INTERNATIONAL CITY MANAGEMENT ASSOCIATION RETIREMENT CORPORATION (ICMA) (CITY MANAGER) 1E

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❑ 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 VA. for a discussion of nondiscrimination moles which ntay apply to non - collectively bargained, selfiaruurad 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 XILD.) 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 Dreyfus Cash Management fund* (or another fund selected by the Employer),. The account balance may be reallocated by the surviving spouse or dependents: *An investment In the Dreyf s Cash Nlimgyement money marketfund it not hesured orguaranteed by the Toderal Deposit Insurance Corporation orany other-government agency. Alebotugh the fitedseekr to preserve the value ofyour investment at $1.00pershare, it is possible to lore money by investing in tbeRand. Investors should consider the investment objectives, risks, charges, and expenses gletbe fiend care(l y before btvesting. You may visit as at nuww.icmare.org m'call 800 -669-7400 to obtain a prorpectur that eomaim this andotber information about. the fund. Read tbeprorpectus carefrdly before investing If a partic'ipant'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, 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 to the Plan to be applied as specified in Section VIII. XII. The Plan will operate according to the following provisions: A. Employer Responsibilities L The Employer will submit all VanuageCare Retirement Health Savings Plan contribution data viaeleerrmuc submission. 2. The Employer will submit all VantageCare Retirement Health Savings Plan Participant status updates or personal information updates via electronic submission. This includes but is not limited to termination notification and benefit eligibility notification. B. Participant accomu administration and asset-based fees will be paid through the redemption of Participant account shares, unless agreed upon otherwise in the Administrative Services Agreement.