GODINEZ, RAUL II (2) - Laserfiche WebLink

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A-2019-013-01 B. No Surviving Spouse or Surviving Dependents If there are no living spouse or dependents at the time of death of the participant, the account will revert in accordance with the Employer's election under Section Vill of the lrantageCare RHS Adoption Agreement. XII. The Plan will operate according to the following ptuvisions: A. Employer Responsibilities 1. The Employer will submit all VantageCarc Retirement Health Savings Plan contribution data via electronic submission. 2. The ]employer will submit all VantageCarc Retirement Health Savings Plan Participant stains updates or personal information updates via eiecrrnnfc submission. This includes but is not limited to termfnatmn notification, benefit eligibility, and vesting notification. B. Participant account administration and asset-based fees will be paid through the redemption of participant account shares, unless agreed upon otherwise in the Administrative Services Agreement. C. Assignment of benefits is not permitted. Benefits will be paid only to the Participant, his/her Survivors, the Employer, or an insurance provider (as allowed by the claims administrator). Payments to a third -patty, payer (e.g., medical service provider) are not permitted with the exception of reimbursement to the Employer or insurance provider (as allowed by the claims administrator). D. An eligible dependent is (a) the Participant's lawful spouse, (b) the Participants child under the age of 27, as defined by IRC Section 152(f)(1) and Internal Revenue Service Notice 2010-38, or (e) any other individual who is a person described in IRC Section 152(x), as clarified by Internal Revenue Service Notice 2004-79. E. The Employer will be responsible for withholding, reporting and remitting any applicable taxes for payments which are deemed to be discriminatory under IRC Section 105(h), as outlined in the VamagrCare Retirement Health Savings EmployerManaal. X121. Employer Acknowledgements A. The Employer hereby acknowledges It understands that failure to properly fill our this VarnogeCare Retirement Health Savings Adoption Agreement may result in the loss of tax exemption of the Trust and/or loss of tax-deferred status for Employer contributions. B. ❑ Check this box if you are including supporting documents that Include plan provisions. EMPLOYER SIGNATURE By, 2SO I �i��1 Titles-Oy-�= � +-{- Attest: Tldc.._ Norma Mitre _ Acting Clerk of the Council Approved to Form R.,t��v Sonia R. Carvalho City Attorney 11:18 Date: _ y— }..— J