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Item 19 - Agreement with Empower Annuity Insurance Company for the Employee Deferred Compensation Plan
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09/19/2023 Regular
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Item 19 - Agreement with Empower Annuity Insurance Company for the Employee Deferred Compensation Plan
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10/24/2023 11:43:40 AM
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10/24/2023 11:35:25 AM
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City Clerk
Doc Type
Agenda Packet
Agency
Finance & Management Services
Item #
19
Date
9/19/2023
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56 <br />For security purposes, QDRO Consultants strongly encourages parties and/or their counsel to use the <br />Personal Information Addendum Form. <br />Alternate Payee's Attorney Information: <br />Attorney’s Name: _________________________________________ <br />Address: _________________________________________ <br />Phone: _________________________________________ <br />Email: ________________________________________ <br />The Alternate Payee shall have the duty to notify the Plan Administrator in writing of any changes in his/her <br />mailing address subsequent to the entry of this Order. <br />4. State Domestic Relations Law: This Order is entered pursuant to the authority granted in the <br />applicable domestic relations laws of the State of _________. <br />5. Marital Property Rights, Spousal Support, and/or Child Support: This Order relates to the provision <br />of [marital property rights] [spousal support] [child support] to the Alternate Payee. <br />6. Benefit Assignment: This Order assigns to the Alternate Payee [____% OR $________] (but in no <br />event more than 100%) of the Participant’s vested account balance in the Plan as of the Assignment Date <br />or the closest valuation date thereto) (“Assignment Date”). The “Assignment Date” is <br />In this blank enter the date of divorce, separation, or other appropriate or agreed upon date. Delete this <br />instruction after filling in the blank. <br />Any outstanding Participant loan in the Plan shall not be included in the Participant’s vested account <br />balance for purposes of determining the amount to be assigned to the Alternate Payee, and no portion of <br />any such loan shall be assigned to the Alternate Payee. If the Participant’s account balance consists of <br />different sub-accounts and/or is invested in different investment fund options, the benefit assignment to the <br />Alternate Payee shall be allocated on a pro rata basis from such vested sub -accounts and/or investment <br />fund options. The assigned benefit shall be adjusted for gains and/or losses from the Assignment Date <br />through the date that the Plan segregates the Alternate Payee’s assigned benefit from the Participant’s <br />account balance. <br />7. QDRO Review and Determination Fee: A QDRO review and determination fee will be assessed against <br />the Participant's account balance upon initial review of the DRO. However, once the final QDRO has been <br />approved, the Plan Administrator will reduce the Alternate Payee's assigned share of the benefits by 50% of <br />the fee. <br />8. Alternate Payee’s Separate Account: Upon determining that this Order is a QDRO, the Plan shall <br />segregate the Alternate Payee’s assigned benefit into a separate account in the Alternate Payee’s name. The <br />Alternate Payee’s account shall be invested in the same options and in the same proportions as the assigned <br />benefits were invested prior to being assigned to the Alternate Payee. <br />9. Time and Form of Payment: The Alternate Payee may elect to receive a distribution from the Alternate <br />Payee’s account as soon as administratively feasible following the date this Order is approved as a QDRO
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