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Section 125 Cafeteria Plan Summary Plan Document (SPD)

A Division of TASC Section 125 Cafeteria Plan Summary Plan Document (SPD) As Adopted By Employer: EMPLOYERS RESOURCE MANAGEMENT COMPANY This sample form Section 125 Cafeteria Plan Summar y P lan Document (SPD) is a n important Document which should b e carefully consid ere d in light of t he E mployer s p articular circumstances. eflexgroup, Inc. (eflex), a div ision o f TASC, has pro vid ed t his d ocument as a s ample . You should consult wit h Counsel regardin g your use and a ll required modifications to t his sample t o pro tect and fit your particular needs a nd interests. Neither eflex nor any o f it s consultants , a gents , re pre sentatives, o r advisors a re r esponsib le for th e P lan s legal or ta x aspects o r implications, n or th e P lan s appro priateness or fitn ess for a particular purpose. The E mployer re cognizes t hat eflex is n ot engaged in t he p ractice o f law and does n ot pro vid e t ax a dvice.

Claims Administrator: TASC- Total Administrative Service Corp 2302 International Lane Madison, WI 53704 877-933-3539 www.tasconline.com Plan Year: 01/01-12/31 Employer EIN: 54-1340867 Plan Number: 501 ... Health Flexible Spending Account Benefits ...

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