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I IX. Eligibility Requirements to Receive Medical Benefit Payments From the VantageCare Retirement Heahh Savings Plan A. A Participant is eligible to receive benefits: ❑ At retirement only (also complete Scc ion B.) Definition of retirement: ❑ Sameas Section Vll.B. j ❑ Other m Ar sepamtion From scivicc with rhe following restrictions ® No restrictions ❑ Other i B. Termination prior to general benefit eligibility; In ease where the general benefit eligibilky as outlined in Section IX.A includes a retirement component, a Participant who separates from service of the Employer prior to retirement will be eligible To receive benefits: I m Immetliamly upon sepamtion fmm service ❑ Other C. A Participant that becomes totally and permanently disabled ❑ as defined by the Social Security Administration as defined by the Employer's primary retirement plan i ❑ other will become immediately eligible to receive medical benefit payments from his/her VantageCare Retirement Health Savings Plan account. D. Upon the death of the Participant, benefits shill become payable as outlined in Section XI. X. Permissible Medical Benefit Payments Benefits eligible for reimbursement consist of: ® tMI Medical Expenses eligible under IRC Section 213' otter than (i) direct longterm care expenses. and (ii) expenses for medicines or drugs which are not prescribed drugs (other than insulin). ❑ The following Medical Expenses eligible under IRC Section 213' ocher than (i) direct longterm care expemes, and (ii) expenses For medicines or drugs which are nor prescribed drugs (other than insulin). Select only die expenses you wish to 4 cover under the VantageCare Retirement Health Savings Plan: j ❑ 4lediml Insurance Premiums ❑ Mediml Our -of -Pucker Expenses' I ❑ \dedictre Part B Insurance Premiums ❑ Medicare Parr D Insurance Premiums I 25E-95