ORDER NO. 31693 SIGNING OF HRA AGREEMENTS WITH DATAPATH, INC. FOR 2010 Came to be heard this the 12th day of April, 2010, with a motion made by Commissioner Baldwin, seconded by Commissioner Oehler, the Court unanimously approved by a vote of 4 -0 -0 to: Authorize the County Judge to sign the HRA Agreement with Datapath, Inc. for 2010. ~.~~ COMMISSIONERS' COURT AGENDA REQUEST PLEASE FURNISH ONE ORIGINAL AND TEN COPIES OF THIS REQUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT. MADE BY: E. Hyde OFFICE: H.R. MEETING DATE: 04-12-10 TIME PREFERRED: SUBJECT: Consider, discuss, and take appropriate action to sign updated HRA agreements with Datapath Inc. for 2010. EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON) NO Personnel Matters 551.074 a) This chapter does not require a governmental body to conduct an open meeting: 1) to deliberate the appointment, employment, evaluation, reassignment, duties, discipline, or dismissal of a public official or employee; or 2) to hear a complaint or charge against an officer or employee. b) Subsection a) does not apply if the officer or employee who is the subject of the deliberation or hearing requests a public hearing. NAME OF PERSON ADDRESSING THE COURT: Carey Malek, G. Looney, E. Hyde ESTIMATED LENGTH OF PRESENTATION: 10 minutes IF PERSONNEL MATTER -NAME OF EMPLOYEE: Eva Hyde Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter 551 and 552, Government Code, is as follows: Meeting scheduled for Mondays 5:00 P.M. previous Tuesday. 3 C~q3 THIS REQUEST RECEIVED BY: THIS REQUEST RECEIVED ON: All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court Meetings.. Your cooperation will be appreciated and contribute towards your request being addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners' Court. Kerr County Health Reimbursement Agreement ADOPTION AGREEMENT Effective Date: 01/01/2010 Kerr County hereby establishes a Health Reimbursement Arrangement (the "Plan") with one or more Health Reimbursement Accounts ("HRAs") for its Employees. The Plan's purpose is to reimburse eligible Employees of the Employer for the certain Eligible Medical Expenses incurred by them, their Spouses, and eligible Dependents. It is intended that the Plan meet the requirements for qualification under Internal Revenue Code § 106, and that benefits paid employees hereunder be excludable from their gross incomes by virtue of Internal Revenue Code § 105(b). Nothing in this Adoption Agreement shall be intended to ovemde the terms of the Summary Plan Description to which it is attached, which the parties hereby affirm. --- Item 1: E-mployer-Infor-mati 1.01 Employer Name and Address Kerr County 700 Main Street, BA104 Kem~ille, TX 78028 1.02 Participating Affiliated Employers N/A Item 2: Plan Information 2.01 Plan Name and Number Plan No. Health Reimbursement Arrangement 2.02 Effective Date of Plan The Effective Date of this Plan is 01/01/2008. 2.03 Effective Date of Appendix The Effective Date of this Appendix is 01/01/2010. This Appendix should replace all other appendices (if any) with an earlier effective date. 2.04 Plan Year A Plan Year shall be the twelve (12) consecutive month period of O1/Ol - 12/31. For the year in which the Plan becomes effective, the ending date changes, or the Plan terminates, the Plan Year maybe shorter than twelve (12) months. 2.05 Plan Administrator 2.06 Plan Service Provider In addition to other duties, the Plan Service Provider is responsible for processing claims filed under the Plan and for making the initial determination (and in some cases, the first level of appeal if the Plan has two levels of appeal) as to whether such claims are payable in accordance with the terms of the Plan. Notwithstanding the Plan Service Provider's responsibility to review the claim and make the initial determination, the Plan Administrator identified below retains the authority and discretion for making the final determination in accordance with the Plan's claims review procedures. DataPath Administrative Services, Inc. HEALTH REIMBURSEMENT ARRANGEMENT 1601 Westpark Drive Suite 9 Little Rock, AR 72204 Contact: Ben Robbins Contact Phone: (877) 685-0655 Item 3: Contacts and Responsibilities 3.01 Employer's Benefits Coordinator Eva Hyde, Human Resources Director Kerr County 700 Main Street, BA104 Kerrville, TX 78028 (830)896-9023 Item 4: HRAs 4.01 HRAs under this Plan HRA Linked Effective Date: 01/01/2008 cER_COMI'ANY» 4.02 Reimbursement Cap The Plan may set a maximum amount of reimbursement for Eligible Medical Expenses that each Participant can receive during a Plan Year from the current Plan Year's Annual Employer Contributions and/or any available Carry-Over funds. The limits for this Plan are: Linked HRAs: Less than the Gap up to 3000.00 Non-Linked HRAs: N/A 4.03 Eligible Expenses Not Reimbursed during Plan Year If the Employee has submitted a claim, but the Eligible Medical Expenses (or a portion thereof) have not been reimbursed by the close of the Plan Year because the available balance in the HRA is insufficient or the HRA Cap has been reached, then: An Employee can submit unreimbursed claims from a previous Plan Year for payment during the current Plan Year if (a) the Employee was a Participant in the HRA during the previous year and (b) the Employee is a Participant in the current Plan Year. 4.04 Group Health Plan The Group Health Plan(s) referenced in the SPD means one or more of the following: HRA' 4.05 Coordination of Benefits with FSA If the Employee participates in a Health FSA under a § 125 Cafeteria Plan and the Employee's Eligible Medical Expenses are covered under both the Health FSA and the HRA, the Employer has the choice of determining whether the Health FSA or HRA pays first. Under this Plan, the following will occur: For Linked HRAs: If an employee participates in a Health FSA under the employer's § 125 Cafeteria Plan and an HRA under this Plan and both cover the employee's Eligible Medical Expenses, the expenses will be paid out of the HRA first until the funds are exhausted, and then from the Health FSA. For non-Linked HRAs: If an employee participates in a Health FSA under the employer's § 125 Cafeteria Plan and an HRA under this Plan and both cover the employee's Eligible Medical Expenses, the expenses will be paid out of the Health FSA first until the funds are exhausted, and then from the HRA. ADOPTION AGREEMENT (REV. 11/27/02) PAGE 2 EFFECTIVE «pl effdate» HEALTH REIMBURSEMII~ r ARR ANGEMENf Item 5: Spend-Down Option 5.01 Spend-Down Coverages «ER COMPANY» Below are listed the Qualifying Events, if any, which would activate the Spend-Down Option. The Conversion Percentage and Coverage Period are explained below. Qualifying Event Covered Conversion Percentage Coverage Period Termination Disability Death Retirement Loss of Eligibility wlo Loss of Employment USERRA Leave exceeding 31 Days 5.02 Spend-Down Conversion Percentage A percentage of your HRA balances (if set forth in 5.01 above) will be converted to Spend-Down amounts. 5.03 Spend-Down Coverage Period The Spend-Down Coverage Period (if set forth in 5.01 above) will begin on the date coverage is lost as result of the Qualifying Spend-Down Event and will last for the length of time indicated. 5.04 Eligible Spend-Down Expenses "Eligible Spend-Down Expenses" are any medical care expenses incurred by you or your Eligible Dependents that would otherwise qualify for a deduction under Code § 213 (irrespective of the income limitations set forth in Code § 213), and have not been or will not be reimbursed by any other source. Notwithstanding this, qualified long term care services and COBRA payments will be not be eligible for reimbursement. For purposes of this Plan, an expense is "incurred" when the Participant or beneficiary is furnished the medical care or services giving rise to the claimed expense. 5.05 Spend-Down Closing Period The Spend-Down Closing Period is the period of time beginning at the end of the Spend-Down Coverage Period during which claims for expenses incurred during the Spend-Down Period maybe submitted. The Spend-Down Closing Period is 90 days. 5.06 Conversion of Spend-Down Amounts after Employee Regains Eligibility. If a Participant in the Spend-Down Option regains eligibility under the Plan, any remaining Spend-Down balance will be transferred to the Participant's newly elected HRA(s) according to the following procedure: If the employee elects both a Linked HRA and anon-Linked HRA, the remaining Spend-Down amount will be added to the Linked HRA's balance. If the employee elects more than one Linked HRA, the remaining Spend-Down amounts will be split between the Linked HRAs. Item 6: Plan Participation 6.01 Eligibility Requirements The eligibility requirements for employees to participate in the Plan are: The following employees are not eligible to participate: Additional Eligibility Requirements maybe added for an HRP, (see Item 9). ADOPTION AGREEMENT (REV. 11/27/02) PAGE 3 EFFECTIVE upl effdate» HEALTH REIMBURSEMENT ARRANGEMENT «ER_COMPANY» 6.02 Service Period Requirement The Service Period Requirement is the period of time that the Employee must be employed to be eligible to participate in the Plan. fI'he Service Period Requirement for this Plan is An alternate Service Period maybe set for an HRA in Item 9. (The HRA Service Period cannot be shorter than the Service Period set for the Plan.) 6.03 Plan Entry Date The Plan Entry Date is the date when an employee may commence participation in the Plan once the Service Period Requirement has been satisfied. The Plan Entry Date will be 1 st pay date after requirements are met. A separate entry date for an HRA maybe imposed as set forth in Item 9. 6.04 Eligible Dependents The Eligible Dependents will be as set forth in the SPD unless otherwise stated in Item 9. Item 7: Reimbursements 7.01 Required Substantiation Requests for reimbursement must be accompanied with proper substantiation as set forth below. The claims maybe denied if this substantiation is not provided. Substantiation for Linked HRAs consists of Explanation of Benefits (EOB) Form(s) from the linked insurance policy indicating the amount(s) that you are obligated to pay. Substantiation for non-Linked HRAs consists of Written statement from an independent third party stating the day the services were incurred, the name of the person incurring the service, and the amount of the services. 7.02 Claim Submission Periods The Closing Period is the period of time following the end of the Plan Year during which claims maybe submitted for reimbursement. The Closing Period for linked HRAs is 90 days. The Closing Period for non-linked HRAs is 90 days. The Claims Submission Grace Period is the period of time after an employee terminates employment (or loses eligibility to participate in the Plan) during which the employee can submit claims for expenses incurred during the Plan Year prior to termination of participation. If no Claims Submission Grace Period is set, then the Closing Period dates will apply. The Claim Submission Grace Pcriod for linked HRAs is 0 days. The Claim Submission Grace Period for non-linked HRAs is 0 days. 7.03 Minimum Payment Amount The Minimum Payment Amount described in the Summary Plan Description is $0.00. Item 8: HRA Carryover 8.01 Caryover Funds See Item 9 for terms governing the Carry-Over amount for each fiRA. Item 9: HRA Parameters Following is a report listing each HR.A and its parameters. ADGPTION AGREEMENT (REV. 11/27/02) PAGE 4 EFFECTIVE apl effdate» HFAT.TH R.EIIviBURSEMENT ARRANGEMENT Item 10: Signature Block Name: ~T"i•v`~..E.Y Title:~av,u~y ~/ J D crF_ Executed at: Kerr County 700 Main Street, BA104 Kerrville, TX 78028 Signature: Name: Title: