25A - AGMT FOR FLEX SPENDING - Laserfiche WebLink

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DocuSigp Envelope ID: CFCE3443-EF37-4FD4-8DCD-D85D559F77AE qualification of the Plan for meeting non-discrimination requirements. In addition, the Client agrees to initiate any action required in the event that one or more component benefit programs are reported as discriminatory. If the Client requests additional non-discrimination testing services, the Client will be responsible for updating all data necessary to conduct said testing and agrees to pay resulting administrative fees as set forth in Exhibit A, if applicable. 13. The Client shall retain documentation relating to its Reimbursement Program operations that may be requested in an IRS or Department of Labor audit - including, but not limited to: non-discrimination testing information, executed copies of reimbursement account documentation, Salary Redirection Agreements (e.g. Enrollment Forms), Amendments, Resolutions adopting the Reimbursement Program, and Form 5500s (if applicable), for seven years after the close of each "Plan Year" with respect to the Program, as such term is defined under ERISA §3(39), if applicable. 14. The Client shall ensure that only common law employees participate in the Reimbursement Program [employees of companies described in Code §414 (b), (c) or (m) and listed in the Plan as participating affiliates may also participate] and to ensure that the terms of its documentation are properly enforced. Client solely is responsible for determining whetheror not it is a component memberof a controlled group, common control group, or affiliated service group, under Code § 414(b), (c), or (m) and for the consequences, under ERISA and the Code, of such status. 15. The Client agrees that, unless alternate arrangements have been made with the Contract Administrative Firm's approval, payment for services performed will be taken directly from the Funding Account as defined in Section 1.a.i.3 and 1.b.i.8 herein, in accordance with Exhibit A. Fees will be assessed on or about the first day of the month in which services are being provided. If the Client is still completing open enrollment during a billing month, fees associated with participation counts will be estimated. In these cases, adjustments will be made as necessary during the next month's billing cycle. Unless alternate arrangements have been made with the Contract Administrative Firm's approval, payment for fees will be drawn from said account via an ACH transaction no later than the 20t1, of the applicable billing month. A written statement of such fee assessments and ACH activity will be provided by the Contract Administrative Firm at least 2 business days prior to when the ACH is initiated. Administrative fees set forth in Exhibit A are subject to review by the Contract Administrative Firm upon expiration of the Rate Guarantee Period defined in Exhibit A. The Contract Administrative Firm must give written notice to the Client regarding any change in fees at least sixty (60) days prior to the expiration of the Rate Guarantee Period. 16. The Client Agrees that if the Card is contracted and Participant uses his/her Card for a transaction that falls outside of the Card parameters set forth by the IRS, the Contract Administrative Firm will send a written J /GDE .,„...s............ "' City of Santa Ana Spending Account Administrative Services Agreement Clientlnitials: PEPM17 Page 9 25A-11