Resolution 2919-12 1 RESOLUTION NO. 2919-12
2 A RESOLUTION BY THE BOARD OF DIRECTORS
OF THE SOUTH TAHOE PUBLIC UTILITY DISTRICT
3 HEALTH CARE FLEXIBLE SPENDING ACCOUNT AMENDMENT
4 ARTICLE I
5 PREAMBLE
6 WHEREAS, 1.1 Adoption and effective date of amendment-The Employer adopts this
7 Amendment to the South Tahoe Public Utility District Medical Care Reimbursement Plan
8 ("Plan") to reflect changes to Internal Revenue Code (IRC) Section 125(i), as amended
9 by the Affordable Care Act (ACA). The sponsor intends this Amendment as good faith
10 compliance with the requirements of this provision. This Amendment shall be effective
11 on or after the date the Employer elects in Section 2.1 below.
12 WHEREAS, 1.2 Supersession of inconsistent provisions-This Amendment shall supersede
13 the provisions of the Plan to the extent those provisions are inconsistent with the
14 provisions of this Amendment.
15 ARTICLE II
16 LIMITATION ON ALLOCATIONS
17 WHEREAS, 2.1 Effective Date -This Amendment is effective as of January 1, 2013.
18 WHEREAS, 2.2 Limitation on Allocations - Notwithstanding any provision contained in this
19 Health Care Flexible Spending Account to the contrary, the maximum annual
20 contribution amount that may be allocated to the Health Care Flexible Spending
21 Account Benefit may not exceed the lesser of the Participant's salary reduction elected
22 for the plan year or$2,500 plus any Employer contributions that may be made. (The
23 $2,500 amount will be indexed each year to reflect any anticipated cost of living
24 adjustments as assigned by the IRS.)
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1 2919-12
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3 WE, THE UNDERSIGNED, do hereby certify that the above and foregoing
4 resolution was duly and regularly adopted and passed by the Board of Directors of the
5 South Tahoe Public Utility District at a regular meeting duly held on the of
6 no Y , 2012, by the following vote:
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AYES: Cefalu, Jones, Vogelgesang, Sheehan, Schafer
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9 NOES: None
10 ABSENT: None
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13 Eric Schafer, B ar resident
14 ATTEST:
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17 Kathy Shar. Clerk of the hoard
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1 SUMMARY OF MATERIAL MODIFICATIONS (SMM)
2 For the
3 South Tahoe Public Utility District Medical Care Reimbursement Plan
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5 (1) General. This is a Summary of Material Modifications regarding the above
6 referenced Plan ("Plan"). This Summary of Material Modifications supplements and
7 amends the Summary Plan Description (SPD) previously provided to you. You should
8 retain this document with your copy of the SPD.
9 (2) Identification of Employer. The legal name, address and Federal Employer
10 Identification number of the Employer are
11 South Tahoe Public Utility District EIN: 94-1337914
12 1275 Meadow Crest Drive
13 South Lake Tahoe CA 96150
14 FOR CAFETERIA PLANS:
15 (3) Description of Modifications. The Employer has amended your Plan effective as of
16 the first day of the Plan year coinciding with or following January 1, 2013. Subsequent
17 plan years will reflect the IRS cost-of-living adjustment indexed amount.
18 If you have any questions regarding the application of this provision to you, contact
19 your Plan Administrator.
20 BENEFITS
21 Annual Health Care Spending Account Amount. The maximum annual
22 contribution amount that may be allocated to your Health Care Flexible Spending
23 Account Benefit may not exceed the lesser of your salary reduction (contribution)
24 elected for the year or$2,500 plus any Employer contributions that may be made. (The
25 $2,500 amount will be indexed each year to reflect any anticipated cost of living
26 adjustments as assigned by the IRS.)
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1 CERTIFICATE OF ADOPTING RESOLUTION
2 The undersigned authorized representative of South Tahoe Public Utility District
3 hereby certifies that the following resolutions were duly adopted by Employer on
4 November 15, 2012, and that such resolutions have not been modified or rescinded as
5 of the date hereof;
6 RESOLVED, that the Amendment to the South Tahoe Public Utility District Medical
7 Care Reimbursement Plan (the Amendment) is hereby approved and adopted, and
8 that an authorized representative of the Employer is hereby authorized and directed to
9 execute and deliver to the Administrator of the Plan one or more counterparts of the
10 amendment.
11 The undersigned further certifies that attached hereto is a copy of the
12 Amendment approved and adopted in the foregoing resolution.
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14 Date: November 15, 2012
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16 Signed: A
17 Kathy S Op, Clerk of the Board
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