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Adoption Agreement

Health Reimbursement Account Program


  1. Payment of health care reimbursements shall be made through the following employee welfare benefit plan maintained by the Company: Muncie Community Schools Employee Benefit Plan

  2. Company Name: Muncie Community Schools
    Company Address: Anthony Admin Building
    2501 N Oakwood Ave
    Muncie, IN 47304
    765-747-5222
    Employer Identification Number: 35-6002674

  3. Effective Date: January 1, 2008

  4. Plan Year: The 12 month commencing January 1st and ending December 31st of each year.

    Participants shall be provided with contributions credited to their Health Reimbursement Accounts as follows: Each Participant eligible to have Health Reimbursement Account contributions shall receive $1,200 if enrolled in Single Medical Plan Coverage sponsored by the Company or $2,400 if enrolled in Employee + 1 or Family Medical Plan Coverage sponsored by the Company, in Health Reimbursement Account contributions for each Plan Year.

    Any Participant who is eligible for Health Reimbursement Account contributions with respect to less than a full Plan Year shall receive the same Health Reimbursement Account contributions as participants who are eligible to participate for the full year.

  1. Dependents for which Health Reimbursement Account reimbursements may be made include only those persons who are “dependents” as defined under the group health plan covering employees of the Employer.

  2. Employees eligible to have a Health Reimbursement Account are the same employees who are eligible for coverage under the group health plan covering employees of the Employer.

  3. For Rollover, even though benefits are fully available immediately, Participants shall be deemed to accrue benefits at the rate of $100 per month for single coverage and $200 per month for family coverage. Participants will receive a rollover benefit equal to the single or family accrual rate multiplied by the number of months they have accrued the benefit during the plan year minus claims reimbursed. Unused Health Reimbursement Account balances at the end of each Plan Year shall be allocated to the Health Reimbursement Account of that Participant in the following Plan Year subject to the following restrictions or limits: Current year contributions may only be used for expenses that can be applied toward the deductible of the Health Plan sponsored by the Company. Any remaining contributions after the end of the Plan Year are considered “rollover money” and may be utilized for any Medical Expense as defined under IRS Section 213(d).

  4. Terminated Employee coverage ends as of the date employment ends or the date the Employee is no longer eligible to participate. The terminated participant has three months from the date coverage ends to submit claims incurred prior to termination.

  5. Employees that retiree from the company may retain their Health Reimbursement Account; however no further contributions will be made to the account after reaching Medicare age. Eligible retirees may continue to incur and be reimbursed for eligible expenses up to their remaining account balance.

Amendment One

Muncie Community Schools

Health Reimbursement Account Program

By this Agreement the Muncie Community Schools Health Reimbursement Account Program Adoption Agreement, effective January 1, 2008 is hereby amended as follows:

To clarify the original intent of the Plan, item 10 of the Adoption Agreement is deleted in its entirety and the following language is substituted therein:

  1. Employees that retiree from the company may retain their Health Reimbursement Account; however no further contributions will be made to the account after the retiree becomes Medicare eligible due to age or disability. Eligible retirees may continue to incur and be reimbursed for eligible expenses up to their remaining account balance.
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