Employee Benefit Plan
Notice of Federal Continuation Rights
Very Important Notice Continuation Coverage Rights Under COBRA
Cafeteria Plan Component Summary
Q-1. What is the purpose of the Cafeteria Plan?
Q-2. Who can participate in the Cafeteria Plan?
Q-3. When does my participation in the Cafeteria Plan end?
Q-4. How do I become a Participant?
Q-5. What are the tax advantages and disadvantages of participating in the Cafeteria Plan?
Q-6. What are the election periods for enrolling in the Cafeteria Plan?
Q-7. How is my Benefit Plan Option coverage paid for under this Plan?
Q-8. Under what circumstances can I change my election during the Plan Year?
Q-9. What happens to my participation under the Cafeteria Plan if I take a leave of absence?
Q-10. How long will the Cafeteria Plan remain in effect?
Q-11. What happens if my request for a benefit under this Cafeteria Plan is denied?
Plan Information Summary
a) Eligibility Requirements and Eligibility Date
Special Rule for Health Savings Accounts
Q-1. What is a Health Savings Account for which contributions can be made under this Plan?
Q-2. Who is eligible for an HSA?
Q-3. Who is an account beneficiary?
Q-4. Who is a custodian or trustee?
Q-5. What are the rules regarding contributions made to an HSA under the Plan?
Q-6. What are the election change rules under this Plan for HSA elections?
Q-7. Where can I get more information on my HSA and its related tax consequences?
Benefit Plan Options Summary
APPENDIX I. – Claims Review Procedure Chart
APPENDIX II. – Tax Advantages Example
APPENDIX III. – Election Change Chart
Benefit Descriptions
Independent Health: iDirect 1 Series
Aflac: MDe Plan (Cancer Plan)(effective for initial enrollments on or after January 1, 2012)
Aflac: MD Plan (Cancer Plan)(effective for enrollments prior to January 1, 2012)
Aflac: Accident Indemnity Advantage (Accident-only Plan)
Guardian Life Insurance Company: Dental-Guard Preferred
Standard Life Insurance Company: Life, Accidental Death and Dismemberment Insurance
Standard Life Insurance Company: Group Long Term Disability Insurance