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❑ Medicare Supplemental Insurance premiums ❑ Prescription Drug Laurance Premiums ❑ COBRA Insurance Premiums ❑ Dental Insurance Premiums ❑ Dental Out-of-pocket Expenses' ❑ Vision Insurance Premiums ❑ Vision Our-of-Pocker Expenses' ❑ Qualified Long -Term Care Insurance Premiums ❑ Non -Prescription medications allowed under IRS guidance' ❑ Other qualifying medical expenses (describe)' See Section VA. far a dirtunion ofnatdherindnation rulrs which pray apply to non -collectively bargained, re/f-inrnred Plans. XI. Benefits After the Death of the Participant In the event of 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.) oFche 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. 71n inrertnrent in the Dreyf n Car, Alanagmioo money nmrketf..rd it not inrured orguaraweed by the Federal Deporit Ln'raun Corporation many otberguvernmeut gency. Although the f urd reeky to prererre for vabre efyour invatnrearat 51.00 perrbare, it it parrible to lore money by inverting in thefund. Inverrorr should consider ibe inrertnrent objretiver, rirkr, rlragei, and erpenrer ofibe fund nrrefrd/y beforr inveitiug. You nnty visit nr at mtvrv.ieruam-org or call SOO.669-7400 to obtain a pm pectis t,nt rontainr tbii and other it formation about the fiord. Reid the prorpecna carefully before inverriug. If a Participant's account balance has nor 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 Sponse 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 1. The Employer will submit all VantageCare Retirement Health Savings Plan contribution data via electronic submission. 2. The Employer will submit all VantageCam Retirement Health Savings Plan Participant status updates or personal information updates via electronic submission. This includes bur is not limited to termination notification and benefit eligibility 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. 5E=83