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Home My WebLink About5/14/2013 - Regular Roanoke County Board of Supervisors May 14, 2013 ×ÒÊÑÝßÌ×ÑÒæ Ü®ò Í«®»¸µ«³¿® Í»ª»²¬¸ Ü¿§ ß¼ª»²¬·¬ Î»º±®³ Ó±ª»³»²¬ ÐÔÛÜÙÛ ÑÚ ßÔÔÛÙ×ßÒÝÛ ÌÑ ÌØÛ ËÒ×ÌÛÜ ÍÌßÌÛÍ ÚÔßÙ Disclaimer: he official start of the Board meeting shall be the voluntary offering of a private citizen, to and for the benefit of the Board. The views or beliefs expressed by the invocation speaker have not been previously reviewed or approved by the Board and do not necessarily represent the religious beliefs or views of the Board in part or as a whole. No member of the community is required to attend or participate in the invocation and such decision will have no impact on their right to actively participate in the business of Ð¿¹» ï ±º ì Roanoke County Board of Supervisors Agenda May 14, 2013 Ù±±¼ ¿º¬»®²±±² ¿²¼ ©»´½±³» ¬± ±«® ³»»¬·²¹ º±® Ó¿§ ïìô îðïíò Î»¹«´¿® ³»»¬·²¹ ¿®» ¸»´¼ ±² ¬¸» »½±²¼ ¿²¼ º±«®¬¸ Ì«»¼¿§ ¿¬ íæðð °ò³ò Ð«¾´·½ ¸»¿®·²¹ ¿®» ¸»´¼ ¿¬ éæðð °ò³ò ±² ¬¸» º±«®¬¸ Ì«»¼¿§ ±º »¿½¸ ³±²¬¸ò Ü»ª·¿¬·±² º®±³ ¬¸· ½¸»¼«´» ©·´´ ¾» ¿²²±«²½»¼ò Ì¸» ³»»¬·²¹ ¿®» ¾®±¿¼½¿¬ ´·ª» ±² ÎÊÌÊô Ý¸¿²²»´ íô ¿²¼ ©·´´ ¾» ®»¾®±¿¼½¿¬ ±² Ì¸«®¼¿§ ¿¬ éæðð °ò³ò ¿²¼ ±² Í¿¬«®¼¿§ ¿¬ ìæðð °ò³ò Þ±¿®¼ ±º ©»¾·¬» ¿¬ ©©©òÎ±¿²±µ»Ý±«²¬§Êßò¹±ªò Ñ«® ³»»¬·²¹ ¿®» ½´±»¼ó½¿°¬·±²»¼ô ± ·¬ · ·³°±®¬¿²¬ º±® »ª»®§±²» ¬± °»¿µ ¼·®»½¬´§ ·²¬± ¬¸» ³·½®±°¸±²» ¿¬ ¬¸» °±¼·«³ò ×²¼·ª·¼«¿´ ©¸± ®»¯«·®» ¿·¬¿²½» ±® °»½·¿´ ¿®®¿²¹»³»²¬ ¬± °¿®¬·½·°¿¬» ·² ±® ¿¬¬»²¼ Þ±¿®¼ ±º Í«°»®ª·±® ³»»¬·²¹ ¸±«´¼ ½±²¬¿½¬ ¬¸» Ý´»®µ ¬± ¬¸» Þ±¿®¼ ¿¬ øëìð÷ ééîóîððë ¿¬ ´»¿¬ ìè ¸±«® ·² ¿¼ª¿²½»ò Ð´»¿» ¬«®² ¿´´ ½»´´ °¸±²» ±ºº ±® °´¿½» ±² ·´»²¬ò ßò ÑÐÛÒ×ÒÙ ÝÛÎÛÓÑÒ×ÛÍ øíæðð °ò³ò÷ ïò Î±´´ Ý¿´´ Þò ÎÛÏËÛÍÌÍ ÌÑ ÐÑÍÌÐÑÒÛô ßÜÜ ÌÑ ÑÎ ÝØßÒÙÛ ÌØÛ ÑÎÜÛÎ ÑÚ ßÙÛÒÜß ×ÌÛÓÍ Ýò ÐÎÑÝÔßÓßÌ×ÑÒÍô ÎÛÍÑÔËÌ×ÑÒÍô ÎÛÝÑÙÒ×Ì×ÑÒÍ ßÒÜ ßÉßÎÜÍ ïò Ð®±½´¿³¿¬·±² ¼»½´¿®·²¹ ¬¸» ©»»µ ±º Ó¿§ ïç ¬¸®±«¹¸ îëô îðïíô ¿ Û³»®¹»²½§ Ó»¼·½¿´ Í»®ª·½» É»»µ ·² ¬¸» Ý±«²¬§ ±º Î±¿²±µ» øÖ±»§ Í¬«³°ô Ü·ª··±² Ý¸·»ºô Ú·®» ¿²¼ Î»½«»÷ Üò ÞÎ×ÛÚ×ÒÙÍ Ûò ÒÛÉ ÞËÍ×ÒÛÍÍ ïò Î»¯«»¬ ¬± ¿°°®±°®·¿¬» üîðôðïë º±® ¬¸» Ö«²» ïïô îðïíô Ü»³±½®¿¬·½ Ð®·³¿®§ Û´»½¬·±² øÖ«¼·¬¸ Í¬±µ»ô Î»¹·¬®¿®÷ Ð¿¹» î ±º ì îò Î»±´«¬·±² ¿¼±°¬·²¹ °±´·½·» º±® ¬¸» °®±¬»½¬·±² ±º °®·ª¿¬» °®±°»®¬§ ®·¹¸¬ ·² ¬¸» ¼»ª»´±°³»²¬ ±º Î±¿²±µ» Ý±«²¬§ °®±¶»½¬ ±® ¬¸» ¿¼±°¬·±² ±º Ý±«²¬§ ±®¼·²¿²½» øÐ¿«´ Óò Ó¿¸±²»§ô Ý±«²¬§ ß¬¬±®²»§÷ Úò Ú×ÎÍÌ ÎÛßÜ×ÒÙ ÑÚ ÑÎÜ×ÒßÒÝÛÍ ïò Ñ®¼·²¿²½» ¬± ¿°°®±°®·¿¬» º«²¼ º±® ¬¸» º·½¿´ §»¿® îðïíóîðïì ¾«¼¹»¬ ¿²¼ ¿°°®±ª¿´ ±º ¬¸» Ý´¿·º·½¿¬·±² Ð´¿² º±® º·½¿´ §»¿® îðïíóîðïì øÉò Þ®»²¬ Î±¾»®¬±²ô Ü·®»½¬±® ±º Ó¿²¿¹»³»²¬ ¿²¼ Þ«¼¹»¬÷ Ùò ßÐÐÑ×ÒÌÓÛÒÌÍ ïò Ý¿°·¬¿´ ×³°®±ª»³»²¬ Ð®±¹®¿³ øÝ×Ð÷ Î»ª·»© Ý±³³·¬¬»» ø¿°°±·²¬»¼ ¾§ Ü·¬®·½¬÷ îò Ð¿®µô Î»½®»¿¬·±² ¿²¼ Ì±«®·³ ß¼ª·±®§ Ý±³³··±² ø¿°°±·²¬»¼ ¾§ Ü·¬®·½¬÷ Øò ÝÑÒÍÛÒÌ ßÙÛÒÜß ßÔÔ ÓßÌÌÛÎÍ Ô×ÍÌÛÜ ËÒÜÛÎ ÌØÛ ÝÑÒÍÛÒÌ ßÙÛÒÜß ßÎÛ ÝÑÒÍ×ÜÛÎÛÜ ÞÇ ÌØÛ ÞÑßÎÜ ÌÑ ÞÛ ÎÑËÌ×ÒÛ ßÒÜ É×ÔÔ ÞÛ ÛÒßÝÌÛÜ ÞÇ ÑÒÛ ÎÛÍÑÔËÌ×ÑÒ ×Ò ÌØÛ ÚÑÎÓ ÑÎ ÚÑÎÓÍ Ô×ÍÌÛÜ ÞÛÔÑÉò ×Ú Ü×ÍÝËÍÍ×ÑÒ ×Í ÜÛÍ×ÎÛÜô ÌØßÌ ×ÌÛÓ É×ÔÔ ÞÛ ÎÛÓÑÊÛÜ ÚÎÑÓ ÌØÛ ÝÑÒÍÛÒÌ ßÙÛÒÜß ßÒÜ É×ÔÔ ÞÛ ÝÑÒÍ×ÜÛÎÛÜ ÍÛÐßÎßÌÛÔÇ ïò ß°°®±ª¿´ ±º ³·²«¬» ß°®·´ çô îðïíå ß°®·´ îíô îðïí îò Î»¯«»¬ ¬± ¿¼±°¬ ¿ ®»±´«¬·±² ¬± ¿«¬¸±®·¦» ¿ ¸»¿´¬¸ ®»·³¾«®»³»²¬ ¿®®¿²¹»³»²¬ ¿²¼ ¿°°®±ª» °´¿² ¼±½«³»²¬ íò Î»¯«»¬ ¬± ¿°°®±ª» ¿² ¿¹®»»³»²¬ ©·¬¸ ¬¸» Ç¿µ¿³¿ Ò¿¬·±² ¬± ®»±´ª» °»²¼·²¹ ´·¬·¹¿¬·±² ìò Î»¯«»¬ ¬± ¿°°®±°®·¿¬» üîêôêééòèð ¬± ¬¸» Ý´»®µ ±º ¬¸» Ý·®½«·¬ Ý±«®¬ º®±³ ¬¸» Ý±³³±²©»¿´¬¸ ±º Ê·®¹·²·¿ º±® º·½¿´ §»¿® îðïîñîðïí ×ò ÎÛÏËÛÍÌÍ ÚÑÎ ÉÑÎÕ ÍÛÍÍ×ÑÒÍ Öò ÎÛÏËÛÍÌÍ ÚÑÎ ÐËÞÔ×Ý ØÛßÎ×ÒÙÍ Õò Ð¿¹» í ±º ì Ôò ÎÛÐÑÎÌÍ ïò Ù»²»®¿´ Ú«²¼ Ë²¿°°®±°®·¿¬»¼ Þ¿´¿²½» îò Ý¿°·¬¿´ Î»»®ª» íò Î»»®ª» º±® Þ±¿®¼ Ý±²¬·²¹»²½§ Óò ÎÛÐÑÎÌÍ ßÒÜ ×ÒÏË×Î×ÛÍ ÑÚ ÞÑßÎÜ ÓÛÓÞÛÎÍ ïò îò Ý¸¿®´±¬¬» ßò Ó±±®» íò Î·½¸¿®¼ Ýò Ú´±®¿ ìò ëò Ó·½¸¿»´ Éò ß´¬·¦»® Òò ÉÑÎÕ ÍÛÍÍ×ÑÒÍ ïò îðïì »·±² ±º ¬¸» Ê·®¹·²·¿ Ù»²»®¿´ ß»³¾´§ øÐ¿«´ Óò Ó¿¸±²»§ô Ý±«²¬§ îò É±®µ »·±² ¬± °®»»²¬ ¬¿ºº ®»½±³³»²¼¿¬·±² º±® º·®¬ ¬·»® °®±¶»½¬ ±º ¬¸» Ý¿°·¬¿´ ×³°®±ª»³»²¬ ß¼³·²·¬®¿¬±®÷ Ñò ÝÔÑÍÛÜ ÓÛÛÌ×ÒÙô °«®«¿²¬ ¬± ¬¸» Ý±¼» ±º Ê·®¹·²·¿ ¿ º±´´±©æ ïò Í»½¬·±² îòîòíéïïòßòïô Ð»®±²²»´ô ²¿³»´§ ¼·½«·±² ½±²½»®²·²¹ ¿² ¿°°±·²¬³»²¬ ¬± ¬¸» Ý´»¿² Ê¿´´»§ Ý±«²½·´å Ý±³³«²·¬§ Ð±´·½§ ¿²¼ Ó¿²¿¹»³»²¬ Ì»¿³ øÝÐÓÌ÷å ¬¸» Ý±«®¬ Ý±³³«²·¬§ Ý±®®»½¬·±² Ð®±¹®¿³ Î»¹·±²¿´ Ý±³³«²·¬§ Ý®·³·²¿´ Ö«¬·½» Þ±¿®¼å ¬¸» Î±¿²±µ» Ê¿´´»§ß´´»¹¸¿²§ Î»¹·±²¿´ Ý±³³··±² ¿²¼ ¬¸» Î±¿²±µ» Ê¿´´»§ Î»¹·±²¿´ ÝßÌÊ Ý±³³·¬¬»» Ðò ÝÛÎÌ×Ú×ÝßÌ×ÑÒ ÎÛÍÑÔËÌ×ÑÒ Ïò ßÜÖÑËÎÒÓÛÒÌ Ð¿¹» ì ±º ì AT A REGULAR MEETING OF THE BOARD OF SUPERVISORS OF ROANOKE COUNTY, VIRGINIA, HELD AT THE ROANOKE COUNTY ADMINISTRATION CENTER ON TUESDAY, MAY 14, 2013 RESOLUTION ADOPTING POLICIES FOR THE PROTECTION OF PRIVATE PROPERTY RIGHTS IN THE DEVELOPMENT OF ROANOKE COUNTY PROJECTS OR THE ADOPTION OF COUNTY ORDINANCES WHEREAS, private property ownership is the foundation of individual liberty for American citizens; and WHEREAS, in 2012 the citizens of the Commonwealth of Virginia voted to amend Article 1, Section 11 of the constitution of Virginia further defining “public uses” and that no private property shall be damaged or taken except for public use without just compensation; and WHEREAS, the Board of Supervisors of Roanoke County hereby agrees to establish the following policies for the implementation and development of County projects; and WHEREAS, the County intends to manage growth in a positive way, to act conservatively and with deliberation when making decisions that will affect our high quality of life and that of our children’s children; and WHEREAS, the County seeks to empower our citizens to protect and maintain their neighbourhoods and communities from actions that might be a detriment to their peace and tranquillity; and WHEREAS, the County has adopted ordinances and programs to preserve the integrity of the surrounding mountains and open space; and Page 1 of 4 WHEREAS, the County supports the “right to farm” and encourages a high level of mutual respect among farmers, non-farm owners and rural visitors to protect individual property rights, responsibilities and privacy. NOW, THEREFORE, BE IT RESOLVED by the Board of Supervisors of Roanoke County, Virginia as follows: 1. That all citizens’ private property rights shall be placed in the highest priority of consideration during planning and zoning activities. 2. That Roanoke County will protect citizens’ property rights as long as that does not interfere with basic services for the safety and welfare of all citizens or the property rights of adjacent landowners. Basic services are defined as those which preserve and protect the public health, safety and the general welfare of the public, including but not limited to fire and rescue, police, garbage services and public education. 3. That property owners have the right to use their land as they see fit as long as that use does not interfere with the rights of others. 4. That the County will endeavour to provide information to citizens concerning the possible property rights infringement or possible loss of value of their private property; to provide copies of any cost-benefit analyses and to provide an opportunity to challenge the governmental action. 5. That in accordance with the Constitution and laws of the Commonwealth of Virginia, private property owners shall have an opportunity to recover the value of their private property damaged or taken for public use including lost profits, lost access and damages to the residue caused by the taking of private property. Page 2 of 4 6. That residential or agriculturally zoned areas may not be changed to commercial or utility zoning without a valid public purpose, and prime natural assets such as rivers, lakes, parks and mountains may not be converted to commercial or utility use unless there is a significant benefit to the public. 7. That citizens have the right to quiet enjoyment, to be free from unreasonable and on-going nuisances such as odours, noise, dust, vibrations, pollution, trash and debris, whether the source is a neighbour or a governmental activity. 8. That citizens have the right to expect that regulations will be interpreted, where ambiguous, in favour of the property owner. 9. That citizens have the right to be free from administrative decisions in the regulation of property that are not supported by Federal, State or local laws or regulations. 10. That in the event of a significant planned rezoning, affected property owners will be notified in writing prior to Planning Commission review, and they will have the opportunity to participate in an in information session where particulars of the plan and possible impacts will be available for review. Property owners’ opinions of the proposed zoning change may be presented by a representative of the affected landowners to the Planning Commission and be given high priority in consideration for approval of the change. 11. That no County officer or employee shall enter upon private property except as authorized by law. Police emergencies, fire events, property inspections and normal social service visits may be conducted as authorized without advance notice. Non-emergency visits to private property must be conducted during daylight hours and Page 3 of 4 advance notice to the property owner is required. Exceptions to this policy may be granted by the County administrator and such exceptions must be approved by a majority of the Board of Supervisors. Page 4 of 4 ßÌ ß ÎÛÙËÔßÎ ÓÛÛÌ×ÒÙ ÑÚ ÌØÛ ÞÑßÎÜ ÑÚ ÍËÐÛÎÊ×ÍÑÎÍ ÑÚ ÎÑßÒÑÕÛ ÝÑËÒÌÇô Ê×ÎÙ×Ò×ßô ØÛÔÜ ßÌ ÌØÛ ÎÑßÒÑÕÛ ÝÑËÒÌÇ ßÜÓ×Ò×ÍÌÎßÌ×ÑÒ ÝÛÒÌÛÎ ÑÒ ÌËÛÍÜßÇô ÓßÇ ïìô îðïí ORDINANCE APPROPRIATING FUNDS FOR THE 2013-2014 FISCAL YEAR BUDGET FOR ROANOKE COUNTY, VIRGINIA ÉØÛÎÛßÍô «°±² ²±¬·½» ¼«´§ °«¾´·¸»¼ ·² ¬¸» ²»©°¿°»®ô ¿ °«¾´·½ ¸»¿®·²¹ ©¿ ¸»´¼ ±² ß°®·´ îíô îðïíô ½±²½»®²·²¹ ¬¸» ¿¼±°¬·±² ±º ¬¸» ¿²²«¿´ ¾«¼¹»¬ º±® Î±¿²±µ» Ý±«²¬§ º±® º·½¿´ §»¿® îðïíóîðïìå ¿²¼ ÉØÛÎÛßÍô ¬¸» Þ±¿®¼ ±º Í«°»®ª·±® ±º Î±¿²±µ» Ý±«²¬§ô Ê·®¹·²·¿ô ¿°°®±ª»¼ ¿·¼ ¾«¼¹»¬ ±² Ó¿§ ïìô îðïíô °«®«¿²¬ ¬± ¬¸» °®±ª··±² ±º Í»½¬·±² ïíòðî ±º ¬¸» Î±¿²±µ» Ý±«²¬§ Ý¸¿®¬»® ¿²¼ Ý¸¿°¬»® îë ±º Ì·¬´» ïëòî ±º ¬¸» ïçëð Ý±¼» ±º Ê·®¹·²·¿ô ¿ ¿³»²¼»¼å ¿²¼ ÉØÛÎÛßÍô ¬¸» º·®¬ ®»¿¼·²¹ ±º ¬¸· ¿°°®±°®·¿¬·±² ±®¼·²¿²½» ©¿ ¸»´¼ ±² Ó¿§ ïìô îðïíô ¿²¼ ¬¸» »½±²¼ ®»¿¼·²¹ ±º ¬¸· ±®¼·²¿²½» ©¿ ¸»´¼ ±² Ó¿§ îèô îðïíô °«®«¿²¬ ¬± ¬¸» °®±ª··±² ±º Í»½¬·±² ïèòðì ±º ¬¸» Î±¿²±µ» Ý±«²¬§ Ý¸¿®¬»®ò ÞÛ ×Ì ÑÎÜß×ÒÛÜ ¾§ ¬¸» Þ±¿®¼ ±º Í«°»®ª·±® ±º Î±¿²±µ» Ý±«²¬§ô Ê·®¹·²·¿ô ¿ º±´´±©æ ïò Ì¸¿¬ ¬¸» º±´´±©·²¹ ¿°°®±°®·¿¬·±² ¿®» ¸»®»¾§ ³¿¼» º®±³ ¬¸» ®»°»½¬·ª» º«²¼ º±® ¬¸» °»®·±¼ ¾»¹·²²·²¹ Ö«´§ ïô îðïíô ¿²¼ »²¼·²¹ Ö«²» íðô îðïìô º±® ¬¸» º«²½¬·±² ¿²¼ °«®°±» ·²¼·½¿¬»¼æ County of Roanoke Adopted FY 2013-2014 Budget May 14, 2013 Revenues: General Fund: General Government$170,969,088 Communications & Information Technology8,179,339 Comprehensive Services5,227,799 Law Library27,175 Public Works Projects184,481 SB&T-Social Services Building444,580 Recreation Fee Class5,379,462 Police Special Programs1,000 Criminal Justic Academy149,410 Fleet Service Center2,770,000 Total General Fund$193,332,334 Debt Service Fund - County$6,999,924 Capital Projects Fund$4,553,856 Internal Service Fund - Risk Management$1,702,631 School Funds: Operating$133,799,052 Nutrition5,818,000 Debt14,177,897 Grants5,113,019 Capital845,488 Instructional Resources945,575 Bus325,000 Laptop Insurance Reserve305,600 Total School Fund$161,329,631 Total All Funds$367,918,376 Expenditures: General Government: General Administration Board of Supervisors$293,582 County Administrator291,306 Public Information181,566 Asst. Co. Administrators361,754 Human Resources758,820 County Attorney550,776 County of Roanoke Adopted FY 2013-2014 Budget May 14, 2013 Economic Development524,119 Total General Administration$2,961,923 Constitutional Officers Treasurer$769,261 Commonwealth Attorney1,071,134 Commissioner of the Revenue793,362 Clerk of the Circuit Court1,066,296 Sheriff's Office9,715,131 Total Constitutional Officers$13,415,184 Judicial Administration Circuit Court$237,972 General District Court69,940 Magistrate1,590 J & DR Court21,086 Court Service Unit480,144 Total Judicial Administration$810,732 Management Services Real Estate Assessments$847,625 Finance1,223,110 Public Transportation420,000 Management and Budget291,666 Procurement Services396,101 Total Management Services$3,178,502 Public Safety Police$11,278,325 Fire and Rescue13,537,568 Total Public Safety$24,815,893 Community Services General Services$5,794,587 Community Development3,978,282 Building Maintenance1,189,705 Total Community Services$10,962,574 County of Roanoke Adopted FY 2013-2014 Budget May 14, 2013 Human Services Grounds Maintenance$2,267,553 Parks and Recreation2,152,085 Public Health500,358 Social Services8,420,785 Contributions-Human Service, Cultural, Tourism, Dues 1,690,465 Library3,385,129 VA Cooperative Extension87,097 Elections314,064 Total Human Services$18,817,536 Non-Departmental Employee Benefits$2,584,997 Miscellaneous1,834,432 Internal Service Charges7,245,446 Total Non-Departmental$11,664,875 Transfers to Other Funds Transfer to Debt - General & Schools$16,294,134 Transfer to (from) Capital(202,184) Transfer to Schools64,568,020 Transfer to Schools - Dental Insurance477,299 Transfer to Public Works Projects184,481 Transfer to Internal Services1,067,119 Transfer to Comprehensive Services1,853,000 Total Transfers to Other Funds$84,241,869 Unappropriated Balance Board Contingency$100,000 Total General Government$170,969,088 Communications & Information Technology$8,179,339 Comprehensive Services$5,227,799 Law Library$27,175 Public Works Projects$184,481 SB&T-Social Services Building$444,580 County of Roanoke Adopted FY 2013-2014 Budget May 14, 2013 Recreation Fee Class$5,379,462 Police Special Programs$1,000 Criminal Justice Academy$149,410 Fleet Service Center$2,770,000 Total General Fund$193,332,334 Debt Service Fund - County$6,999,924 Capital Projects Fund$4,553,856 Internal Services Fund - Risk Management$1,702,631 Scoo Funs: hld Operating$133,799,052 Nutrition5,818,000 Debt14,177,897 Grants5,113,019 Capital845,488 Instructional Resources945,575 Bus325,000 Laptop Insurance Reserve305,600 Total School Funds$161,329,631 Total All Funds$367,918,376 îò Ì¸¿¬ ¬¸» Ý±«²¬§ ß¼³·²·¬®¿¬±® ³¿§ ¿«¬¸±®·¦» ±® ¼»´»¹¿¬» ¬¸» ¿«¬¸±®·¦¿¬·±² ±º ¬¸» ¬®¿²º»® ±º ¿²§ «²»²½«³¾»®»¼ ¾¿´¿²½» ±® °±®¬·±² ¬¸»®»±º º®±³ ±²» ¼»°¿®¬³»²¬ ¬± ¿²±¬¸»®ò íò Ì¸¿¬ ¿´´ º«²¼»¼ ±«¬¬¿²¼·²¹ »²½«³¾®¿²½»ô ¾±¬¸ ±°»®¿¬·²¹ ¿²¼ ½¿°·¬¿´ô ¿¬ Ö«²» íðô îðïíô ¿®» ®»ó¿°°®±°®·¿¬»¼ ¬± ¬¸» îðïíóîðïì º·½¿´ §»¿® ¬± ¬¸» ¿³» ¼»°¿®¬³»²¬ ¿²¼ ¿½½±«²¬ º±® ©¸·½¸ ¬¸»§ ¿®» »²½«³¾»®»¼ ·² ¬¸» °®»ª·±« §»¿®ò ìò Ì¸¿¬ ¿°°®±°®·¿¬·±² ¼»·¹²¿¬»¼ º±® ½¿°·¬¿´ °®±¶»½¬ ©·´´ ²±¬ ´¿°» ¿¬ ¬¸» »²¼ ±º ¬¸» º·½¿´ §»¿® ¾«¬ ¸¿´´ ®»³¿·² ¿°°®±°®·¿¬»¼ «²¬·´ ¬¸» ½±³°´»¬·±² ±º ¬¸» °®±¶»½¬ ±® «²¬·´ ¬¸» Þ±¿®¼ ±º Í«°»®ª·±®ô ¾§ ¿°°®±°®·¿¬» ¿½¬·±²ô ½¸¿²¹» ±® »´·³·²¿¬» ¬¸» ¿°°®±°®·¿¬·±²ò Ë°±² ½±³°´»¬·±² ±º ¿ ½¿°·¬¿´ °®±¶»½¬ô ¬¿ºº · ¿«¬¸±®·¦»¼ ¬± ½´±» ±«¬ ¬¸» °®±¶»½¬ ¿²¼ ¬®¿²º»® ¬± ¬¸» º«²¼·²¹ ±«®½» ¿²§ ®»³¿·²·²¹ ¾¿´¿²½»ò Ì¸· »½¬·±² ¿°°´·» ¬± ¿°°®±°®·¿¬·±² º±® Ý¿°·¬¿´ Ð®±¶»½¬ ¿¬ Ö«²» íðô îðïíô ¿²¼ ¿°°®±°®·¿¬·±² ·² ¬¸» îðïíó îðïì ¾«¼¹»¬ò ëò Ì¸¿¬ ¿´´ ½¸±±´ º«²¼ ¿°°®±°®·¿¬·±² ®»³¿·²·²¹ ¿¬ ¬¸» »²¼ ±º ¬¸» îðïîóïí º·½¿´ §»¿® ²±¬ ´¿°» ¾«¬ ¸¿´´ ¾» ¿°°®±°®·¿¬»¼ ¬± ¬¸» Í½¸±±´ Ý¿°·¬¿´ Ú«²¼ ·² º·½¿´ §»¿® îðïíó ïì ¿ º±´´±©æ ¿ò÷ Ì©±ó¬¸·®¼ ±º ¬¸» §»¿®ó»²¼ ¾¿´¿²½» ·² ¬¸» ½¸±±´ ±°»®¿¬·²¹ º«²¼ ©·´´ ¾» ¿´´±½¿¬»¼ ¬± ¬¸» Ó¿¶±® Í½¸±±´ Ý¿°·¬¿´ Î»»®ª»å ¾ò÷ Ñ²»ó¬¸·®¼ ±º ¬¸» §»¿®ó»²¼ ¾¿´¿²½» ·² ¬¸» ½¸±±´ ±°»®¿¬·²¹ º«²¼ ©·´´ ¾» ¿´´±½¿¬»¼ ¬± ¬¸» Ó·²±® Í½¸±±´ Ý¿°·¬¿´ Î»»®ª»å êò Ì¸¿¬ ¿´´ Ù»²»®¿´ Ú«²¼ «²»¨°»²¼»¼ ¿°°®±°®·¿¬·±² ¿¬ ¬¸» »²¼ ±º ¬¸» îðïîó îðïí º·½¿´ §»¿® ²±¬ ´¿°» ¾«¬ ¸¿´´ ¾» ®»ó¿°°®±°®·¿¬»¼ô ¿ °®±ª·¼»¼ ¾§ Î»±´«¬·±² ïîîïðìóìô ¿ º±´´±©æ ¿÷ Ú±®¬§ °»®½»²¬ øìðû÷ ±º ¬¸»» «²»¨°»²¼»¼ ¿°°®±°®·¿¬·±² ¸¿´´ ¾» ¬®¿²º»®®»¼ ¬± ¬¸» «²ó¿°°®±°®·¿¬»¼ Ó·²±® Ý±«²¬§ Ý¿°·¬¿´ Ú«²¼ Î»»®ª»å ¾÷ Í·¨¬§ °»®½»²¬ øêðû÷ ±º ¬¸»» «²»¨°»²¼»¼ ¿°°®±°®·¿¬·±² ¸¿´´ ¾» ®»ó ¿°°®±°®·¿¬»¼ ¬± ¬¸» ¿³» ¼»°¿®¬³»²¬ º±® »¨°»²¼·¬«®» ·² º·½¿´ §»¿® îðïíóîðïì éò Ì¸¿¬ ¿´´ Ù»²»®¿´ Ú«²¼ ®»ª»²«» ½±´´»½¬»¼ ·² »¨½» ±º ¿°°®±°®·¿¬»¼ ®»ª»²«» ¸¿´´ ¾» ®»ó¿°°®±°®·¿¬»¼ô ¿ °®±ª·¼»¼ ¾§ Î»±´«¬·±² ïîîïðìóëô ¿ º±´´±©æ ¿ò÷ Î»ª»²«» ·² »¨½» ±º ¾«¼¹»¬ ©·´´ º·®¬ ¾» ¿´´±½¿¬»¼ ¬± ¬¸» Ù»²»®¿´ Ú«²¼ Ë²¿°°®±°®·¿¬»¼ Þ¿´¿²½»ô «²¬·´ ¬¸» ³¿¨·³«³ ¿³±«²¬ º±® ¬¸» ½«®®»²¬ §»¿® · ³»¬ô ¿ °»½·º·»¼ ·² ¬¸» Ù»²»®¿´ Ú«²¼ Ë²¿°°®±°®·¿¬»¼ Þ¿´¿²½» Ð±´·½§ô ¿ ¿¼±°¬»¼ ¾§ Î»±´«¬·±² ïîîïðìóîå ¾ò÷ Ì¸» ®»³¿·²¼»® ±º ®»ª»²«» ·² »¨½» ±º ¾«¼¹»¬ ©·´´ ¬¸»² ¾» ¿´´±½¿¬»¼ ¬± ¬¸» Ó¿¶±® Ý±«²¬§ Ý¿°·¬¿´ Ú«²¼ Î»»®ª»ò èò Î»½«» º»» ½±´´»½¬»¼ ¾§ ¬¸» Ú·®» ¿²¼ Î»½«» Ü»°¿®¬³»²¬ ·² »¨½» ±º ¾«¼¹»¬»¼ ¿³±«²¬ ©·´´ ¾» ®»ó¿°°®±°®·¿¬»¼ ¿²¼ ¿´´±½¿¬»¼ ¬± ¬¸» Ú·®» ¿²¼ Î»½«» Ý¿°·¬¿´ Î»»®ª»ò çò ß½½±«²¬ ¾¿´¿²½» ®»³¿·²·²¹ ·² ¬¸» Ú»» Ý´¿ ½±´´»½¬»¼ ¾§ ¬¸» Ð¿®µ ¿²¼ Î»½®»¿¬·±² Ü»°¿®¬³»²¬ ©·´´ ¾» ¿´´±½¿¬»¼ ¬± ¿½½±«²¬ ¿ ¼»º·²»¼ ¾§ ¬¸» Ú»» Ý´¿ ß½½±«²¬ Ð®±½»¼«®»ò ïðò ß½½±«²¬ ¾¿´¿²½» ®»³¿·²·²¹ ·² º«²¼ ïïïóïéë ©·´´ ½¿®®§ ±ª»® ±²» ¸«²¼®»¼ °»®½»²¬ øïððû÷ ¿²¼ ¾» ®»ó¿°°®±°®·¿¬»¼ ¬± ¬¸» ·²¼·ª·¼«¿´ º«²¼ò ïïò Ì¸· ±®¼·²¿²½» ¸¿´´ ¬¿µ» »ºº»½¬ Ö«´§ ïô îðïíò ACTION NO. _______________ ITEM NO. ______G-1.2__________ AT A REGULAR MEETING OF THE BOARD OF SUPERVISORS OF ROANOKE COUNTY, VIRGINIA HELD AT THE ROANOKE COUNTY ADMINISTRATION CENTER MEETING DATE: May 14, 2013 AGENDA ITEM: Appointments to Committees, Commissions and Boards SUBMITTED BY: Deborah C. Jacks Clerk to the Board APPROVED BY: B. Clayton Goodman III County Administrator COUNTY ADMINISTRATOR'S COMMENTS: SUMMARY OF INFORMATION: 1. Capital Improvement Program (CIP) Review Committee (appointed by District) The following one-year term expired on August 31, 2012: a) Becky Walter, representing the Hollins Magisterial District; Ms. Walter has served three consecutive terms and therefore cannot be reappointed. 2. Parks, Recreation and Tourism Advisory Commission (appointed by District) The three-year term of Roger L. Falls who represents the Vinton District expired on June 30, 2012. Page 1 of 1 AT A REGULAR MEETING OF THE BOARD OF SUPERVISORS OF ROANOKE COUNTY, VIRGINIA, HELD AT THE ROANOKE COUNTY ADMINISTRATION CENTER ON TUESDAY, MAY 14, 2013 RESOLUTION ADOPTING THE HEALTH REIMBURSEMENT ARRANGEMENT FOR ROANOKE COUNTY BE IT RESOLVED by the Board of Supervisors of Roanoke County, as follows: 1. That the Health Reimbursement Arrangement effective July 1, 2013, presented to the Board of Supervisors at this meeting is hereby approved and adopted and that the County Administrator, or his designee, is hereby authorized and directed to execute and deliver to Flex Benefit Administrators, the Administrator of the Plan, one or more counterparts of the Plan; and 2. That the Administrator of the Plan shall be instructed to take such actions that are deemed necessary and proper in order to implement the Plan, and to set up adequate accounting and administrative procedures to provide benefits under the Plan; and 3. That the County Administrator, or his designee, shall act as soon as possible to notify the employees of the County of the adoption by delivering to each participating employee a copy of the summary description of the Plan in the form of the Summary Plan Description presented to this meeting, which form is hereby approved; and 4. That the Clerk to the Board of Supervisors further certifies that attached hereto as Exhibits A and B, respectively, are true copies that have not been modified or rescinded of the County of Roanoke Health Reimbursement Arrangement Plan Page 1 of 2 Document and the Summary Plan description approved and adopted in the foregoing resolutions; and 5. That this Resolution is effective from and after July 1, 2013. Page 2 of 2 Attachment A County of Roanoke HR EALTHEIMBURSEMENT A RRANGEMENT BPD ASIC LAN OCUMENT úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ TC ABLE OF ONTENTS AI RTICLE D EFINITIONS 1.1 Administrator 1 1.2 Affiliated Employer 1 1.3 Code 1 1.4 Coverage Period 1 1.5 Dependent 1 1.6 Effective Date 1 1.7 Eligible Employee 1 1.8 Employee 2 1.9 Employer 2 1.10 Employer Contribution 2 1.11 ERISA 2 1.12 Leased Employee 2 1.13 Participant 2 1.14 Plan 3 1.15 Premiums 3 1.16 Qualifying Medical Expenses 3 AII RTICLE P ARTICIPATION 2.1 Eligibility 3 2.2 Effective Date of Participation 3 2.3 Termination of Participation 4 AIII RTICLE B ENEFITS 3.1 Establishment of Plan 4 3.2 Nondiscrimination Requirements 4 3.3 Health Reimbursement Arrangement Claims 5 3.4 Debit and Credit Cards 5 AIV RTICLE ERISAP ROVISIONS 4.1 Claim for Benefits 7 4.2 Named Fiduciary 9 4.3 General Fiduciary Responsibilities 9 4.4 Nonassignability of Rights 9 úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ AV RTICLE A DMINISTRATION 5.1 Plan Administration 10 5.2 Examination of Records 10 5.3 Indemnification of Administrator 11 AVI RTICLE ATP MENDMENT OR ERMINATION OF LAN 6.1 Amendment 10 6.2 Termination 11 AVII RTICLE M ISCELLANEOUS 7.1 Plan Interpretation 11 7.2 Gender and Number 11 7.3 Written Document 11 7.4 Exclusive Benefit 12 7.5 12 7.6 Action by the Employer 12 7.7 No Guarantee of Tax Consequences 12 7.8 Indemnification of Employer by Participants 12 7.9 Funding 13 7.10 Governing Law 13 7.11 Severability 13 7.12 Headings 13 7.13 Continuation of Coverage 13 7.14 Family and Medical Leave Act 13 7.15 Health Insurance Portability and Accountability Act 13 7.16 Uniformed Services Employment and Reemployment Rights Act 14 7.17 HIPAA Privacy Standards 14 7.18 HIPAA Electronic Security Standards 16 Certificate of Adopting Resolution 19 Copyright 2005 SunGard Inc. HRA EALTHEIMBURSEMENTRRANGEMENT As used in this Plan, the following words and phrases shall have the meanings set forth herein unless a different meaning is clearly required by the context: AI RTICLE D EFINITIONS 1.1 d by the Employer to carry out the administration of the Plan. In the event the Administrator has not been appointed, or resigns from a prior appointment, the Employer shall be deemed to be the Administrator. 1.2 hich is a member of a controlled group of corporations (as defined in Code Section 414(b)) which includes the Employer; any trade or business (whether or not incorporated) which is under common control (as defined in Code Section 414(c)) with the Employer; any organization (whether or not incorporated) which is a member of an affiliated service group (as defined in Code Section 414(m)) which includes the Employer; and any other entity required to be aggregated with the Employer pursuant to Treasury regulations under Code Section 414(o). 1.3 1.4 1.5 152 (as modified by Code Section 105(b)). Any child of a Participant who is an "alternate recipient" under a qualified medical child support order under ERISA Section 609 shall be considered a Dependent under this Arrangement. 1.6 ate specified in the Adoption Agreement. 1.7 if such individual is not reported on the payroll records of the Employer as a common law employee. In particular, it is expressly intended that individuals not treated as court or administrative agency determines that such individuals are common law employees and not independent contractors. Furthermore, Employees of an Affiliated Employer will not be r adopts the Plan as a Participating Employer. However, a self-employed individual as defined under Code Section 401(c) or a 2-percent shareholder as defined under Code Section 1372(b) shall not be eligible to participate in this Plan. Copyright 2005 SunGard Inc. 1 1.8 any person who is employed by the Employer. The term Employer and any Leased Employee deemed to be an Employee as provided in Code Section 414(n) or (o). 1.9 ity specified in the Adoption Agreement, any successor which shall maintain this Plan and any predecessor which has maintained this Plan. In Participating Employer which shall adopt this Plan. 1.10 1.11 from time to time. 1.12 lan Years beginning on or after January 1, 1997, any person (other than an Employee of the recipient Employer) who, pursuant to an agreement between the recipient Employer and any other person or the recipient (or for the recipient and related persons determined in accordance with Code Section 414(n)(6)) on a substantially full time basis for a period of at least one year, and such services are performed under primary direction or control by the recipient Employer. Contributions or benefits provided a Leased Employee by the leasing organization which are attributable to services performed for the recipient Employer shall be treated as provided by the recipient Employer. Furthermore, Compensation for a Leased Employee shall only include Compensation from the leasing organization that is attributable to services performed for the recipient Employer. A Leased Employee shall not be considered an employee of the recipient Employer if: (a) such employee is covered by a money purchase pension plan providing: (1) a nonintegrated employer contribution rate of at least ten percent (10%) of compensation, as defined in Code Section 415(c)(3), but for Plan Years beginning prior to January 1, 1998, including amounts contributed pursuant to a salary reduction agreement which 125, 402(e)(3), 402(h)(1)(B), 403(b), or for Plan Years beginning on or after January 1, 2001 (or as of a date, no earlier than January 1, 1998, as specified in an addendum to the Adoption Agreement), 132(f)(4), (2) immediate participation, and (3) full and immediate vesting; and (b) leased employees do not constitute more than twenty percent (20%) of the highly compensated workforce. 1.13 Section 2.1 and has not for any reason become ineligible to participate further in the Plan. Copyright 2005 SunGard Inc. 2 1.14 ption Agreement as adopted by the Employer, including all amendments thereto. "Plan" means the "Health Reimbursement Arrangement." 1.15 1.16 le for reimbursement under (within the meaning of Code Section 213(d) and as allowed under Code Section 105 and the rulings and Treasury regulations thereunder) of the Particip spouse or a Dependent and not otherwise used by the Participant as a deduction in health coverage, including a health Flexible Spending Account. Qualifying Medical Expenses covered by this Plan are limited as elected in the Adoption Agreement. -term care h Savings Accounts for Participants, Qualifying Medical Expenses reimbursed shall be limited to those allowed under Code Section 223. AII RTICLE P ARTICIPATION 2.1 Eligibility Any Eligible Employee shall be eligible to participate hereunder on the date such Employee satisfies the conditions of eligibility elected in the Adoption Agreement. 2.2 Effective Date of Participation An Eligible Employee who has satisfied the conditions of eligibility pursuant to Section 2.1 shall become a Participant effective as of the date elected in the Adoption Agreement. otherwise have become a Participant, shall go from a classification of a noneligible Employee to an Eligible Employee, such Employee shall become a Participant on the date such Employee becomes an Eligible Employee or, if later, the date that the Employee would have otherwise entered the Plan had the Employee always been an Eligible Employee. If an Employee, who has satisfied the otherwise become a Participant, shall go from a classification of an Eligible Employee to a noneligible class of Employees, such Employee shall become a Participant in the Plan on the date such Employee again becomes an Eligible Employee, or, if later, the date that the Employee would have otherwise entered the Plan had the Employee always been an Eligible Employee. Copyright 2005 SunGard Inc. 3 2.3 Termination of Participation This Section shall be applied and administered consistent with any rights a Participant Section 7.13 of the Plan, or any election on the Adoption Agreement. In the case of the death of the Participant, any remaining balances may only be paid out as reimbursements for Qualifying Medical Expenses and shall not constitute a death AIII RTICLE B ENEFITS 3.1 Establishment of Plan (a) This Health Reimbursement Arrangement is intended to qualify as a Health Reimbursement Arrangement under Code Section 105 and shall be interpreted in a manner consistent with such Code Section and the Treasury regulations thereunder. (b) Participants in this Health Reimbursement Arrangement may submit claims for the reimbursement of Qualifying Medical Expenses as defined under the Plan and the Adoption Agreement. Unless otherwise elected in the Adoption Agreement, this Plan shall reimburse any expenses only after amounts in all other Plans that could reimburse the expense have been exhausted. (c) The Employer shall make available to each Participant an Employer Contribution as elected in the Adoption Agreement, for the reimbursement of Qualifying Medical Expenses. No salary reductions may be made to this Health Reimbursement Arrangement. (d) cafeteria plan (as defined in Code Section 125), except as permitted by the Code and the Treasury regulations thereunder, to the extent necessary to maintain this Plan as a Health Reimbursement Arrangement. (e) If the Employer maintains Health Savings Accounts for Participants, this Arrangement shall be operated in accordance with the restrictions under Code Section 223. 3.2 Nondiscrimination Requirements (a) It is the intent of this Health Reimbursement Arrangement not to discriminate in violation of the Code and the Treasury regulations thereunder. Copyright 2005 SunGard Inc. 4 (b) If the Administrator deems it necessary to avoid discrimination under this Health Reimbursement Arrangement, it may, but shall not be required to reduce benefits in order to assure compliance with this Section. Any act taken by the Administrator under this Section shall be carried out in a uniform and nondiscriminatory manner. 3.3 Health Reimbursement Arrangement Claims (a) The Administrator shall direct the reimbursement to each eligible Participant for all Qualifying Medical Expenses. All Qualifying Medical Expenses eligible for reimbursement pursuant to Section 3.1(b) shall be reimbursed during the Coverage Period, even though the submission of such a claim occurs after his participation hereunder ceases; but provided that the Qualifying Medical Expenses were incurred during a Coverage Period. Claims must include receipts or documentation that the expense being incurred is eligible for reimbursement, in order to claim reimbursement. Expenses may be reimbursed in subsequent Coverage Period, subject to the provisions of Number 21 on the Adoption Agreement and Section 3.3(c) below. However, a Participant may not submit claims incurred prior to beginning participation in the Plan and/or the Effective Date of the Plan, whichever is earlier. (b) Notwithstanding the foregoing, if elected in the Adoption Agreement, Qualifying Medical Expenses shall not be reimbursable under this Plan if eligible for Spending Account or Health Savings Account, if applicable. (c) Claims for the reimbursement of Qualifying Medical Expenses incurred in any Coverage Period shall be paid as soon after a claim has been filed as is administratively practicable. However, if a Participant fails to submit a claim within the period elected at Question 21 on the Adoption Agreement immediately following the end of the Coverage Period or calendar year, as selected, those Medical Expense claims shall not be considered for reimbursement by the Administrator. (d) Reimbursement payments under this Plan shall be made directly to the Participant. (e) If the maximum amount available for reimbursement for a Coverage Period is not utilized in its entirety, such remainder shall be carried forward to another Coverage Period or forfeited, as elected in the Adoption Agreement. 3.4 Debit and Credit Cards (a) Participants may, subject to a procedure established by the Administrator and applied in a uniform nondiscriminatory manner, use debit and/or credit (stored Qualifying Medical Expenses, subject to the following terms: Copyright 2005 SunGard Inc. 5 (b) Each Participant issued a card shall certify that such card shall only be used for Medical Expenses. The Participant shall also certify that any Medical Expense paid with the card has not already been reimbursed by any other plan covering health benefits and that the Participant will not seek reimbursement from any other plan covering health benefits. (c) and reissued for each Coverage Period the Participant remains a Participant in the Health Reimbursement Arrangement. Such card shall be automatically cancelled withdraws from the Health Reimbursement Arrangement. (d) The dollar amount of coverage available on the card shall be the amount elected by the Participant for the Plan Year. The maximum dollar amount of coverage available shall be the maximum amount for the Plan Year as set forth on the Adoption Agreement. (e) The cards shall only be accepted by such merchants and service providers as have been approved by the Administrator. (f) The cards shall only be used for Medical Expense purchases at these providers, including, but not limited to, the following: (i) Co-payments for doctor and other medical care; (ii) Purchase of drugs; (iii) Purchase of medical items such as eyeglasses, syringes, crutches, etc. (g) Such purchases by the cards shall be subject to substantiation by the Administrator, usually by submission of a receipt from a merchant or service provider describing the service or product, the date of the purchase and the amount. Some charges shall be considered substantiated at the time of charge by the nature of the charge, such as co-payments. Some charges shall be considered expenses previously approved as to amount, provider, and time period. At point of sale, the service provider or merchant can provide information to the Administrator to substantiate the charge. All charges shall be conditional pending confirmation and substantiation. (h) If such purchase is later determined by the Administrator to not to be a Qualifying Medical Expense, the Administrator, in its discretion, shall use the one of the following correction methods to make the Plan whole. Until the amount is repaid, the Administrator shall take further action to ensure that further violations of the terms of the card do not occur, up to and including denial of access to the card. (i) Repayment of the improper amount by the Participant; (ii) Withholding the improper payment from the Participant's wages or other compensation to the extent consistent with applicable federal or state law; Copyright 2005 SunGard Inc. 6 (iii) Claims substitution or offset of future claims until the amount is repaid. AIV RTICLE ERISAP ROVISIONS 4.1 Claim for Benefits Any claim for Benefits shall be made to the Administrator. The following timetable for claims and rules below apply: Notification of whether claim is accepted or denied30 days Extension due to matters beyond the control of the Plan15 days Insufficient information on the Claim: Notification of15 days Response by Participant45 days Review of claim denial60 days The Administrator will provide written or electronic notification of any claim denial. The notice will state: (1) The specific reason or reasons for the denial. (2) Reference to the specific Plan provisions on which the denial was based. (3) A description of any additional material or information necessary for the claimant to perfect the claim and an explanation of why such material or information is necessary. (4) applicable to such procedures. This will include a statement of the right to bring a civil action under section 502 of ERISA following a denial on review. (5) A statement that the claimant is entitled to receive, upon request and free of charge reasonable access to, and copies of, all documents, records, and other information relevant to the Claim. Copyright 2005 SunGard Inc. 7 (6) If the denial was based on an internal rule, guideline, protocol, or other similar criterion, the specific rule, guideline, protocol, or criterion will be provided free of charge. If this is not practical, a statement will be included that such a rule, guideline, protocol, or criterion was relied upon in making the denial and a copy will be provided free of charge to the claimant upon request. When the Participant receives a denial, the Participant shall have 180 days following receipt of the notification in which to appeal the decision. The Participant may submit written comments, documents, records, and other information relating to the Claim. If the Participant requests, the Participant shall be provided, free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claim. The period of time within which a denial on review is required to be made will begin at the time an appeal is filed in accordance with the procedures of the Plan. This timing is without regard to whether all the necessary information accompanies the filing. A document, record, or other information shall be considered relevant to a Claim if it: (1) was relied upon in making the claim determination; (2) was submitted, considered, or generated in the course of making the claim determination, without regard to whether it was relied upon in making the claim determination; (3) demonstrated compliance with the administrative processes and safeguards designed to ensure and to verify that claim determinations are made in accordance with Plan documents and Plan provisions have been applied consistently with respect to all claimants; or (4) constituted a statement of policy or guidance with respect to the Plan concerning the denied claim. The review will take into account all comments, documents, records, and other information submitted by the claimant relating to the Claim, without regard to whether such information was submitted or considered in the initial claim determination. The review will not afford deference to the initial denial and will be conducted by a fiduciary of the Plan who is neither the individual who made the adverse determination nor a subordinate of that individual. Copyright 2005 SunGard Inc. 8 4.2 Named Fiduciary the Employer and (2) the Administrator. The named Fiduciaries shall have only those specific powers, duties, responsibilities, and obligations as are specifically given them under the Plan including, but not limited to, any agreement allocating or delegating their responsibilities, the terms of which are incorporated herein by reference. In general, the Employer shall have the sole responsibility for providing benefits under the Plan; and shall have the sole authority to appoint and remove the Administrator; and to amend the elective provisions of the Adoption Agreement or terminate, in whole or in part, the Plan. The Administrator shall have the sole responsibility for the administration of the Plan, which responsibility is specifically described in the Plan. Furthermore, each named Fiduciary may rely upon any such direction, information or action of another named Fiduciary as being proper under the Plan, and is not required under the Plan to inquire into the propriety of any such direction, information or action. It is intended under the Plan that each named Fiduciary shall be responsible for the proper exercise of its own powers, duties, responsibilities and obligations under the Plan. Any person or group may serve in more than one Fiduciary capacity. 4.3 General Fiduciary Responsibilities The Administrator and any other fiduciary under ERISA shall discharge their duties with respect to this Plan solely in the interest of the Participants and their beneficiaries and (a) for the exclusive purpose of providing Benefits to Participants and their beneficiaries and defraying reasonable expenses of administering the Plan; (b) with the care, skill, prudence and diligence under the circumstances then prevailing that a prudent man acting in like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and with like aims; and (c) in accordance with the documents and instruments governing the Plan insofar as such documents and instruments are consistent with ERISA. 4.4 Nonassignability of Rights The right of any Participant to receive any reimbursement under the Plan shall not be alienable by the Participant by assignment or any other method, and shall not be subject to the rights of creditors, and any attempt to cause such right to be so subjected shall not be recognized, except to such extent as may be required by law. Copyright 2005 SunGard Inc. 9 AV RTICLE A DMINISTRATION 5.1 Plan Administration The operation of the Plan shall be under the supervision of the Administrator. It shall be a principal duty of the Administrator to see that the Plan is carried out in accordance with its terms, and for the exclusive benefit of Employees entitled to participate in the Plan. The Administrator shall have full power to administer the Plan in all of its details, shall include, but shall not be limited to the following authority, in addition to all other powers provided by this Plan: (a) To make and enforce such rules and regulations as the Administrator deems necessary or proper for the efficient administration of the Plan; (b) be final and conclusive on all persons claiming benefits under the Plan; (c) To decide all questions concerning the Plan and the eligibility of any person to participate in the Plan and to receive benefits provided under the Plan; (d) To limit benefits for certain highly compensated individuals if it deems such to be desirable in order to avoid discrimination under the Plan in violation of applicable provisions of the Code; (e) To approve reimbursement requests and to authorize the payment of benefits; and (f) To appoint such agents, counsel, accountants, consultants, and actuaries as may be required to assist in administering the Plan. (g) To establish and communicate procedures to determine whether a medical child support order is qualified under ERISA Section 609. Any procedure, discretionary act, interpretation or construction taken by the Administrator shall be done in a nondiscriminatory manner based upon uniform principles consistently applied and shall be consistent with the intent that the Plan shall continue to comply with the terms of Code Section 105(h) and the Treasury regulations thereunder. 5.2 Examination of Records The Administrator shall make available to each Participant, Eligible Employee and any other Employee of the Employer such records as pertain to their interest under the Plan for examination at reasonable times during normal business hours. Copyright 2005 SunGard Inc. 10 5.3 Indemnification of Administrator The Employer agrees to indemnify and to defend to the fullest extent permitted by law any Employee serving as the Administrator or as a member of a committee designated as Administrator (including any Employee or former Employee who previously served as Administrator or as a member of such committee) against all liabilities, damages, claims approved by the Employer) occasioned by any act or omission to act in connection with the Plan, if such act or omission is in good faith. AVI RTICLE ATP MENDMENT OR ERMINATION OF LAN 6.1 Amendment The Employer, at any time or from time to time, may amend any or all of the provisions of the Plan without the consent of any Employee or Participant. 6.2 Termination The Employer is establishing this Plan with the intent that it will be maintained for an indefinite period of time. Notwithstanding the foregoing, the Employer reserves the right to terminate the Plan, in whole or in part, at any time. In the event the Plan is terminated, no further reimbursements shall be made. AVII RTICLE M ISCELLANEOUS 7.1 Plan Interpretation All provisions of this Plan shall be interpreted and applied in a uniform, nondiscriminatory manner. This Plan shall be read in its entirety and not severed except as provided in Section 7.11. 7.2 Gender and Number Wherever any words are used herein in the masculine, feminine or neuter gender, they shall be construed as though they were also used in another gender in all cases where they would so apply, and whenever any words are used herein in the singular or plural form, they shall be construed as though they were also used in the other form in all cases where they would so apply. 7.3 Written Document This Plan, in conjunction with any separate written document which may be required by law, is intended to satisfy the written Plan requirement of Code Section 105 and any Treasury regulations thereunder. Copyright 2005 SunGard Inc. 11 7.4 Exclusive Benefit This Plan shall be maintained for the exclusive benefit of the Employees who participate in the Plan. 7.5 This Plan shall not be deemed to constitute an employment contract between the Employer and any Participant or to be a consideration or an inducement for the employment of any Participant or Employee. Nothing contained in this Plan shall be deemed to give any Participant or Employee the right to be retained in the service of the Employer or to interfere with the right of the Employer to discharge any Participant or Employee at any time regardless of the effect which such discharge shall have upon him as a Participant of this Plan. 7.6 Action by the Employer Whenever the Employer under the terms of the Plan is permitted or required to do or perform any act or matter or thing, it shall be done and performed by a person duly authorized by its legally constituted authority. 7.7 No Guarantee of Tax Consequences Neither the Administrator nor the Employer makes any commitment or guarantee that any amounts paid to or for the benefit of a Participant under the Plan will be excludable other federal or state tax treatment will apply to or be available to any Participant. It shall be the obligation of each Participant to determine whether each payment under the purposes, and to notify the Employer if the Participant has reason to believe that any such payment is not so excludable. Notwithstanding the foregoing, the rights of Participants under this Plan shall be legally enforceable. 7.8 Indemnification of Employer by Participants If any Participant receives one or more payments or reimbursements under the Plan that are not for a permitted Medical Expense such Participant shall indemnify and reimburse the Employer for any liability it may incur for failure to withhold federal or state income tax or Social Security tax from such payments or reimbursements. However, such indemnification and reimbursement shall not exceed the amount of additional federal and state income tax (plus any penalties) that the Participant would have owed if the payments or reimbursements had been made to the Participant as regular cash been paid on such compensation, less any such additional income and Social Security tax actually paid by the Participant. Copyright 2005 SunGard Inc. 12 7.9 Funding Unless otherwise required by law, amounts made available by the Employer need not be placed in trust, but may instead be considered general assets of the Employer. Furthermore, and unless otherwise required by law, nothing herein shall be construed to require the Employer or the Administrator to maintain any fund or segregate any amount for the benefit of any Participant, and no Participant or other person shall have any claim against, right to, or security or other interest in, any fund, account or asset of the Employer from which any payment under the Plan may be made. 7.10 Governing Law This Plan and Trust shall be construed and enforced according to the Code, ERISA, and located (unless otherwise designated in the Adoption Agreement), other than its laws respecting choice of law, to the extent not pre-empted by ERISA. 7.11 Severability If any provision of the Plan is held invalid or unenforceable, its invalidity or unenforceability shall not affect any other provisions of the Plan, and the Plan shall be construed and enforced as if such provision had not been included herein. 7.12 Headings The headings and subheadings of this Plan have been inserted for convenience of reference and are to be ignored in any construction of the provisions hereof. 7.13 Continuation of Coverage Notwithstanding anything in the Plan to the contrary, in the event any benefit under this Plan subject to the continuation coverage requirement of Code Section 4980B becomes unavailable, each qualified beneficiary (as defined in Code Section 4980B) will be entitled to continuation coverage as prescribed in Code Section 4980B. 7.14 Family and Medical Leave Act Notwithstanding anything in the Plan to the contrary, in the event any benefit under this Plan becomes subject to the requirements of the Family and Medical Leave Act and regulations thereunder, this Plan shall be operated in accordance with Regulation 1.125-3. 7.15 Health Insurance Portability and Accountability Act Notwithstanding anything in this Plan to the contrary, this Plan shall be operated in accordance with HIPAA and regulations thereunder. Copyright 2005 SunGard Inc. 13 7.16 Uniformed Services Employment and Reemployment Rights Act Notwithstanding any provision of this Plan to the contrary, contributions, benefits and service credit with respect to qualified military service shall be provided in accordance with USERRA and the regulations thereunder. 7.17 HIPAA Privacy Standards (a) If this Plan is subject to the Standards for Privacy of Individually Identifiable shall apply. (b) The Plan shall not disclose Protected Health Information to any member of are the Privacy Standards but generally shall mean individually identifiable information about the past, present or future physical or mental health or condition of an individual, including information about treatment or payment for treatment. (c) workforce shall be used or disclosed by them only for purposes of Plan nistrative functions shall include all ivities taken to determine or fulfill Plan responsibilities with respect to eligibility, coverage, provision of benefits, or reimbursement for health care. (d) The Plan shall disclose Protected Health Information only to members of the force who are authorized to receive such Protected Health Information, and only to the extent and in the minimum amount necessary for that ll employees and other persons under the control of the Employer. The Employer shall keep an updated list of those authorized to receive Protected Health Information. (1) Protected Health Information shall use or disclose the Protected Health Information only to the extent necessary to perform his or her duties with respect to the Plan. (2) discloses Protected Health Information other than as permitted by this Section and the Privacy Standards, the incident shall be reported appropriate action, including: Copyright 2005 SunGard Inc. 14 (i) investigation of the incident to determine whether the breach occurred inadvertently, through negligence or deliberately; whether there is a pattern of breaches; and the degree of harm caused by the breach; (ii) appropriate sanctions against the persons causing the breach which, depending upon the nature of the breach, may include oral or written reprimand, additional training, or termination of employment; (iii) mitigation of any harm caused by the breach, to the extent practicable; and (iv) documentation of the incident and all actions taken to resolve the issue and mitigate any damages. (e) The Employer must provide certification to the Plan that it agrees to: (1) Not use or further disclose the information other than as permitted or required by the Plan documents or as required by law; (2) Ensure that any agent or subcontractor, to whom it provides Protected Health Information received from the Plan, agrees to the same restrictions and conditions that apply to the Employer with respect to such information; (3) Not use or disclose Protected Health Information for employment- related actions and decisions or in connection with any other benefit or employee benefit plan of the Employer; (4) Report to the Plan any use or disclosure of the Protected Health Information of which it becomes aware that is inconsistent with the uses or disclosures permitted by this Section, or required by law; (5) Make available Protected Health Information to individual Plan members in accordance with Section 164.524 of the Privacy Standards; (6) Make available Protected Health Information for amendment by individual Plan members and incorporate any amendments to Protected Health Information in accordance with Section 164.526 of the Privacy Standards; (7) Make available the Protected Health Information required to provide an accounting of disclosures to individual Plan members in accordance with Section 164.528 of the Privacy Standards; Copyright 2005 SunGard Inc. 15 (8) Make its internal practices, books and records relating to the use and disclosure of Protected Health Information received from the Plan available to the Department of Health and Human Services for purposes of determining compliance by the Plan with the Privacy Standards; (9) If feasible, return or destroy all Protected Health Information received from the Plan that the Employer still maintains in any form, and retain no copies of such information when no longer needed for the purpose for which disclosure was made, except that, if such return or destruction is not feasible, limit further uses and disclosures to those purposes that make the return or destruction of the information infeasible; and (10) Ensure the adequate separation between the Plan and members of the 164.504(f)(2)(iii) of the Privacy Standards and set out in (d) above. 7.18 HIPAA Electronic Security Standards If this Plan is subject to the Security Standards for the Protection of Electronic Protected then this Section shall apply as follows: (a) The Employer agrees to implement reasonable and appropriate administrative, physical and technical safeguards to protect the confidentiality, integrity and availability of Electronic Protected Health Information that the Employer creates, maintains or transmits on behalf of generally shall mean Protected Health Information that is transmitted by or maintained in electronic media. (b) The Employer shall ensure that any agent or subcontractor to whom it provides Electronic Protected Health Information shall agree, in writing, to implement reasonable and appropriate security measures to protect the Electronic Protected Health Information. (c) The Employer shall ensure that reasonable and appropriate security measures are implemented to comply with the conditions and requirements set forth in Section 7.17. (d) The Plan shall not disclose Protected Health Information to any member of of the conditions set out in this Section are the Privacy Standards but generally shall mean individually identifiable information about the past, present or future physical or mental health or condition of an individual, including information about treatment or payment for treatment. Copyright 2005 SunGard Inc. 16 (e) workforce shall be used or disclosed by them only for purposes of Plan admin Standards, but the term determine or fulfill Plan responsibilities with respect to eligibility, coverage, provision of benefits, or reimbursement for health care. (f) The Plan shall disclose Protected Health Information only to members of the Information, and only to the extent and in the minimum amount necessary for that control of the Employer. The Employer shall keep an updated list of those authorized to receive Protected Health Information. (1) eives Protected Health Information shall use or disclose the Protected Health Information only to the extent necessary to perform his or her duties with respect to the Plan. (2) discloses Protected Health Information other than as permitted by this Section and the Privacy Standards, the incident shall be reported appropriate action, including: (i) investigation of the incident to determine whether the breach occurred inadvertently, through negligence or deliberately; whether there is a pattern of breaches; and the degree of harm caused by the breach; (ii) appropriate sanctions against the persons causing the breach which, depending upon the nature of the breach, may include oral or written reprimand, additional training, or termination of employment; (iii) mitigation of any harm caused by the breach, to the extent practicable; and (iv) documentation of the incident and all actions taken to resolve the issue and mitigate any damages. Copyright 2005 SunGard Inc. 17 (g) The Employer must provide certification to the Plan that it agrees to: (1) Not use or further disclose the information other than as permitted or required by the Plan documents or as required by law; (2) Ensure that any agent or subcontractor, to whom it provides Protected Health Information received from the Plan, agrees to the same restrictions and conditions that apply to the Employer with respect to such information; (3) Not use or disclose Protected Health Information for employment- related actions and decisions or in connection with any other benefit or employee benefit plan of the Employer; (4) Report to the Plan any use or disclosure of the Protected Health Information of which it becomes aware that is inconsistent with the uses or disclosures permitted by this Section, or required by law; (5) Make available Protected Health Information to individual Plan members in accordance with Section 164.524 of the Privacy Standards; (6) Make available Protected Health Information for amendment by individual Plan members and incorporate any amendments to Protected Health Information in accordance with Section 164.526 of the Privacy Standards; (7) Make available the Protected Health Information required to provide an accounting of disclosures to individual Plan members in accordance with Section 164.528 of the Privacy Standards; (8) Make its internal practices, books and records relating to the use and disclosure of Protected Health Information received from the Plan available to the Department of Health and Human Services for purposes of determining compliance by the Plan with the Privacy Standards; (9) If feasible, return or destroy all Protected Health Information received from the Plan that the Employer still maintains in any form, and retain no copies of such information when no longer needed for the purpose for which disclosure was made, except that, if such return or destruction is not feasible, limit further uses and disclosures to those purposes that make the return or destruction of the information infeasible; and (10) Ensure the adequate separation between the Plan and members of the 164.504(f)(2)(iii) of the Privacy Standards and set out in (d) above. Copyright 2005 SunGard Inc. 18 Attachment B CR OUNTY OF OANOKE HR EALTH EIMBURSEMENT A RRANGEMENT SPD UMMARY LAN ESCRIPTION úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ TC ABLE OF ONTENTS I E LIGIBILITY 1. What Are the Eligibility Requirements for Our Plan? 1 2. When is My Entry Date? 1 3. Are There Any Employees Who Are Not Eligible? 1 II B ENEFITS 1. What Benefits Are Available? 1 2. When Must Expenses Be Incurred? 2 3. When Will I Receive Payment From the Plan? 2 4. What Happens If I Terminate Employment? 3 5. Family and Medical Leave Act (FMLA) 3 6. Uniformed Services Employment and Reemployment Rights Act (USERRA) 3 7. Newborn and Mothers Health Protection Act 3 8. Qualified Medical Child Support Order 3 III GI ENERALNFORMATION 1. General Plan Information 4 2. Employer Information 4 3. Plan Administrator Information 4 4. Third Party Claims Administrator Information 4 5. Service of Legal Process 5 6. Type of Administration 5 IV API DDITIONAL LANNFORMATION 1. Your Rights Under ERISA 5 2. How to Submit a Claim 6 V CCRUCOBRA ONTINUATION OVERAGE IGHTS NDER 1. What is COBRA Continuation Coverage? .8 2. Who Can Become a Qualified Beneficiary? .9 3. What is a Qualifying Event? .9 4. What Factors Should Be Considered When Determining to Elect COBRA Continuation Coverage 10 úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ 5. What is the Procedure for Obtaining COBRA Continuation Coverage? 11 6. What is the Election Period and How Long Must It Last? 11 7. Is a Covered Employee or Qualified Beneficiary Responsible for Informing the Plan Administrator of the Occurrence of a Qualifying Event? 12 8. Is a Waiver Before the End of the Election Period Effective to End a Qualified 13 9. Is COBRA Coverage Available If a Qualified Beneficiary Has Other Group Health Plan Coverage or Medicare? 13 10. Terminated? 13 11. What Are the Maximum Coverage Periods for COBRA Continuation Coverage? 14 12. Under What Circumstances Can the Maximum Coverage Period Be Expanded? 15 13. How Does a Qualified Beneficiary Become Entitled to a Disability Extension? 15 14. Does the Arrangement Require Payment for COBRA Continuation Coverage? 15 15. Must the Arrangement Allow Payment for COBRA Continuation Coverage to Be Made in Monthly Installments? 16 16. What is Timely Payment for Payment for COBRA Continuation Coverage? 16 17. Must a Qualified Beneficiary Be Given the Right to Enroll in a Conversion Health Plan at the End of the Maximum Coverage Period for COBRA Continuation Coverage? 16 úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ HRA EALTHEIMBURSEMENTRRANGEMENT I NTRODUCTION We are pleased to establish this Health Reimbursement Arrangement to provide you with additional health coverage benefits. The benefits available under this Plan are outlined in this summary plan description. We will also tell you about other important information concerning the Plan, such as the rules you must satisfy before you become eligible and the laws that protect your rights. Read this summary plan description carefully so that you understand the provisions of our Plan and the benefits you will receive. You should direct any questions you have to the Administrator. There is a plan document on file, which you may review if you desire. In the event there is a conflict between this summary plan description and the plan document, the plan document will control. I E LIGIBILITY 1.What Are the Eligibility Requirements for Our Plan? You will be eligible to join the Plan if you are an employee working 40 or more hours per week. 2. When is My Entry Date? You can join the Plan on the same day you can enter our group medical plan. 3. Are There Any Employees Who Are Not Eligible? Yes, there are certain employees who are not eligible to join the Plan. They are: -- Employees who are part-time. A part-time employee is someone who works, or is expected to work, less than 40 hours a week. II B ENEFITS 1. What Benefits Are Available? The plan allows you to be reimbursed for certain out-of-pocket medical expenses which are incurred by you and your dependents. The expenses, which qualify, are those permitted by Section 213(d) of the Internal Revenue Code. A list of some of the expenses that qualify is available from the Administrator. For Retirees, the plan allows you to be reimbursed by the Employer for any insurance premiums, which are incurred by you or your dependents, in addition to the expenses that fall under Section 213(d) of the Internal Revenue Code. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ1 08/01/05 The maximum allowed each year is $500.00 for single coverage and $1,000 for family coverage, plus any unused amounts from prior Coverage Periods. However, the lifetime maximum that can be carried forward to a later Coverage Period is $25,000. For example, suppose the maximum benefit for a Coverage Period is $500 (single) plus any unused amounts carried over from prior Coverage Periods. Also, assume that the overall lifetime maximum benefit (including unused amounts from prior Coverage Periods) is $25,000. If you did not incur any covered expenses for the first Coverage Period, then your maximum benefit for the next Coverage Period is $1,000. We will provide you with a debit or credit card to use to pay for your medical expenses. The Administrator will provide you with further details. is paid for. Any amounts reimbursed to you under the Plan may not be claimed as a deduction on your personal income tax return nor reimbursed by other health plan coverage including our health flexible spending account. You must first use all amounts in our health flexible spending account before submitting any claims to this plan. 2. When Must Expenses Be Incurred? 3.When Will I Receive Payments From the Plan? During the course of the Coverage Period, you may submit requests for reimbursement of expenses you have incurred. However, you must make your requests for reimbursements no later than 90 days after the end of the Plan Year, if you are an active employee. If you retired during the Plan Year, you must make your requests for reimbursements no later than 365 days following your date of retirement. Upon death, the surviving spouse/executor has 6 months from date of death to make requests for reimbursements for eligible expenses incurred while retired but prior to death. The Administrator will provide you with acceptable forms for submitting these requests for reimbursement. In addition, you must submit to the Administrator proof of the expenses you have incurred and that they have not been paid by any other health plan coverage. If the request qualifies as a benefit or expense that the Plan has agreed to pay, you will receive a reimbursement payment soon thereafter. Remember, reimbursements made from the Plan are generally not subject to federal income tax or withholding. Nor are they subject to Social Security taxes. 4. What Happens If I Terminate Employment? If your employment is terminated during the Plan Year for any reason, your participation in the Plan will continue through the end of termination month unless you have chosen COBRA. You may submit requests for reimbursement of expenses you have incurred while being an active employee, however, you must make your request for reimbursements no later than 90 days following your date of termination. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ2 08/01/05 5. Family and Medical Leave Act (FMLA) If you take leave under the Family and Medical Leave Act, you may revoke or change your existing elections for health insurance. If your coverage in these benefits terminates, due to your revocation of the benefit while on leave or due to your non-payment of contributions, you will be permitted to reinstate coverage for the remaining part of the Plan Year upon your return. If you continue your coverage during your unpaid leave, you may pre-pay for the coverage, you may pay for your coverage on an after-tax basis while you are on leave, or you and return. 6. Uniformed Services Employment and Reemployment Rights Act (USERRA) If you are going into or returning from military service, you may have special rights to health care coverage under your Health Reimbursement Arrangement under the Uniformed Services Employment and Reemployment Rights Act of 1994. These rights can include extended health care coverage. If you may be affected by this law, ask your Administrator for further details. 7. Newborn and Mothers Health Protection Act Group health plans generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). 8. Qualified Medical Child Support Order A medical child support order is a judgment, decree or order (including approval of a property settlement) made under state law that provides for child support or health coverage for the child of a participant. The child becomes an "alternate recipient" and can receive benefits under the health plans of the Employer, if the order is determined to be obtain, without charge, a copy of the procedures governing the determination of qualified medical child support orders from the Plan Administrator. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ3 08/01/05 III GIAOP ENERAL NFORMATION BOUT URLAN This Section contains certain general information, which you may need to know about the Plan. 1. General Plan Information County of Roanoke Health Reimbursement Arrangement is the name of the Plan. Your Employer has assigned Plan Number 503 to your Plan. The provisions of your Plan become effective on July 1, 2013. 2. Employer Information County of Roanoke P.O. Box 29800 Roanoke, VA 24018 54-6001572 The Plan allows other employers to adopt its provisions. You or your beneficiaries may examine or obtain a complete list of employers, if any, who have adopted your Plan by making a written request to the Administrator. 3. Plan Administrator Information County of Roanoke P.O. Box 29800 Roanoke, VA (540) 772-2018 The Plan Administrator keeps the records for the Plan and is responsible for the administration of the Plan. The Administrator will also answer any questions you may have about our Plan. The Plan Administrator has the exclusive right to interpret the appropriate plan provisions. Decisions of the Administrator are conclusive and binding. You may contact the Administrator for any further information about the Plan. 4. Third Party Claims Administrator Information The name, address and business telephone number of the Third Party Claims Administrator are: Flexible Benefit Administrators, Inc Post Office Drawer 8188 Virginia Beach, VA 23450 The Third Party Claims Administrator is responsible for the actual processing of claims on behalf of the Plan Administrator. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ4 08/01/05 5. Service of Legal Process 6. Type of Administration The Plan is a health reimbursement arrangement and the administration is provided through a Third Party Claims Administrator. The Plan is not funded or insured. Benefits are paid from the general assets of the Employer. IV API DDITIONAL LAN NFORMATION 1. Your Rights Under ERISA Plan Participants, eligible employees and all other employees of the Employer may be entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA) and the Internal Revenue Code. These laws provide that Participants, eligible employees and all other employees are entitled to: (a) including insurance contracts, collective bargaining agreements, and a copy of the latest annual report (Form 5500 Series) filed by the Plan with the U.S. Department of Labor, and available at the Public Disclosure Room of the Employee Benefits Security Administration. (b) Obtain copies of all Plan documents and other Plan information upon written request to the Administrator. The Administrator may charge a reasonable fee for the copies. (c) Continue health care coverage for a Plan Participant, Spouse, or other dependents if there is a loss of coverage under the Plan as a result of a qualifying event. Employees or dependents may have to pay for such coverage. (d) Review this summary plan description and the documents governing the Plan on the rules governing COBRA continuation coverage rights. If your claim for a benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. If you have a claim for benefits, which is denied or ignored, in whole or in part, you may file suit in a state or Federal court. Under ERISA there are steps you can take to enforce the above rights. For instance, if you request materials from the Plan and do not receive them within thirty (30) days, you may file suit in a Federal court. In such a case, the court may request the Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Administrator. If úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ5 08/01/05 you have a claim for benefits, which is denied or ignored, in whole or in part, you may file suit in a state or Federal court. concerning the qualified status of a medical child support order, he or she may file suit in federal court. In addition to creating rights for Plan Participants, ERISA imposes obligations upon the individuals who are responsible for the operation of the Plan. The individuals who operate tly and in the interest of the Plan Participants and their beneficiaries. No one, including the Employer or any other person, may fire a Plan Participant or otherwise discriminate against a Plan Participant in any way to prevent the Plan Participant from obtaining benefits under the Plan or from exercising his or her rights under ERISA. discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees; for example, if it finds your claim is frivolous. If you have any questions about the Plan, you should contact the Administrator. If you have any questions about this statement, or about your rights under ERISA or the Health Insurance Portability and Accountability Act (HIPAA), or if you need assistance in obtaining documents from the Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in the telephone directory or the Division of Technical Assistance and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. 2. How to Submit a Claim When you have a Claim to submit for payment, you must: (1) Obtain a claim form from the Plan Administrator. (2) Complete the Employee portion of the form. (3) Attach copies of all bills from the service provider for which you are requesting reimbursement. A Claim is defined as any request for a Plan benefit, made by a claimant or by a representative o benefit Claims. The times listed are maximum times only. A period of time begins at the time the Claim is filed. Decisions will be made within a reasonable period of time appropriat úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ6 08/01/05 Notification of whether Claim is accepted or denied30 days Extension due to matters beyond the control of the 15 days Plan Insufficient information on the Claim: Notification of15 days Response by Participant45 days Review of Claim denial60 days The Plan Administrator will provide written or electronic notification of any Claim denial. The notice will state: (1) The specific reason or reasons for the denial. (2) Reference to the specific Plan provisions on which the denial was based. (3) A description of any additional material or information necessary for the claimant to perfect the Claim and an explanation of why such material or information is necessary. (4) A descrip such procedures. This will include a statement of your right to bring a civil action under Section 502 of ERISA following a denial on review. (5) A statement that the claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claim; and (6) If the denial was based on an internal rule, guideline, protocol, or other similar criterion, the specific rule, guideline, protocol, or criterion will be provided free of charge. If this is not practical, a statement will be included that such a rule, guideline, protocol, or criterion was relied upon in making the denial and a copy will be provided free of charge to the claimant upon request. When you receive a denial, you will have 180 days following receipt of the notification in which to appeal the decision. You may submit written comments, documents, records, and other information relating to the Claim. If you request, you will be provided, free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claim. The period of time within which a denial on review is required to be made will begin at the time an appeal is filed in accordance with the procedures of the Plan. This timing is without regard to whether all the necessary information accompanies the filing. A document, record, or other information shall be considered relevant to a Claim if it: (1) was relied upon in making the Claim determination; úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ7 08/01/05 (2) was submitted, considered, or generated in the course of making the Claim determination, without regard to whether it was relied upon in making the Claim determination; (3) demonstrated compliance with the administrative processes and safeguards designed to ensure and to verify that Claim determinations are made in accordance with Plan documents and Plan provisions have been applied consistently with respect to all claimants; (4) or constituted a statement of policy or guidance with respect to the Plan concerning the denied Claim. The review will take into account all comments, documents, records, and other information submitted by the claimant relating to the Claim, without regard to whether such information was submitted or considered in the initial Claim determination. The review will not afford deference to the initial denial and will be conducted by a fiduciary of the Plan who is neither the individual who made the adverse determination nor a subordinate of that individual. V CONTINUATIONCOVERAGERIGHTSUNDERCOBRA Under federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), certain employees and their families covered under this Arrangement will be entitled to the to inform Participants and beneficiaries, in summary fashion, of their rights and obligations under the continuation coverage provisions of COBRA, as amended and reflected in final and proposed regulations published by the Department of the Treasury. This notice is intended to reflect the law and does not grant or take away any rights under the law. The Plan Administrator or its designee is responsible for administering COBRA continuation coverage. Complete instructions on COBRA, as well as election forms and other information, will be provided by the Plan Administrator or its designee to Participants who become Qualified Beneficiaries under COBRA. The Arrangement itself can provide group health benefits and may this section, it means any of the health benefits under this Plan. 1.What is COBRA Continuation Coverage? COBRA continuation coverage is the temporary extension of group health plan coverage that must be offered to certain Participants and their eligible family members (called triggered by the occurrence of a life event that results in the loss of coverage under the terms of the e identical to the coverage that the Qualified Beneficiary had immediately before the Qualifying Event, or if the coverage has been changed, the coverage must be identical to the coverage provided to similarly situated active employees who have not experienced a Qualifying Event (in other words, similarly situated non-COBRA beneficiaries). úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ8 08/01/05 2.Who Can Become a Qualified Beneficiary? In general, a Qualified Beneficiary can be: (1)Any individual who, on the day before a Qualifying Event, is covered under the Arrangement by virtue of being on that day either a covered Employee, the Spouse of a covered Employee, or a Dependent child of a covered Employee. If, however, an individual who otherwise qualifies as a Qualified Beneficiary is denied or not offered coverage under the Arrangement under circumstances in which the denial or failure to offer constitutes a violation of applicable law, then the individual will be considered to have had the coverage and will be considered a Qualified Beneficiary if that individual experiences a Qualifying Event. (2)Any child who is born to or placed for adoption with a covered Employee during a period of COBRA continuation coverage, and any individual who is covered by the Arrangement as an alternate recipient under a qualified medical support order. If, however, an individual who otherwise qualifies as a Qualified Beneficiary is denied or not offered coverage under the Arrangement under circumstances in which the denial or failure to offer constitutes a violation of applicable law, then the individual will be considered to have had the coverage and will be considered a Qualified Beneficiary if that individual experiences a Qualifying Event. (3)A covered Employee who retired on or before the date of substantial elimination of health coverage which is the result of a bankruptcy proceeding under Title 11 of the U.S. Code with respect to the Employer, as is the Spouse, surviving Spouse or Dependent child of such a covered Employee if, on the day before the bankruptcy Qualifying Event, the Spouse, surviving Spouse or Dependent child was a beneficiary under the Arrangement. Arrangement due to his or her performance of services for the employer sponsoring the Arrangement. However, this provision does not establish eligibility of these individuals. Eligibility for Plan coverage shall be determined in accordance with Plan Eligibility provisions. An individual is not a Qualified Beneficiary if the i Employee is attributable to a period in which the individual was a nonresident alien who sources within the United States. If, on account of the preceding reason, an individual is not a Qualified Beneficiary, then a Spouse or Dependent child of the individual will also not be considered a Qualified Beneficiary by virtue of the relationship to the individual. A domestic partner is not a Qualified Beneficiary. Each Qualified Beneficiary (including a child who is born to or placed for adoption with a covered Employee during a period of COBRA continuation coverage) must be offered the opportunity to make an independent election to receive COBRA continuation coverage. 3.What is a Qualifying Event? A Qualifying Event is any of the following if the Arrangement provided that the participant would lose coverage (i.e., cease to be covered under the same terms and conditions as in úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ9 08/01/05 effect immediately before the Qualifying Event) in the absence of COBRA continuation coverage: (1)The death of a covered Employee. (2) (3)The divorce or legal separation of a covered Employee from the Employee's Spouse. anticipation of a divorce or legal separation, and a divorce or legal separation later occurs, then the divorce or legal separation may be considered a Qualifying Event legal separation. (4) (5) requirements for a Dependent child (for example, attainment of the maximum age for dependency under the Arrangement). (6)A proceeding in bankruptcy under Title 11 of the U.S. Code with respect to an Employer from whose employment a covered Employee retired at any time. If the Qualifying Event causes the covered Employee, or the covered Spouse or a Dependent child of the covered Employee, to cease to be covered under the Arrangement under the same terms and conditions as in effect immediately before the Qualifying Event (or in the case of the bankruptcy of the Employer, any substantial elimination of coverage under the Arrangement occurring within 12 months before or after the date the bankruptcy proceeding commences), the persons losing such coverage become Qualified Beneficiaries under COBRA if all the other conditions of COBRA are also met. For example, any increase in contribution that must be paid by a covered Employee, or the Spouse, or a Dependent child of the covered Employee, for coverage under the Arrangement that results from the occurrence of one of the events listed above is a loss of coverage. constitute a Qualifying Event. A Qualifying Event will occur, however, if an Employee does not return to employment at the end of the FMLA leave and all other COBRA continuation coverage conditions are present. If a Qualifying Event occurs, it occurs on the last day of FMLA leave and the applicable maximum coverage period is measured from this date (unless coverage is lost at a later date and the Arrangement provides for the extension of the required periods, in which case the maximum coverage date is measured from the date when the coverage is lost.) Note that the covered Employee and family members will be entitled to COBRA continuation coverage even if they failed to pay the employee portion of premiums for coverage under the Arrangement during the FMLA leave. 4. What Factors Should Be Considered When Determining to Elect COBRA Continuation Coverage? You should take into account that a failure to continue your group health coverage will affect your rights under federal law. First, you can lose the right to avoid having úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ10 08/01/05 pre-existing condition exclusions applied by other group health plans if there is more than a 63-day gap in health coverage and election of COBRA continuation coverage may help you avoid such a gap. Second, if you do not elect COBRA continuation coverage and pay the appropriate premiums for the maximum time available to you, you will lose the right to convert to an individual health insurance policy, which does not impose such pre-existing condition exclusions. Finally, you should take into account that you have special enrollment rights under federal law (HIPAA). You have the right to request special enrollment in another group health plan for which you are otherwise eligible er Plan coverage ends due to a Qualifying Event listed above. You will also have the same special right at the end of COBRA continuation coverage if you get COBRA continuation coverage for the maximum time available to you. 5. What is the Procedure for Obtaining COBRA Continuation Coverage? TheArrangement has conditioned the availability of COBRA continuation coverage upon the timely election of such coverage. An election is timely if it is made during the election period. 6. What is the Election Period and How Long Must It Last? The election period is the time period within which the Qualified Beneficiary must elect COBRA continuation coverage under the Arrangement. The election period must begin not later than the date the Qualified Beneficiary would lose coverage on account of the Qualifying Event and must not end before the date that is 60 days after the later of the date the Qualified Beneficiary would lose coverage on account of the Qualifying Event or the date notice is provided to the Qualified Beneficiary of her or his right to elect COBRA continuation coverage. Note: If a covered employee who has been terminated or experienced a reduction of hours qualifies for a trade readjustment allowance or alternative trade adjustment assistance under a federal law called the Trade Act of 2002, and the employee and his or her covered dependents have not elected COBRA coverage within the normal election period, a second opportunity to elect COBRA coverage will be made available for themselves and certain family members, but only within a limited period of 60 days or less and only during the six months immediately after their group health plan coverage ended. Any person who qualifies or thinks that he or she and/or his or her family members may qualify for assistance under this special provision should contact the Plan Administrator or its designee for further information. The Trade Act of 2002 also created a new tax credit for certain TAA-eligible individuals and for certain retired employees who hare receiving pension payments from the Pension Benefit Guaranty Corporation (PBGC) (eligible individuals). Under the new tax provisions, eligible individuals can either take a tax credit or get advance payment of 65% of premiums paid for qualified health insurance, including continuation coverage. If you have questions about these new tax provisions, you may call the Health Coverage Tax Credit Consumer Contact Center toll-free at 1-866-628-4282. TTD/TTY callers may call toll-free at 1-866- 626-4282. More information about the Trade Act is also available at www.doleta.gov/tradeact/2002act_index.asp. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ11 08/01/05 7. Is a Covered Employee or Qualified Beneficiary Responsible for Informing the Plan Administrator of the Occurrence of a Qualifying Event? The Arrangement will offer COBRA continuation coverage to Qualified Beneficiaries only after the Plan Administrator or its designee has been timely notified that a Qualifying Event has occurred. The Employer will notify the Plan Administrator or its designee of the Qualifying Event within 30 days following the date coverage ends when the Qualifying Event is: (1)the end of employment or reduction of hours of employment, (2) death of the employee, (3)commencement of a proceeding in bankruptcy with respect to the Employer, or (4)enrollment of the employee in any part of Medicare, IMPORTANT: For the other Qualifying Events (divorce or legal separation of the employee and spouse or n your behalf must notify the Plan Administrator or its designee in writing within 60 days after the Qualifying Event occurs, using the procedures specified below. If these procedures are not followed or if the notice is not provided in writing to the Plan Administrator or its designee during the 60-day notice period, any spouse or dependent child who loses coverage will not be offered the option to elect continuation coverage. You must send this notice to the Plan Administrator or its designee. NOTICE PROCEDURES: Any notice that you provide must be in writing. Oral notice, including notice by telephone, is not acceptable. You must mail, fax or hand-deliver your notice to the person, department or firm listed below, at the following address: County of Roanoke, P.O. Box 29800, Roanoke, VA 24018 If mailed, your notice must be postmarked no later than the last day of the required notice period. Any notice you provide must state: name of the plan or plans the under which you lost or are losing coverage, name and address of the employee the covered under the plan, name(s) and address(es) of the Qualified Beneficiary(ies) the , and Qualifying Eventdate theand the it happened. divorce or legal separationa copy of the If the Qualifying Event is a , your notice must include divorce decree or the legal separation agreement . Be aware that there are other notice requirements in other contexts, for example, in order to qualify for a disability extension. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ12 08/01/05 Once the Plan Administrator or its designee receives timely notice that a Qualifying Event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each Qualified Beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage for their spouses, and parents may elect COBRA continuation coverage on behalf of their children. For each Qualified Beneficiary who elects COBRA continuation coverage, COBRA continuation coverage will begin on the date that coverage would otherwise have been lost (if under your coverage the COBRA period begins on the date of the Qualifying Event, even though coverage date of continuation coverage within the 60-day election period described above, the right to elect continuation coverage will be lost. 8. Is a Waiver Before the End of the Election Period Effective to End a Qualified If, during the election period, a Qualified Beneficiary waives COBRA continuation coverage, the waiver can be revoked at any time before the end of the election period. Revocation of the waiver is an election of COBRA continuation coverage. However, if a waiver is later revoked, coverage need not be provided retroactively (that is, from the date of the loss of coverage until the waiver is revoked). Waivers and revocations of waivers are considered made on the date they are sent to the Plan Administrator or its designee, as applicable. 9.Is COBRA Coverage Available If a Qualified Beneficiary Has Other Group Health Plan Coverage or Medicare? Qualified Beneficiaries who are entitled to elect COBRA continuation coverage may do so even if they are covered under another group health plan or are entitled to Medicare benefits on or before the date on which COBRA is elected. However, a Qualified ically if, after electing COBRA, he or she becomes entitled to Medicare or becomes covered under other group health plan coverage (but only after any applicable preexisting condition exclusions of that other plan have been exhausted or satisfied). 10. Terminated? During the election period, a Qualified Beneficiary may waive COBRA continuation coverage. Except for an interruption of coverage in connection with a waiver, COBRA continuation coverage that has been elected for a Qualified Beneficiary must extend for at least the period beginning on the date of the Qualifying Event and ending not before the earliest of the following dates: (1)The last day of the applicable maximum coverage period. (2)The first day for which Timely Payment is not made to the Arrangement with respect to the Qualified Beneficiary. (3)The date upon which the Employer ceases to provide any group health plan (including a successor plan) to any employee. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ13 08/01/05 (4)The date, after the date of the election, that the Qualified Beneficiary first becomes covered under any other Plan that does not contain any exclusion or limitation with respect to any pre-existing condition, other than such an exclusion or limitation that does not apply to, or is satisfied by, the Qualified Beneficiary. (5)The date, after the date of the election that the Qualified Beneficiary first enrolls in the Medicare program (either part A or part B, whichever occurs earlier). (6)In the case of a Qualified Beneficiary entitled to a disability extension, the later of: (a)(i) 29 months after the date of the Qualifying Event, or (ii) the first day of the month that is more than 30 days after the date of a final determination under Title II or XVI of the Social Security Act that the disabled Qualified entitlement to the disability extension is no longer disabled, whichever is earlier; or (b)the end of the maximum coverage period that applies to the Qualified Beneficiary without regard to the disability extension. The Arrangement can terminate for cause the coverage of a Qualified Beneficiary on the same basis that the Arrangement terminates for cause the coverage of similarly situated non-COBRA beneficiaries, for example, for the submission of a fraudulent claim. In the case of an individual who is not a Qualified Beneficiary and who is receiving ship to a Qualified Beneficiary, if the Arrangement's obligation to make COBRA continuation coverage available to the Qualified Beneficiary ceases, the Arrangement is not obligated to make coverage available to the individual who is not a Qualified Beneficiary. 11. What Are the Maximum Coverage Periods for COBRA Continuation Coverage? The maximum coverage periods are based on the type of the Qualifying Event and the status of the Qualified Beneficiary, as shown below. (1)In the case of a Qualifying Event that is a termination of employment or reduction of hours of employment, the maximum coverage period ends 18 months after the Qualifying Event if there is not a disability extension and 29 months after the Qualifying Event if there is a disability extension. (2) experiencing a Qualifying Event that is a termination of employment or reduction of hours of employment, the maximum coverage period for Qualified Beneficiaries other than the covered Employee ends on the later of: (a)36 months after the date the covered Employee becomes enrolled in the Medicare program; or (b)18 months (or 29 months, if there is a disability extension) after the date of the covered Employee's termination of employment or reduction of hours of employment. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ14 08/01/05 (3)In the case of a bankruptcy Qualifying Event, the maximum coverage period for a death. The maximum coverage period for a Qualified Beneficiary who is the covered Spouse, surviving Spouse or Dependent child of the retiree ends on the earlier of the Qualified Beneficiary's death or 36 months after the death of the retiree. (4)In the case of a Qualified Beneficiary who is a child born to or placed for adoption with a covered Employee during a period of COBRA continuation coverage, the maximum coverage period is the maximum coverage period applicable to the Qualifying Event giving rise to the period of COBRA continuation coverage during which the child was born or placed for adoption. (5)In the case of any other Qualifying Event than that described above, the maximum coverage period ends 36 months after the Qualifying Event. 12. Under What Circumstances Can the Maximum Coverage Period Be Expanded? If a Qualifying Event that gives rise to an 18-month or 29-month maximum coverage period is followed, within that 18- or 29-month period, by a second Qualifying Event that gives rise to a 36-months maximum coverage period, the original period is expanded to 36-months, but only for individuals who are Qualified Beneficiaries at the time of and with respect to both Qualifying Events. In no circumstance can the COBRA maximum coverage period be expanded to more than 36-months after the date of the first Qualifying Event. The Plan Administrator must be notified of the second qualifying event within 60 days of the second qualifying event. This notice must be sent to the Plan Administrator or its designee and in accordance with the procedures above. 13. How Does a Qualified Beneficiary Become Entitled to a Disability Extension? A disability extension will be granted if an individual (whether or not the covered Employee) who is a Qualified Beneficiary in connection with the Qualifying Event that is a under Title II or XVI of the Social Security Act to have been disabled at any time during the first 60 days of COBRA continuation coverage. To qualify for the disability extension, the Qualified Beneficiary must also provide the Plan Administrator with notice of the disability determination on a date that is both within 60 days after the date of the determination and before the end of the original 18-month maximum coverage. This notice must be sent to the Plan Administrator or its designee and in accordance with the procedures above. 14. Does the Arrangement Require Payment for COBRA Continuation Coverage? For any period of COBRA continuation coverage under the Arrangement, Qualified Beneficiaries who elect COBRA continuation coverage may be required to pay up to 102% of the applicable premium and up to 150% of the applicable premium for any expanded period of COBRA continuation coverage covering a disabled Qualified Beneficiary due to a disability extension. Your Plan Administrator will inform you of any costs. The the first day of any period for which timely payment is not made. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ15 08/01/05 15. Must the Arrangement Allow Payment for COBRA Continuation Coverage to Be Made in Monthly Installments? Yes. The health coverage is also permitted to allow for payment at other intervals. 16. What is Timely Payment for Payment for COBRA Continuation Coverage? Timely Payment means a payment made no later than 30 days after the first day of the coverage period. Payment that is made to the Arrangement by a later date is also considered Timely Payment if either under the terms of the Arrangement, covered employees or Qualified Beneficiaries are allowed until that later date to pay for their coverage for the period or under the terms of an arrangement between the Employer and the entity that provides benefits on the Emplo that later date to pay for coverage of similarly situated non-COBRA beneficiaries for the period. Notwithstanding the above paragraph, the Arrangement does not require payment for any period of COBRA continuation coverage for a Qualified Beneficiary earlier than 45 days after the date on which the election of COBRA continuation coverage is made for that Qualified Beneficiary. Payment is considered made on the date on which it is postmarked to those providing coverage. If Timely Payment is made to the Arrangement in an amount that is not significantly less than the amount the Arrangement requires to be paid for a period of coverage, then the amount paid will be deemed to satisfy the Arrangement's requirement for the amount to be paid, unless the Arrangement notifies the Qualified Beneficiary of the amount of the deficiency and grants a reasonable period of time for payment of the deficiency to be made. rovided. A shortfall in a Timely Payment is not significant if it is no greater than the lesser of $50 or 10% of the required amount. Must a Qualified Beneficiary Be Given the Right to Enroll in a Conversion Health 17. Plan at the End of the Maximum Coverage Period for COBRA Continuation Coverage? as a result of the expiration of the applicable maximum coverage period, the Arrangement will, during the 180 day period that ends on that expiration date, provide the Qualified Beneficiary with the option of enrolling under a conversion health plan if such an option is otherwise generally available to similarly situated non-COBRA beneficiaries under the Arrangement. If such a conversion option is not otherwise generally available, it need not be made available to Qualified Beneficiaries. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ16 08/01/05 IF YOU HAVE QUESTIONS If you have questions about your COBRA continuation coverage, you should contact the Plan Administrator or its designee. For more information about your rights under ERISA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department www.dol.gov/ebsa. KEEP YOUR PLAN ADMINISTRATOR INFORMED OF ADDRESS CHANGES In order to changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator or its designee. úÎÍÄËÔÖÕÉ êÈÏöÜËÙôÏÚ17 08/01/05 Î±¿²±µ»Ý±«²¬§Ý×ÐÎ»ª·»©Ý±³³·¬¬»» Ý¿°·¬¿´Ð®±¶»½¬Ð®·±®·¬·¦¿¬·±² Ì·»®ïÐ®±¶»½¬ Ý±³³·¬¬»»Ì±¬¿´ Ð®±¶»½¬ßª»®¿¹»Ð®±¶»½¬Ý±¬ Ú·®»¿²¼Î»½«»Í¬¿¬·±²ß´»®¬·²¹Í§¬»³êîòððüìéðôððð Ð¿®µ¿²¼Î»½Í°±®¬Ô·¹¸¬·²¹æß®²±´¼Þ«®¬±²ëçòêíüíððôððð Ð¿®µ¿²¼Î»½Í°±®¬Ô·¹¸¬·²¹æÜ¿®®»´´Í¸»´´Ð¿®µëêòëðüíððôððð Í±½·¿´Í»®ª·½»Ñºº·½»Î»²±ª¿¬·±²ëëòêíüíôðððôððð Ù»²»®¿´Í»®ª·½»Î»°´¿½»³»²¬±ºÚ«»´Í¬±®¿¹»Ì¿²µëìòéïüîëðôððð Ð¿®µ¿²¼Î»½Í¬¿®µ»§Ð¿®µëíòððüïëðôððð Ô·¾®¿®§Ê·²¬±²Þ®¿²½¸Ô·¾®¿®§ëîòîëüçôîëðôððð Ú·®»¿²¼Î»½«»Í¬¿¬·±²Ù»²»®¿¬±®Ð®±¹®¿³ëîòððüçîèôîðð Ú·²¿²½»Û²¬»®°®·»Î»±«®½»Ð´¿²²·²¹øÛÎÐ÷ëïòéëüìôëððôððð Ð¿®µ¿²¼Î»½Þ®¿³¾´»¬±²Ý»²¬»®ëðòéëüëððôððð Ô·¾®¿®§Ó¬òÐ´»¿¿²¬Þ®¿²½¸Ô·¾®¿®§ëðòîëüîôçèèôðîð Ð¿®µ¿²¼Î»½Ý¿³°Î±¿²±µ»ìçòððüîêéôëðð