The Borough of Lavallette (hereinafter referred to as the "plan
sponsor") has established the plan for the purpose of providing those
employees of the plan sponsor who are eligible to participate in the
plan with a choice between receiving cash (in the form of unreduced
compensation or taxable benefits treated as cash) or of receiving
certain benefits under such health benefit arrangements as may be
in effect for the plan sponsor's employees from time to time (the
"Health Care Program"). In addition, the plan offers employees who
are eligible to elect the health care Program the right to elect to
receive a taxable payment in lieu of health care benefits (the "Health
Premium Waiver Benefit"). It is the plan sponsor's intention that
the plan qualify as a "cafeteria plan" as that term is defined in
§ 125(d)(1) of the Internal Revenue Code of 1986, as amended
(the "Code") and that the health care benefits offered under the plan
qualify for exclusion from the gross income of participating employees
under Code § 125, and such other sections of the Code as
may be applicable. It is also the intention of the plan sponsor that
the plan be interpreted in a manner consistent with the requirements
of § 125 of the Code, Treasury Regulations promulgated by
the IRS thereunder, and any other requirements of the Code and/or
Treasury Regulations as may be applicable in connection with the qualification
for exemption from gross income of the health care benefits offered
under the plan.
As used in this article, the following terms shall have the
meanings indicated:
BENEFIT AND BENEFIT OPTIONS
Any health care benefit, including, but not limited to, medical,
dental, vision or similar benefits offered under the plan.
CODE
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 regulations thereunder and any comparable or succeeding
provisions of any legislation which amends, supplements or replaces
such section or subsection.
COMPENSATION
Remuneration paid by the plan sponsor that is includable
in gross income, before reduction for nontaxable contributions to
this plan (or other benefit plan), not including amounts available
before an employee is eligible for the plan.
EFFECTIVE DATE
The date the plan sponsor has established the plan for the
purpose of providing those employees of the plan sponsor who are eligible
to participate in the plan with a choice between receiving cash (in
the form of unreduced compensation or taxable benefits treated as
cash) or of receiving certain benefits under such health benefit arrangements
as may be in effect for the plan sponsor's employees from time to
time (the "health care Program").
ELECTION FORM
Any appropriate election form to include electronic forms
provided by the plan sponsor or plan administrator or any person providing
benefits under the plan for the purposes of electing to participate
in benefit options and authorizing salary reduction contributions
to pay for such benefit options under the plan.
EMPLOYEE
Any person performing services under the direction and control
of the plan sponsor who is either currently in pay status of the plan
sponsor, including, but not limited to, paid sick leave, paid vacation,
and paid administrative leave, or on unpaid authorized leave from
a plan sponsor. The term "employee" shall not include any individuals
hired to perform services for a plan sponsor as leased employees,
agency contract personnel or independent contractors, and their respective
employees or agents, notwithstanding that such individuals may be
subsequently reclassified by a court, government agency, tribunal
or arbitrator as common law employees of a plan sponsor.
EXCLUDED EMPLOYEE
Any employee excluded from participation hereunder by the
plan sponsor; employee who is a member of a collective bargaining
unit to which this plan has not been extended; leased employee within
the meaning of Code § 414(n); and independent contractors
or agency contract personnel; provided, however, that if a leased
employee, independent contractor, or contract worker is reclassified
as an "employee" by any federal or state agency such shall continue
to be an excluded employee for the remainder of the plan year in which
such reclassification determination occurs.
FMLA
The Family and Medical Leave Act of 1993.
FMLA LEAVE
A leave of absence provided to an employee subject to and
pursuant to the terms of the FMLA.
HEALTH CARE BENEFITS
Any health benefit arrangement, including, but not limited
to, medical, dental, vision or similar benefits provided through contract
or policies with a provider entered into by the plan sponsor from
time to time for this purpose or provided by the plan sponsor from
time to time for this purpose, the premiums for which are paid by
the plan sponsor and/or the participant.
HEALTH PREMIUM WAIVER BENEFIT
A payment made by the plan sponsor on an after-tax basis
to an eligible employee in lieu of the eligible employee's participation
in health care benefits during the plan year provided the eligible
employee elects to waiver his/her participation in health care benefits
and completes the appropriate benefits waiver forms.
HIPAA
The Health Insurance Portability and Accountability Act of
1996, the regulations promulgated thereunder, and any amendments to
either.
KEY EMPLOYEE
An individual who is a key employee within the meaning of
Code § 416.
LEAVE OF ABSENCE
Any leave of absence approved by the plan sponsor, including,
but not limited to, FMLA Leave and/or a period of duty in the uniformed
services.
OPEN ENROLLMENT PERIOD
The general election period held prior to the beginning of
each plan year. The dates of the general election period will be determined
annually and announced in advance by the plan administrator.
PARTICIPANT
An eligible employee who has elected to participate in the benefits offered under the plan in accordance with §
45-41.
PERIOD OF COVERAGE
The plan year, or for an employee who first becomes eligible
to participate in the plan or benefit option during a plan year, the
remainder of such plan year, or to the extent applicable, the period
of coverage is any other shorter period as may result from a permitted
or required change to a participant's benefit option elections made
during a plan year.
PLAN
The premium-only § 125 plan with opt-out as set
forth herein, together with any and all amendments and supplements
hereto.
PLAN ADMINISTRATOR
The plan sponsor or such other person or committee as may
be appointed from time to time by the plan sponsor to supervise the
administration of the plan.
PLAN SPONSOR
The government entity, municipality, township, etc. identified
on the title page of this Code.
PLAN YEAR
The twelve-month period beginning on January 1 and ending
on December 31 of each year.
PREMIUM or PREMIUMS
The portion of premium cost that a participant is required to contribute for the coverage designated under the benefits in which the participant has elected to enroll pursuant to §
45-41.
PROVIDER
A licensed insurance company that has issued a group policy
or contract under any of the benefits offered under the plan.
QUALIFIED BENEFIT
Any benefit which, with the application of Code § 125(a) is not includable in the gross income of an employee by reason of an express provision of Chapter
1 of the Code.
SALARY REDUCTION AGREEMENT
A written agreement on an election form prescribed by the
plan administrator entered into by the plan sponsor and the eligible
employee under which the eligible employee's compensation is reduced
to pay for qualified benefits through salary reduction contributions.
UNIFORMED SERVICES
The Armed Forces, the Army National Guard, and the Air National
Guard when engaged in active duty for training, inactive duty training,
or full-time National Guard duty; the commissioned corps of the public
health service, and any other category of persons designated by the
President of the United States in time of war or emergency.
USERRA
The Uniformed Services Employment and Re-employment Rights
Act of 1994, as amended from time to time.