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2005-063
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2005-063
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Last modified
7/8/2016 2:09:53 PM
Creation date
9/30/2015 8:22:00 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Plan
Approved Date
02/15/2005
Control Number
2005-063
Agenda Item Number
7.L.
Entity Name
Flex Company of America
Subject
Health Plan for Circuit Court Cafeteria Plan Flexible Spending
Archived Roll/Disk#
4000
Supplemental fields
SmeadsoftID
4673
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7 . 11 COORDINATION WITH CAFETERIA PLAN <br /> All Participants under the Cafeteria Plan are eligible to receive Benefits under <br /> this Dependent Day Care Reimbursement Plan . The enrollment and termination of participation <br /> under the Cafeteria Plan shall constitute enrollment and termination of participation under this <br /> Dependent Day Care Reimbursement Plan . In addition , other matters concerning contributions , <br /> elections and the like shall be governed by the general provisions of the Cafeteria Plan . <br /> 7 . 12 DEPENDENT DAY CARE REIMBURSEMENT PLAN CLAIMS <br /> The Administrator shall direct the payment of all such Dependent Day Care <br /> Reimbursement Plan claims to the Participant upon the presentation to the Administrator or <br /> Plan Service Provider of documentation of such expenses in a form satisfactory to the <br /> Administrator. In its discretion in administering the Plan , the Administrator may utilize forms and <br /> require documentation of costs as may be necessary to verify the claims submitted . At a <br /> minimum , the form shall include a statement from an independent third party as proof that the <br /> expense has been incurred and the amount of such expense . In addition , the Administrator may <br /> require that each Participant who desires to receive reimbursement under this Program for <br /> Employment- Related Dependent Care Expenses submit a statement which may contain some <br /> or all of the following information : <br /> ( a ) The Dependent or Dependents for whom the services were <br /> performed ; <br /> ( b ) The nature of the services performed for the Participant , the cost <br /> of which he wishes reimbursement ; <br /> ( c ) The relationship , if any, of the person performing the services to <br /> the Participant ; <br /> ( d ) If the services are being performed by a child of the Participant , <br /> the age of the child ; <br /> ( e ) A statement as to where the services were performed ; <br /> (f) If any of the services were performed outside the home , a <br /> statement as to whether the Dependent for whom such services were performed <br /> spends at least 8 hours a day in the Participant' s household ; <br /> ( g ) If the services were being performed in a day care center, a <br /> statement containing the following : <br /> ( 1 ) that the day care center complies with all applicable laws and <br /> regulations of the state of residence , <br /> ( 2 ) that the day care center provides care for more than 6 individuals <br /> ( other than individuals residing at the center) , and <br /> ( 3 ) of the amount of fee paid to the provider. <br /> ( h ) If the Participant is married , a statement containing the following : <br /> ( 1 ) the Spouse's salary or wages if he or she is employed , or <br /> ( 2 ) if the Participant' s Spouse is not employed , that <br /> 18 <br />
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