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BENEFIT OPTIONS • <br /> The Premium Conversion Plan allows you to use before-tax <br /> salary dollars to pay the employee share of the premiums for <br /> certain employer sponsored group insurance plans. If you decide <br /> to use this option, your portion of premiums will be deducted <br /> from your pay before taxes.' The remainder of the cost will be <br /> paid by the employer, just as in the past. <br /> The amount of required Participant contributions for medical <br /> coverage shall be a flat dollar amount to be determined and <br /> communicated prior to the start of each plan year. Participants <br /> electing dental or optional life insurance shall pay the full <br /> premium cost. If there is a change in your share of the cost of <br /> a health plan because of a change in the premium charged by the <br /> insurance company, the amount of salary reduction will be <br /> adjusted automatically. <br /> ENROLLMENT AND ADMINISTRATION <br /> Election Process <br /> Each year you will have the opportunity to re-enroll in the <br /> plan. Elections do not carry forward from one year to the next. <br /> Elections must be in writing on the form provided and received <br /> prior to the first day of the period of coverage. If you fail to 0 <br /> return the required election form, it will be assumed that you <br /> have chosen to receive the full amount of your pay, after taxes, <br /> in cash. <br /> Once an election becomes effective, it stays in effect until <br /> the following plan year. You may not change your election during <br /> the plan year except under the following circumstances. <br /> 1) If the premium amount for a health plan significantly <br /> increases, you may make a corresponding change in salary <br /> reduction election, or revoke the election and receive <br /> coverage under another health plan with similar coverage. <br /> 2) If the coverage under a health plan is significantly <br /> curtailed or ceases, you may revoke your election and <br /> receive coverage under another health plan with similar <br /> coverage. <br /> 3) If you have a change in family status, you may revoke your <br /> election and submit a new election for the remainder of the <br /> plan year. A change in family status for this purpose <br /> includes marriage or divorce, death of a child or spouse, <br /> birth or adoption of a child, termination or commencement of <br /> a spouse's employment, change from full-time to part-time <br /> 2 <br />