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HomeMy WebLinkAboutCC RES 03-011 A RESOLUTION APPROVING AND ADOPTING CHANGE TO THE CITY OF ST. ANTHONY FLEXIBLE BENEFIT PLAN Meeting Sheet IIIIIIVIIIVIIIVIIIVIIIVIIIIIIIIIII ioasoo Box: 31 Folder: RES 2003 Document: CC RES 03-011 A RESOLUTION APPROVING AND � ADOPTING CHANGE TO THE CIN OF ST. ANTHONY FLEXIBLE BENEFIT PLAN • CITY OF ST. ANTHONY VILLAGE RESOLUTION 03-011 A RESOLUTION APPROVING AND ADOPTING CHANGE TO THE CITY OF ST. ANTHONY FLEXIBLE BENEFIT PLAN WHEREAS, the City of St. Anthony previously adopted the City of St. Anthony Flexible Benefit Plan("Plan") on January 1, 1991; and WHEREAS, the City of St. Anthony desires to amend and restate the Plan in the following manner: Effective January 1,2003: • The Plan will operate using the Final FMLA Regulations issued October 17, 2001, and updated Claims Appeal Process issued July 1, 2002. NOW, THEREFORE, BE IT RESOLVED, that the City of St. Anthony Flexible Benefit Plan be and the same is amended and restated. • BE IT FURTHER RESOLVED, that any proper members of the City Council are hereby authorized to make such contributions from the funds of the City as are necessary to carry out the provisions of said Plan at any time. BE IT FURTHER RESOLVELD, that in the event any conflict arises between the provisions of said Plan and the Employee Retirement Income Security Act of 1974 (ERISA) or any other applicable law or regulation(as such law or regulation may be interpreted or amended), the City shall resolve such conflict in a manner which complies with ERISA or such law or regulation. Adopted this L4 day of 2003. Mayor ATTEST: City Clerk • Reviewed for Administration: City anger • STANTON GROUP December 30,2002 Mr. Roger Larson City of St Anthony 3301 Silver Lake Road St Anthony,MN 55418 Re: Summary of Material Modification for City of St Anthony Flexible Benefit Plan Dear Roger: In response to your request,please find the following: • A Summary of Material Modification(SMM) for City of St Anthony. Each participant/eligible employee should receive a copy of the SMM within 210 days of the effective date and it should become a part of your current Summary Plan Description/ Communication Booklet. • Resolution of the Board of City Commissioners. The Board of City Commissioners should formally approve/adopt the change to the Plan. Please forward a copy of the executed Resolution of the Board of City Commissioners to me for your file here at Stanton Group. The Resolution should be signed prior to the effective date of the changes. Should you have any questions or require further information,please call me at(763)278- 4278 or Shannel Dehkes,your FSA Coordinator at(763)278-4266. We thank you for your continued business with Stanton Group. Sincerely, A'- Michelle L. Conger Benefit Administration Implementation Specialist Enclosures 3405 Annapolis Lane North • Minneapolis, MN 55447 • www.stanton-group.com • 763-278-4000 • fax 763 278-4007 December 29, 2002 TO: Eligible Employees and Participants of the City of St Anthony Flexible Benefit Plan RE: Summary of Material Modification for the City of St Anthony Flexible Benefit Plan Effective January 1,2003,the City of St Anthony Flexible Benefit Plan shall be administered using the Final FMLA Regulations issued October 17,2001; and the updated Claims Appeal Process issued July 1,2002. The sections of your Summary Plan Description that will be affected are: 1. Leaves Of Absences,And Family Or Medical Leaves 2. Claims For Benefits • Final FMLA Regulations WHAT HAPPENS IF I TAKE A LEAVE OF ABSENCE OR FAMILY OR MEDICAL LEAVE? • If you take a leave of absence that is not a family or medical leave under the Family and Medical Leave Act of 1993, the way in which you may participate in the Plan will depend on whether or not you continue to receive compensation from the Employer. If during a leave you continue to be paid by the Employer,your benefit election will remain in effect and the Employer will continue to withhold Pre-tax Contributions. If you are not being paid by the Employer,your participation in the Plan will be treated in the same way as if you had terminated employment. Thus, you cannot make contributions to your Dependent Care Reimbursement Account,but you can continue to submit claims through the end of the Plan Year or, if earlier, until your account is depleted. Also, you may continue to pay for your health coverage, dental coverage, life coverage and any health care expense reimbursement benefits on an after-tax basis. In doing so,your prior benefit election will be reinstated when you return to work (see Continuation of Coverage section). If you take a leave of absence that is a family or medical leave under the Family and Medical Leave Act of 1993, you should contact the Assistant City Manager in order to discuss your continued participation in the Plan during the leave. In general, if you take an unpaid family or medical leave, you may continue to participate in the Plan provided you continue to pay foryourbenefits. You can elect to pay for your benefits in one of the following three ways: 1. You can pay for your benefits on a pre-tax basis by allowing us to deduct your required contributions from your paychecks before the leave. (Due to certain tax law restrictions, you can only prepay on a pre-tax basis through • the end of a Plan Year.) 2. You can pay for your benefits for the duration of the leave on an after-tax basis by a single lump-sum payment at the beginning of the leave. • 3. You can pay for your benefits on an after-tax basis during the leave by sending your payment to City of St Anthony on or before the first of each month. If you receive taxable pay from the Employer during your leave, you can pay for your benefits on a pre-tax basis through Pre-tax Contributions from that pay. If you fail to make arrangements to pay for your benefits during a family or medical leave, the Employer reserves the right to recover the cost of such coverage from you at the end of the family or medical leave to the fullest extent authorized by the Family and Medical Leave Act of 1993. If you are on a family or medical leave under the Family and Medical Leave Act of 1993 at any point during a Plan Year, you will be entitled to revoke your election with respect to health coverage, dental coverage, life coverage and any health care expense reimbursement benefits under the Plan. Following your return from the family or medical leave you will be entitled to reinstate those coverages for the remainder of the Plan Year, on the terms that applied prior to family or medical leave. However, if you reinstate health care reimbursement coverage following a family or medical leave,,(a) your Period of Coverage for the Plan Year will exclude periods for which your coverage had lapsed because of the revocation or termination, (b) no expenses incurred during the excluded period will be eligible for reimbursement under the Plan, (c) your level of coverage for the Plan Year of the reinstatement will equal your coverage level in effect at the time of your revocation or termination, reduced on a pro rata basis to reflect excluded • periods for which your coverage had lapsed, (d) all previously paid benefits will be charged against your revised coverage level, and (e) your revised coverage level can be (i) your coverage level in effect for the Plan Year of the Reinstatement reduced on a pro rata basis or(ii) your original coverage level for the period of coverage with higher post- leave salary reductions to make up the difference, if you so elect. For,exam lef as`s`ume<t)iat;Louise:elected$1=20Uof`healthacarejeimtursement 0 f "e`'6 Coverage= ' �tF-,,�.s .. for<thePlan o-Yearand was'paying;foi-tlus`beriefit on:a, re-taz'basisrat arate=o $5 =° ar•' .: ,.` 'i, ,-t.,.; . . :semi=monthly ypay.=period:- On :November.=1 sle"began a family/medical',leave"that. �xtended tliough December Through Octobei 31 E'she had uicuired"4400,of:rereimbui bld, health'%are` expenses " = fib' .,. , .. , �_� �� fid, t. ';, y S}ie revoked 1ep� election h,u,November al. aud=reinstated° the , �a�!, _.m .fi.= ,„n 4 '*psi � ,q °4 a' � :T:'^ R� ,*4BY -v.3 =coverage,.dhl Januarys l::' Because'Louise,revoked;herrelection;rather"than•.coritinuing'it and4paging,foSL°tlie coverage-using^one-of'the met> ods°descrilied above; ariy healtfi bare expenses`sheincured'from;November::1`.`throughYDeceinber3l will not:be;:elgitle`for ��i�'.�'�°r'.,'.�,_- -: r-.�`i t.>,"fiwr ""'�vi�s.;r:t 4�"`i''-'. ;�'.'�,'r .<' ?' �;.�,a-.•:ti<r� '«.X yp�°'„U''y` �-'4s,X��':°: reimbursemenf ;.Ilponcremst`atement=her Period of"Coverage for tl ea PIan:Year Swill e3 AugustFal. ughOctober-3tland'Jamary.`1 ,through,lulyN 3x1{cjf thatAPlari°.Year;'un les"sf �, «. iyf • - •- •§%--c:,f:_.tr y Xa- <;.', - ~there:iskan.earlier:�termination.under";the rules,tt at;apply,to all,;participhhK-,�Because.of ,''-�jia,, ., -, '�- ..:::: _ -3iM..,. mk,.;-r a-,x'r•,:,+r c=,a-:•.4„ ' athis two-month Elapse€period;upon,reinstatement.Louise s eIeciibif46f the'<PIa'Y6ar wi11 ' - -,:';, ;5• ':.r '„ +;y-.s .fix.; - _ - - -�-..,;•ai.n;'- '- a.; " .-"i'>,"TM.xe,zt"�"="'= $ a"-> ;' ::XD`s•'. Abe-.adjusted�from�$31;200,•to=$1;000�(�150%12)�`�wBecause;shehas�already.�,receixed $400�of; benefits;I owse;swill'be eligible forup°gto $600 of addirional:revntiursement forthe'Plan �" ,r• a " ?"a-1r",-�,6i.� YearF If°'Lqui"se;elects=the;liigheislevel ($1,2UU) ) er post leavessalaryXreductions uvill >?e .^.t: - ,.:.'trfsri..`."`&•aar . i�..j;;-. - 1'28:5 7 afi&= er'aciditional `"v .` ur E` $ ,a ailablereunburseinent".:amount for,the'Plaa<YeaTa;willrbe= y3.� a« �s,,` grz• c,,. :-`-?;`"i - "-+-aa'�=`;T��•3,�„?. - ..:4"x:. §'.i.iv>----`.:;`°,:`�,.,• - ' -`nr:°• ,;c;�.,- t`-B�s,«, � rai-_ {,tee,^ ;;���-�,4t^✓'�':�^' �'T�,.z,'- - '„r°- - - _ m.x µ , • Any revocation, request for reinstatement and post-leave coverage choice must be made • using Employer forms. In the case of a revocation, the form must be submitted no later than 30 days after the commencement of the family and medical leave. In the case of a request for reinstatement, the form must be submitted no later than 30 days after return from the family or medical leave. If you take a military leave of absence you may have a right to have your coverage under the medical expense reimbursement portion of this Plan continued. Upon your return from a military leave of absence you may have a right to reinstate your coverage without any waiting periods. Please contact the Assistant City Manager at 612-789-8881 as soon as you know you will be taking a family or medical leave or a military leave of absence. ■ Updated Claims Appeal Process: CLAIMS FOR BENEFITS Claims under the health insurance, dental insurance or life insurance are described in the Certificates of Coverage for those benefits. Unless otherwise proved in this document,the Certificates of Coverage or other documents governing a particular benefit plan,the following procedure will apply to claims for benefits under the Plan. You or your beneficiary may file a written claim with the Employer requesting a benefit • under the Plan or objecting to the determination of your benefit. You must file a claim on the form or forms available for that purpose in order for a claim to be valid. Forms are available from the sources referenced in this booklet,or you may obtain the form you need from the Plan Administrator. The Plan Administrator will notify you in writing within 30 days after your written application for benefits of your eligibility or non-eligibility for benefits under the Plan. If the Plan Administrator needs additional time to evaluate your claim, it will notify you within the first 30 days how much additional time is needed,but not more than another 15 days. If the Plan Administrator requests additional information, you will have 45 days to provide that information. The review period will be suspended until the specified information is received. If the Plan Administrator determines that you are not eligible for benefits or full benefits,the notice will tell you: (1) the specific reasons for the denial, (2) the specific provision of the Plan on which denial is based, (3) a description of any additional information or material necessary for you to perfect your claim(and an explanation of why such information or material is necessary),and (4) an explanation of the Plan's claim review procedure, including the time limits applicable to the review procedure. If the Plan Administrator determines that you are not eligible for benefits,or if you believe that you are entitled to greater or different benefits,you will have the opportunity to have • your claim reviewed by the City Manager by filing a petition for review with the City Manager within 180 days after you receive the notice issued by the Plan Administrator. Your petition should state the specific reasons why you believe you are entitled to benefits, or greater or different benefits. You have the right to obtain from the Employer, on request and free of charge,reasonable access to and copies of all documents,records and other information relevant to your claim for benefits. You should make sure that your request for review includes all the information relevant to your claim. Within 60 days after the City Manager receives the petition,City Manager will give you a written decision of its review. The City Manager may hold a hearing for the review of your claim if you request and it decides such a hearing is necessary. The City Manager's written decision will state: (1) the specific reason or reasons for the adverse determination, (2) the specific Plan provisions and/or rule on which the benefit determination is based, (3) that you are entitled to receive,on request and free of charge, reasonable access to,and copies of,all documents,records,and other information relevant to your claim for benefits, and You may choose to have a representative represent you in the claims procedure. If you do,the Employer may require proof that the individual is authorized to act on your behalf. Note that you must follow this claims procedure if you have a claim, and the failure to do so will prevent you from challenging an adverse decision in court. Please file this notice with your copy of the Summary Plan Description.