ICMA-RC 1 -2011 - Laserfiche WebLink

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X. Permissible Medical Benefit Payments Benefits eligible for reimbursement consist of: Q All Medical Expenses eligible under IRC Section 213* other than direct long-term care expenses, and including non-prescription medications allowed under IRS guidance. ❑ The following Medical Expenses (select only the expenses you wish to cover under the VantageCare Retirement Health Savings Plan): ❑ Medical Insurance Premiums ❑ Medical Out -of -Pocket Expenses* ❑ Medicare Part B Insurance Premiums ❑ Medicare Part D Insurance Premiums ❑ Medicare Supplemental Insurance Premiums ❑ Prescription Drug Insurance Premiums ❑ COBRA Insurance Premiums ❑ Dental Insurance Premiums ❑ Dental Out -of -Pocket Expenses* ❑ Vision Insurance Premiums ❑ Vision Out -of -Pocket Expenses* ❑ Qualified Long -Term Care Insurance Premiums ❑ Non -Prescription medications allowed under IRS guidance* ❑ Other qualifying medical expenses (describe)* * See Section V.A. for a discussion of nondiscrimination rules which may apply to non -collectively bargained, self -insured Plans. XI. Benefits After the Death of the Participant In the event of a Participant's death, the following shall apply: A. Surviving Spouse and/or Surviving Dependents The surviving spouse and/or surviving eligible dependents (as defined in Section XII.D.) of the deceased Participant are immediately eligible to maintain the account and utilize it to fund eligible medical benefits specified in Section X above. Upon notification of a Participant's death, the Participant's account balance will be transferred into the Vantagepoint Money Market Fund* (or another fund selected by the Employer). The account balance may be reallocated by the surviving spouse or dependents. * Please read the current Vantagepoint Mittual Funds prospectus carefzdly prior to investing. An investment in this fitnd is neither insured nor guaranteed and there can be no assurance that the Fund will be able to maintain a stable net asset value of$1.00 per share. Vantagepoint Mutual Funds are distributed by ICMA-RC Services, LLC, a wholly -owned broker -dealer affiliate of ICMA Retirement Corporation. Member FINRAISIPC. If a Participant's account balance has not been fully utilized upon the death of the eligible spouse, the account balance may continue to be utilized to pay benefits of eligible dependents. Upon the death of all eligible dependents, the account will revert to the Plan to be applied as specified in Section VIII.