Page History
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Revised June 2, 2020
Revised January 6, 2021
Revised June 8, 2021
I. INTRODUCTION...................................................................................................... 1
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1.1. Purpose of Plan................................................................................................ . 11.2. Cafeteria
- Cafeteria Plan Status....................................................................................... 1
II,. DEFINITIONS.................................................................................................... ....... 1
2.1. “Administrator”............................................................................................... .. 1
2.2. “Code”................................................................................................................. . 1
2.3. “Company”......................................................................................................... 1
2.4. “Dependent Care Assistance Plan”................................................................. 1
2.5. “Effective Date”.............................................................................................. . 1
2.6. “Employee”..................................................................................................... .. 1
2.7. “Key Employee................................................................................................ 1
2.8. “Participant”..................................................................................................... 1
2.9. “Plan”................................................................................................................. . 1
2.10. “Plan Year”.................................................................................................... . 2
2.11 “Health Savings Account” ....................................................................... 2III. PARTICIPATION.... 2
III. PARTICIPATION............................................................................................ 2
3.1. Commencement of Participation..................................................................... 2
3.2. Cessation of Participation.......................................................................... 23...... 2
3.3.3. Reinstatement of Former Participant............................................................... 2
IV. OPTIONAL BENEFITS.................................................................................... 2
4.1. Benefit Options................................................................................................ 2
4.2. Description of Benefits Other than Cash......................................................... 2
4.3. Election of Optional Benefits in Lieu of Cash................................................ 3
4.4. Election Procedure.......................................................................................... 3
4.5. New Participants.............................................................................................. 3
4.6. Failure to Elect................................................................................................ 4
4.7. Changes by Administrator............................................................................... 4
4.8. Irrevocability of Election by the participant During the Plan Year................. 4
4.9. Automatic Termination of Election..................................................... 54.10. Maximum Employer Contribution.......... 5
4.10. Maximum Employer Contribution........................................ 54.11. Health Savings Account...................... 5
4.11. Health Savings Account................................................ 5
V. ADMINISTRATION OF PLAN................................ 5
4.12. Employer Contribution to the Health Savings Account................................. 5
4... 55.1. Plan Administrator13. Adoption Agreement...................................................................................... 55
4.2. Examination of Records14. Prospective HSA salary reduction elections & changes allowed................... 6
4.....15. Temporary Suspension of the Forfeiture (Use-it-or-lose-it-Rule)................. 6
V.ADMINISTRATION OF PLAN................................ 65.3. Reliance on Tables, etc....................................... 6
5.1. Plan Administrator............................................... 65.4. Nondiscriminatory Exercise of Authority......................................... 6
5.52. Indemnification Examination of AdministratorRecords....................................................... 6VI. AMENDMENT AND TERMINATION OF PLAN.......................... 7
5.3. Reliance on Tables, etc........... 6VII. MISCELLANEOUS PROVISIONS............................................................. 67...1. Information to be Furnished....... 7
5.4. Nondiscriminatory Exercise of Authority....................................................... 67
75.25. Limitation Indemnification of RightsAdministrator.................................................................... 7
VI. AMENDMENT AND TERMINATION OF PLAN............. 67.3. Governing Law........................... 7
VII. MISCELLANEOUS PROVISIONS................................................................ 7
Reliant Mission
Cafeteria Plan
ARTICLE I – Introduction
1.1. Purpose of Plan. The purpose of this Plan is to provide employees of Reliant Mission a choice between cash and benefits under the dependent care and health savings account program maintained by Reliant Mission.
1.2. Cafeteria Plan Status. This Plan is intended to qualify as a "cafeteria plan" under Section 125 of the Internal Revenue Code of 1986, as amended, and is to be interpreted in a manner consistent with the requirements of Section 125.
ARTICLE II – Definitions
2.1. “Administrator” means the Company or such other person or committee as may be appointed from time to time by the Company to supervise the administration of the Plan.
2.2. “Code” means the Internal Revenue Code of 1986, as amended from time to time. Reference to any section or subsection of the Code includes reference to any comparable or succeeding provisions of any legislation which amends, supplements, or replaces such section or subsection.
2.3. “Company” means Reliant Mission, a nonprofit corporation.
2.4. “Dependent Care Assistance Plan” means the Reliant Mission Dependent Care Assistance Plan as amended from time to time.
2.5. “Effective Date” means January 1, 2013.
2.6. “Employee” means the individual employed by the Company. “Employee” shall not include non-resident aliens normally working outside of the United States.
2.7. “Key Employee” means any person who is a key employee as defined in Section 416(i)(1) of the Code.
2.8. “Participant” means any individual who participates in the Plan in accordance with Article III.
2.9. “Plan” means the Reliant Mission Cafeteria Plan as set forth herein, together with any and all amendments and supplements hereto.
2.10. “Plan Year” means the period beginning on the Effective Date and ending on December 31, 2013, and the 12-month period ending on each December 31 thereafter.
2.11. “Health Savings Account” means an account as defined in Section 223 of the Code.
A pronoun or adjective in the masculine gender includes the feminine gender, and the singular includes the plural, unless the context clearly indicates otherwise.
ARTICLE III – Participation
7.1. Information to be Furnished............................................................................ 7
7.2. Limitation of Rights........................................................................................ 8
7.3. Governing Law................................................................................................ 8
Reliant Mission
Cafeteria Plan
ARTICLE I – Introduction
1.1. Purpose of Plan. The purpose of this Plan is to provide employees of Reliant Mission a choice between cash and benefits under the dependent care and health savings account program maintained by Reliant Mission.
1.2. Cafeteria Plan Status. This Plan is intended to qualify as a "cafeteria plan" under Section 125 of the Internal Revenue Code of 1986, as amended, and is to be interpreted in a manner consistent with the requirements of Section 125.
ARTICLE II – Definitions
2.1. “Administrator” means the Company or such other person or committee as may be appointed from time to time by the Company to supervise the administration of the Plan.
2.2. “Code” means the Internal Revenue Code of 1986, as amended from time to time. Reference to any section or subsection of the Code includes reference to any comparable or succeeding provisions of any legislation which amends, supplements, or replaces such section or subsection.
2.3. “Company” means Reliant Mission, a nonprofit corporation.
2.4. “Dependent Care Assistance Plan” means the Reliant Mission Dependent Care Assistance Plan as amended from time to time.
2.5. “Effective Date” means January 1, 2013.
2.6. “Employee” means the individual employed by the Company. “Employee” shall not include non-resident aliens normally working outside of the United States.
2.7. “Key Employee” means any person who is a key employee as defined in Section 416(i)(1) of the Code.
2.8. “Participant” means any individual who participates in the Plan in accordance with Article III.
2.9. “Plan” means the Reliant Mission Cafeteria Plan as set forth herein, together with any and all amendments and supplements hereto.
2.10. “Plan Year” means the period beginning on the Effective Date and ending on December 31, 2013, and the 12-month period ending on each December 31 thereafter.
2.11. “Health Savings Account” means an account as defined in Section 223 of the Code.
A pronoun or adjective in the masculine gender includes the feminine gender, and the singular includes the plural, unless the context clearly indicates otherwise.
ARTICLE III – Participation
3.1. Commencement of Participation. Each Employee regularly working five (5) or 3.1. Commencement of Participation. Each Employee regularly working five (5) or more hours each week will be eligible to participate in the Plan. An Employee will become a Participant on the later of (a) the Effective Date or (b) the first day of the month following the date he becomes eligible to participate under the preceding sentence.
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- Payment of insurance premium for vision care or other health insurance sponsored by the company, including Continuance Coverage.
- Payment of health insurance premiums for any other health insurance coverage sponsored by the company and offered to Participant. This includes the ability to pay the portion of any premium which is not paid by Company.
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A change in family status for this purpose includes:
(a) marriage,
- (b) divorce,
(c) death of a spouse or child,
(d) birth or adoption of a child,
(e) change in legal custody of a child,
(f) formal placement of a foster child who is a dependent of the employee
(g) termination of or change in employment of employee, employee’s spouse or other dependent,
(h) change in residency,
(i) entitlement to Medicare or Medicaid,
(j) significant cost or coverage changes in employee’s coverage, employee’s spouse’s coverage, or other dependent’s coverage (including coverage by another employer), and
(k) such other events that the Administrator determines will permit a change or revocation of an election during a Plan Year under regulations and ruling of the Internal Revenue Service.
Any new election under this Section 4.8 shall be effective at such time as the Administrator shall prescribe, but not earlier than the first pay period beginning after the election form is completed and returned to the Administrator.
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- The Health Savings Account established by Participant, including all assets, income and distributions, shall belong to participant. Participant shall be solely responsible for any investment or tax issues associated with the Health Savings Account.
- Company may assist Participant in establishing Participant in establishing the Health Savings Account, but provided Company has exercised reasonable care in the selection of the trustee for the Health Savings Account, Company shall have no liability for the continuing qualification of such account for any tax benefits under the Code.
- Company may provide Participant with information regarding the operation and taxation of the Health Savings Account, but provided Company has exercised reasonable care in the selection of the trustee for the Health Savings Account, Company shall have no liability for the continuing qualification of such account for any tax benefits under the Code.
- Company may provide Participant with information regarding the operation and taxation of the Health Savings Account, but provided Company has exercised reasonable care in compiling such information, Company shall have no liability for the accuracy or effectiveness of such information.
4.12. Employer Contributions to the Health Savings Account. There may be an employer Health Saving Account contribution.
- Reliant may make an employer contribution
- The employer contribution will be credited to the applicable account at such a time determined by the Company, generally on a monthly basis.
- In order for an employee to be eligible for the employer contribution, he/she must be enrolled in a HSA compatible HDHP offered by the Company.
4.13. Adoption Agreement. The Company may make an employer HSA contribution to the extent provided in the Adoption Agreement. Such contributions shall be credited to the applicable account at such time as determined by the Company.
- compiling such information, Company shall have no liability for the accuracy or effectiveness of such information.
4.12. Employer Contributions to the Health Savings Account. There may be an employer Health Saving Account contribution.
- Reliant may make an employer contribution
- The employer contribution will be credited to the applicable account at such a time determined by the Company, generally on a monthly basis.
- In order for an employee to be eligible for the employer contribution, he/she must be enrolled in a HSA compatible HDHP offered by the Company.
4.13. Adoption Agreement. The Company may make an employer HSA contribution to the extent provided in the Adoption Agreement. Such contributions shall be credited to the applicable account at such time as determined by the Company.
4.14. Prospective HSA salary reduction elections and changes in HSA salary reduction elections allowed. Employees may prospectively make, change, or revoke HSA salary reduction elections at any time during the plan year. Such salary reduction elections, changes to elections, or revocations of elections must become effective before the employee’s affected salary becomes currently available. Salary reduction elections, changes to elections, or revocations of elections may be made before any payroll period, but no less frequently than monthly. In addition, any employee with a current salary reduction election that becomes ineligible to make HSA contributions may prospectively revoke his or her HSA salary reduction election.
4.15. A Participant shall be entitled to carryover any unused amounts remaining in their Dependent Care Assistance Plan account at the end of the 2020 coverage period into the coverage period beginning on January 1, 2021.
Any unused funds carried over from the 2020 coverage period that remain at the end of the 2021 coverage period (December 31, 2021) shall be forfeited.
These changes are effective for Plan Years beginning on or after January 1, 2020 through the end of the 2021 coverage period (December 31, 2021).4.14. Prospective HSA salary reduction elections and changes in HSA salary reduction elections allowed. Employees may prospectively make, change, or revoke HSA salary reduction elections at any time during the plan year. Such salary reduction elections, changes to elections, or revocations of elections must become effective before the employee’s affected salary becomes currently available. Salary reduction elections, changes to elections, or revocations of elections may be made before any payroll period, but no less frequently than monthly. In addition, any employee with a current salary reduction election that becomes ineligible to make HSA contributions may prospectively revoke his or her HSA salary reduction election.
ARTICLE V - Administration of Plan
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5.1. Plan Administrator. The administration of the Plan shall be under the supervision of the Administrator. It shall be a principal duty of the Administrator to see that the Plan is carried out, in accordance with its terms, for the exclusive benefit of persons entitled to participate in the Plan without discrimination among them. The Administrator will have full power to administer the Plan in all of its details, subject to applicable requirements of law. For this purpose, the Administrator's powers will include, but will not be limited to, the following authority, in addition to all other powers provided by this Plan:
(a) To make and enforce such rules and regulations as it deems necessary or proper for the efficient administration of the Plan, including the establishment of any claims procedures that may be required by applicable provisions of law;
(b) To interpret the Plan, its interpretation thereof in good faith to be final and conclusive on all persons claiming benefits under the Plan;
(c) To decide all questions concerning the Plan and the eligibility of any person to participate in the Plan;
(d) To appoint such agents, counsel, accountants, consultants, and other persons as may be required to assist in administering the Plan; and
(e) To allocate and delegate its responsibilities under the Plan and to designate other persons to carry out any of its responsibilities under the Plan, any such allocations, delegation or designation to be in writing.
Notwithstanding the foregoing, any claim which arises under the Dependent Care Assistance Plan, or health savings account shall not be subject to review under this Plan, and the Administrator's authority under this Section 5.1 shall not extend to any matter as to which an administrator under any such other plan is empowered to make determinations under such plan.
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IN WITNESS WHEREOF, The Company has caused this Revised Plan to be executed in its name and behalf this 8th day of NOVEMBER 2019JUNE 2021, by its officer thereunto duly authorized.
With amendments effective 06/0208/20202021.
Reliant Mission
By: Reliant Mission Board of Directors
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