2000-61Resolution No. 2000- 61
RESOLUTION FOR THE CREATION OF
• UNION EMPLOYEE RETIREE MEDICAL EXPENSE REIMBURSEMENT PLAN AND
• NON -UNION EMPLOYEE RETIREE MEDICAL EXPENSE REIMBURSEMENT PLAN
WHEREAS, the Village has previously established by Resolution No. 2000 -54 on the 20th day of
November 2000, a Retiree Health Savings plan ( "RHS Plans ") to be administered by the ICMA
Retirement Corporation and /or its affiliates for union and non -union employees; and
WHEREAS, under the Internal Revenue Code ( "Code ") employers who establish RHS Plans that
wish to maximize tax efficiency of the RHS Plan are required to publish Employee Retiree
Medical Expense Reimbursement Plan(s); and
WHEREAS, the Village wishes to maximize tax efficiency of the benefits of both its RHS Plans;
and
NOW, THERFORE BE IT RESOLVED, by the CORPORATE AUTHORITIES, of the Village of
Buffalo Grove, Cook and Lake Counties, Illinois, that the Village hereby adopts the Union
Employee Retiree Medical Expense Reimbursement Plan (attached hereto as Exhibit "A ") and
the Non -Union Employee Retiree Medical Expense Reimbursement Plan (attached hereto as
Exhibit "B ").
BE IT FURTHER RESOLVED, that the Village Manager shall be given authority to execute, with
staff to attest, all documents pertaining to the reporting and administration of these plans.
BE IT FURTHER RESOLVED, that both Plans are effective the 18th day of December 2000.
AYES: 5 — Marienthal, Braiman, Glvoer, Berman, Johnson
NAYES: 0 — None
ABSENT: 1 — Hendricks
Approved December 11 2000 Passed December 11 ,2000
Village Presided
Attest:
0A4 �,M , 3AZ40,v,
Vill !erk
Exhibit "A"
VILLAGE OF BUFFALO GROVE
UNION EMPLOYEE RETIREE
MEDICAL EXPENSE REIMBURSEMENT PLAN
ARTICLE I
PREAMBLE
This instrument made and published by the Village of Buffalo Grove, Illinois
(hereinafter called the "Employer ") as of the 18th day of December, 2000, creates
the Village of Buffalo Grove Union Employee Retiree Medical Expense Reimbursement
Plan, as follows:
1.01 Establishment of Plan
The Employer named above hereby establishes a Retiree Medical Expense
Reimbursement Plan (the "Plan ") as of the 18th day of December, 2000.
1.02 Purpose of Plan
This Plan has been established to reimburse the eligible Retirees of the
Employer for medical expenses incurred by them, their Spouses and
Dependents, pursuant to the Employer's VantageCare Retiree Health Savings
(RHS) Plan.
ARTICLE II
DEFINITIONS
The following words and phrases as used herein.shall have the following meanings,
unless a different meaning is plainly required by the context:
2.01 "Benefits" means any amounts paid to a Participant in the Plan as
reimbursement for Eligible Medical Expenses incurred by the Participant
during a Plan Year by him, his Spouse, or his Dependents.
2.02 "Code" means the Internal Revenue Code of 1986, as amended.
2.03 "Dependent" means any individual who is a dependent of the Participant
within the meaning of the Code Section 152.
2.04 "Eligible Medical Expenses" means those expenses designated by the Employer
as eligible for reimbursement in the VantageCare Retiree Health Savings
Plan Adoption Agreement, specifically those expenses eligible under Code
Section 213.
2.05 "Employer" means the Village of Buffalo Grove, Illinois.
2.06 "Entry Date" means the first day the Participant meets the eligibility
requirements of Article III.
2.07 "Participant" means any Retiree who has met the eligibility requirements
set forth in Article III.
2.08 "Plan Administrator" means the Employer or other person appointed by the
Employer who has the authority and responsibility to manage and direct the
operation and administration of the Plan.
2.09 "Plan Year" means the annual accounting period of the Plan, which begins
on the 18th day of December, 2000, and ends on the 31st day of December,
2001, with respect to the first Plan Year, and thereafter as long as this
Plan remains in effect, the period that begins on January 1st and ends on
1
•
December 31st.
•
2.10 "Retiree" means any individual who, while in the service of the Employer,
was considered to be in a legal employer- employee relationship with the
Employer for federal withholding tax purposes, and who was part of the
classification of employees designated as covered by the Employer's
VantageCare Retiree Health Savings Plan.
2.11 "Spouse" means the Participant's lawful spouse as determined under the laws
of the state in which the Participant has his primary place of residence.
All other defined terms in this Plan shall have the meanings specified in the
various Articles of the Plan in which they appear.
ARTICLE III
ELIGIBILITY
3.01 General Requirements
Each Retiree who meets the eligibility requirements outlined in the
Employer's VantageCare Retiree Health Savings Plan shall be eligible to
participate in this Plan.
3.02 Termination of Coverage of an Eligible Dependent
An Eligible Dependent's coverage shall terminate:
(a) after the death of the Retiree, upon the attainment of age 19 (or 24
for a full time student);
(b) Notwithstanding (a) above, an Eligible Dependent's coverage shall not
cease if the individual is incapable of self- sustaining employment
by reason of mental or physical handicap and he or she became
handicapped while an Eligible Dependent of the Participant. The
account balance may continue to be utilized to pay Benefits of the
individual if he or she qualified as a Dependent of the Participant
during the Participant's life, and the Plan has received due proof
of incapacity within 31 days of when the individual's coverage under
the Plan would otherwise terminate. The individual's coverage may
be continued as long as the individual remains incapacitated. The
Plan may request proof of the continued existence of such incapacity
from time to time.
ARTICLE IV
AMOUNT OF BENEFITS
4.01 Annual Benefits Provided by the Plan
Each Participant shall be entitled to reimbursement for his documented,
Eligible Medical Expenses incurred during the Plan Year in an annual
amount not to exceed the account balance of the Participant in the
Employer's VantageCare Retiree Health Savings Plan.
4.02 Cost of Coverage
The expense of providing the benefits set out in Section 4.01 shall be
contributed as outlined in the Employer's VantageCare Retiree Health
Savings Plan.
2
ARTICLE V
PAYMENT OF BENEFITS
5.01 Eligibility for Benefits
A. Each Participant in the Plan shall be entitled to a benefit
hereunder for all Eligible Medical Expenses incurred by the
Participant on or after the Entry Date of his or her participation,
(and after the effective date of the Plan) subject to the
limitations contained in Article V, below, regardless of whether the
mental or physical condition for which the Participant makes
application for benefits under the Plan was detected, diagnosed, or
treated before the Participant became covered by the Plan.
B. In order to be eligible for benefits, the Participant must meet the
benefit eligibility criteria outlined in the Employer's VantageCare
Retiree Health Savings Plan Adoption Agreement.
C. A Participant who dies or becomes totally and permanently disabled
(as defined by the Social Security Administration) will become
immediately eligible to receive medical benefit payments from the
Plan.
5.02 Claims for Benefits
No benefit shall be paid hereunder unless a Participant has first
submitted a written claim for benefits to the Plan Administrator on a form
specified by the Plan Administrator, and pursuant to the procedures set
out in Article VI below. Upon receipt of a properly documented claim, the
Plan Administrator shall pay the Participant the benefits provided under
this Plan as soon as is administratively feasible.
ARTICLE VI
PLAN ADMINISTRATION
6.01 Allocation of Authority
The Employer shall control and manage the operation and Administration of
the Plan. The Employer shall have the exclusive right to interpret the
Plan and to decide all matters arising thereunder, including the right to
remedy possible ambiguities, inconsistencies, or omissions. All
determinations of the Employer with respect to any matter hereunder shall
be conclusive and binding on all persons.
Without limiting the generality of the foregoing, the Employer shall have
the following powers and duties:
(a) To decide on questions concerning the Plan and the eligibility of
any Employee to participate in the Plan, in accordance with the
provisions of the Plan;
(b) To determine the amount of benefits that shall be payable to any
person in accordance with the provisions of the Plan; to inform the
Employee, as appropriate, of the amount of such Benefits; and to
provide a full and fair review to any Participant whose claim for
benefits has been denied in whole or in part; and
(c) To designate other persons to carry out any duty or power which
would otherwise be a fiduciary responsibility of the Plan
Administrator, under the terms of the Plan.
3
•
(d) To require any person to furnish such reasonable information as it
may request for the purpose of the proper administration of the Plan
as a condition to receiving any benefits under the Plan;
(e) To make and enforce such rules and regulations and prescribe the use
of such forms as he shall deem necessary for the efficient
administration of the Plan.
6.02 Provision for Third -Party Plan Service Providers
The Plan Administrator, subject to approval of the Employer, may employ
the services of such persons or entity as it may deem necessary or
desirable in connection with the operation of the Plan. The Plan
Administrator, the Employer (and any person to whom it may delegate any
duty or power in connection with the administration of the Plan), and all
persons connected therewith may rely upon all tables, valuations,
certifications, reports and opinions furnished by any duly appointed
actuary, accountant, (including Employees who are actuaries or
accountants), consultants, third party administration service provider,
legal counsel, or other specialist, and they shall be fully protected in
respect to any action taken or permitted in good faith in reliance
thereon. All actions so taken or permitted shall be conclusive and
binding as to all persons.
6.03 Several Fiduciary Liability
To the extent permitted by law, neither the Plan Administrator nor any
other person shall incur any liability for any acts or for failure to act
except for its own willful misconduct or willful breach of this Plan.
6.04 Compensation of Plan Administrator
Unless otherwise agreed to by the 'Board, the Plan Administrator shall
serve without compensation for services rendered in such capacity, but all
reasonable expenses incurred in the performance of his duties shall be
paid by the Employer.
6.05 Bonding
Unless otherwise determined by the Board, or unless required by any
Federal or State law, the Plan Administrator shall not be required to give
any bond or other security in any jurisdiction in connection with the
administration of this Plan.
6.06 Payment of Administrative Expenses
All reasonable expenses incurred in administering the Plan, including but
not limited to administrative fees and expenses owing to any third party
administrative service provider, actuary, consultant, accountant,
attorney, specialist, or other person or organization that may be employed
by the Plan Administrator in connection with the administration hereof,
shall be paid by the Employer, provided, however that each Participant
shall bear the monthly cost (if any) charged by a third party
administrator for maintenance of his Benefit Account unless otherwise paid
by the Employer.
6.07 Timeliness of Payments
Payments shall be made as soon as administratively feasible after the
required forms and documentation have been received by the Plan
4
•
Administrator.
6.08 Annual Statements
•
The Plan Administrator shall furnish each Participant with an annual
statement of his medical expense reimbursement account within ninety (90)
days after the close of each Plan Year.
ARTICLE VII
CLAIMS PROCEDURE
7.01 Procedure if Benefits are Denied Under the Plan
Any Participant, Spouse or Eligible Dependent, or his duly authorized
representative may file a claim for a plan benefit to which the claimant
believes that he is entitled. Such a claim must be in writing on a form
provided by the Plan Administrator and delivered to the Plan
Administrator, in person or by mail, postage paid. Within thirty (30)
days after receipt of such claim, the Plan Administrator shall send to the
claimant, by mail, postage prepaid, notice of the granting or denying, in
whole or in part, of such claim, unless special circumstances require an
extension of time for processing the claim. In no event may the extension
exceed ninety (90) days from the end of the initial period. If such
extension is necessary, the claimant will be given a written notice to
this effect prior to the expiration of the initial 30 -day period. The
Plan Administrator shall have full discretion to deny or grant a claim in
whole or in part. If notice of the denial of a claim in not furnished in
accordance with this Section, the claim shall be deemed denied and the
claimant shall be permitted to exercise his right to review pursuant to
Sections 7.03 through 7.05.
7.02 Requirement for Written Notice of Claim Denial
The Plan Administrator shall provide, to every claimant who is denied a
claim for benefits, written notice setting forth in a manner calculated to
be understood by the claimant:
(a) The specific reason or reasons for the denial;
(b) Specific reference to pertinent Plan provisions on which the denial
is based;
(c) A description of any additional material or information necessary
for the claimant to perfect the claim and an explanation of why such
material is necessary, and
(d) An explanation of the Plan's claim review procedure.
7.03 Right to Request Hearing on Benefit Denial
Within sixty (60) days after the receipt by the claimant of written
notification of the denial (in whole or in part) of his claim, the
claimant or his duly authorized representative, upon written application
to the Plan Administrator, in person or by certified mail, postage
prepaid, may request a review of such denial, may review pertinent
documents, and may submit issues and comments in writing.
7.04 Disposition of Disputed Claims
Upon its receipt of notice of a request for review, the Plan Administrator
5
shall make a prompt decision on the review. The decision on review shall
be written in a manner calculated to be understood by the claimant and
shall include specific reasons for the decision and specific references to
the pertinent Plan provisions on which the decision is based. The
decision on review shall be made not later than sixty (60) days after the
Plan Administrator's receipt of a request for a review, unless special
circumstances require an extension of time for processing, in which case
a decision shall be rendered not later than one hundred - twenty (120) days
after receipt of a request for review. If an extension is necessary, the
claimant shall be given written notice of the extension prior to the
expiration of the initial sixty (60) day period. If notice of the
decision on the review is not furnished in accordance with this Section,
the claim shall be deemed denied and the claimant shall be permitted to
exercise his right to legal remedy pursuant to Section 7.05
7.05 Preservation of Other Remedies
After exhaustion of the claims procedures provided under this Plan,
nothing shall prevent any person from pursuing any other legal or
equitable remedy otherwise available.
ARTICLE VIII
AMENDMENT OR TERMINATION OF PLAN
8.01 Permanency
While the Employer fully expects that this Plan will continue
indefinitely, due to unforeseen, future business contingencies, permanency
of the Plan will be subject to the Employer's right to amend or terminate
the Plan, as provided in Sections 8.02 and 8.03 below.
8.02 Employer's Right to Amend
The Employer reserves the right to amend the Plan at any time and from
time -to -time, and retroactively if deemed necessary or appropriate to meet
the requirements of the Code, or any similar provisions of subsequent
revenue or other laws, or the rules and regulations in effect under any of
such laws or to conform with governmental regulations or other policies,
to modify or amend in whole or in part any of all of the provisions of the
Plan.
8.03 Employer's Right to Terminate
The Employer reserves the right to discontinue or terminate the Plan at
any time without prejudice.
ARTICLE IX
GENERAL PROVISIONS
9.01 No Employment Rights Conferred
Neither this Plan nor any action taken with respect to it shall confer
upon any person the right to be continued in the employment of the
Employer.
9.02 Payments to Beneficiary
Any benefits otherwise payable to a Participant following the date of
death of such Participant shall be paid as outlined in the Employer's
VantageCare Retiree Health Savings Plan Adoption Agreement.
ri
9.03 Nonalienation of Benefits
No benefit under the Plan shall be subject in any manner to anticipation,
alienation, sale, transfer, assignment, pledge, encumbrance or charge, and
any attempt to do so shall be void. No benefit under the Plan shall in
any manner be liable for or subject to the debts, contracts, liabilities,
engagements or torts of any person. If any person entitled to benefits
under the Plan becomes bankrupt or attempts to anticipate, alienate, sell,
transfer, assign, pledge, encumber or charge any benefit under the Plan,
or if any attempt is made to subject any such benefit to the debts,
contracts, liabilities, engagements or torts of the person entitled to any
such benefit, except as specifically provided in the Plan, then such
benefit shall cease and terminate in the discretion of the Plan
Administrator, and it may hold or apply the same or any part thereof to
the benefit of any dependent or beneficiary of such person, in such manner
and proportion as it may deem proper.
9.04 Mental or Physical Incompetency
If the Plan Administrator determines that any person entitled to payments
under the Plan is incompetent by reason of phyiscal or mental disability,
it may cause all payments thereafter becoming due to such person to be
made to any other person for his benefit, without responsibility to follow
the application of amounts so paid. Payments made pursuant to this
Section shall completely discharge the Plan Administrator and the
Employer.
9.05 Inability to Locate Payee
If the Plan Administrator is unable to make payment to any Participant or
other person to whom a payment is due under the Plan because it cannot
ascertain the identity or whereabouts of such Participant or other person
after reasonable efforts have been made to identify or locate such person
(including a notice of the payment so due mailed to the last known address
of such Participant or other person as shown on the records of the
Employer), such payment and all subsequent payments otherwise due to such
Participant or other person shall be escheated under the laws of the State
of last known address of the Participant or other persons eligible for
benefits.
9.06 Requirement of Proper Forms
All communications in connection with the Plan made by a Participant shall
become effective only when duly executed on forms provided by and filed
with the Plan Administrator.
9.07 Source of Payments
The Employer shall be the sole source of benefits under the Plan. No
Employee or beneficiary shall have any right to, or interest in, any
assets of the Employer upon termination of employment or otherwise, except
as provided from time to time under the Plan, and then only to the extent
of the benefits payable under the Plan to such Employee or beneficiary.
9.08 Tax Effects
Neither the Employer nor the Plan Administrator makes any warranty or
other representation as to whether any payments received by a Participant
hereunder will be treated as includible in gross income for federal or
state income tax purposes.
9.09 Multiple Functions
Any person or group of persons may serve in more than one fiduciary
capacity with respect to the Plan.
9.10 Gender and Number
Masculine pronouns include the feminine as well as the neuter gender, and
the singular shall include the plural, unless indicated otherwise by the
context.
9.11 Headings
The Article and Section headings contained herein are for convenience of
reference only, and shall not be construed as defining or limiting the
matter contained thereunder.
9.12 Applicable Laws
The provisions of the Plan shall be construed, administered and enforced
according to the laws of the State of Illinois.
9.13 Severability
Should any part of this Plan subsequently be invalidated by a court of
competent jurisdiction, the remainder thereof shall be given effect to the
maximum extent possible.
In Witness Whereof we have executed this Plan Agreement the date and year first
written above.
For Village of Buffalo Grove, Cook and Lake Counties, Illinois.
Union Employee Retiree Medical Expense Reimbursement Plan
Buffalo Grove Professional Firefighter /Paramedic Association Local 3177
By: W
Attest:
0
Exhibit "B"
VILLAGE OF BUFFALO GROVE
NON -UNION EMPLOYEE RETIREE
MEDICAL EXPENSE REIMBURSEMENT PLAN
ARTICLE I
PREAMBLE
This instrument made and published by the Village of Buffalo Grove, Illinois
(hereinafter called the "Employer ") as of the 18th day of December, 2000, creates
the Village of Buffalo Grove Non -Union Employee Retiree Medical Expense
Reimbursement Plan, as follows:
1.01 Establishment of Plan
The Employer named above hereby establishes a Retiree Medical Expense
Reimbursement Plan (the "Plan ") as of the 18th day of December, 2000.
1.02 Purpose of Plan
This Plan has been established to reimburse the eligible Retirees of the
Employer for medical expenses incurred by them, their Spouses and
Dependents, pursuant to the Employer's VantageCare Retiree Health Savings
(RHS) Plan.
ARTICLE II
DEFINITIONS
The following words and phrases as used herein shall have the following meanings,
unless a different meaning is plainly required by the context:
2.01 "Benefits" means any amounts paid to a Participant in the Plan as
reimbursement for Eligible Medical Expenses incurred by the Participant
during a Plan Year by him, his Spouse, or his Dependents.
2.02 "Code" means the Internal Revenue Code of 1986, as amended.
2.03 "Dependent" means any individual who is a dependent of the Participant
within the meaning of the Code Section 152.
2.04 "Eligible Medical Expenses" means those expenses designated by the Employer
as eligible for reimbursement in the VantageCare Retiree Health Savings
Plan Adoption Agreement, specifically those expenses eligible under Code
Section 213.
2.05 "Employer" means the Village of Buffalo Grove, Illinois.
2.06 "Entry Date" means the first day the Participant meets the eligibility
requirements of Article III.
2.07 "Participant" means any Retiree who has met the eligibility requirements
set forth in Article III.
2.08 "Plan Administrator" means the Employer or other person appointed by the
Employer who has the authority and responsibility to manage and direct the
operation and administration of the Plan.
2.09 "Plan Year" means the annual accounting period of the Plan, which begins
on the 18th day of December, 2000, and ends on the 31st day of December,
2001, with respect to the first Plan Year, and thereafter as long as this
Plan remains in effect, the period that begins on January 1st and ends on
1
December 31st.
2.10 "Retiree" means any individual who, while in the service of the Employer,
was considered to be in a legal employer- employee relationship with the
Employer for federal withholding tax purposes, and who was part of the
classification of employees designated as covered by the Employer's
VantageCare Retiree Health Savings Plan.
2.11 "Spouse" means the Participant's lawful spouse as determined under the laws
of the state in which the Participant has his primary place of residence.
All other defined terms in this Plan shall have the meanings specified in the
various Articles of the Plan in which they appear.
ARTICLE III
ELIGIBILITY
3.01 General Requirements
Each Retiree who meets the eligibility requirements outlined in the
Employer's VantageCare Retiree Health Savings Plan shall be eligible to
participate in this Plan.
3.02 Termination of Coverage of an Eligible Dependent
An Eligible Dependent's coverage shall terminate:
(a) after the death of the Retiree, upon the attainment of age 19 (or 24
for a full time student);
(b) Notwithstanding (a) above, an Eligible Dependent's coverage shall not
cease if the individual is incapable of self - sustaining employment
by reason of mental or physical handicap and he or she became
handicapped while an Eligible Dependent of the Participant. The
account balance may continue to be utilized to pay Benefits of the
individual if he or she qualified as a Dependent of the Participant
during the Participant's life, and the Plan has received due proof
of incapacity within 31 days of when the individual's coverage under
the Plan would otherwise terminate. The individual's coverage may
be continued as long as the individual remains incapacitated. The
Plan may request proof of the continued existence of such incapacity
from time to time.
ARTICLE IV
AMOUNT OF BENEFITS
4.01 Annual Benefits Provided by the Plan
Each Participant shall be entitled to reimbursement for his documented,
Eligible Medical Expenses incurred during the Plan Year in an annual
amount not to exceed the account balance of the Participant in the
Employer's VantageCare Retiree Health Savings Plan.
4.02 Cost of Coverage
The expense of providing the benefits set out in Section 4.01 shall be
contributed as outlined in the Employer's VantageCare Retiree Health
Savings Plan.
F
•
ARTICLE V
PAYMENT OF BENEFITS
5.01 Eligibility for Benefits
n
A. Each Participant in the Plan shall be entitled to a benefit
hereunder for all Eligible Medical Expenses incurred by the
Participant on or after the Entry Date of his or her participation,
(and after the effective date of the Plan) subject to the
limitations contained in Article V, below, regardless of whether the
mental or physical condition for which the Participant makes
application for benefits under the Plan was detected, diagnosed, or
treated before the Participant became covered by the Plan.
B. In order to be eligible for benefits, the Participant must meet the
benefit eligibility criteria outlined in the Employer's VantageCare
Retiree Health Savings Plan Adoption Agreement.
C. A Participant who dies or becomes totally and permanently disabled
(as defined by the Social Security Administration) will become
immediately eligible to receive medical benefit payments from the
Plan.
5.02 Claims for Benefits
No benefit shall be paid hereunder unless a Participant has first
submitted a written claim for benefits to the Plan Administrator on a form
specified by the Plan Administrator, and pursuant to the procedures set
out in Article VI below. Upon receipt of a properly documented claim, the
Plan Administrator shall pay the Participant the benefits provided under
this Plan as soon as is administratively feasible.
ARTICLE VI
PLAN ADMINISTRATION
6.01 Allocation of Authority
The Employer shall control and manage the operation and Administration of
the Plan. The Employer shall have the exclusive right to interpret the
Plan and to decide all matters arising thereunder, including the right to
remedy possible ambiguities, inconsistencies, or omissions. All
determinations of the Employer with respect to any matter hereunder shall
be conclusive and binding on all persons.
Without limiting the generality of the foregoing, the Employer shall have
the following powers and duties:
(a) To decide on questions concerning the Plan and the eligibility of
any Employee to participate in the Plan, in accordance with the
provisions of the Plan;
(b) To determine the amount of benefits that shall be payable to any
person in accordance with the provisions of the Plan; to inform the
Employee, as appropriate, of the amount of such Benefits; and to
provide a full and fair review to any Participant whose claim for
benefits has been denied in whole or in part; and
(c) To designate other persons to carry out any duty or power which
would otherwise be a fiduciary responsibility of the Plan
Administrator, under the terms of the Plan.
3
•
(d) To require any person to furnish such reasonable information as it
may request for the purpose of the proper administration of the Plan
as a condition to receiving any benefits under the Plan;
(e) To make and enforce such rules and regulations and prescribe the use
of such forms as he shall deem necessary for the efficient
administration of the Plan.
6.02 Provision for Third -Party Plan Service Providers
The Plan Administrator, subject to approval of the Employer, may employ
the services of such persons or entity as it may deem necessary or
desirable in connection with the operation of the Plan. The Plan
Administrator, the Employer (and any person to whom it may delegate any
duty or power in connection with the administration of the Plan), and all
persons connected therewith may rely upon all tables, valuations,
certifications, reports and opinions furnished by any duly appointed
actuary, accountant, (including Employees who are actuaries or
accountants), consultants, third party administration service provider,
legal counsel, or other specialist, and they shall be fully protected in
respect to any action taken or permitted in good faith in reliance
thereon. All actions so taken or permitted shall be conclusive and
binding as to all persons.
6.03 Several Fiduciary Liability
To the extent permitted by law, neither the Plan Administrator nor any
other person shall incur any liability for any acts or for failure to act
except for its own willful misconduct or willful breach of this Plan.
6.04 Compensation of Plan Administrator
Unless otherwise agreed to by the Board, the Plan Administrator shall
serve without compensation for services rendered in such capacity, but all
reasonable expenses incurred in the performance of his duties shall be
paid by the Employer.
6.05 Bonding
Unless otherwise determined by the Board, or unless required by any
Federal or State law, the Plan Administrator shall not be required to give
any bond or other security in any jurisdiction in connection with the
administration of this Plan.
6.06 Payment of Administrative Expenses
All reasonable expenses incurred in administering the Plan, including but
not limited to administrative fees and expenses owing to any third party
administrative service provider, actuary, consultant, accountant,
attorney, specialist, or other person or organization that may be employed
by the Plan Administrator in connection with the administration hereof,
shall be paid by the Employer, provided, however that each Participant
shall bear the monthly cost (if any) charged by a third party
administrator for maintenance of his Benefit Account unless otherwise paid
by the Employer.
6.07 Timeliness of Payments
Payments shall be made as soon as administratively feasible after the
required forms and documentation have been received by the Plan
4
•
Administrator.
6.08 Annual Statements
•
The Plan Administrator shall furnish each Participant with an annual
statement of his medical expense reimbursement account within ninety (90)
days after the close of each Plan Year.
ARTICLE VII
CLAIMS PROCEDURE
7.01 Procedure if Benefits are Denied Under the Plan
Any Participant, Spouse or Eligible Dependent, or his duly authorized
representative may file a claim for a plan benefit to which the claimant
believes that he is entitled. Such a claim must be in writing on a form
provided by the Plan Administrator and delivered to the Plan
Administrator, in person or by mail, postage paid. Within thirty (30)
days after receipt of such claim, the Plan Administrator shall send to the
claimant, by mail, postage prepaid, notice of the granting or denying, in
whole or in part, of such claim, unless special circumstances require an
extension of time for processing the claim. In no event may the extension
exceed ninety (90) days from the end of the initial period. If such
extension is necessary, the claimant will be given a written notice to
this effect prior to the expiration of the initial 30 -day period. The
Plan Administrator shall have full discretion to deny or grant a claim in
whole or in part. If notice of the denial of a claim in not furnished in
accordance with this Section, the claim shall be deemed denied and the
claimant shall be permitted to exercise his right to review pursuant to
Sections 7.03 through 7.05.
7.02 Requirement for Written Notice of Claim Denial
The Plan Administrator shall provide, to every claimant who is denied a
claim for benefits, written notice setting forth in a manner calculated to
be understood by the claimant:
(a) The specific reason or reasons for the denial;
(b) Specific reference to pertinent Plan provisions on which the denial
is based;
(c) A description of any additional material or information necessary
for the claimant to perfect the claim and an explanation of why such
material is necessary, and
(d) An explanation of the Plan's claim review procedure.
7.03 Right to Request Hearing on Benefit Denial
Within sixty (60) days after the receipt by the claimant of written
notification of the denial (in whole or in part) of his claim, the
claimant or his duly authorized representative, upon written application
to the Plan Administrator, in person or by certified mail, postage
prepaid, may request a review of such denial, may review pertinent
documents, and may submit issues and comments in writing.
7.04 Disposition of Disputed Claims
Upon its receipt of notice of a request for review, the Plan Administrator
5
shall make a prompt decision on the review. The decision on review shall
be written in a manner calculated to be understood by the claimant and
shall include specific reasons for the decision and specific references to
the pertinent Plan provisions on which the decision is based. The
decision on review shall be made not later than sixty (60) days after the
Plan Administrator's receipt of a request for a review, unless special
circumstances require an extension of time for processing, in which case
a decision shall be rendered not later than one hundred - twenty (120) days
after receipt of a request for review. If an extension is necessary, the
claimant shall be given written notice of the extension prior to the
expiration of the initial sixty (60) day period. If notice of the
decision on the review is not furnished in accordance with this Section,
the claim shall be deemed denied and the claimant shall be permitted to
exercise his right to legal remedy pursuant to Section 7.05
7.05 Preservation of Other Remedies
After exhaustion of the claims procedures provided under this Plan,
nothing shall prevent any person from pursuing any other legal or
equitable remedy otherwise available.
ARTICLE VIII
AMENDMENT OR TERMINATION OF PLAN
8.01 Permanency
While the Employer fully expects that this Plan will continue
indefinitely, due to unforeseen, future business contingencies, permanency
of the Plan will be subject to the Employer's right to amend or terminate
the Plan, as provided in Sections 8.02 and 8.03 below.
8.02 Employer's Right to Amend
The Employer reserves the right to amend the Plan at any time and from
time -to -time, and retroactively if deemed necessary or appropriate to meet
the requirements of the Code, or any similar provisions of subsequent
revenue or other laws, or the rules and regulations in effect under any of
such laws or to conform with governmental regulations or other policies,
to modify or amend in whole or in part any of all of the provisions of the
Plan.
8.03 Employer's Right to Terminate
The Employer reserves the right to discontinue or terminate the Plan at
any time without prejudice.
ARTICLE IX
GENERAL PROVISIONS
9.01 No Employment Rights Conferred
Neither this Plan nor any action taken with respect to it shall confer
upon any person the right to be continued in the employment of the
Employer.
9.02 Payments to Beneficiary
Any benefits otherwise payable to a Participant following the date of
death of such Participant shall be paid as outlined in the Employer's
VantageCare Retiree Health Savings Plan Adoption Agreement.
0
9.03 Nonalienation of Benefits
No benefit under the Plan shall be subject in any manner to anticipation,
alienation, sale, transfer, assignment, pledge, encumbrance or charge, and
any attempt to do so shall be void. No benefit under the Plan shall in
any manner be liable for or subject to the debts, contracts, liabilities,
engagements or torts of any person. If any person entitled to benefits
under the Plan becomes bankrupt or attempts to anticipate, alienate, sell,
transfer, assign, pledge, encumber or charge any benefit under the Plan,
or if any attempt is made to subject any such benefit to the debts,
contracts, liabilities, engagements or torts of the person entitled to any
such benefit, except as specifically provided in the Plan, then such
benefit shall cease and terminate in the discretion of the Plan
Administrator, and it may hold or apply the same or any part thereof to
the benefit of any dependent or beneficiary of such person, in such manner
and proportion as it may deem proper.
9.04 Mental or Physical Incompetency
If the Plan Administrator determines that any person entitled to payments
under the Plan is incompetent by reason of phyiscal or mental disability,
it may cause all payments thereafter becoming due to such person to be
made to any other person for his benefit, without responsibility to follow
the application of amounts so paid. Payments made pursuant to this
Section shall completely discharge the Plan Administrator and the
Employer.
9.05 Inability to Locate Payee
If the Plan Administrator is unable to make payment to any Participant or
other person to whom a payment is due under the Plan because it cannot
ascertain the identity or whereabouts of such Participant or other person
after reasonable efforts have been made to identify or locate such person
(including a notice of the payment so due mailed to the last known address
of such Participant or other person as shown on the records of the
Employer), such payment and all subsequent payments otherwise due to such
Participant or other person shall be escheated under the laws of the State
of last known address of the Participant or other persons eligible for
benefits.
9.06 Requirement of Proper Forms
All communications in connection with the Plan made by a Participant shall
become effective only when duly executed on forms provided by and filed
with the Plan Administrator.
9.07 Source of Payments
The Employer shall be the sole source of benefits under the Plan. No
Employee or beneficiary shall have any right to, or interest in, any
assets of the Employer upon termination of employment or otherwise, except
as provided from time to time under the Plan, and then only to the extent
of the benefits payable under the Plan to such Employee or beneficiary.
9.08 Tax Effects
Neither the Employer nor the Plan Administrator makes any warranty or
other representation as to whether any payments received by a Participant
hereunder will be treated as includible in gross income for federal or
state income tax purposes.
9.09 Multiple Functions
Any person or group of persons may serve in more than one fiduciary
capacity with respect to the Plan.
9.10 Gender and Number
Masculine pronouns include the feminine as well as the neuter gender, and
the singular shall include the plural, unless indicated otherwise by the
context.
9.11 Headings
The Article and Section headings contained herein are for convenience of
reference only, and shall not be construed as defining or limiting the
matter contained thereunder.
9.12 Applicable Laws
The provisions of the Plan shall be construed, administered and enforced
according to the laws of the State of Illinois.
9.13 Severability
Should any part of this Plan subsequently be invalidated by a court of
competent jurisdiction, the remainder thereof shall be given effect to the
maximum extent possible.
In Witness Whereof we have executed this Plan Agreement the date and year first
written above.
For Village of Buffalo Grove, Cook and Lake Counties, Illinois.
Non -Union Employee Retiree Medical Expense Reimbursement Plan
By:
Attest: A��'
0