IBEW 292 Benefits

1 ibew 292 Benefits ibew 292 TWELVE COUNTY AREA PREMIUM PAYMENT PLAN Effective February 1, 2010 i TABLE OF CONTENTS ARTICLE I. INTRODUCTION .. 1 Establishment of Plan .. 1 Legal Status .. 1 ARTICLE II. DEFINITIONS .. 1 Adopting Employer .. 1 Bargaining Unit Employee .. 1 Benefits .. 1 Benefit Package Option .. 1 Change in Status .. 2 Code .. 2 Collective Bargaining Agreement(s) .. 2 Contributions .. 2 Compensation .. 2 Dependent .. 2 Effective Date .. 3 Election Form/Salary Reduction Agreement .. 3 Eligible Employee .. 3 Employee .. 3 Employer .. 3 Employer s Association .. 4 ERISA .. 4 FMLA .. 4 Health Plan .. 4 Open Enrollment Period .. 4 Participant .. 4 Period of Coverage .. 4 Plan .. 4 Plan Administrator .. 5 Plan Year .. 5 QMCSO .. 5 Salary 5 Spouse.

2 5 Student .. 5 Union .. 5 ARTICLE III. ELIGIBILITY AND PARTICIPATION .. 5 Eligibility to Participate .. 5 Termination of Participation .. 6 Participation Following Termination of Employment or Loss of Eligibility .. 6 FMLA Leaves of Absence .. 6 Non-FMLA Leaves of Absence .. 7 ARTICLE IV. METHOD AND TIMING OF ELECTIONS .. 7 Elections When First Eligible .. 7 Elections During Open Enrollment Period .. 7 Failure of Eligible Employee to File an Election Form/Salary Reduction Agreement .. 8 Irrevocability of Elections .. 8 ARTICLE V. Benefits OFFERED AND METHOD OF FUNDING .. 8 Benefits Offered .. 8 Contributions for Cost of Coverage .. 8 ii The Benefits Provided Under the ibew 292 Health Care 9 Using Salary Reductions to Make Contributions .. 9 Medical Benefits ; COBRA and USERRA .. 10 ARTICLE VI. IRREVOCABILITY OF ELECTIONS; EXCEPTIONS.

3 10 Irrevocability of Elections .. 10 Procedure for Making New Election If Exception to Irrevocability Applies .. 10 Change in Status Defined .. 11 Exceptions to Irrevocability Rule for All Benefits .. 12 Election Modifications Required by Plan 17 ARTICLE VII. RECORDKEEPING AND ADMINISTRATION .. 17 Plan Administrator .. 17 Powers of the Plan Administrator .. 18 Reliance on Participant, Tables, etc.. 19 Provision for Third-Party Plan Service Providers .. 19 Fiduciary Liability .. 19 Compensation of Plan Administrator .. 19 Bonding .. 19 Effect of Mistake .. 19 General Plan Information .. 19 ARTICLE VIII. GENERAL PROVISIONS .. 21 Expenses .. 21 No Contract of Employment .. 21 Non-Alienation of Benefits .. 21 Amendment and Termination .. 21 Governing Law .. 21 Code and ERISA Compliance .. 21 No Guarantee of Tax Consequences.

4 22 Non-Assignability of Rights .. 22 Headings .. 22 Plan Provisions Controlling .. 22 Severability .. 22 Family and Medical Leave Act of 1993 ( FMLA ).. 22 Uniformed Services Employment and Reemployment Rights Act of 1994 ( USERRA ).. 22 Health Insurance Portability and Accountability Act of 1996 ( HIPAA ).. 22 Qualified Medical Child Support Order .. 23 EXHIBIT A .. A-1 1 PREMIUM PAYMENT PLAN ARTICLE I. INTRODUCTION Establishment of Plan Local Union No. 292, international brotherhood of electrical Workers and Minneapolis Chapter of the National electrical Contractors Association ( NECA) establish the ibew 292 Twelve County Area Premium Payment Plan (the Plan ) effective January 15, 2010 (the Effective Date ). Capitalized terms used in this Plan not defined elsewhere in this document will have the meanings given in Article II.

5 This Plan is designed to permit an Eligible Employee of participating Employers to pay for his or her share of Contributions under the ibew 292 Health Care Plan (Health Plan) on a pre-tax Salary Reduction basis. Legal Status The Plan Sponsor intends this Plan to qualify as a cafeteria plan under Code 125, the corresponding regulations, and this Plan will be interpreted to accomplish that objective. ARTICLE II. DEFINITIONS The following words and phrases are used in this Plan and will have the meaning assigned in this Article unless a different meaning is clearly required by the context or is defined within an Article. Adopting Employer Adopting Employer means a corporation, partnership, limited liability company, sole proprietorship or other legal entity that is a signatory to a Collective Bargaining Agreement or, with the Plan Sponsor s permission, adopts this Plan by completing and executing a participation agreement.

6 Bargaining Unit Employee Bargaining Unit Employee means an Employee who is a member of a collective bargaining unit represented by the Union and who is an Employee of an Employer who has agreed to make Contributions to the Plan on the Employee s behalf. Benefits Benefits means the Premium Payment Benefits offered under the Plan. Benefit Package Option Benefit Package Option means a qualified benefit under Code 125(f) that is offered under a cafeteria plan, or an option for coverage under an underlying accident or health plan (such as an indemnity option, an HMO option, or a PPO option under an accident or health plan). 2 Change in Status Change in Status has the meaning described in Section Code Code means the Internal Revenue Code of 1986, as amended. Collective Bargaining Agreement(s) Collective Bargaining Agreement(s) means any collective bargaining agreement(s) in force and effect between the Union and an Employer or the Employers of an Employer's Association which require the Employers to make contributions to the Health Plan on behalf of their Employees for work performed within the jurisdiction of the Union, together with any modifications or amendments of such collective bargaining agreements.

7 Contributions Contributions means the amount contributed to pay for the cost of Premium Payment Benefits of an Eligible under the Plan. Compensation Compensation generally means wages or salary paid to an Eligible Employee by the Employer, as reported in Box 1 of Form W-2, but adding back any wages or salary forgone by virtue of any (a) Salary Reduction election under this Plan, (b) salary reduction election under any other cafeteria plan, and (c) compensation reduction under any Code 132(f)(4) plan but determined after (d) any salary deferral elections under any Code 401(k), 403(b), 408(k) or 457(b) plan or arrangement. Dependent Dependent means: (a) An individual who qualifies as a Dependent under the terms and conditions of the ibew 292 Health Care Plan. (b) A Participant s unmarried child who would be eligible for Benefits under the Health Plan as a registered student but for an absence from school may extend dependent coverage, provided the child is on a leave of absence: (i) from an accredited post-secondary educational institution, (ii) which is medically necessary, (iii) due to his or her serious illness or injury, and (iv) which caused the child to lose registered full-time student status.

8 The child must have been registered or enrolled as a full-time student at an accredited post-secondary educational institution immediately prior to the medically necessary leave of absence. A partial reduction in schedule to part-time student status is sufficient if all other conditions are met. Dependent coverage under this paragraph may be extended only until the earlier of: (i) the first anniversary of the start of the medically necessary leave of absence, or (ii) the date on which the Plan s coverage would otherwise terminate due to any other reason. The child s treating physician must certify to the Plan, in writing, that the child is suffering from a serious illness or injury, and that the leave of absence is medically necessary. 3 Effective Date Effective Date of this Plan is January 15, 2010.

9 Election Form/Salary Reduction Agreement Election Form/Salary Reduction Agreement means the form provided by the Plan Administrator for allowing an Eligible Employee to participate in this Plan by electing Salary Reductions to pay for Premium Payment Benefits . It includes an agreement pursuant to which an Eligible Employee or Participant authorizes the Employer to make Salary Reductions. Eligible Employee Eligible Employee means (1) a Bargaining Unit Employee, or (2) an actively-employed Non-Bargaining Unit Employee of an Employer who has signed a contribution agreement with the Plan. Employee Employee means an individual who the Employer classifies as a common-law employee and who is on the Employer s W-2 payroll, but does not include any of the following, whether or not any such individual is on the Employer s W-2 payroll or is determined by the IRS or others to be a common-law employee of the Employer.

10 (a) any leased employee (including but not limited to those individuals defined as leased employees in Code 414(n)) or an individual classified by the Employer as a contract worker , independent contractor, temporary employee, or casual employee for the period during which such individual is so classified, (b) any individual who performs services for the Employer but who is paid by a temporary or other employment or staffing agency for the period during which such individual is paid by such agency; (c) any employee included within a unit of employees covered by a collective bargaining unit unless such agreement expressly provides for coverage of the employee under this Plan; (d) any self-employed individual; (e) any partner in a partnership; and (f) any more-than-2% shareholder in a Subchapter S corporation.