Reso 2006-995 - Laserfiche WebLink

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There will be no elective withholding of federal, state, or local taxes for medical benefit payments to the Participant's spouse's or dependent's designated beneficiary(ies). If there are no living spouse or dependents at the time of death of the Participant. the account will be available for medical benefits for the designated beneficiary(ies) of the Participant. Assets remaining upon the death of all designated beneficiaries shall be available for medical benefits of the beneficiary's beneficiary. If there is no liv- ing beneficiary(ies), the account will revert to the Plan to be applied as specified in Section VIII. There will be no elective withholding of federal, state, or local taxes for medical benefit payments to the Participant's beneficiary(ies) or any beneficiary's beneficiary. XII. De Minimis Accounts Upon separation from the service of the Employer prior to a Participant becoming eligible for medical benefits from a VantageCare Retirement Health Savings Plan account, Participant accounts that are considered de min- imis as specified below will be paid to the Participant. o The de minimis account value shall be $5,000 or less. o The de minimis account value shall be $ $5,000) or less. {insert dollar amount between $0 and C9"'The Plan shall not allow de minimis account distributions, XIII. The Plan will operate according to the following provisions: A. Employer Responsibilities 1, The Employer will submit all VantageCare Retirement Health Savings Plan contribution data via electronic submission. 2. Participant status updates and/or changes or personal information updates and/or changes (Participants' termination dates, Participants' benefit eligibility dates, etc.) will be provided via electronic submission. B. Participant account administration fees will be paid through the redemption of Participant account shares, unless agreed upon otherwise in the Administrative Services Agreement. C. Employer plan fees will be paid by the Employer as outlined in the Administrative Services Agreement. D. Assignment of benefits is not permitted. E. Payments to an alternate payee (payee other than a Participant) are not permitted with the exception of reim- bursement of health insurance premiums to the Employer. F. An eligible dependent is the Participant's lawful spouse and any other individual who is a person described in IRC Section 152(a). G. The Employer will be responsible for withholding, reporting and remitting any applicable taxes, as outlined in the VantageCare Retirement Health Savings Plan Employer Manual. XIV. 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. 17