/08/2010 a Records Man.g.-r"a 9 ern KENT WASH HGTOH _ Document Y CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: _ 712-0)(A - C, Vendor Number: JD Edwards Number Contract Number: E-S06 - ,271 This is assigned by City Clerk's Office Project Name:`t ma�-m)o7mT 41earTR 45pr Lw-- S !DNS G� i t-'T Description: ❑ Interlocal Agreement ❑ Change Order (Amendment ❑ Contract ❑ Other: Contract Effective Date: Ih- 'i 1D Termination Date: 0IV Contract Renewal Notice (Days): p,-t I (A Numberof days required notice for termination or renewal or amendment Contract Manager: iZ) ZDepartment: r Detail: (i.e. address, location, parcel number, tax id, etc.): S Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 EMPLOYER VANTAGECARE RETIREMENT HEALTH SAVINGS (RHS) PLAN ADOPTION AGREEMENT Plan Number 8 03016 Check one: New Plan Amendment to Existing Plan Employer Retirement Health Savings Plan Name• L Employer Name: City of Kent State- CA H. The Employer hereby attests that it is a unit of a state or local government or an agency or instrumentality of one or more units of a state or local government. III. Effective Date of the Plan: October 8.2010 IV. The Employer intends to utilize the Trust to fund only welfare benefits pursuant to the following welfare benefit plan(s) established by the Employer: V. Eligible Groups,Participation and Participant Eligibility Requirements A. Eligible Groups The following group or groups of Employees are eligible to participate in the VantageCare Retirement Health Savings Plan(check all applicable boxes) ❑ All Employees All Full-Time Employees Non-Union Employees 0 Public Safety Employees—Police(Captain,Lieutenant,Police Deputy Chief,Non-Rep out of Captain,Lieutenant Contract Public Safety Employees—Firefighters ❑ General Employees ❑ Collectively-Bargained Employees(Specify unit(s)) ❑ Other(specify group(s)) The Employee group(s)specified must correspond to a group(s)of the same designation that is defined in the statutes, ordinances,rules,regulations,personnel manuals or other documents or provisions in effect in the state or locality of the Employer. B. Participation Mandatory Participation:All Employees in the covered group(s)are required to participate in the Plan and shall receive contributions pursuant to Section VI If the Employer's underlying welfare benefit plan or funding under this VantageCare Retirement Health Savings Plan is in whole or part a non-collectively bargained,self-insured plan,the nondiscrimination requirements of Internal Revenue Code(IRC)Section 105(h)will apply These rules may impose taxation on the benefits received by highly compensated individuals if the Plan discriminates in favor of highly compensated individuals in terms of eligibility or benefits The Employer should discuss these rules with appropriate counsel C. Participant Eligibility Requirements Minimum service The minimum period of service required for participation is N/A (write N/A if no minimum service is required) Minimum age The minimum age required for eligibility to participate is N/A (write N/A if no minimum age is required) VI.Contribution Sources and Amounts (Retired military employees of the federal government who have qualified for retiree health care benefits shall be excluded for contributions and cash out upon retirement from the City of Kent's Retirement Health Savings(RHS)program as of October 1,2011) A. Definition of Earnings The definition of Earnings will apply to all RHS Contribution Features that reference"Earnings",including Direct Employer Contributions(Section VI B 1 )and Mandatory Employee Compensation Contributions(Section VLB 2). Definition of earnings Base Pav B. Direct Employer Contributions and Mandatory Contributions Direct Employer Contributions The Employer shall contribute on behalf of each Participant ❑X 3 %of Earnings(of base pay for Lieutenant,except age 60 and over) ❑ $ each Plan Year ❑ A discretionary amount to be determined each Plan Year ❑ Other(describe): 2. Mandatory Employee Compensation Contributions The Employer will make mandatory contributions of Employee compensation as follows ❑x Reduction in Salary- 3 %of Earnings or$ will be contributed for the Plan Year. ❑ Decreased Merit or Pay Plan Adjustment-All or a portion of the Employees' annual merit or pay plan adjustment will be contributed as follows: An Employee shall not have the right to discontinue or vary the rate of Mandatory Contributions of Employee Compensation 3. Mandatory Employee Leave Contributions The Employer will make mandatory contributions of accrued leave as follows(provide formula for determining Mandatory Employee Leave contributions) ❑R Accrued Sick Leave- under age 50 - 50% at retirement or at separation -Ages 50 - 59 - 100%at retirement or at separation -Over age 60- 100%at retirement or at separation from service M Accrued Vacation Leave-under age 50- 50%at retirement or at separation -Ages 50 - 59 - 100% at retirement or at separation -Over age 60 - 100% at retirement or at separation from service ❑ Other(specify type of leave)Accrued Leave An Employee shall not have the right to discontinue or vary the rate of mandatory leave contributions. C. Limits on Total Contributions(check one box) The total contribution by the Employer on behalf of each Participant(including Direct Employer and Mandatory Employee Contributions)for each Plan Year shall not exceed the following limit(s)below Limits on individual contribution types are defined within the appropriate section above. M There is no Plan-defined limit on the percentage or dollar amount of earnings that maybe contributed. ❑ %of earnings* *Definition of earnings: ❑ Same as Section VI.A.. ❑ Other ❑ $ for the Plan year. See Section V.B for a discussion of nondiscrimination rules that may apply to non-collectively bargained self-insured Plans. VII.Vesting for Direct Employer Contributions A. Vesting Schedule(check one box) Q The account is 100%vested at all times. ❑ The following vesting schedule shall apply to Direct Employer Contributions as outlined in Section VI.B.I.: B. The account will become 100%vested upon the death,disability,retirement*,or attainment of benefit eligibility(as outlined in Section IX) by a Participant. *Definition of retirement(check one box). ❑ Retirement as defined in the primary retirement plan of the Employer ❑x Separation from service ❑ Other C. Any period of service by a Participant prior to a rehire of the Participant by the Employer shall not count toward the vesting schedule outlined in A above. VIIL Forfeiture Provisions Upon separation from the service of the Employer prior to attainment of benefit eligibility (as outlined in Section IX),or upon reversion to the Trust of a Participant's account assets remaining upon the participant's death(as outlined in Section XI),a Participant's non-vested funds shall(check one box) ❑ Remain in the Trust to be reallocated among all remaining Employees participating in the Plan as Direct Employer Contributions for the next and succeeding contribution cycle(s). 0 Remain in the Trust to be reallocated on an equal dollar basis among all Plan Participants. ❑ Remain in the Trust to be reallocated among all Plan Participants based upon Participant account balances. ❑ Revert to the Employer. s IX.Eligibility Requirements to Receive Medical Benefit Payments from the VantageCare Retirement Health Savings Plan A. A Participant is eligible to receive benefits: ❑x At retirement only(also complete Section B.) Definition of retirement. ❑ Same as Section VILB ❑ Other At separation from service with the following restrictions ❑X No restrictions ❑ Other At age only At retirement and age (also complete section B) Definition of retirement: Same as Section V11 B. Other At retirement or age Definition of retirement- Same as Section VII B. Other x❑ Other, specified as follows(also complete Section B if applicable): B. Termination prior to general benefit eligibility: In the case where the general benefit eligibility as outlined in Section IX.A includes a retirement component,a Participant who separates from the service of the Employer prior to retirement will be eligible to receive benefits: Immediately upon separation from service At age C. A Participant that becomes totally and permanently disabled ❑ as defined by the Social Security Administration 0 as defined by the Employer's primary retirement plan ❑ other will become immediately eligible to receive medical benefit payments from his/her VantageCare Retirement Health Savings Plan account D. Upon the death of the Participant,benefits shall become payable as outlined in Section XI X. Permissible Medical Benefit Payments Benefits eligible for reimbursement consist of rxl All Medical Expenses eligible under IRC Section 213* other than direct long-term care expenses,and including non- prescription medications allowed under IRS guidance. ❑ The following Medical Expenses(select only the expenses you wish to cover under the VamageCare Retirement Health Savings Plan)- Medical Insurance Premiums Medical Out-of-Pocket Expenses* Medicare Part B Insurance Premiums Medicare Part D Insurance Premiums Medicare Supplemental Insurance Premiums Prescription Drug Insurance Premiums COBRA Insurance Premiums Dental Insurance Premiums Dental Out-of-Pocket Expenses* Vision Insurance Premiums Vision Out-of-Pocket Expenses* Qualified Long-Term Care Insurance Premiums Non-Prescription medications allowed under IRS guidance* Other qualifying medical expenses(describe)* *See Section V A for a discussion of nondiscnmination rules which may apply to non-collectively bargained, self- insured Plans X1. Benefits After the Death of the Participant In the event of a Participant's death,the followmg shall apply: A. Surviving Spouse and/or Surviving Dependents The surviving spouse and/or surviving eligible dependents(as defined in Section XII D.)of the deceased Participant are immediately eligible to maintain the account and utilize it to fund eligible medical benefits specified in Section X above. Upon notification of a Participant's death,the Participant's account balance will be transferred into the Vantagepoint Money Market Fund*(or another fund selected by the Employer) The account balance maybe reallocated by the surviving spouse or dependents If a Participant's account balance has not been fully utilized upon the death of the eligible spouse,the account balance may continue to be utilized to pay benefits of eligible dependents Upon the death of all eligible dependents,the account will revert to the Plan to be applied as specified in Section VIII B. No Surviving Spouse or Surviving Dependents If there are no living spouse or dependents at the time of death of the Participant,the account will revert to the Plan to be applied as specified in Section VIII XII.The Plan will operate according to the following provisions: A. Employer Responsibilities The Employer will submit all VantageCare Retirement Health Savings Plan contribution data via electronic submission. The Employer will submit all VantageCare Retirement Health Savings Plan Participant status updates or personal information updates via electronic submission This includes but is not limited to termmation notification and benefit eligibility notification B. Participant account administration and asset-based fees will be paid through the redemption of Participant account shares, unless agreed upon otherwise in the Administrative Services Agreement C. Assignment of benefits is not permitted Benefits will be paid only to the Participant,his/her Survivors,the Employer,or an insurance provider(as allowed by the claims administrator) Payments to an third-party payee(e g,medical service provider)are not permitted with the exception of reimbursement to the Employer or insurance provider(as allowed by the claims administrator) D. An eligible dependent is the Participant's lawful spouse and any other individual who is a person described in IRC Section 152(a),as clarified by Internal Revenue Service Notice 2004-79 E. The Employer will be responsible for withholding,reporting and remitting any applicable taxes for payments which are deemed to be discriminatory under iRC Section 105(h),as outlined in the VantageCare Retirement Health Savings Plan Employer Manual. XIIi. Employer Acknowledgements A. The Employer hereby acknowledges it understands that failure to properly fill out this Employer VantageCare Retirement Health Savings Plan Adoption Agreement may result in the loss of tax exemption of the Trust and/or loss of tax-deferred status for Employer contributions B. ❑ Check this box if you are including supporting documents that include plan provisions. EMPLOYER SIGNATURE 1 By: J lX�-� Date Title: Z Attest: Date: I O Title: Accepted VANTAGEPOINT TRANSFER AGENTS,LLC Assistant Secretary, ICMA-RC VANTAGECARE RETIREMENT HEALTH SAVINGS PLAN ANNOUNCEMENT LETTER Re City of Kent Retirement Health Savings Plan VantageCare Retirement Health Savings Plan Dear Employee: We are very pleased to inform you that you are eligible to participate in our VantageCare Retirement Health Savings (RHS) Plan a benefit provided through the ICMA Retirement Corporation (ICMA-RC) that gives you tools to help you save for healthcare expenses on a tax-advantaged basis All of the information contained in the accompanying Employee Enrollment Kit is very important Many of your questions may be answered by referencing the VantageCare Retirement Health Savings Employee Question and Answer Brochure included in the Enrollment Kit There are, however, individual features that have been selected for our RHS Plan that are detailed in the attachment to this letter Please keep this Announcement Letter with your other benefits information so that you may refer to it as needed. You should also carefully read the forms that you will be given for enrollment What is VantageCare RHS? The VantageCare Retirement Health Savings (RHS) Plan is a tax-advantaged savings plan dedicated to funding one of your most significant financial exposures -- healthcare costs RHS allows you to accumulate assets now to pay, on a tax-free basis, medical expenses you incur later Medical costs are likely to be one of your largest expenditures in retirement The national average for health care premiums for a retired couple is $11,000 per year While your cost may be lower or higher than this, you should know that the cost of health care increases outpace general inflation at the rate of three to one each year You can use your pension or deferred compensation savings to help pay for retirement health expenses, but these payments will be taxable to you The VantageCare RHS Plan allows you to receive reimbursements for health care expenses on a tax-advantaged basis Some of the benefits of our RHS Plan include- • tax-free contributions and tax-free investment growth ■ tax-free medical expense reimbursements ■ Vantagepoint Mutual Funds*that provide you with a full range of investments, ■ upon your death, the funds are passed along to your surviving spouse and/or eligible dependents for their health expenses ■ experienced health benefit claims processing, and ■ quarterly account statements * Please consult the current Vantagepoint Funds prospectus carefully for a complete summary of all fees, expenses, charges, financial highlights and investment objectives, risks and performance information pnor to investing any money Vantagepoint securities are distributed by ICMA-RC Services, LLC, a broker dealer affiliate of ICMA-RC, member NASD/SIPC For a current prospectus, contact ICMA-RC Services LLC< 777 North Capitol Street NE< Washington, DC 20002-4240 1-800-669-7400 The attached Summary of Plan Provisions provides information on the details of our RHS Plan Please direct any questions you may have to your benefits office VantageCare RHS - It's a benefit for you that can last a lifetime VANTAGECARE 4, RETIREMENT HEALTH SAVINGS (RHS) PLAN SUMMARY OF PLAN PROVISIONS g i (Amended October 8, 2010) RHS Plan Information Plan Name: City of Kent Plan Number: 803016 Account Number: Your ICMA-RC assigned Reference Number Eligible Employees The following groups of employees are eligible to participate in our VantageCare RHS Plan Public Safety Employees-Police (Captain, Lieutenant, Police Deputy Chief, Non-Rep out of Captain, Lieutenant Contract) Participation Your participation in the RHS plan is mandatory, you may not choose to opt out of the RHS program To enroll, simply fill out the VantageCare RHS Plan Employee Enrollment/Change Form and return it to your benefits office Contributions The contribution feature(s) shown below are available in our RHS Plan All RHS contributions are made to your account on a pre-tax basis No Social Security, Medicare, or income`taxes are payable on these amounts Retired military employees of the federal government who have qualified for retiree health care benefits shall be excluded for contributions and cash out upon retirement from the City of Kent's Retirement Health Savings(RHS)program as of October 1, 2011. The following contribution types are available in our RHS plan Direct Employer Contributions: For Lieutenants below age 60, your Employer shall contribute 3% of base pay Mandatory Employee Compensation Contributions: Your Employer shall contribute 3% of earnings for eligible groups Check with your benefits office regarding state taxes Most states do not tax RHS contributions Mandatory Employee Leave Contributions: The Employer will make mandatory contributions of accrued leave for eligible groups as follows - Accrued Sick and Vacation Leave - under age 50- 50% at retirement or at separation - Ages 50—59— 100% at retirement or at separation - Over age 60— 100 % at retirement or at separation Limits on Total Contributions: There is no Plan-defined limit on the percentage or dollar amount of earnings that may be contributed Definition of Earnings: Base Pay Vesting Schedule The account is 100% vested at all times Healthcare Benefits Timing of Eligibility: You are eligible to submit for reimbursements of healthcare benefits at retirement or at separation from service You will also become eligible for benefits if you become totally and permanently disabled Total and permanent disability is as defined by the Employer's primary retirement plan Permissible Healthcare Benefit Payments: Healthcare benefits eligible for reimbursement consist of: ❑X All Medical Expenses eligible under IRC Section 213 other than direct long-term care expenses, and including non-prescription medications allowed under IRS guidance. ❑ Medical Insurance Premiums ❑ Medical Out-of-Pocket Expenses ❑ Medicare Part B Insurance Premiums ❑ Medicare Part D Insurance Premiums ❑ Medicare Supplemental Insurance Premiums ❑ Prescription Drug Insurance Premiums ❑ COBRA Insurance Premiums ❑ Dental Insurance Premiums ❑ Dental Out-of-Pocket Expenses ❑ Vision Insurance Premiums ❑ Vision Out-of-Pocket Expenses ❑ Qualified Long-Term Care Insurance Premiums ❑ Non-Prescription medications allowed under IRS guidance ❑ Other Qualify medical expenses (describe) Amounts paid from your account to reimburse qualifying healthcare benefits for you, your spouse, and your dependents will be tax-free Please note that if your plan amends the allowable healthcare benefits during your benefit eligibility period, the timing of the amendment could cause certain claims to be denied. Reimbursement Requests: Once you are eligible for healthcare benefits, your Employer will notify ICMA-RC of your eligibility You must also complete the VantageCare RHS Plan Benefit Eligibility Form to provide ICMA-RC your spouse and dependent information Then you may begin requesting reimbursements by filing the VantageCare RHS Plan Reimbursement Request Form Reimbursement requests are submitted directly to Mentain Health, ICMA-RC's third-party claims processor for RHS Plans Mentain's address and telephone number are on the form You may call Mentain directly with any claims related questions Post-Death Account Use In the event of your death, ■ Your account will be transferred to your surviving spouse and/or surviving eligible dependents for continuing tax-free healthcare benefits ■ If no spouse or eligible dependents survive you, your remaining account assets will remain in the RHS Plan trust to be reallocated on an equal dollar basis among all Plan Participants Please refer to the VantageCare RHS Plan Employee Enrollment/Change Form for important information on this designation Questions? For further information on our new VantageCare RHS Plan, please contact your benefits office or ICMA-RC's Investor Services associates at 1-800-669-7400 You can also read important information about the plan in your VantageCare RHS Plan Employee Enrollment Kit VantageCare RHS - It's a benefit for you that can last a lifetime