Very Important Notice Continuation Coverage Rights Under COBRA
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?
a) Eligibility Requirements and Eligibility Date
b) Annual Election Rules
c) Change of Election Period
d) Benefit Plan Options
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?
I. Cafeteria Plan Benefits
II. Default Benefits
APPENDIX I. – Claims Review Procedure Chart
APPENDIX II. – Tax Advantages Example
APPENDIX III. – Election Change Chart
Independent Health: FlexFit
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