(a) Applicability. The Grace Period shall apply uniformly to Participants in accordance with applicable Treasury Regulations. A Participant who was covered by the Dependent Care FSA on the last day of the Plan Year shall be eligible to use any applicable prior Plan Year balance for Eligible Dependent Care Expenses incurring during the Grace Period, subject to the terms of the Plan.
(b) No Cash-Out or Conversion. Amounts remaining from a prior Plan Year may not be cashed out or converted to another taxable or nontaxable benefit and may be used only for reimbursement of Eligible Dependent Care Expenses. Dependent Care Flexible Spending Account amounts may not be used to reimburse Eligible Medical Care Expenses. (c) Order of Reimbursement. Eligible Dependent Care Expenses incurred during the Grace Period shall be reimbursed first from any available prior Plan Year balance and then, to the extent permitted by the Plan and applicable law, from amounts available for the current Plan Year.
The Administrator may establish reasonable administrative procedures governing the order and processing of claims.
(d) Forfeiture. Any amount remaining after the expiration of the applicable Grade Period and completion of the applicable run-out period shall be forfeited in accordance with the Plan and applicable law.
9.9 Forfeitures and Plan Administration. Forfeited amounts shall be treated and applied in accordance with the general forfeiture provisions of the Plan and applicable Treasury Regulations.
Nothing in this Article IX shall be construed to require forfeited amounts to be distributed to Participants or to prohibit the use of forfeited amounts for purposes permitted under applicable law.
9.10 Coordination with Applicable Law. The Dependent Care FSA shall be administered in accordance with Code Sections 125 and 129, the applicable Treasury Regulations, and applicable IRS guidance. If a provision of this Article IX is inconsistent with a mandatory requirement of applicable law, the provision shall be administered to the extent necessary to comply with such requirement, and the Plan shall be interpreted and, if necessary, amended accordingly Nothing in this Article IX shall be construed to permit reimbursement of any expense unless the expense constitutes an Eligible Dependent Care Expense under this Plan and satisfies the requirements of Code Sections 125 and 129 and the applicable Treasury Regulations. To the extent any provision of this Article IX is inconsistent with a mandatory requirement of applicable federal tax law, this Article IX shall be administered in a manner consistent with such requirement.
ARTICLE X
HEALTH CARE FLEXIBLE SPENDING ACCOUNT
10.1 Component Plan. This Article X sets forth the provisions for the CITY OF CORONA HEALTH CARE FLEXIBLE SPENDING ACCOUNT PLAN (the “Health Care Flexible Spending Account” or “Health Care FSA”). Benefits under the Health Care FSA shall be provided through reimbursement of Eligible Medical Care Expenses incurred by a Participant or an individual whose expenses are eligible for reimbursement under this Article X during the Participant’s Period of Coverage. A Participant shall be entitled to reimbursement only for Eligible Medical Care Expenses incurred during the Participant’s Period of Coverage, subject to the applicable provisions of this Article X.
10.2 Definitions. For purposes of this Article X, the following definitions shall supplement the definitions contained elsewhere in the Plan. To the extent of any conflict, the definitions in this Article X shall control with respect to the Health Care FSA; provided, however, that applicable provisions of the Internal Revenue Code and Treasury Regulations shall control to the extent required by law.
(a) Eligible Medical Care Expense. “Eligible Medical Care Expense means an expense incurred for medical care as defined in Code Section 213(d), as amended, and the applicable Treasury Regulations, that is eligible for reimbursement under a health flexible spending arrangement and is properly substantiated in accordance with the Plan and applicable law.
Eligible Medical Care Expenses may include, to the extent permitted under Code Section 213(d) and applicable guidance, expenses for medical, dental, and vision care, prescription drugs, over-the-counter medicines and drugs, and other eligible medical care expenses not otherwise reimbursed or reimbursable under insurance or another plan or arrangement. Eligible Medical Care Expenses shall not include premiums for accident or health insurance or premiums for qualified long-term care insurance, except to the extent otherwise permitted by applicable law.
An expense shall not constitute an Eligible Medical Care Expense to the extent that it is reimbursed or reimbursable under any other plan or arrangement, or to the extent the expense is otherwise ineligible under applicable law. (b) Dependent. “Dependent” means an individual who is a dependent as defined in Code Section 152, determined without regard to Code Section 152(b)(1), (b)(2), or (d)(1)(B), as required by Code Section 105(b) and applicable Treasury Regulations.
10.3 Annual Election. For each Plan Year, an eligible Employee who elects to participate in the Health Care FSA shall affirmatively elect the amount of Compensation to be contributed through Salary Reduction for that Plan Year.
The maximum amount that may be elected for a Plan Year shall not exceed the maximum salary reduction contribution permitted for a health flexible spending arrangement under
Code Section 125(i), as amended from time to time, subject to any lower maximum established by the Plan or the Employer.
For Plan Years beginning in 2026, the maximum annual salary reduction election shall not exceed $3,400. Any amount permitted to be carried over from a prior Plan Year under Section 10.8 shall not count against the annual salary reduction election limit for the current Plan Year.
10.4 Health Care Flexible Spending Account; Uniform Availability of Benefits. The Health Care FSA shall be maintained as an unfunded bookkeeping account established for each Participant pursuant to the Participant’s annual election under Section 6.1.
The full amount of the Participant’s annual Health Care FSA election, reduced by amounts previously reimbursed for the applicable Period of Coverage, shall be available throughout the Participant’s Period of Coverage for reimbursement of Eligible Medical Care Expenses, without regard to the amount of Salary Reduction contributions actually made by the Participant at the time the expense is incurred.
Any amount carried over from a prior Plan Year pursuant to Section 10.8 shall be available in addition to the Participant’s annual election for the current Plan Year and shall be subject to the terms and limitations of the carryover provision.
10.5 Reimbursement of Eligible Expenses. A Participant shall be entitled to reimbursement of Eligible Medical Care Expenses incurred during the Participant’s Period of Coverage, subject to the terms of this Article X and the Plan’s applicable claims and substantiation procedures.
An Eligible Medical Care Expense shall be considered incurred when the medical care or service giving rise to the expense is provided, regardless of when is billed for or pays the expense.
Reimbursement shall not be made for an expense that has not been properly substantiated or that is not an Eligible Medical Care Expense. Reimbursement shall be made in accordance with the uniform coverage requirements applicable to health flexible spending arrangements.
A Participant may submit a claim for reimbursement after cessation of participation to the extent the expense was incurred during the Participant’s Period of Coverage and the claim is otherwise timely and properly submitted under the Plan.
10.6 Debit Card and Other Electronic Payment Procedures. (a) Use of Debit Card. The Administrator may make available to Participants a Health Care Flexible Spending Account debit card or other electronic payment method for the payment of Eligible Medical Care Expenses. Use of the debit card or other electronic payment method shall be subject to the terms and conditions established by the Administrator and its designated third-party administrator.
(b) Substantiation. The use of a debit card or other electronic payment method does not eliminate the requirement that each expense be substantiated in accordance with Code Section 125, applicable Treasury Regulations, and other applicable guidance. Transactions may be substantiated through an automated or electronic substantiation process when permitted by applicable law, including through merchant-level substantiation, electronic claims information, explanation-of-benefits information, or other documentation or data that satisfies applicable substantiation requirements.
(c) Additional Documentation. If a transaction cannot be automatically substantiated, the Participant may be required to provide additional documentation or information, including an itemized receipt, explanation of benefits, or other documentation sufficient to establish that the expense is an Eligible Medical Care Expense. (d) Improper or Unsubstantiated Transactions. If a debit card transaction is determined to be ineligible or remains unsubstantiated after reasonable efforts to obtain substantiation, the Administrator may take corrective action permitted under applicable law and the procedures of the third-party administrator, including requiring repayment of the improper payment, offsetting the amount against subsequently submitted Eligible Medical Care Expenses to the extent permitted by law, suspending the Participant’s use of the debit card, or taking other corrective action permitted under applicable law.
(e) Administrative Procedures. The Administrator may establish and periodically modify reasonable administrative procedures governing the use of debit cards, electronic payment methods, automated substantiation, claims submission, documentation, reimbursement, and correction of improper payments, provided that such procedures are consistent with the Plan and applicable law.
10.7 Claims and Substantiation Procedures.
(a) Reimbursement Claim. A Participant who pays an Eligible Medical Care Expense without using an approved debit card or other electronic payment method may submit a claim for reimbursement to the Administrator or its designated third-party administrator in the form and manner prescribed under the Plan or applicable administrative procedures of the designated third-party administrator.
(b) Substantiation. Claims and payment-card transactions shall be substantiated in accordance with Code Section 125, applicable Treasury Regulations, and applicable administrative guidance. The Administrator or its designated third-party administrator may require documentation reasonably necessary to establish the nature, date, and amount of the expense and that the expense constitutes an Eligible Medical Care Expense. No reimbursement shall be made unless the expense has been properly substantiated in accordance with applicable law.
(c) Claims Administration. The Administrator may engage or delegate to a qualified third-party administrator responsibility for receiving, reviewing, adjudicating, substantiating, and processing claims and payment-card transactions pursuant to an administrative
services agreement or other arrangement. The Administrator and any designated third-party administrator shall administer claims in accordance with the terms of the Plan, applicable administrative procedures of the designated third-party administrator and applicable law. The retention of a third-party administrator shall not relieve the Employer or the Plan of any obligation imposed by applicable law.
(d) Notice and Appeals. The Administrator or its designated third-party administrator shall provide claimants with any notices concerning denied claims and applicable claim review and appeal rights to the extent required by applicable law. The applicable claims and appeals procedures may be set forth in separate administrative materials or procedures maintained by the Administrator or its designated third-party administrator and applied consistently with the Plan and applicable law.
(e) Approved Transactions. A Participant shall not be required to submit a separate claim for a transaction that has been properly paid through an approved debit card or other electronic payment method and has been properly substantiated through an automated or electronic substantiation process in accordance with applicable law. If additional substantiation is required, the Participant shall provide the requested substantiation within the time and in the manner prescribed by the Administrator or its designated third-party administrator.
10.8 Carryover; Run-Out Period; Forfeiture.
(a) Carryover. The Plan shall permit a Participant to carry over unused amounts remaining in the Participant’s Health Care FSA at the end of a Plan Year to the immediately following Plan Year, subject to the maximum amount permitted under applicable law.
For Plan Years beginning in 2026, the maximum amount that may be carried over from a Plan Year shall be $680, or such other amount as may be permitted under Code Section 125 and applicable guidance for the applicable Plan Year. The Employer may establish a lower carryover amount, provided that the limitation applies uniformly in accordance with applicable law. The maximum amount that may be carried over in subsequent Plan Years shall be specified in Schedule “A”.
(b) Determination of Carryover Amount. The amount eligible for carryover shall be determined after the end of the Plan Year and after giving effect to all Eligible Medical Care Expenses incurred during the Plan Year and properly submitted during the applicable run-out period. The amount eligible for carryover shall not exceed the applicable carryover limit. (c) Use of Carryover Amounts. Amounts carried over from a prior Plan Year may be used to reimburse Eligible Medical Care Expenses incurred during the entire subsequent Plan Year, subject to the terms of the Plan. Carryover amounts shall not be cashed out or converted to any other taxable or nontaxable benefit and may be used only to pay or reimburse Eligible Medical Care Expenses.
(d) Run-Out Period. The Plan shall provide a run-out period following the end of each Plan Year during which Participants may submit claims for Eligible Medical Care Expenses
incurred during the immediately preceding Plan Year. The run-out period is solely a period for submitting and processing claims for expenses incurred during the preceding Plan Year and is not a Grace Period. Expenses incurred during the run-out period shall not be reimbursable from the prior Plan Year’s Health Care FSA merely because the claim is submitted during the run-out period. (e) Order of Reimbursement. The Administrator may establish reasonable administrative procedures governing the order in which current Plan Year amounts and carryover amounts are applied to Eligible Medical Care Expenses, provided that such procedures are consistent with applicable law. The Administrator may, for administrative convenience, apply reimbursements for current Plan Year expenses first against amounts credited for the current Plan Year and thereafter against applicable carryover amounts. (f) Forfeiture. Any unused amount in a Participant’s Healthcare FSA remaining from a Plan Year after completion of the applicable run-out period that exceeds the amount permitted to be carried over under this Section shall be forfeited in accordance with the Plan and applicable law.
(g) No Grace Period. The Health Care FSA shall not provide a Grace Period for any Plan Year. The carryover provision in this Section is intended to replace, and shall be administered in lieu of, any Grace Period provision.
10.9 Continuation Upon Cessation of Participation. Upon termination of participation in the Health Care FSA, reimbursement of Eligible Medical Care Expenses shall be subject to the terms of the Plan and applicable law. Nothing in this Article shall be construed to provide a posttermination reimbursement period or continuation of coverage except to the extent expressly provided under the Plan or required or permitted under applicable law, including applicable COBRA requirements.
To the extent a Participant or Qualified Beneficiary is entitled to COBRA continuation coverage with respect to the Health Care FSA, such continuation coverage shall be administered in accordance with applicable COBRA requirements and the procedures established by the Administrator or its designated third-party administrator.
10.10 Forfeitures and Plan Administration. Forfeited amounts under the Health Care FSA shall be treated and applied in accordance with the general forfeiture provisions of the Plan and applicable law. Such amounts may be used for purposes permitted under applicable law, including, to the extent permitted, defraying reasonable expenses of administering the Plan.
10.11 Compliance with Applicable Law. The Health Care FSA shall be administered in accordance with Code Sections 105, 125, and 213, the applicable Treasury Regulations, and applicable IRS guidance. If a provision of this Article X is inconsistent with a mandatory requirement of applicable federal tax law, the provision shall be administered in a manner consistent with such requirement, and the Plan shall be amended as necessary.
Nothing in this Article X shall be construed to permit reimbursement of an expense unless the expense constitutes an Eligible Medical Care Expense under this Plan and satisfies the
requirements of applicable law.
ARTICLE XI
CONTINUATION COVERAGE
11.1 In General. To the extent required by applicable law, continuation coverage shall be available under the Plan with respect to Benefits providing medical, surgical, hospital, dental, vision, prescription drug, or other health care coverage that are subject to federal continuation coverage requirements. Such continuation coverage shall be provided in accordance with applicable federal law, including COBRA, the Public Health Service Act, applicable Treasury regulations, PEMHCA, requirements of the California Public Employees’ Retirement System (“CalPERS”), and the terms and procedures of the applicable health plan.
11.2 Qualified Beneficiaries and Qualifying Events. A “Qualified Beneficiary” and “Qualifying Event” shall have the meanings prescribed under applicable federal law and, to the extent applicable to coverage provided through CalPERS, PEMHCA and CalPERS requirements. Subject to applicable law, Qualifying Events generally include the death of a covered Employee; termination of employment or reduction in hours resulting in loss of coverage; divorce or legal separation; the covered Employee’s entitlement to Medicare; and a Dependent child ceasing to qualify as a Dependent under the applicable health plan. A registered domestic partner shall be treated in accordance with PEMHCA, CalPERS, and applicable law
11.3 Election and Type of Coverage. A Qualified Beneficiary who would otherwise lose coverage as a result of a Qualifying Event shall have the right to elect continuation coverage within the period prescribed by applicable law. Each Qualified Beneficiary shall have an independent right to elect continuation coverage to the extent required by applicable law. Continuation coverage shall be substantially identical to the coverage available to similarly situated active Participants, subject to applicable law and the terms of the applicable health plan.
11.4 Coverage Period. Continuation coverage shall be available for the period required by applicable law. Subject to applicable law, the maximum period generally shall be eighteen (18) months following a termination of employment or reduction in hours resulting in loss of coverage, with applicable extensions, including the disability extension and extension following a second Qualifying Event. For Qualifying Events other than termination of employment or reduction in hours, continuation coverage may be available for up to thirty-six (36) months. No provision of this Article shall be construed to limit any longer period of continuation coverage or other extension required under PEMHCA, CalPERS requirements, or applicable law.
11.5 Premiums. Continuation coverage shall be contributory. The Qualified Beneficiary shall be responsible for timely payment of the applicable premium, which shall not exceed the maximum amount permitted under applicable law. Premiums shall be paid to CalPERS, the applicable health plan, or another entity designated to administer continuation coverage, in accordance with applicable procedures and applicable law. The timing and manner of premium payments,
including applicable rules concerning initial payments, grace periods, and insufficient or deficient payments, shall be administered in accordance with applicable law. Failure to make timely payment may result in termination of continuation coverage as permitted by applicable law.
11.6 Notice and Administration. Notices concerning continuation coverage, including notices of Qualifying Events, election notices, and notices concerning termination of continuation coverage, shall be provided in the manner and within the time periods required by applicable law.
The Administrator, CalPERS, the applicable health plan, or another designated administrator may establish and administer reasonable procedures for the administration of continuation coverage.
11.7 Health Care Flexible Spending Account.
(a) General Rule. Notwithstanding any other provision of this Article XI, continuation coverage under the Health Care FSA shall be subject to the special rules applicable to health care flexible spending arrangements under Code Section 4980B, the Treasury Regulations thereunder, and other applicable guidance. A Participant who experiences a Qualifying Event and who is otherwise a Qualified Beneficiary with respect to the Health Care Flexible Spending Account shall be offered continuation coverage to the extent required by applicable law. (b) Availability of Continuation Coverage. The Health Care FSA shall not be required to offer continuation coverage for the remainder of the Plan Year in which the Qualifying Event occurs if, as of the date of the Qualifying Event, the applicable conditions under Treasury Regulation § 54.4980B-2 are satisfied for the Health Care FSA to be excepted from the requirement to offer such continuation coverage. The Administrator shall determine the availability of continuation coverage in accordance with applicable law. (c) Amount of Coverage Available. If continuation coverage is available and elected, the Qualified Beneficiary shall be entitled to receive reimbursement for Eligible Medical Care Expenses incurred during the period of continuation coverage, subject to the terms and limitations of Article X and applicable law. The maximum amount of benefits available during the remainder of the Plan Year shall be determined in accordance with applicable law and shall take into account any unused amount carried over from the preceding Plan Year under Section 10.8, to the extent required by applicable law.
(d) Carryover Amounts. If the Plan permits a carryover of unused Health Care FSA amounts under Section 10.8, a Qualified Beneficiary who elects COBRA continuation coverage shall be permitted to use any carryover amount on the same terms and conditions applicable to similarly situated Participants, subject to applicable law. A carryover amount shall not be included in determining the applicable premium that may be charged for COBRA continuation coverage.
(e) COBRA Premium. The premium for continuation coverage under the Health Care FSA shall be determined in accordance with applicable law and shall not exceed the maximum amount permitted under Code Section 4980B and the Treasury Regulations thereunder.
In determining the applicable premium, unused amounts carried over from a prior Plan Year shall not be included.
(f) Duration. Continuation coverage under the Health Care FSA generally shall continue only through the end of the Plan Year in which the Qualifying Event occurs, except to the extent that applicable law requires or permits continued access to benefits, including through a permitted carryover of unused amounts or other applicable extension. Nothing in this Section shall require the Plan to permit a Qualified Beneficiary to make additional Salary Reduction contributions for a subsequent Plan Year or to receive the Employer Allowance for a subsequent Plan Year, except as otherwise required by applicable law. (g) Coordination with Article X. The Health Care FSA shall be administered in accordance with Article X, including the Plan’s provisions concerning the annual election, uniform availability of benefits, eligible expenses, substantiation, claims, run-out period, carryover, and forfeiture, except to the extent that a different rule is required for COBRA continuation coverage under applicable law.
11.8 Coordination with PEMHCA and State Law. Continuation coverage provided through CalPERS shall be administered in accordance with PEMHCA, CalPERS requirements, the applicable health plan documents, and applicable federal and state law. Any additional continuation coverage or extension of coverage required or made available under PEMHCA, CalPERS requirements, or applicable state law shall be provided in accordance with the applicable requirements and procedures.
11.9 Governing Requirements. If any provision of this Article is inconsistent with applicable federal law, PEMHCA, CalPERS requirements, or the terms of the applicable health plan, the applicable law, requirement, or plan provision shall control. The Administrator may implement procedures and make administrative adjustments necessary to comply with applicable law and the requirements of CalPERS and the applicable health plans without formal amendment of this Article, provided that such procedures and adjustments do not materially reduce a benefit otherwise provided under the Plan.
ARTICLE XII
DISCRIMINATION
12.1 Memorandum of Understanding. This Plan was adopted pursuant to the terms of one or more memorandum of understanding between the Employer and the Employees and hence, is exempt from the discrimination provisions set forth in Section 125 of the Code, as of the Effective Date.
12.2 Methods to Avoid Discrimination. Notwithstanding any other provisions of the Plan, the Administrator may limit the amounts reimbursed or paid with respect to any Highly Compensated Participant to the extent the Administrator deems such limitation advisable to assure compliance
with any nondiscrimination provision of the Code. Such limitation may be imposed whether or not is results in a forfeiture.
12.3 Reimbursement Plans. The Plan is intended not to discriminate in favor of “highly compensated individuals” (as defined in Section 414(q) of the Code with respect to the Dependent Care Flexible Spending Account and as defined in Section 105(h) of the Code with respect to the Health Care Flexible Spending Account) as to eligibility to participate, contributions, and/or Benefits under the Health Care Flexible Spending Account and Dependent Care Flexible Spending Account (the “Reimbursement Plans”). If the Administrator determines the operation of either Reimbursement Plan in any Plan Year would result in such discrimination, then the Administrator shall select and exclude from coverage under the applicable Reimbursement Plan such Participants and/or reduce such contributions and/or Benefits to ensure compliance with the nondiscrimination requirements of Section 129 and 105 of the Code.
ARTICLE XIII
CLAIMS PROCEDURE
13.1. Claims for Benefits. Except as otherwise provided under Article IX with respect to Dependent Care FSA benefits and Article X with respect to Health Care FSA benefits, all claims for Benefits that are provided through insurance contracts, whether such contracts are between the insurer and the Employer or the insurer and the Participant, shall be made in accordance with the claims procedures established under the applicable insurance contract or Component Plan document. The Employer shall not be responsible for processing, reviewing, or paying claims for insured Benefits, except to the extent otherwise required by applicable law or the terms of the applicable Component Plan document. All disputes regarding such insured Benefits shall be resolved in accordance with the procedures established under the applicable Component Plan document or insurance contract.
13.2 Claims and Reimbursement Procedures for Flexible Spending Accounts. Claims for reimbursement under the Dependent Care FSA and Health Care FSA shall be administered in accordance with Articles IX and X, applicable law, and the procedures established by the Administrator or the third-party administrator designated by the Employer. The Employer may delegate to a third-party administrator responsibility for receiving claims, substantiating expenses, administering payment-card transactions, determining whether expenses qualify for reimbursement, processing reimbursements, communicating claim determinations, and administering applicable claims and appeals procedures; provided that the Plan shall remain administered in accordance with the requirements of Code Section 125 and other applicable law.
The use of a third-party administrator shall not relieve the Employer or the Plan of any obligation imposed by applicable law.
ARTICLE XIV
AMENDMENTS. TERMINATION AND ACTION BY EMPLOYER
14.l Action by Employer. Any action by the Employer under this Plan, including but not limited to, termination of this Plan, shall be by action of the Employer, or by any person or persons duly authorized by action of the Employer to act on its behalf.
14.2 Amendments. The Employer reserves the right to make, from time to time, any amendment or amendments to this Plan as it deems necessary or desirable, without retroactive effect, unless specifically permitted to comply with the law.
14.3 Right to Terminate. The Employer may terminate this Plan at any time. In the event of the dissolution, merger, consolidation or reorganization of the Employer, the Plan shall terminate unless the Plan is continued by a successor to the Employer in accordance with the Employer’s procedures.
14.4 Plan Termination. Upon the termination of the Plan, the Administrator may determine the best method to make payments to the effected Participants.
ARTICLE XV
HIPAA PRIVACY, SECURITY, AND BREACH NOTIFICATION
15.1 Purpose. This Article is intended to ensure that the Plan is administered in compliance with the privacy, security, and breach notification requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended by the Health Information Technology for Economic and Clinical Health Act (“HITECH Act”), and the regulations promulgated thereunder, including 45 C.F.R. Parts 160 and 164, as amended. Nothing in this Article shall be construed to alter the Benefits provided under the Plan or to affect eligibility for Benefits.
15.2 Definitions. Unless otherwise defined in the Plan, terms used in this Article shall have the meanings assigned to them under HIPAA and its implementing regulations, including, without limitation, “Protected Health Information” (“PHI”), “Electronic Protected Health Information” (“ePHI”), “Summary Health Information,” “Plan Administration Functions,” “Payment,” “Health Care Operations,” “Business Associate,” and “Privacy Rule.”
15.3 Employer as Plan Sponsor. The Employer serves as the Plan Sponsor for purposes of HIPAA. In performing Plan Administration Functions, the Plan Sponsor shall comply with this Article and all applicable federal privacy and security requirements. The Plan Sponsor shall designate one or more Privacy Officials and Security Officials responsible for administering the Plan’s HIPAA compliance program as it applies to Plan Sponsor. Such officials may delegate responsibilities as appropriate.
15.4 Certification by Plan Sponsor. The Plan may disclose PHI to the Plan Sponsor only after the Plan Sponsor has certified to the Plan that:
(a) the Plan has been amended to incorporate the provisions required by HIPAA; (b) the Plan Sponsor agrees to the restrictions and conditions on the use and disclosure of PHI required by HIPAA;
(c) the Plan Sponsor agrees to comply with this Article and the Plan’s HIPAA policies and procedures that apply to Plan Sponsor.
15.5 Permitted Uses and Disclosures. The Plan Sponsor may use or disclose PHI received from the Plan solely for Plan Administration Functions permitted under HIPAA. The Plan Sponsor shall not use or disclose PHI:
(a) for employment-related decisions or actions;
(b) in connection with any other employee benefit plan or program except as expressly permitted by HIPAA;
(c) for any purpose not permitted by HIPAA or this Plan; or (d) in any manner inconsistent with the Plan’s HIPAA policies and procedures appliable to Plan Sponsor.
Nothing in this Article shall prohibit disclosures expressly permitted or required by HIPAA.
15.6 Responsibilities of the Plan Sponsor. The Plan Sponsor shall:
(a) use appropriate administrative, physical, and technical safeguards to protect the privacy, security, and confidentiality of PHI and ePHI;; (b) comply with the HIPAA Security Rule with respect to ePHI; (c) comply with the HIPAA minimum necessary standard to the extent applicable; (d) require any Business Associate, agent, or subcontractor receiving PHI on its behalf to comply with applicable HIPAA requirements;
(e) promptly report to the Plan any use or disclosure of PHI that is inconsistent with this Article or applicable law of which the Plan Sponsor becomes aware.; (f) report breaches of unsecured PHI as required by HIPAA and cooperate with the Plan in satisfying applicable breach notification requirements; (g) make PHI available to individuals as required by HIPAA, including rights of access, amendment, and accounting of disclosures;
(h) make its books, records, policies, and practices relating to PHI available to the Secretary of the United States Department of Health and Human Services for purposes of determining HIPAA compliance; and
(i) when PHI is no longer needed for the purpose for which it was disclosed, return or securely destroy the PHI if feasible or, if return or destruction is not feasible, continue to protect the information and limit further uses and disclosures to those purposes that make return or destruction infeasible.
15.7 Persons Authorized to Receive Protected Health Information. Only those employees, officers, or other persons designated by the Plan Sponsor whose duties require access to PHI for Plan Administration Functions shall be permitted access to PHI. The Plan Sponsor shall maintain appropriate policies identifying the classes of workforce members authorized to receive PHI and shall ensure that such persons receive appropriate HIPAA training.
15.8 Summary Health Information and Enrollment Information. The Plan may disclose Summary Health Information to the Plan Sponsor for obtaining premium bids, modifying, amending, or terminating the Plan, or for other purposes permitted by HIPAA. The Plan may disclose enrollment, disenrollment, and participation information to the Plan Sponsor as permitted by HIPAA.
15.9 De-Identified Information. Information that has been de-identified in accordance with HIPAA shall not constitute PHI and may be used or disclosed as permitted by applicable law.
15.10 Separation Between the Plan and the Plan Sponsor. The Plan Sponsor shall establish and maintain adequate separation between the Plan and the Plan Sponsor, including administrative safeguards reasonably designed to ensure that PHI is accessed and used only by authorized workforce members for Plan Administration Functions.
15.11 Other Applicable Law. The Plan shall be administered in accordance with applicable federal and California laws governing the privacy and security of medical information to the extent not preempted by HIPAA.
15.12 Scope of Article. This Article applies only to those components of the Plan that constitute a group health plan or otherwise are subject to HIPAA. It does not apply to benefits or programs that are not subject to HIPAA.
ARTICLE XVI
GENERAL PROVISIONS
16.1 Written Plan. The Administrator shall, upon request, provide each Participant with a copy of the Plan(s) detailing the benefits available to the Participant.
16.2 No Trust Fund Required. The Employer shall have no obligation, but shall have the right, to insure any benefits under the Plan or to establish any fund or trust for the payment of Benefits under the Plan.
16.3 Insured Benefits. The Employer shall have no responsibility for the payment of any Benefits covered under the Component Plans provided by policies of insurance.
16.4 Rights to Employer’s Assets. No Employee or beneficiary shall have any right to, or interest in, any specific asset of the Employer by reason of participation in the Plan. Benefits shall be payable only in accordance with the terms of the Plan and applicable law. Nothing in the Plan shall be construed to create a trust or other separate ownership interest in any assets of the Employer, unless expressly provided otherwise by the Plan or required by applicable law.
16.5 Nonalienation of Benefits. Benefits payable under this Plan shall not be subject in any manner to anticipation, alienation, sale, transfer, assignment, pledge, encumbrance, charge, garnishment, execution, or levy of any kind, either voluntary or involuntary, including any such liability which is for alimony or other payments for the support of a spouse or former spouse, or for any other relative of the Employee, prior to actually being received by the person entitled to the benefit under the terms of the Plan; and any attempt to anticipate, alienate, sell, transfer, assign, pledge, encumber, charge or otherwise dispose of any right to benefits payable hereunder shall not be recognized, except to the extent required by law. The Employer shall not in any manner be liable for, or subject to, the debts, contracts, liabilities, engagements, or torts of any person entitled to benefits hereunder.
16.6 Divestment of Benefits. Subject only to the specific provisions of this Plan, nothing shall be deemed to divest a Participant of a right to the Benefit to which the Participant becomes entitled in accordance with the provision of this Plan.
16.7 Discontinuance of Contributions. In the event of a permanent discontinuance of contributions to the Plan, all Participants shall receive any and all Benefits to which they were entitled as of the date the discontinuance of contributions occurred.
16.8 Plan Interpretation. This Plan and the various Component Plans are intended to be read in conjunction with one another. However, to the extent of any conflict, the provisions of the Plan shall control, unless otherwise provided by Sections 125, 129 or 105(b) of the Code or the Regulations issued thereunder.
16.9 Governing Law. The Plan shall be administered in the State of California and its validity, construction, and all rights hereunder shall be governed by the laws of the State of California, unless superseded by the Code or other federal law.
16.8 Severability. If any provision of the Plan shall be held invalid or unenforceable, the remaining provisions shall continue to be fully effective.
16.9 Gender and Number. Words used in the masculine, feminine, or neuter gender shall each be deemed to refer to the other whenever the context so requires. Words used in the singular or plural number shall each be deemed to refer to the other whenever the context so requires.
16.10 Headings. Headings used in the Plan are intended solely for reference and are not intended to explain, modify or place any construction on any of the provisions of the Agreement. Any conflict between such headings and the text shall be resolved in favor of the text.
16.11 Successors and Assigns. The Plan shall inure to the benefit of and be binding upon the parties hereto, their successors and assigns. The right of a Participant to receive reimbursement under the Participant’s Health FSA or Dependent Care FSA shall not be assigned or subject to claims by creditors.
16.12 Discharge of Employee. The adoption and maintenance of the Plan shall not be deemed to be a contract between the Employer and the Employee. Nothing herein contained shall be deemed to give any Employee the right to be retained in the employ of the Employer or to interfere with the right of the Employer to discharge any Employee at any time.
16.15. Consolidation With Other Plan Documents. In the event the Plan merges or consolidates with, or transfers the assets and liabilities to, any other plan, no Participant herein shall, solely on account of such consolidation or transfer, be entitled to a Benefit on the day following such event which is less than the Benefit to which he or she was entitled on the day preceding such event. For the purpose of this Section, the benefit to which a Participant is entitled shall be calculated and based upon the assumption that a Plan termination and distribution of assets occurred on the day as of which the amount of the Participant’s entitlement is being determined.
16.16 Counterparts. The Plan may be executed in an original and any number of counterparts by the Employer, each of which shall be deemed an original of one and the same instrument.
IN WITNESS WHEREOF, the Employer has caused this Restated Section 125 Cafeteria Plan to be executed on [**INSERT DATE**].
EMPLOYER:
CITY OF CORONA
By:
Jacob Ellis
City Manager
ATTEST:
By: ___________________________
Sylvia Edwards
City Clerk
APPROVED AS TO FORM AND CONTENT:
By: ____________________________
Dean Derleth
City Attorney
SCHEDULE “A”
SCHEDULE OF BENEFITS
as of August 19, 2026
The following Schedule of Benefits, which may be amended from time to time by the Employer, specifies the Benefits and the Component Plans which set forth the terms, conditions and limitations of the Benefits offered to Participants. The periods of coverage for the Component Plans shall be the same as the Plan Year of the Plan, unless specified otherwise.
The following definitions shall apply for purposes of this Schedule of Benefits. Capitalized terms not otherwise defined in this Schedule of Benefits shall be as defined in Article III of the City of Corona Section 125 Cafeteria Plan.
1. “Base Contribution Rate” shall refer to the rate of contribution applicable to the Employer with respect to each Employee bargaining group as determined under the provisions of Section 22892 of the California Government Code in accordance with the Employer’s resolution filed with the California Public Employees'’ Retirement System.
2. “Confidential Personnel” shall mean Employees who are subject to the terms of the Compensation and Benefits for City of Corona Confidential Employees, as established by resolution of the City Council and as may be amended from time to time.
3. “Executive Personnel” shall mean Employees who are subject to the terms of the Compensation and Benefits for City of Corona Executive Employees, as established by resolution of the City Council and as may be amended from time to time.
4. “Fire Personnel” shall mean Employees who are members of the Corona Firefighters Association IAFF Local 3757 covered under the “Corona Firefighters Association IAFF Local #3757 Memorandum of Understanding” in effect from 2025 through 2027, as amended from time to time.
5. “General Personnel” shall mean Employees who are covered under the "“Corona Public Service Employees Association Memorandum of Understanding"” in effect from January 1, 2025 through December 31, 2027, as amended from time to time.
6. “Management Personnel” shall mean Employees who are subject to the terms of the Compensation and Benefits for City of Corona Management Employees, as established by resolution of the City Council and as may be amended from time to time.
7. “Memorandum of Understanding” shall refer to a memorandum of understanding between the Employer and a bargaining unit of Employees.
8. “PEMHCA” shall mean the CalPERS Health Program as governed by the Public Employees’ Medical & Hospital Care Act.
9. “Police Personnel” shall mean Employees covered under the: (i) “Corona Police Employees Association Memorandum of Understanding” in effect from January 1, 2025 through December 31, 2027, as amended from time to time; and (ii) “Corona Police Supervisors Association Memorandum of Understanding” in effect from January 1, 2025 through December 31, 2027, as amended from time to time.
10. “Retiree” shall mean Retired Elected Officials or Retired M/C Personnel.
11. “Supervisory Personnel” shall mean Employees covered under the “Corona Supervisors Association Memorandum of Understanding” in effect from January 1, 2025 through December 31, 2027, as amended from time to time.
12. “Utilities Personnel” shall mean Employees covered under the Corona Utilities Employee Association” in effect from July 1, 2026 through December 31, 2027, as amended from time to time.
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*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
FIRE PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Fire Personnel Plan Year $2,408.95
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Fire Personnel Plan Year N/A N/A
Vision
Insurance
All Fire Personnel Plan Year N/A N/A
Dependent
Care Flexible
Spending
Account
All Fire Personnel Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Fire Personnel Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance OptOut
All Fire Personnel Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if Employee opts-out
of Core Coverage pursuant to Section
6.3.
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GENERAL PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health Insurance All General
Personnel
Plan Year $2,273
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental Insurance All General
Personnel
Plan Year N/A N/A
Vision Insurance All General
Personnel
Plan Year N/A N/A
Dependent Care
Flexible Spending
Account
All General
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care Flexible
Spending Account
All General
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical Insurance OptOut AllowanceAll General
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if Employee
opts-out of Core Coverage
pursuant to Section 6.3.
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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UTILITIES PERSONNEL
as of July 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health Insurance All Utilities
Personnel
Plan Year $2,273
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental Insurance All Utilities
Personnel
Plan Year N/A N/A
Vision Insurance All Utilities
Personnel
Plan Year N/A N/A
Dependent Care Flexible
Spending Account
All Utilities
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care Flexible
Spending Account
All Utilities
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical Insurance OptOut AllowanceAll Utilities
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if Employee
opts-out of Core Coverage
pursuant to Section 6.3.
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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CONFIDENTIAL PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health Insurance All Confidential
Personnel
Plan Year $2,708
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental Insurance All Confidential
Personnel
Plan Year N/A N/A
Vision Insurance All Confidential
Personnel
Plan Year N/A N/A
Dependent Care Flexible
Spending Account
All Confidential
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care Flexible
Spending Account
All Confidential
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical Insurance OptOut AllowanceAll Confidential
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if Employee
opts-out of Core Coverage
pursuant to Section 6.3.
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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EXECUTIVE PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health Insurance All Executive
Personnel
Plan Year $2,708
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental Insurance All Executive
Personnel
Plan Year N/A N/A
Vision Insurance All Executive
Personnel
Plan Year N/A N/A
Dependent Care Flexible
Spending Account
All Executive
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care Flexible
Spending Account
All Executive
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical Insurance OptOut AllowanceAll Executive
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if Employee
opts-out of Core Coverage
pursuant to Section 6.3.
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
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MANAGEMENT PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health Insurance All Confidential
Personnel
Plan Year $2,708
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental Insurance All Management
Personnel
Plan Year N/A N/A
Vision Insurance All Management
Personnel
Plan Year N/A N/A
Dependent Care Flexible
Spending Account
All Management
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care Flexible
Spending Account
All Management
Personnel
Plan Year
(+Grace
Period)
$3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical Insurance OptOut AllowanceAll Management
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if Employee
opts-out of Core Coverage
pursuant to Section 6.3.
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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POLICE PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health Insurance All Police
Personnel
Plan Year $2,273
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental Insurance All Police
Personnel
Plan Year N/A N/A
Vision Insurance All Police
Personnel
Plan Year N/A N/A
Dependent Care Flexible
Spending Account
All Police
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care Flexible
Spending Account
All Police
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical Insurance OptOut AllowanceAll Police
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if Employee
opts-out of Core Coverage
pursuant to Section 6.3.
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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SUPERVISORY PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health Insurance All Supervisory
Personnel
Plan Year $2,708
(Employee+2 or
more
N/A
OTHER AVAILABLE BENEFITS
Dental Insurance All Supervisory
Personnel
Plan Year N/A N/A
Vision Insurance All Supervisory
Personnel
Plan Year N/A N/A
Dependent Care Flexible
Spending Account
All Supervisory
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care Flexible
Spending Account
All Supervisory
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical Insurance OptOut AllowanceAll Supervisory
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if Employee
opts-out of Core Coverage
pursuant to Section 6.3.
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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RETIREES
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MAXIMUM CITY CONTRIBUTION - The City will contribute an Employer Allowance of up to a maximum of $1,500 that can be applied to any of the benefits listed below.
Dental Insurance Retiree Plan Year N/A N/A
Vision Insurance Retiree Plan Year N/A N/A
Dependent Care
Flexible Spending
Account
Retiree Plan Year
(+Grace
Period)
N/A N/A
Health Care Flexible
Spending Account
Retiree Plan Year N/A N/A
CASH-OUT OPTION
Medical Insurance
Opt-Out Allowance
Retiree Plan Year Up to $1,500 Available only if a
Retiree elects benefits
having an aggregate cost
lessthan his or
her allowance
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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CERTIFICATION OF CITY OF CORONA
TO CITY OF CORONA SECTION 125 CAFETERIA PLAN
The CITY OF CORONA is the sponsor of the CITY OF CORONA SECTION 125 CAFETERIA PLAN. Certain benefits provided under the Cafeteria Plan constitute group health plans or health care components subject to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and its implementing regulations. The health care components of the Cafeteria Plan include the following separate group health plans:
All Group Health Plans offered by CalPERS and in accordance with PEMHCA The City of Corona Health Care Flexible Spending Account Plan Delta Care PMI
Reliance Standard Dental Insurance
Eye Med Vision Care
The Cafeteria Plan (excluding the non-health care components) and the health care components included in the Cafeteria Plan are Group Health Plans within the meaning of HIPAA (collectively, the “Plan”). The Plan and the City of Corona desire to exchange health information protected under HIPAA for purposes related to administration of the Plan. The City of Corona, acting in its capacity as plan sponsor of the Plan (“Plan Sponsor”) makes the following certifications for purposes of administering the Plan as required by the “Standards for Privacy of Individually Identifiable Health Information,” 45 CFR § 164.102 et seq. (the “Privacy Rule”):
The plan document of the Plan has been amended to incorporate the following provisions and Plan Sponsor agrees to:
• not use or further disclose any protected health information (“PHI”) received from the Plan (including any health insurance issuer or HMO with respect to the Group Health Plan) except as permitted or required by the Plan documents or required by law; • ensure that any agents or subcontractors to whom it discloses any PHI agree to the same restrictions and conditions that apply to the Plan Sponsor with respect to such information; • not use or disclose PHI for employment-related actions and decisions; • not use or disclose PHI in connection with any other benefit plan, program, or arrangement of the City of Corona except to the extent such other benefit plan, program or arrangement is part of an organized health care arrangement of which the Plan also is a part; • report to the Plan any use or disclosure-of PHI that is inconsistent with the uses and disclosures specified in the Plan of which it becomes aware; • give individuals access rights to PHI in its possession in accordance with the policies and procedures of the Plan;
• permit individuals to request amendment of their PHI in the Plan Sponsor’s
JAMIER\09000.25600\10323005.2
possession, and to make any necessary amendments, in accordance with the policies and procedures of the Plan;
• make information available to provide any necessary accounting of disclosures of PH1 in accordance with the policies and procedures of the Plan; • make its internal practices, books, and records relating to the use and disclosure of PHI from the Plan available to the Secretary of the Department of Health and Human Services for purposes of determining the Plan’s compliance with the Privacy Rule; • if feasible, to return to the Plan or destroy any PHI from the Plan that it maintains in any form, and shall retain no copies of the PHI when the PHI is no longer needed for the purpose for which disclosure was originally made. If it is not feasible to return or destroy the PHI, the Pian Sponsor agrees that it shall further limit any uses and disclosures to those purposes that make the return or the destruction of the information not feasible; and • agrees to ensure that adequate separation between the Plan Sponsor and the Plan is established.
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CITY OF CORONA
RESTATED SECTION 125 CAFETERIA PLAN
The CITY OF CORONA (the “Employer”) established the CITY OF CORONA RESTATED CAFETERIA PLAN (the “Plan”) for the benefit of its employees and their dependents effective November 1, 1998. The Employer hereby amends and restates the Plan, effective [**INSERT DATE**].
ARTICLE I
TITLE AND PURPOSE
This Cafeteria Plan shall be known as the CITY OF CORONA SECTION 125 CAFETERIA PLAN (the "“Plan"”). The purpose of the Plan is to furnish to eligible employees choices among certain Benefits provided by the Employer, so that employees may receive Benefits that best meet their individual needs. The Plan is intended to provide benefits in accordance with Sections 125, 105 and 129 of the Internal Revenue Code, as amended, and the Regulations issued thereunder, so that the Benefits that an Employee elects to receive under the Plan are eligible for exclusion from the Employee’s income for federal income tax purposes. The Employer shall offer at least one permitted taxable benefit and at least one nontaxable qualified benefit.
The Plan is also intended to qualify under Sections 105(b) and 129(d) of the Internal Revenue Code with regard to the written documentation requirements for self-funded health care reimbursement and dependent care assistance plans.
ARTICLE II
COMPONENT PLANS
The Benefits offered under this Plan are provided through separate Component Plans which are set forth in separate plan documents, group insurance policies or administrative service contracts and are incorporated herein and identified in Schedule “A” attached hereto. Schedule “A” shall be updated administratively by the Administrator, or his or her designee, consistent with any changes to the Benefits or Employer Allowance approved by the City Council, or as required by federal or state law. Notwithstanding, the provisions of the separate Health Flexible Spending Account and Dependent Care Flexible Spending Account Component Plans are set forth in this Plan document. Schedule "A" shall be updated or revised as required after such time the City Council has approved said core coverage allowances authorized by the labor contracts or the memorandum of understanding with the identified labor associations or the master list of Benefits for the Management, Confidential, and Executive Employees established by resolution of the City Council.
ARTICLE III
DEFINITIONS
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The following words and phrases, when used herein, shall have the following meanings, unless a different meaning is clearly required by the context:
3.1 Administrator. “Administrator” means the Employer or any person or entity appointed by the Employer to administer this Plan on its behalf, as provided in Article IV.
3.2 Benefit. “Benefit” means any of the qualified benefits and permitted taxable benefits which may be purchased under this Plan. “Benefits” shall also mean any amounts paid to a Participant in the Plan as reimbursement under the Health Flexible Spending Account (see Article X) or the Dependent Care Flexible Spending Account (see Article IX).
3.3 CalPERS. “CalPERS” shall refer to the Public Employees’ Retirement System created under the authority of the Public Employees’ Retirement Law as provided under Section 20000 et. seq. of the California Government Code and as administered by the CalPERS Board of Administration. ·
3.4 Code. “Code” means the Internal Revenue Code of 1986, as amended and regulations issued thereunder. References to any section of the Code include references to any comparable or succeeding provision of any legislation which amends, supplements or replaces such section.
3.5 Compensation. "Compensation" means all earnings of a Participant reportable on Form W-2 for the Plan Year but does not include any amounts received from a dependent care assistance plan, any pension or annuity, or as unemployment or worker's compensation in accordance with Section 129(e)(2) of the Code.
3.6 Component Plan. “Component Plan” means any plan offering Benefits available under this Plan; as set forth in the separate plan documents, except for the Health Flexible Spending Account (see Article X) and the Dependent Care Flexible Spending Account (see Article IX).
3.7 Core Coverage. “Core Coverage” means the mandatory means the Benefit option consisting of at least employee-only health coverage under the Employer's Group Health Planplans offered by the Employer which a Participant, other than a Retiree, is required to elect under the terms described in Section 6.3. A Participant that elects either single or family health coverage under the Employer's Group Health Plans shall be deemed to have satisfied the mandatory Core Coverage provisions of Section 6.3 .
3.7 Core Coverage Allowance. "Core Coverage Allowance" means the amount of Employer contribution to the Plan made by the Employer on behalf of each Participant, for the purchase of Core Coverage as set forth in Schedule “A”.
3.8 Dependent “Dependent” means (a) an individual who qualifies as the Participant's dependent under Code § 105(b); (b) any child of the Participant (within the meaning of Code § 152(f)(1)) who has not attained age 26, to the extent required by applicable federal law for purposes of the Employer's group health plans; and (c) solely for purposes of the Dependent Care Flexible Spending Account, a Qualifying Individual as defined in Code §§ 21(b)(1) and 129. The term "Dependent" shall be interpreted and administered in accordance with applicable provisions of the
JAMIER\09000.25600\10323009.6
Code, the Affordable Care Act, and other applicable federal law. To the extent the eligibility requirements for a particular Benefit option differ under applicable law, the requirements applicable to that Benefit option shall control.
3.8 Core Coverage Opt-Out Allowance. "Core Coverage Opt-Out Allowance" means the amount available to a Participant, in the event that such Participant satisfies the requirements for waiving the Core Coverage Allowance option pursuant to Section 6.3. Such amount shall be as set forth in the Schedule of Benefits for each Employee group as set forth in Schedule “A”.
3.9 Dependent "Dependent" means a dependent per Code § 105(b), any child (as defined in Code § 152(f)(1)) of the Participant who as of the end of the previous calendar month has not attained age 26, and (3) any child of the Participant to whom IRS Revenue Procedure 2008-48 and (b) for purposes of the Dependent Care Flexible Savings Account, a Qualifying Individual.
Notwithstanding the preceding, if a Component Plan permits a Participant to cover an individual other than the Participant’s Spouse or Dependent (including a Participant’s registered domestic partner as recognized by the State of California), the term Dependent as used throughout the Plan document shall also include such individual provided the benefit is treated as a taxable benefit in accordance with Section 8.8.
3.9 3.10 Effective Date. "“Effective Date" means the” means the effective date of this restatement which is __________, 2026. The date this Plan was first became effective, which isadopted was November 1, 1998.
3.10 3.11 Employee. “Employee”” shall include any active employee of the Employer that is coveredentitled to receive an Employer Allowance under a memorandum of understanding between the Employer and a bargaining unit of Employees. “Employee” shall also mean all other regular full time employees of the Employer and, to the extent necessary, former employees who are entitled to receive paymentsBenefits under this Plan.
3.11 3.12 Employer. “Employer” means the City of Corona.
3.12 Employer Allowance. “Employer Allowance” means the amount specified in Schedule “A” for the applicable employee group and contributed by the Employer on behalf of each Participant, other than a Retiree, toward the purchase of coverage under a Health Benefit Plan.
3.13 3.13 Entry Date. “Entry Date” means, for all newly hired Employees, the first day of the month following date of hire unless otherwise provided under the terms of the applicable memorandum of understanding. In all other cases, the “Entry Date” shall mean the first day of each Plan Year.
3.14 3.14 ERISA. “ERISA” means the Employee Retirement Income Security Act of 1974.
3.15 3.15 FMLA. “FMLA” means the Family Medical Leave Act of 1993, as amended and including all regulations issued thereunder.
3.16 Grace Period. “Grace Period” means the period commencing on the date immediately
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following the end of the Plan Year and ending no later than then fifteenth day of the third month following the end of the Plan Year.
3.17 3.16 Group Health Benefit Plan. “Group Health Benefit Plan” means an employee welfareshall mean any medical, dental, vision, or other group health benefit plan establishedsponsored or maintained by an employer or by an employee organization (such as a union), or both, that provides medical care for Participants or their Dependents directly or through insurance, reimbursement, or otherwise.the Employer and offered to eligible Employees or Retirees, including any health benefit plan made available through CalPERS, as designated by the Employer from time to time.
3.18 3.17 Leave of Absence. “Protected Leave of Absence” means any absence of an Employee which is authorized by the Employer and is state or federally protected under Family Medical Leave Act, California Family Rights Act, Pregnancy Disability Act, Workers’ Compensation Leave, Military Leave, or Kin Care Leave. “Unprotected Leave of Absence” means any absence of an Employee that may be authorized by the Employer but does not fall under any of the above listed state or federal protections.
3.18 Medical Difference. "Medical Difference" means the excess, if any, of Core Coverage Allowance after the purchase of Core Coverage, which may only be used to pay for dental and/or vision premiums for the Participant, Spouse, or Dependent .
3.19 Medical Insurance Opt-Out. “Medical Insurance Opt-Out ” means the amount available to a Participant, other than a Retiree, in the event that such Participant satisfies the requirements for waiving the Core Coverage option pursuant to Section 6.3. Such amount shall be as set forth in the Schedule of Benefits for each Employee group as set forth in Schedule “A”. ‘
3.20 3.19 Open Enrollment Period. “Open Enrollment Period" means the period before the beginning of the next Plan as determined by the Administrator. For a new Employee, “Open Enrollment Period” shall mean the period between the Employee’s date of hire and the first day which an Employee may become a Participant.
3.21 3.20 Participant. “Participant” means an Employee, and a Retiree with respect to the Flexible BenefitEmployer Allowance only, who becomes enrolled in the Plan pursuant to Article V. "“Participant"” shall also mean a former Employee who elects to continue health coverage under the Plan.
3.22 3.21 Period of Coverage. “Period of Coverage” generally means the Plan Year beginning on January 1 and ending on December 31. A Participant’s Period of Coverage may be less than 12 months if a new Participant enters the Plan during the year or a Participant completes a permitted election change in accordance with Article VI. A Participant’s Period of Coverage shall also include continuation coverage elected by a terminated Participant or Qualified Beneficiary. A Participant’s Period of Coverage under the Health Flexible Spending Account or Dependent Care Flexible Spending Account shall not be less than twelve (12) months unless the Plan Year is a Short Plan Year.
3.23 3.22 Plan. “Plan” means the CITY OF CORONA RESTATED SECTION 125
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CAFETERIA PLAN, set forth herein, including all subsequent amendments and modifications hereto.
3.24 3.23 Plan Year. “Plan Year” means the twelve (12) consecutive month period commencing January 1 and ending on December 31.
3.25 Retired Elected Officials. “Retired Elected Officials” shall refer to the following: (i) former members of the Employer’s legislative body elected prior to January 1, 1999 and who retired from the City of Corona under the CalPERS system on or prior to February 18, 2009; and (ii) any individual elected to serve as the treasurer of the City of Corona prior to· January l, 1999 and who retired from the City of Corona under the CalPERS system on or prior to February 18, 2009.
3.26 Retired M/C Personnel. “Retired M/C Personnel” shall mean employees of the Employer subject to the terms of the master list of Benefits for the Management, Confidential and Executive Employees established by resolution of the City Council , as amended from time to time, hired by the Employer prior to January 1, 1999 that are receiving retirement benefits under the Employer’s retirement plans.
3.27 Retiree. “Retiree” shall mean Retired Elected Officials or Retired M/C Personnel.
3.28 3.24 Salary Reduction. “Salary Reduction” means the amounts paid into the Plan pursuant to elections made by the Participant, to reduce his or her Compensation for the purchase of Benefits elected by the Participant.
3.25 Short Plan Year. "Short Plan Year" shall mean a Plan Year which is less than twelve (12) months and which ends on the last day of the Plan Year. This Short Plan Year shall arise only in the following circumstances: (i) the initial Plan Year did not begin on January 1; or (ii) the Employer changes the Plan Year for a valid business purpose resulting in a Short Plan Year. In the event that a Short Plan Year is in effect, all references to "Plan Year" shall be replaced by "Short Plan Year" in all instances where it is appropriate.
3.29 3.26 Spouse. “Spouse” means the person to whom the Participant is legally married but shall not include an individual legally separated from a Participant under a decree of legal separation unless it is court ordered. Notwithstanding, a Participant’s registered domestic partner shall be entitled to and receive the same rights and coverage attributable to medical and health benefits offered under the Plan pursuant to the California Domestic Partner Rights and Responsibilities Act of 2003.
3.30 3.27 Student. “Student” means an individual who during each of the five calendar months during a Plan Year is enrolled as a full-time student at an “educational institution.” For this purpose, “educational institution” means any institution which normally maintains a regular faculty and curriculum and normally has a regularly enrolled body of pupils or students in attendance at the place where its educational activities are regularly carried on.
3.28 Uniformed Services. “Uniformed Services” means the Armed Forces, the Armed National Guard, and the Air National Guard when engaged in active duty for training, inactive duty training,
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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.
ARTICLE IV
ADMINISTRATION
4.1 Allocation of Responsibility for Administration.
(a) Designated Representatives. The Employer may appoint an individual or an administrative committee to serve at its discretion as Administrator. The Administrator shall have only those powers, duties, responsibilities and obligations as are specifically given to the Administrator under the Plan.
(b) Employer Responsibilities. The Employer shall have the sole responsibility for making the contributions provided for under Article VII and shall have the sole authority to amend or terminate, in whole or in part, the Plan at any time. (c) Administrator’s Responsibilities. The Administrator shall have the sole responsibility for the administration of the Plan, as set forth herein. The Administrator warrants that any directions given, information furnished, or action taken by it shall be in accordance with the provisions of the Plan authorizing or providing for such direction, information or action. The Administrator shall be responsible for the proper exercise of its own powers, duties, responsibilities and obligations under this Plan and shall not be responsible for any act or failure to act of another Employee. Neither the Administrator, nor the Employer makes any guarantee to any Participant in any manner for any loss or other event because of the Participant’s participation in the Plan.
(d) Transfer of Duties. The Employer may, at any time, assign all or any portion of the Administrator’s duties to a contracting third party.
4.2 Powers and Duties of Administrator.
(a) Powers and Duties Delegated to Administrator. The Administrator shall supervise the administration of the Plan. The Administrator shall be responsible for ensuring that the terms and conditions of the Plan are carried out for the exclusive benefit of persons entitled to participate in the Plan without discrimination. The Administrator shall have full power to administer the Plan, subject to the applicable requirements of the law and any agreement executed by and between the Employer and the Administrator. For this purpose, the Administrator’s powers shall include the following:
(1) to construe and interpret the Plan, decide all questions of eligibility and determine the amount, manner and time of payment of any Benefits hereunder; (2) to prescribe the procedures for the Participants to follow in filing applications for Benefits and to prepare forms to be used by the Participants;
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(3) to prepare and distribute, in such manner as the Administrator determines appropriate, information explaining the Plan;
(4) to receive from the Employer, Participants, Participant’s Spouses and Dependents, and other persons such information as shall be necessary for the proper administration of the Plan;
(5) to furnish to the Employer and the Participants, upon request, annual reports detailing the administration of the Plan;
(6) to receive, review and keep on file records pertaining to the Plan, as the Administrator deems convenient and proper;
(7) to allocate its administrative responsibilities;
(8) to appoint or employ individuals and any other Agents the Administrator deems advisable, including legal and actuarial counsel, to assist in the administration of the Plan (9) to adopt such rules as the Administrator deems necessary, desirable or appropriate, subject to applicable law. All rules and decisions of the Administrator shall be uniformly and consistently applied to all Participants in similar circumstances; and (10) to take all other steps necessary to properly administer the Plan in accordance with its terms and conditions and the requirements of the applicable law. (b) Powers and Duties Not Delegated to Administrator. The Administrator shall have no power to add to, subtract from or modify any of the terms of the Plan, or to change or add to any Benefits provided by the Plan, or to waive or fail to apply any requirements of eligibility for a Benefit under the Plan, except as may be expressly provided herein. Interpretations of the provisions of the Plan shall not be deemed to be additions, subtractions, or modifications of the Plan.
4.3 Nondiscriminatory Exercise of Authority. Whenever in the administration of the Plan any discretionary action by the Administrator is required, the Administrator shall exercise its authority in a nondiscriminatory manner so that all persons similarly situated shall receive substantially the same treatment.
4.4 Incapacity of Participant. Whenever, in the Administrator's opinion, a person entitled to receive any payment of a Benefit hereunder or an installment thereof is under a legal disability or is incapacitated in any way so as to be unable to manage the person's financial affairs, the Administrator may direct the Employer to make payments to such Participant or to such person or to the person's legal representative or to a relative or friend of such person on such person's behalf, or the Administrator may apply the payment for the benefit of such Participant in such manner as the Administrator considers advisable. Any payment of a Benefit or installment in accordance with the provisions of this Section shall be a complete discharge of any liability for the making of such
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payment under the provisions of the Plan.
4.4 Payments to Authorized Representatives. If a Participant or other person entitled to receive a payment under the Plan is deceased, legally incapacitated, or otherwise legally unable to receive the payment, the Administrator may make the payment to the Participant’s personal representative, conservator, guardian, attorney-in-fact acting under a valid power of attorney, or other person authorized under applicable law or a court order. The Administrator may rely in good faith on documentation reasonably establishing such authority, and any payment made in good-faith reliance on such documentation shall fully discharge the Employer, the Plan, and the Administrator with respect to the amount paid.
4.5 Indemnification of Administrator. The Employer agrees to indemnify any Employee serving as Administrator (including any Employee or former Employee who formerly served as Administrator), against any and all liabilities, damages, costs and expenses (including attorneys'’ fees and amounts paid in settlement of any claims approved by the Employer) occasioned by any act or omission to act in connection with the Plan, if such act or omission is made in good faith pursuant to the provisions of the Plan and not as a result of the Administrator’s gross negligence or willful misconduct.
4.6 Use of Electronic Medium for Participant NoticesCommunications and Elections. To the extent permitted by applicable law, the Administrator may furnish any notice, disclosure, election form, reimbursement request, certification, consent, or other communication required or permitted under the Plan by electronic means, including electronic mail, an Internet or intranet website, or another electronic enrollment or benefits administration system designated by the Employer, provided the intended recipient has the effective ability to access the electronic medium used. (a) Definition of Electronic Medium. "Electronic Medium" means an electronic method of communication between the Administrator (or its designated representative) and Employee thereby allowing each party to send and receive notice and elections through the same medium.
The only form of electronic communication permitted by the Plan shall be via electronic mail on the Employer's network or intranet, through an interactive website, or to a private e-mail address supplied to the Employer by the Employee for communication purposes. The electronic medium must be designed so that the information provided is no less understandable to the receiving party than a written paper document. The electronic medium shall be designed to alert the Employee, at the time a notice is provided, to the significance of the information in the notice (including identification of the subject matter of the notice), and provide any instructions needed to access the notice, in a manner that is readily understandable. The electronic medium shall be designed to preclude any person, other than the appropriate individual, from making a Participant election, such as Salary Reduction Agreement, or accessing individual Participant account information.
The Administrator may establish reasonable procedures governing the use of electronic communications and electronic signatures, including procedures for authentication of Participants, confirmation of elections, correction of errors, maintenance of records, and requests for paper copies of Plan communications. To the extent required by applicable law, a Participant shall be advised of the right to request a paper copy of any electronically furnished communication at no charge.
(b) Disclosure and Consent Requirements.
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An election, consent, or other document submitted through an authorized electronic system in accordance with such procedures shall be deemed to satisfy any requirement under the Plan that the communication be in writing or signed.
(1) Disclosure Statement. Prior to electronically transmitting any consent or notice to the Employee, the Administrator shall provide a statement which contains the following: (i) informs the Employee of the right to receive a paper document of the notice or other Plan-related material either prior to or after giving consent to electronic transmission; (ii) informs the Employee of the right to withdraw his or her consent at any time and the procedures for withdrawal, including any conditions or consequences arising from such withdrawal; (iii) describes the scope and duration of the consent as it related to various Plan transactions; (iv) describes the procedures for updating Employee contact information; and (v) describes the hardware of software requirements needed to access and retain the notice.
(2) Consent. The Administrator shall be exempt from the consent requirements of Section 101(c) of the Electronic Signatures in Global and National Commerce Act (E-SIGN) provided the Electronic Medium used to provide notices and Plan-related material is a medium that the Employee has the effective ability to access and the Employee is advised, each time a notice is transmitted, that he or she can request to receive the notice in paper form at no charge.
The form of Electronic Medium utilized by this Plan shall be through an interactive website requiring the Employee to register an e-mail address for communication purposes. (3) Changes in Hardware or Software Requirements. In the event of any changes in the hardware or software requirements needed to access the Electronic Medium, the Administrator, or its designated representative, shall provide a statement to each Employee of the revised requirements and the right to withdraw consent to receive electronic delivery of Plan-related materials without consequence.
(c) Participant Elections. The Administrator, or its designated representative, shall be permitted to electronically distribute Participant elections by Electronic Medium. Each Employee who is provided with enrollment or election information via Electronic Medium will also be informed by the Administrator that he or she may receive a paper copy of the relevant documents upon request. A Participant election will not be treated as being made available to an individual if such individual cannot effectively access the Electronic Medium for purposes of making the election. An election completed by an Employee via Electronic Medium shall be deemed as being provided in written form so long as the following requirements are satisfied:
(1) The Employee has a reasonable opportunity to review, confirm, modify or rescind the terms of the election before the election becomes effective; (2) The Employee receives, within a reasonable time, a confirmation of the election either through written paper form or by electronic mail (e-mail); and (3) Any permissible change to an Employee’s election shall only be effective if made directly through the Employer.
(d) Timing and Content of Elections and Notices. The provisions of this Section 4.6 shall in no way affect or alter the timing or content requirements applicable to each individual notice or document.
ARTICLE V
ELIGIBILITY AND PARTICIPATION
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5.1 Eligibility. Each Employee and Retiree shall be eligible to participate in the Plan as of his or her Entry Date.
5.2 Participation and Elections. An Employee or Retiree may become a Participant by completing and executingsubmitting an enrollment form, current or active Employees will be required to and any other forms or information required by the Administrator. A current Employee who elects to participate in any Benefit option through a Salary Reduction shall also complete and submit a Salary Reduction agreement pursuant toin accordance with Section 6.2. Employees will be required to provide any other information requested by the Employer as is reasonable as a condition of such participation. A Participant's election to participate in the Plan shall continue to be valid for the Plan Year until expressly revoked or altered, as set forth in Article VI. A Retiree shall participate in accordance with the applicable enrollment procedures and payment requirements established by the Administrator.
A Participant’s election shall be effective for the applicable Plan Year. Unless otherwise provided by the Plan, the Administrator, or applicable law, an election of an insured Benefit option, including medical, dental, or vision coverage, shall automatically continue for the following Plan Year unless the Participant makes a timely election to change or revoke such election during the Open Enrollment Period.
Notwithstanding the foregoing, the Administrator may require an affirmative annual election, certification, or other documentation for any Benefit option for which annual elections are required or appropriate under applicable law or administrative procedures, including but not limited to Health Flexible Spending Account elections, Dependent Care Flexible Spending Account elections, and any Medical Insurance Opt-Out benefit.
The Administrator shall establish reasonable procedures for enrollment, elections, certifications, and administration of the Plan, including procedures applicable to Employees, Retirees, and Participants.
5.3 Recommencement of Participation. A former active Participant may recommence participation in the Plan on his or her date of reemployment as an eligible Employee. If a former active Participant is rehired by the Employer within 30 days of his or her date of termination, such Participant shall not be permitted to submit a new election and his or her prior election shall be reinstated for the remainder of the Plan Year. However, a reemployed former active Participant may not make a new election to participate in a health flexible spending account and/or dependent care flexible spending account which is effective during the same Plan Year in which he or she separated from service with the Employer.
Any employee who returns to active employment within ninety (90) days of completing a Protected Leave of Absence for duty in the Uniformed Services shall reenter the Plan upon reemployment. A Participant whose health coverage under the Plan is terminated on account of his or her being in “uniformed service”, and is later reinstated, shall not be subject to a new exclusion or waiting period requirement imposed by such Group Health Plan and/or health flexible spending account, provided that such requirements would not have been imposed if coverage had
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not been terminated as a result of the “uniformed service.”
5.4 Leave of Absence. A Participant shall not be disqualified from participating in the Plan with respect to Core Coverage, dental and/or vision insurance or the Health Flexible Spending Account (“Health Benefits”) during the period in which the Participant is on an Protected Leave of Absence; provided that Participant continues to have an employment relationship with the Employer and arranges to continue to pay his or her required costs, if any, for coverage for the Health Benefits elected for the Plan Year.
The Employer shall continue to provide the Core CoverageEmployer Allowance during the Participant’s Protected Leave of Absence irrespective of whether such leave is paid or unpaid.
However, a Participant who takes an unpaid Unprotected Leave of Absence, the Employer will not continue to provide the Core CoverageEmployer Allowance during the Participant’s Unprotect4edUnprotected Leave of Absence and the Participant shall be required to pay his or her required costs of coverage, if any, in the form provided in Section 8.3. Notwithstanding the preceding, the Participant may revoke his or her election to participate under any health Benefit offered under this Plan, for the remainder of the Plan Year in which such Unprotected Leave of Absence commences. Such revocation shall take effect in accordance with such procedures as prescribed by the Administrator. If the Participant makes such an election, the Employer’s provision of the Core CoverageEmployer Allowance shall also cease. Upon such Participant's return from his or herreturning from an Unprotected Leave of Absence, thea Participant may then elect to be immediately reinstatedresume participation in the Plan, on the same terms that applied to the Participant prior to the Unprotected Leave of Absence taking into account any voluntary revocation with respect to the allocation of any allowances, and with such otherimmediately before the leave, as modified by any election changes validly made during the leave, and shall have such additional rights to revokemake or change elections as are otherwise provided to the Participants under the Plan.
Notwithstanding the foregoing, a Participant on either Protected or Unprotected Leave of Absence shall have no greater rights to Benefits for the remainder of the Plan Year in which the Leave of Absence commences as other Participants.
5.5 Cessation of Participation. An Employee shall cease to be a Participant under this Plan and therefore, under each Component Plan, as of the earliest of:
(a) the date on which the Participant separates from service employment with the Employer; or
(b) the date on which the Administrator, on a consistent and uniform basis, deems the Participant has failed to make the required premium payments, if any, for the elected Benefits, as provided in Section 5.6; or
(c) the date on which the Participant is not eligible to participate in any of the Component Plans for which he or she wishes to make an election; or (d) the date on which the Participant dies; or
(e) the date on which the Plan terminates.
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5.6 Cessation of Required Contributions. A Participant’s election to participate in the Plan may be terminated in accordance with Subsection 5.5(b) if the Participant fails to make the required premium payments with respect to a Benefit. In such case, that Participant may not make a new benefit election for the remaining portion of the Plan Year. In the event a Participant returns from a Protected or Unprotected Leave of Absence, the Participant may then elect to be immediately reinstated in the Plan on the same terms that applied to the Participant prior to the Leave of Absence.
5.7 Eligibility Under Component Plans. The eligibility of a Participant under a Component Plan shall be the same as set forth in this Article, unless otherwise specified in the Component Plan under which a Participant has elected to receive Benefits. Each Component Plan may provide more rigorous eligibility requirements which may cause a Participant to be ineligible to participate in a particular Component Plan but continue to be eligible to participate in this Plan.
ARTICLE VI
ELECTIONS AND PROCEDURES
6.1 Election of Benefits. Prior to the annual Entry Date (or the first Entry Date for newly hired Employees), there shall be an Open Enrollment Period during which the Employee may elect to participate in this Plan. During the Open Enrollment Period, the Administrator shall provide each Employee and Retiree with an enrollment form and for current or active employees a Salary Reduction Agreement. The Participant shall specify on his or her electionenrollment form the amount of Salary Reduction, if any, and Core CoverageEmployer Allowance which are to be applied to provide the Benefits selected, subject to the limitations on use as set forth in this Plan.
6.2 Salary Reduction Agreement. Prior to participation and prior to each Plan Year, the Employee shall complete a Salary Reduction Agreement which shall include, at a minimum, the following information:
(a) that the electionenrollment form must be completed and returned to the Administrator during the Open Enrollment Period; and
(b) that the election shall be irrevocable and effective for the entire Plan Year for which the election is made, unless the Participant is entitled to change his or her election as provided in this Article VI; and
(c) that the Participant’s Salary Reduction shall be considered Employer contributions used to pay for Benefits under the Plan.
Salary Reductions shall be contributed to the Plan by the Employer, on behalf of a Participant on a level and pro rata basis for each payroll period. The Administrator, may, in its discretion, establish a limit on the amount of Salary Reductions which a Participant may elect for the Plan Year or adjust any Salary Reduction election made under the Plan, to ensure that the Plan complies
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with the nondiscrimination provisions of Article XII.
6.3 Core Coverage - Mandatory Health Coverage. Each Employee shall be permitted to select among the Benefits made available under the Plan; however, each Employee shall be required to select Core Coverage under the Plan unless the Employee and his or her eligible Dependents, if any, are currently receiving health benefits fromenrolled in another sourcegroup health plan for the following Plan Year. An Employee shall only be exempt from electing a Core Coverage option upon completion of the following:
(a) The Employee shall provide the Administrator with satisfactory evidence substantiating that the Employee and his or her eligible Dependents, if any, are currently receiving health benefits fromenrolled in a group health plan through another source for the following Plan Year and that the Core Coverage option would duplicate the other coverage. (b) The Employee declines coverage under the Employer's Group Health PlanEmployer’s Health Benefit Plan and agrees in writing to hold the Employer harmless for any consequences resulting in the waiver of such coverage.
(c) The Employee acknowledges in writing that the Employee and his or her eligible Dependents, if any, shall not be permitted to enroll in health coverage under the Plan until the next Open Enrollment Period, subject to the terms and restrictions of the insurance provider.
The Employee completes and submits to the Administrator CalPERS HBD-12 form to decline health coverage under the Planthrough CalPERS.
In the event an Employee satisfies the requirements for waiving the Core Coverage option pursuant to this Section 6.3, the Core Coverage Opt Out Allowance shall be paid in taxable cash in the first two pay periods of each monthEmployee shall receive the Medical Insurance Opt-Out in lieu of the Employer Allowance. The Employee may apply the Medical Insurance Opt-Out toward other Benefit options made available under this Plan, including the cash option described in Section 7.3. The amount of the Core Coverage Opt Out AllowanceMedical Insurance Opt-Out made available to the Employee shall be based upon the opt-out provisions for the respective Employeeemployee group, as set forth on Schedule “A”.
6.4 Failure to Make Initial Election. If an Employee who isfirst becomes eligible to participate in the Plan fails to make elections prior toreturn a completed enrollment form before the end of the Open Enrollment Period, or the Employee fails to elect Core Coverage and does not elect toaffirmatively opt out of Core Coverage in accordance with Section 6.3, the Employee shall be deemed to have elected to enroll in a health insurance plan, employee coverage only, as determined by the Administrator on a uniform and nondiscriminatory basis. automatically enrolled in employee-only Core Coverage under the Health Benefit Plan designated by the Employer or Administrator if permitted by the CalPERS health program. Any optional employee-paid benefits available under this Plan shall be deemed declined unless affirmatively elected by the Employee.
6.5 Elections for Subsequent Plan Years.
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(a) Open Enrollment Period. An Open Enrollment Period shall occur prior to the beginning of each Plan Year. During the Open Enrollment Period, a Participant who wishes to change his or her existing elections shall have the opportunity to elect new or different coverage under the Plan effective for the subsequent Plan Year subject to the terms and conditions of the Component Plans.
(b) Failure to Reelect. If a Participant fails to designate on the election form how he or she wishes to allocate the Employer Allowance but remains eligible to participate, the Participant shall be deemed to have elected to allocate the Employer Allowance towards the premium for Core Coverage, as determined by the Administrator on a uniform and nondiscriminatory basis. (bc) Health Flexible Spending AccountAccounts. Elections to contribute to the Health Flexible Spending Accountflexible spending accounts must be affirmatively elected each year by the Participant and a failure to reelect shall result in nonparticipation under the Health Flexible Spending Account flexible spending accounts.
(cd) Continuation Coverage. During an Open Enrollment Period, any Participant, or a Qualified Beneficiary thereof, that has elected continuation of health coverage under the Plan, shall have the opportunity to elect new or different coverage under the Plan effective for the subsequent Plan Year. However, any such election shall be limited to health care options available under the Plan.
6.6 Special Enrollment Period. In accordance with the Code Section 9801(f) and the regulations issued by the Department of Health and Human Services, an eligible Employee or Dependent, who either incurs a loss of health coverage or becomes otherwise eligible for health coverage under this Plan shall be permitted to enroll for health coverage under the Plan in accordance with one of the special enrollment periods described in paragraphs (a) and (b) below. (a) Loss of Health Coverage. An Employee who is otherwise eligible to enroll in the Plan but has not elected to participate in the Plan, or aenrolled, or an eligible Dependent of Employee thatwho is not enrolled but otherwise eligible under the Plan, shall be permitted to enroll for coverage underin the Plan providedif:
(1) The Employee or Dependent was covered under another Group Health Plangroup health plan or had alternate health insurance coverage (“Prior Health Coverage”) at the time coverage under this Plan was previously offered to the Employee. (2) The Employee stated in writing at such time that Prior Health Coverage was the reason for declining enrollment.
(3) The Employee’s or Dependent’s Prior Health Coverage was either:
(i) under a continuation coverage provision and the coverage period was exhausted; or
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(ii) was terminated as a result of loss of eligibility (including a result from a change in family status) or employer contributions toward such coverage were terminated. (4) Under the terms of the Plan, the Employee requests enrollment in the Plan not later than 30 days after the date of a special enrollment event or the date a certificate of group health coverage is provided following a termination of health coverage.
The Employee requests enrollment under the Plan not later than thirty (30) days after the loss of the other coverage or employer contribution.
(b) Dependent Special Enrollment Period. Any Employee, regardless of whether said Employee is currently enrolled for health coverage under the Plan, who experiences an increase in the number of Dependents whether through marriage, birth, adoption or placement for adoption, shall be permitted to enroll for health coverage under the Plan. In such event, Employee shall have the opportunity to enroll all other Dependents who are otherwise eligible for coverage, including the Employee if not enrolled, provided the Employee elects enrollment within thirty (30) days commencing on the later of: (i) the date Dependent coverage is made available; or (ii)after the date of the marriage, birth, adoption, or placement for adoption, or other event which results in the change of Dependents of Employee.
(c) Health Flexible Spending Account. Notwithstanding the foregoing, the special enrollment rights conveyed under this Section shall not extend to include an election to contribute to a Health Flexible Spending Account offered under the Plan.
6.7 Revocability of Elections. The. Except as otherwise provided in this Plan, a Participant's election for a Plan Year is irrevocable. Notwithstanding the foregoing, the Administrator shallmay permit a Participant to revoke an election and make a new election outside of the Open Enrollment Period for the remainder of a Plan Year only if the new election is for one ofduring a Plan Year to the extent permitted under Section 125 of the Code, Treasury Regulation § 1.125-4 (or any successor regulation), and the terms of this Plan, including the following reasons:
(a) both the revocation and new election are made on account of and are consistent with a change in the Participant's family status, as set forthdescribed in Section 6.9; (b) there is a significant change in the cost orof coverage of the Benefits previously elected by the Participant, as set forth, as described in Sections 6.10 and 6.11; (c) both the revocation and new election are made on account of and pursuant to the terms of a "a qualified medical child support order" as defined in ERISA Section 609, as set forth, as described in Section 6.12; or
(d) the Participant, Spouse or Dependent becomes eligibleeligibility for continuation coverage under Article XI and the Participant desires to elect to increase the amount of his or her Salary Reduction in order to pay for the continuation coverage., as described therein; (e) special enrollment rights under HIPAA;
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(f) entitlement to or loss of entitlement to Medicare or Medicaid; (g) a change in employment status affecting eligibility for coverage; (h) a change in residence affecting eligibility for coverage; (i) Any other event for which a mid-year election change is permitted under Section 125 of the Code, applicable Treasury Regulations, or other applicable IRS guidance, as determined by the Administrator.
6.8 Participant Makes Incorrect Election. If a Participant does not elect the correct amount under his or her Salary Reduction to pay for coverage of the Benefits selected under the Plan, the Administrator is authorized to increase or decrease a Participant’s election Salary Reduction by the amount necessary to provide the Participant’s elected coverage under the Plan.
6.9 Change in Family Status. A Participant may make a change in coverage during a Plan Year due to a change in family status, as set forth in this Section. A Participant must notify the Administrator and must complete a new election form to change coverage. The Participant’s election shall only be deemed valid if the requested change in coverage is necessitated by and corresponds with the change in family status and is consistent with the terms and conditions of the affected Component Plan. A Participant must notify the Administrator and submit a completed election form requesting the change no later than thirty (30) days after the applicable change in family status (or such longer period as required by applicable law). This election shall be effective as of the first day of the month following the date the Participant provides the Administrator with a new election form reflecting the change in coverage due to a change in family status.
A change in family status shall include the following:
(a) a change in the Participant’s marital status, including marriage, death of Spouse, divorce, legal separation, or annulment;
(b) a change in the number of Dependents of a Participant, including a birth of a child, adoption, placement for adoption, or death of a Dependent; (c) any change in the employment status of the Participant, Spouse or Dependent which results in that individual becoming or ceasing to be eligible under this Plan or other employee benefit plan maintained by the employer of the Participant, Spouse or Dependent, including a termination or commencement of employment; a strike or lockout; a commencement or return from an unpaid leave of absence (including leave taken under FMLA); a change in work site; or a reduction or increase in hours of employment (including a switch between part-time and full-time); (d) a Dependent satisfies or ceases to satisfy the eligibility requirements for coverage due to attainment of age, Student status, or any similar circumstances as provided under the Component Plan under which the employee receives coverage;
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(e) a change in the place of residence of the Participant, Spouse, or Dependent; and (f) a Participant, Spouse, or Dependent becoming or ceasing to be entitled to coverage under Medicare or Medicaid.
To the extent the Code, and regulations issued thereunder, alters this definition of change in family status, this Section 6. 9 is intended to be interpreted in accordance with any revised definition or interpretation.
6.10 Change in Cost of Benefit.
(a) Insignificant Change,. If the cost of any Benefit offered under the Component Plans (except a Component Plan which provides for the reimbursement of health or dependent care expenses) increases or decreases during the Plan Year, the Administrator may, on a reasonable and consistent basis, automatically increase or decrease a Participant’s election Salary Reduction by a corresponding amount to ensure that the Participant continues to receive the elected coverage under the Component Plans; provided, however, that if the increase or decrease is a significant change in cost, that the Administrator shall identify and assess the scenario.Participant shall be given the option to elect to change his or her Benefits, as further explained in (b) below. (b) Significant Increase in Cost of Benefit. If the cost of a Benefit option (other than a Component Plan which provides for the reimbursement of health or dependent care expenses) significantly increases during a Plan Year, all affected Participants may make a corresponding change in their Benefit election under the Plan. Changes that may be made include the following:
(1) In the case of a Benefit option which has experienced a significant decrease in cost, a Participant may make a prospective change to an election to commence participation in that Benefit option.
(2) In the case of a Benefit option what has experienced a significant increase in cost, a Participant may change an election to terminate such coverage and either, elect prospective coverage under another Benefit option providing similar coverage or drop coverage if no other Benefit option providing similar coverage is available.
For purposes of this Section 6.10(b), a “cost of increase or decrease"” refers to an increase or decrease in the amount of the Salary Reductions contributed by a Participant under the Plan, whether that increase or decrease results from an action taken by the Employee (such as switching between full-time and part-time status) or from an action taken by the Employer (such as reducing the amount of Employer contributions for a class of Employees). (c) Dependent Care Flexible Spending Account. In the case of a Participant’s election to contribute under the Dependent Care Flexible Spending Account, a Participant’s prior election may be changed only if the cost change is imposed by a Dependent Care Provider who is not a relative of the employee.
6.11 Significant Change in Coverage of Component Plan Benefit.
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(a) Significant Curtailment Without Loss of Coverage, If a Participant or a Participant’s Spouse or Dependent experiences a “significant curtailment of coverage” under a Benefit option that is not a loss of coverage, including a significant increase in the deductible, copayment, or the out-of-pocket cost sharing limit under a Group Health Plan; the Participant may revoke his or her election for such coverage and prospectively elect to receive coverage under another Benefit option providing similar coverage. For purposes of this Section, “significant curtailment of coverage” under a Component Plan occurs only if there is an overall reduction in coverage provided under the Component Plan so as to constitute reduced coverage generally. In this regard, the loss of one particular physician in a health care provider network in most cases will not qualify for a significant curtailment of coverage under this Section. (b) Significant Curtailment With Loss of Coverage. If a Participant or a Participant’s Spouse or Dependent experiences a significant curtailment of coverage that is a “loss of coverage” under a Benefit option, the Participant may revoke his or her election for such coverage and elect either to receive coverage under another Benefit option providing similar coverage or to drop coverage if no other Benefit option providing similar coverage is available under the Plan. For this purpose, a “loss of coverage” means a complete loss of coverage under a Benefit option, including the elimination of a Benefit option, an HMO ceasing to be available in the area where the individual resides, or the individual losing all coverage under the Benefit option by reason of an overall lifetime or annual limitation under a Group Health Plan. In this regard, each of the following is considered to be a “loss of coverage” under this Section:
(1) a substantial decrease in the medical care providers available under the Benefit option (such as a major hospital ceasing to be a member of a preferred provider network or a substantial decrease in the physicians participating in a preferred provider network or an HMO;
(2) a reduction in the Benefits for a specific type of medical condition or treatment with respect to which a Participant or the Participant’s Spouse or Dependent is currently in a course of treatment; or
(3) any other similar fundamental loss of coverage.
(c) Addition or Improvement of Benefit Option. If during the Plan Year, a Component Plan adds a new Benefit package option or other coverage option, or if coverage under an existing Benefit option is significantly improved, any Participant or Employee, who is otherwise eligible to participate in the Plan, may revoke their election under the Plan for the Plan Year and make an election on a prospective basis for coverage under the new or improved Benefit option. (d) Change In Coverage Under Another Employer Plan. A Participant, or an Employee who is otherwise eligible to participate in the Plan but has elected not to participate, may make a prospective election change that is on account of and consistent with a change made under another Group Health Plan (including a plan of the Employer or another employer) by the Employee or the Employee’s Spouse or Dependent, provided the other employer plan allows participants to
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make an election change that would be permitted under the rules of IRS Reg. §1.125-4(c) and as provided in this Plan.
6.12 Qualified Medical Child Support Order. A Participant may make a change in coverage during a Plan Year to provide health coverage under the Plan for Participant’s Dependent pursuant to the terms of a judgement, decree, or order resulting from a family law proceeding, including a “qualified child support order” as defined under ERISA Section 609, requiring Participant to provide health coverage for the Dependent. The Participant may also make a change which cancels health coverage for the Participant’s Dependent provided the order requires the Spouse, former Spouse, or other individual to provide health coverage for the Dependent.
ARTICLE VII
EMPLOYER'S ALLOWANCESEMPLOYER ALLOWANCE
7.1 Core CoverageEmployer Allowance. The Employer shall contribute on behalf of each Participant, a in an amount Core Coverage an Employer Allowance in an amount to be determined each Plan Year by the Employer for each Employeeemployee group in accordance with the provisions set forth in Schedule “A”. Schedule “A” shall be updated or revised as required after such time the City Council has approved said Core Coverage Allowancesthe Employer Allowance authorized by the labor contracts or the memorandum of understanding with the identified labor associations or, the master list of Benefitsbenefits for the Management, Confidential and, Executive Employees, and Retirees established by resolution of the City Council. The Core CoverageEmployer Allowance shall be credited to each Participant as of the first day of each month in each Plan Year during which he or she is a Participant under the Plan and can only be used to purchase Core Coverage, unless the provisions of Section 7.l(c) apply. The Employer shall inform the Participant of the amount of the Core CoverageEmployer Allowance available for each Plan Year during the Open Enrollment Period. Notwithstanding the preceding, a Participant that satisfies the requirements for waiving the Core Coverage option pursuant to Section 6.3 shall receive the Core CoverageMedical Insurance Opt-Out Allowance set forth in Schedule “A” in lieu of the Core CoverageEmployer Allowance.
(a) Designated Employer Contribution. Unless the Participant satisfies the requirements for waiving the Core Coverage option pursuant to Section 6.3, a portion of the Core CoverageEmployer Allowance shall be designated as the Employer’s contribution towards health coverage under the Public Employees’ Medical and Hospital Care Act. The amount shall be determined pursuant to Section 22892 of the California Government Code in accordance with the Employer’s resolution filed with the California Public Employees’ Retirement System. (b) Amount of Allowance for Short Plan Year. In the event of a Short Plan Year of a Participant, the Core Coverage Allowance available to a Participant shall be prorated by the maximum available Core Coverage Allowance for the Plan Year divided by the number of whole months of eligible employment by the Participant, as determined by the Administrator. (cb) Unused Core CoverageEmployer Allowance. If a Participant elects Core Coverage
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having aggregate costs less than the Participant’s Core CoverageEmployer Allowance, the Medical Differenceremaining amount may be used to offset the cost of coverage under the City’s dental and/or vision planplans elected by the Participant. No Participant shall be entitled to the cash value of any unused Medical DifferenceEmployer Allowance.
(dc) Special Rule Regarding Core CoverageMedical Insurance Opt-Out. In the event a Participant elects to waive coverage under the Employer’s Health Benefit Plan in accordance with Section 6.3, he or she shall receive the Core CoverageMedical Insurance Opt-Out Allowance determined on the basis of such Participant'sParticipant’s employee bargaining group, as set forth on Schedule “A” and the enrollment form and Salary Reduction Agreement. The Participant shall receive the Core CoverageMedical Insurance Opt-Out Allowance as taxable cash. The Core CoverageMedical Insurance Opt-Out Allowance shall be paid by the Employer in twenty-four (24) equal installments payable during the first two payroll dates of each month during the Plan Year.
7.2 Nature of Core CoverageEmployer Allowance. No money shall actually be allocated to any account(s) on behalf of Participants. Core CoverageThe Employer Allowance credited to a Participant shall be of a memorandum nature, the amount of which is maintained by the Administrator for accounting purposes and shall not be representative of any identifiable trust assets.
ARTICLE VIII
FUNDING AND AVAILABLE BENEFITS
8.1 Funding. The Benefits provided herein shall be paid by the Employer; provided, however, that the Employer’s payments under the Plan shall be limited to such amounts of Compensation as a Participant elects to forego pursuant to his or her Salary Reduction Agreement and Core Coveragethe Employer Allowance, or if the Participant satisfies the requirements for waiving the Core Coverage option pursuant to Section 6.3, the Core CoverageMedical Insurance Opt-Out Allowance.
8.2 Payment of Contributions While on an Unpaid Leave of Absence. Upon If a Participant takingtakes an unpaid Leave of Absence either, whether protected or unprotected, each healthcontinuation of coverage under any health Benefit elected by the Participant-shall continue during the Leave of Absence for a period not longer than the authorized Leave of Absence period as determined by the Administrator, unless otherwise revoked by the Participant. During the unpaid Leave of Absence, the Participant shall be responsible for making the Participant's required contributions, if any, for such Health Benefits during the period of the Leave of Absence on an after-tax basis as due. Payments shall be made on the same schedule as payments would have been due if the Participant had not been on Leave of Absence. Participant’s failure to pay the required contribution in the time line prescribed will result in cancellation of the health Benefit.Participant shall be subject to the terms and conditions of the applicable Health Benefit Plan, the Participant’s continued eligibility for coverage, the rules of the CalPERS Health Benefits Program under the Public Employees’ Medical and Hospital Care Act (“PEMHCA”), if applicable, and applicable federal, state, and local law.
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To the extent a Participant remains eligible for coverage during an unpaid Leave of Absence, the Participant may be required to make payments directly to the applicable Health Benefit plan or carrier in accordance with the procedures established by the Administrator, CalPERS, or the applicable Health Benefit plan. For Participants enrolled in a PEMHCA plan, such payments may include the full applicable monthly premium under the CalPERS Direct Payment process, rather than only the Participant’s normal employee contribution, as provided under the applicable CalPERS rules and the Employer’s applicable policies.
Any employee contribution that is required to be made through this Plan on an after-tax basis during an unpaid Leave of Absence shall be administered in accordance with applicable federal tax law. No pre-tax salary reduction shall be made under this Plan from compensation that is not otherwise available to the Participant.
If coverage is not continued through the CalPERS Direct Payment process or other applicable continuation arrangement, or if the Participant otherwise experiences a loss of coverage that gives rise to a right to continuation coverage under COBRA or other applicable law, continuation coverage shall be offered and administered in accordance with the applicable COBRA requirements, the applicable CalPERS procedures, and the terms of the applicable Health Benefit plan. COBRA continuation coverage shall be subject to the applicable COBRA premium, election, payment, notice, and termination requirements.
Failure to make any required payment for continued coverage may result in termination of coverage in accordance with the terms of the applicable Health Benefit plan, CalPERS procedures, COBRA requirements, and other applicable law, including any applicable notice and grace-period requirements. The Administrator shall not terminate coverage solely by reason of a missed payment except in accordance with those applicable requirements.
Nothing in this provision shall be construed to require the Employer to continue making an employer contribution toward a Participant’s Health Benefits during an unpaid Leave of Absence unless such contribution is required by applicable law, the applicable CalPERS contract or resolution, the applicable Health Benefit plan, collective bargaining agreement, personnel policy, or other governing Employer policy.
Nothing in this provision shall limit any rights or obligations applicable to a Participant on FMLA, CFRA, pregnancy disability leave, military leave, or any other legally protected leave.
8.3 Uniformed Service Under USERRA. In accordance with the Uniformed Services Employment and Reemployment Rights Act of 1991(“USERR.A”), a Participant who is absent from employment with the Employer on account of being in the Uniformed Services as defined in Section 3.32, may elect to continue participation in the Plan. The coverage period shall extend for the lesser of eighteen (18) months or until the Participant fails to apply for reinstatement or to return to employment with the Employer. The Participant shall be responsible for making the required contributions to pay for Benefits elected during the period during which he or she is in Uniformed Service. The manner in which such payments are made shall be determined by the Administrator, in a manner similar to the payment of contributions with respect to a Leave of Absence.
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8.4 Provision of Benefits. The Employer shall provide those Benefits elected by a Participant on his or her election form for any Period of Coverage in accordance with such election. The Benefits shall be provided pursuant to the terms and conditions of the Component Plans, where applicable, as shall be set forth from time to time in the individual Component Plan documents; provided, however, that the terms and conditions of the Component Plans are not inconsistent with the terms and-conditions of this Plan. No Benefit under the Plan shall be paid in any manner that defers the receipt of Compensation beyond the last day of the Plan Year except as specifically provided in Sections 10.8 with respect to the grace period for reimbursement of Eligible Dependent Care Expenses and Section 9.8 with respect to the Grace Period for reimbursement of Eligible Dependent Care Expenses and Section 10.8 with respect to the carryover provisions for the reimbursement of Eligible Medical Care Expenses.
8.5 Cash Payments. Any cash to be paid to a Participant resulting from the Core CoverageMedical Insurance Opt-Out Allowance shall be added to his or her taxable Compensation and shall be paid in twenty-four (24) equal installments payable during the first two payroll dates of each month during the Plan Year, subject to any applicable wage withholding or similar taxes.
No Benefit under the Plan shall be paid in any manner that defers the receipt of Compensation beyond the last day of the Plan Year.·
8.6 Flexible Spending Accounts. The amounts designated by the Participant to be applied for health care reimbursement or dependent care assistance shall be credited to a separate ledger account in the Participant’s name. Any amounts credited to a Participant’s health flexible spending account for any Plan Year shall be used only toward the payment of or reimbursement for Participant’s Eligible Medical Care Expenses, as that term is defined in Section 10.2(a) below, incurred for such Plan Year, as determined under Article X. Likewise any amounts credited to a Participant’s dependent care flexible spending account for any Plan Year shall be used only toward the payment of or reimbursement for Participant’s Eligible Dependent Care Expenses, as that term is defined in Section 9.2(d) below, incurred for such Plan Year, as determined under Article IX.
8.7 Taxable Benefits. If offered by the Employer, Employees shall be permitted to elect to receive certain permitted taxable benefits. An Employee receiving such benefits shall be treated as having received, at the time that the Benefit is received, cash compensation equal to the full value of the Benefits and then subsequently purchasing the Benefits with after-tax Employee contributions. For example, the Employer may allow Participants to elect health coverage under the Employer’s Health Benefit Plan for an individual who is not the Spouse or Dependent of the Participant; provided, however, that the fair market value of such health coverage is included in the Participant’s W-2 taxable income.
ARTICLE IX
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT
9.1 Component Plan. This Article IX shall setsets forth the provisions forof the CITY OF CORONA DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT PLAN ("“Dependent Care Flexible Spending Account" or “Dependent Care FSA”). Benefits under the Dependent Care
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Flexible Spending Account shall take the form of reimbursement by the Employer for Eligible Dependent Care Expenses incurred by a Participant during the Plan Year. A Participant shall only be entitled toFSA shall be provided through reimbursement of Eligible Dependent Care Expenses incurred after electing to participate inby a Participant during the Participant’s Period of Coverage, subject to the requirements and limitations of Code Sections 125 and 129 and the regulations and guidance thereunder. A Participant shall be entitled to reimbursement only for Eligible Dependent Care Expenses incurred during the period in which the Participant is covered under the Dependent Care Flexible Spending AccountFSA, including any applicable Grace Period.
9.2 Definitions. For purposes of this Article IX, the following words and phrases are intended to supplement, and in some instances replace, the defined terms listed generally in Article III and todefinitions shall supplement the definitions contained elsewhere in the Plan. To the extent of any conflict between the terms set forth herein and those of Article III, the defined terms set forth herein shall control:, the definitions in this IX shall control with respect to the Dependent Care FSA; provided, however, that applicable provisions of the Code and Treasury Regulations shall control to the extent required by law.
(a) Qualifying Day Care Center. “Qualifying Day Care Center”" means a day care center which provides full-time or part-time means facility that satisfies the requirements of Code Section 21(b)(2)(D), including a facility that provides care for more than six individuals (other than individuals who reside at the day care centerfacility) on a regular basis during the Eligible Employee's taxable year, and which:
(1) that complies with applicable laws and regulations of the stateor local jurisdiction in which it is located and complies with all applicable laws and regulations of the state and town, city, or village in which it is located; and
(2) receives a fee, payment or grant for services for any of the individuals to whom it provides services (regardless ofproviding such care, whether such facility isor not operated for a profit).
(b) Qualifying Individual. “Qualifying Individual’" means a Dependent of the Participant, as defined in Code Section 152(a)(1), who is under the age of 13. "Qualifying Individual" shall also mean a Dependent or Spouse of the Participant who is physically or mentally incapable of caring for himself or herself and who has the same principal place of residence as the Participant for more than one-half of the Plan Year, provided such individual regularly spends at least eight hours a day in the Participant's home during such period. means an individual who satisfies the requirements of Code Sections 21(b)(1) and 129, as applicable, including:
(1) a Qualifying Child who is under age 13 when the Eligible Dependent Care Expense is incurred; or
(2) a Spouse or other individual who is physically or mentally incapable of caring for himself or herself and who satisfies the applicable residence and dependency requirements under Code Section 21(b)(1).
For purposes of determining whether an individual is a Qualifying Individual, the applicable
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requirements of the Code and Treasury Regulations shall apply. (c) Qualifying Dependent Care Services. “Qualifying Dependent Care Services”" or " " means” means employment-related dependent care services described in Code Sections 21(b)(2) and 129, including services performed to enable a Participant or his or her Spouse to remain gainfully employed and which are relevant to the care of a Qualifying Individual. Qualifying Services may be performed either in the home or outside the home of the Participant. Such an expense shall be an Eligible Dependent Care Expense only if it is payable to a person who is not (1) a Dependent of the Participant; (2) the Participant's Spouse; or (3) a child of the Participant under the age of 19 as of the close of the Plan Year in which the services are rendered.in or outside the Participant’s home, that are incurred for the purpose of enabling the Participant and, if married, the Participant’s Spouse to be gainfully employed or to actively seek employment, subject to the requirements of applicable law.
An expense shall not be an Eligible Dependent Care Expense if the expense is paid to:
(1) the Participant’s Spouse;
(2) a person whom the Participant is entitled to claim as a dependent for federal income tax purposes;
(3) the Participant’s child who is under age 19 as of the close of the taxable year; or
(4) the parent of the Participant’s Qualifying Child if the Qualifying Child is under age 13.
(d) Eligible Dependent Care Expense. “Eligible Dependent Care Expense”" means substantiated expenses incurred by the Participant during the Plan Year or Grace Period described in Section 9.8 means an expense for Qualifying Dependent Care Services or for the cost of sending a Qualifying Individual of the Participant to a Qualifying Day Care Center. Expenses relating to nonrefundable fees charged by a Qualified Day Care Center shall not be eligible for reimbursement unless day care services directly related to the fee are provided. that satisfies the requirements of Code Sections 21 and 129 and the applicable Treasury Regulations and that is incurred during the Participant’s Period of Coverage or applicable Grace Period. An expense is incurred when the Qualifying Dependent Care Services giving rise to the expense are provided, regardless of when the Participant is billed for or pays the expense.
Expenses for nonrefundable registration, enrollment, or similar fees shall be eligible only to the extent permitted under applicable law and the fees are allocable to Eligible Dependent Care Expenses. No expense shall be eligible to the extent it is attributable to education, meals, transportation, lodging, entertainment, or other services that do not constitute employment-related dependent care under applicable law.
9.3 Annual Election. For each Plan Year, a Participant shall affirmatively specify the annual election amount to be allocated to the Participant’s Dependent Care Flexible Spending Account.
The maximum annual amount which may be allocated by a Participant may not exceed the least of the following: an eligible Employee who elects to participate in the Dependent Care FSA shall affirmatively elect the amount of Compensation to be contributed through a Salary Reduction for
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that Plan Year, subject to the applicable annual limit established by the Plan and the limitations by Code Section 129.
(a) $5,000 (or $2,500 in the case of a married Participant filing a federal income tax return separate from his or her Spouse);
The maximum amount that may be elected for a Plan Year shall not exceed the lesser of:
(a) the annual amount permitted under Code Section 129(a)(2), as amended from time to time, subject to any lower maximum established by the Plan; (b) If the Participant’s earned income for the taxable year, if Participant is unmarried at the close of the Plan Year, his or her Compensation for such Plan Yeartaxable year; or (c) Ifthe lesser of the Participant’s earned income or the Partcipant’s Spouse’s earned income for the taxable year, if the Participant is married at the close of a Plan Year, his or her Compensation for such Plan Year. Notwithstanding the above, the maximum election amount must also be reduced by the amount of any tax-exempt dependent care assistance benefits received by the Participant or his or her Spouse from any other employer during the Plan Year.the taxable year.
For purposes of this Section 9.3, "Compensation" means all earnings of a Participant reportable on Form W-2 for the Plan Year but does not include any amounts received from a dependent care assistance plan, any pension or annuity, or as unemployment or worker's compensation in accordance with Section 129(e)(2) of the Code.
The applicable earned-income limitation shall be determined in accordance with Code Section 129 and the applicable Treasury Regulations. If the Participant’s Spouse is a full-time student or is physically or mentally incapable of caring for himself or herself, the Spouse’s earned income shall be determined in accordance with the special rule provided under Code Sections 21(d) and 129.
The maximum amount available under this Section shall be reduced, as required by Code Section 129, by dependent care assistance provided to the Participant or the Participant’s Spouse under any other dependent care assistance program or arrangement that is required to be taken into account for purposes of Code Section 129
For purposes of calculating the maximum annual benefit for a Plan Year, Compensation shall be the lesser of the Participant's Compensation determined under the preceding paragraph or the Participant's Spouse's Compensation, if the Participant is married at the close of the Plan Year.
If during any taxable month the Participant's Spouse is a Student or is physically or mentally incapacitated, the Spouse’s Compensation for such month shall be deemed to be $200 if there is one Qualifying Individual for whom the Participant incurs Eligible Dependent Care Expenses during the Plan Year, or $400 if there are two or more Qualifying Individuals, in accordance with Section 21(d) of the Code.
9.4 Dependent Care Flexible Spending Account. The Dependent Care FSA shall be maintained as an unfunded bookkeeping account established for each Participant in accordance with the Participant’s annual election. The account shall be credited with amounts contributed through Salary Reduction and debited for reimbursements of Eligible Dependent Care Expenses.
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9.4 Flexible Spending Account. The sole source for payment of Dependent Care Benefits under this Article IX shall be the unfunded accounts established for each Participant pursuant to his or her annual election under Section 6.1. The Administrator shall reimburse each Participant for Eligible Dependent Care Expenses and the Participant’s Dependent Care Flexible Spending Account shall be debited accordingly. The aggregate reimbursements made at any time during the Plan Year shall not exceed the Participant's total contributions to the Dependent Care Flexible Spending Account for the Plan Year.
Because the uniform coverage rule applicable to health flexible spending arrangements does not apply to dependent care assistance programs, reimbursement of Eligible Dependent Care Expenses shall be limited to the Participant’s unused account balance attributable to contributions actually made and available for reimbursement at the time the claim is approved, subject to the applicable Grace Period and other provisions of this Article IX
9.5 Reimbursement of Eligible Expenses. A Participant shall be entitled to reimbursement of Eligible Dependent Care Expenses in an amount that does not exceed the balance of his or her Dependent Care Flexible Spending Account. An expense in excess of the account balance shall not be reimbursed. Reimbursement shall be provided to any individual only for Eligible Dependent Care Expenses incurred while that individual is a Participant; however, such reimbursement may be made after such participation ceases. that have been incurred and properly substantiated in accordance with the Plan’s claims procedures.
9.5 An Eligible Dependent Care Expense shall be considered incurred when the servicesQualifying Dependent Care Services giving rise to suchthe expense are provided, irrespective regardless of when such expenses are billed to the Participant. Reimbursement shall not be made for any amount that does not qualify as an Eligible Dependent Care Expense is billed for or pays the expense.
9.6 Limitations on Reimbursement/Forfeiture. The Employer's payment of Dependent Care Benefits for any Plan Year will be limited to the lesser of (1) the Participant's Eligible Dependent Care Expenses for the Plan Year, or (2) the amount of the Participant's election for Dependent Care Benefits for the year. A Participant shall receive no reimbursement for Dependent Care Benefits which are elected but unused during a Plan Year, for any reason. Any balance remaining in the Participant's Dependent Care Flexible Spending Account after all Eligible Dependent Care Expenses have been paid shall be forfeited by the Participant and the account balance reduced to zero at the end of the Grace Period described in Section 9.8. No amounts shall be reimbursed by the Administrator until after the expense has been properly substantiated in accordance with Section 9. 7.
Reimbursement may be made after a Participant’s cessation of participation to the extent the expense was incurred while the Participant was covered under the Dependent Care FSA and the claim is otherwise timely and properly submitted under the Plan.
9.6 Limitations on Reimbursement and Forfeiture. The total amount reimbursed to a
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Participant for any Plan Year and appliable Grace Period shall not exceed the amount of Eligible Dependent Care Expenses incurred during the applicable period and the amount available in the Participant’s Dependent Care FSA for reimbursement.
Amounts elected but not used for Eligible Dependent Care Expenses within the applicable Plan Year and Grace Period shall be forfeited, subject to any rights expressly provided under applicable law or the Plan’s claims and forfeiture provisions.
No reimbursement shall be made unless the expense has been properly substantiated in accordance with the Plan’s claims procedures.
9.7 ClaimClaims for Benefits. EachA Participant who desires to receiveseeking reimbursement under the Plan for Eligible Dependent Care ExpensesFSA shall submit a claim to the Administrator or theits designated claims representative within the time period described in Section 9.8, a form provided by the Employer, or responses to other supplementary factual requests, containing the following information: administrator in the form and within the time prescribed by the Administrator. The Administrator may require such information and documentation as is reasonably necessary to determine whether an expense is an Eligible Dependent Care Expense and to satisfy the substantiation requirements of Code Section 125 and 129.
Such information or documentation may include, as applicable:
(a) the name, age, and relationship to the Participant and identifying information of the Qualifying Individual for whom the Eligible Dependent Care Expenses wereexpense was incurred; (b) if any ofthe dates and nature the Qualifying Dependent Care Services were performed outside the Participant's home for a Qualifying Individual incapable of caring for himself, a statement as to whether said Qualifying Individual regularly spends at least eight (8) hours a day in the Participant's home;
(c) if any of the Qualifying Dependent Care Services are performed for a Qualifying Individual who is physically or mentally incapable of caring for himself, a statement to that effect;the name, address, and taxpayer identification number of the care provider, except to the extent not required by appliable law for a tax-exempt provider; (d) the nature and dates of performance of the Qualifying Dependent Care Services subject to reimbursements amount of the expense and evidence that the expense has been incurred; (e) the relationship, if any, tobetween the Participant of the person(s) providing the Qualifying Dependent Care Services. and the care provider; (f) a statement indicating that the Participant will include on his or her federal income tax return the name, address, and (except in the case of a tax-exempt Qualifying Day Care Center) the taxpayer identification number of the provider of the Qualifying Dependent Care Services.information necessary to establish that the expense was incurred to enable the Participant
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and, if applicable, the Participant’s Spouse to be gainfully employed or to actively seek employment;
(g) if the Participant is married and his or her Spouse is employed, a statement of the Spouse's Compensation; or if the Spouse is not employed, a statement that the Spouse is incapacitated or the Spouse is a Student, indicating the months of the year during which the Spouse attends an Educational Institution on a full-time basis.information concerning the Participant’s and, if applicable, Participant’s Spouse’s earned income and any applicable Student or incapacity status; and.
(h) a statement as to the amount, if any, of tax-exemptinformation concerning dependent care assistance benefits receive from any other employer by the Participant or his or her Spouse during the Plan Year; andreceived under any other plan or arrangement, to the extent necessary to administer the Plan in accordance with Code Section 129. (i) evidence of indebtedness or payment by the Participant to the third party who performed the Qualifying Services.
(j) As soon as administratively feasible following the end of each month, the Administrator shall review all the forms submitted by Participants during that month in accordance with the foregoing procedures and shall pay each Participant the Dependent Care Benefits which each Participant is entitled to receive, in accordance with this Article IX.
The Administrator may rely upon information and documentation submitted by the Participant, subject to applicable substantiation requirements. The Administrator shall process properly submitted claims in accordance with the Plan’s claims procedures.
9.8 Time Limit; Grace Period. No expenses shall be reimbursed for any Plan Year unless the Participant applies for such reimbursement within three (3) months after the end of such Plan Year.
However, any Participant who has unreimbursed contributions remaining in his or her Dependent Care Flexible Spending Account at the end of the Plan Year may submit claims for reimbursement ofClaims for Eligible Dependent Care Expenses incurred during Plan year must be submitted within the run-out period that begins established by the Administrator following the end of the Plan Year.
9.8 During the Grace Period") under the following conditions:
(a) , amounts remaining from the immediately preceding Plan Year may Applicability. In order for a Participant to be reimbursed forbe used to reimburse Eligible Dependent Care Expenses incurred during athe Grace Period from amounts remaining in his or her Dependent Care Flexible Spending Account at the end of the Plan Year to which that . (a) Applicability. The Grace Period relates, he or she must be ashall apply uniformly to Participants in accordance with applicable Treasury Regulations. A Participant withwho was covered by the Dependent Care Flexible Spending Account coverage that is in effectFSA on the last day of thatthe Plan Year shall be eligible to use any applicable prior Plan Year balance for
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Eligible Dependent Care Expenses incurring during the Grace Period, subject to the terms of the Plan.
(b) No Cash-Out or Conversion. PriorAmounts remaining from a prior Plan Year Dependent Care Flexible Spending Account amounts may not be cashed out or converted to any otheranother taxable or nontaxable benefit. For example, prior Plan Yearbenefit and may be used only for reimbursement of Eligible Dependent Care Expenses. Dependent Care Flexible Spending Account amounts may not be used to reimburse Eligible Medical Care Expenses. (c) Order of Reimbursement of Grace Period Expenses. Eligible Dependent Care Expenses incurred during athe Grace Period and approved for reimbursement in accordance with the Plan’s claims procedure for the Dependent Care Flexible Spending Account willshall be reimbursed and charged first againstfrom any available Priorprior Plan Year Dependent Care Flexible Spending Account amountsbalance and then against any, to the extent permitted by the Plan and applicable law, from amounts that are available to reimburse expenses that are incurred duringfor the current Plan Year. All claims for reimbursement under the Dependent Care Flexible Spending Account will be paid in the order in which they are approved. The Administrator may establish reasonable administrative procedures governing the order and processing of claims. (d) Run-Out Period and Forfeitures. Claims for expenses incurred during the Grace Period must be submitted for reimbursement within three (3) months after the end of the Plan Year. Any prior Plan Year Dependent Care Flexible Spending Account amounts that remain after all reimbursements have been made for the Plan Year and its related Grace Period shall not be carried over to reimburse the Participant for expenses incurred after the Grace Period ends. The Participant will forfeit all rights with respect to such balance at the end of the Grace Period.Forfeiture. Any amount remaining after the expiration of the applicable Grade Period and completion of the applicable run-out period shall be forfeited in accordance with the Plan and applicable law.
9.9 No Reversion to Employer. At no time shall any part of Plan assets be used for, or diverted to, purposes other than for the exclusive benefit of Participants or their beneficiaries, or for defraying reasonable expenses of administering the Plan.
9.9 Forfeitures and Plan Administration. Forfeited amounts shall be treated and applied in accordance with the general forfeiture provisions of the Plan and applicable Treasury Regulations.
Nothing in this Article IX shall be construed to require forfeited amounts to be distributed to Participants or to prohibit the use of forfeited amounts for purposes permitted under applicable law.
9.10 Reimbursement of Eligible Expenses. A Participant shall only be entitled to reimbursement of substantiated Eligible Dependent Care Expenses incurred during the Plan Year. An Eligible Dependent Care Expense shall be considered incurred when the services giving rise to such expense are provided, irrespective of when Participant is formally billed or pays for such expenses.
The amount of reimbursement received by a Participant shall at no time exceed the balance of his or her Dependent Care Flexible Spending Account. An expense in excess of the account balance shall not be reimbursed. An expense must be incurred during the Plan Year or the Grace Period to
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be eligible for reimbursement; however, such reimbursement may be made after the Participant's cessation of participation or after the Plan Year as provided in Section 9.8.
9.10 Coordination with Applicable Law. The Dependent Care FSA shall be administered in accordance with Code Sections 125 and 129, the applicable Treasury Regulations, and applicable IRS guidance. If a provision of this Article IX is inconsistent with a mandatory requirement of applicable law, the provision shall be administered to the extent necessary to comply with such requirement, and the Plan shall be interpreted and, if necessary, amended accordingly Nothing in this Article IX shall be construed to permit reimbursement of any expense unless the expense constitutes an Eligible Dependent Care Expense under this Plan and satisfies the requirements of Code Sections 125 and 129 and the applicable Treasury Regulations. To the extent any provision of this Article IX is inconsistent with a mandatory requirement of applicable federal tax law, this Article IX shall be administered in a manner consistent with such requirement.
ARTICLE X
HEALTH CARE FLEXIBLE SPENDING ACCOUNT
10.1 10.1 Component Plan. This Article X shall setsets forth the provisions for the CITY OF CORONA HEALTH CARE FLEXIBLE SPENDING ACCOUNT PLAN (the “Health Care Flexible Spending Account” or “Health Care FSA”). Benefits under the Health Flexible Spending Account shall take the form of reimbursement by the Employer for Eligible Medical Care Expenses incurred by a Participant during the Plan Year. A Participant shall only be entitled toCare FSA shall be provided through reimbursement of Eligible Medical Care Expenses incurred after electing to participate in the Health Flexible Spending Account.by a Participant or an individual whose expenses are eligible for reimbursement under this Article X during the Participant’s Period of Coverage. A Participant shall be entitled to reimbursement only for Eligible Medical Care Expenses incurred during the Participant’s Period of Coverage, subject to the applicable provisions of this Article X.
10.2 10.2 Definitions. For purposes of this Article X, the following words and phrases are intended to supplement, and in some instances replace, the defined terms listed generally in Article III and todefinitions shall supplement the definitions contained elsewhere in the Plan. To the extent of any conflict between the terms set forth herein and those of Article III, the defined terms set forth herein shall control:, the definitions in this Article X shall control with respect to the Health Care FSA; provided, however, that applicable provisions of the Internal Revenue Code and Treasury Regulations shall control to the extent required by law. (a) (a) Eligible Medical Care Expense. “Eligible Medical Care Expense”" means substantiated expenses submitted by the Participant means an expense incurred for medical care as defined in Code Section 213(d), as amended, and the applicable Treasury Regulations, that is eligible for reimbursement of medical, vision and/or dental services incurred by the Participant, or the Participant's Spouse or Dependents during the Plan Year. under a health flexible spending arrangement and is properly substantiated in accordance with the Plan and applicable law.
Eligible Medical Care Expense shall also include amounts paid for prescription and over-the- counter drugs and medicines, and such other expenses which are not
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covered by insurance and which are permitted to be reimbursed under a health flexible spending account pursuant to Section 213(d) of the Code, as amended, or as authorized by the IRS from time to timeExpenses may include, to the extent permitted under Code Section 213(d) and applicable guidance, expenses for medical, dental, and vision care, prescription drugs, over-thecounter medicines and drugs, and other eligible medical care expenses not otherwise reimbursed or reimbursable under insurance or another plan or arrangement. Eligible Medical Care Expense doesExpenses shall not include premiums paid onfor accident or health insurance or premiums onfor qualified long-term care insurance, whether or not such insurance is made available by the Employerexcept to the extent otherwise permitted by applicable law.
An expense shall not constitute an Eligible Medical Care Expense to the extent that it is reimbursed or reimbursable under any other plan or arrangement, or to the extent the expense is otherwise ineligible under applicable law. (b) (b) Dependent. “Dependent”" includes the Spouse or Dependent of a Participant means an individual who is a dependent as defined underin Code Section 152, determined without regard to Code Section 152(b)(1), (b)(2), or (d)(l1)(B), as required by Code Section 105(b) and applicable Treasury Regulations.
10.3 Annual Election. For each Plan Year, a Participantan eligible Employee who elects to participate in the Health Care FSA shall affirmatively specify the annual election amount to be allocated to the Participant’s Health Flexible Spending Accountelect the amount of Compensation to be contributed through Salary Reduction for that Plan Year.
The maximum amount that may be elected for a Plan Year shall not exceed the maximum salary reduction contribution permitted for a health flexible spending arrangement under Code Section 125(i), as amended from time to time, subject to any lower maximum established by the Plan or the Employer.
For Plan Years beginning in 2026, the maximum annual salary reduction election shall not exceed $3,400. Any amount permitted to be carried over from a prior Plan Year under Section 10.8 shall not count against the annual salary reduction election limit for the current Plan Year.
10.4 Health Care Flexible Spending Account. The sole source for payment of Medical Reimbursement Benefits under this Article X shall be the unfunded accounts; Uniform Availability of Benefits. The Health Care FSA shall be maintained as an unfunded bookkeeping account established for each Participant pursuant to his or herthe Participant’s annual election under Section 6.1. The Administrator shall reimburse each Participant for Eligible Medical Care Expenses and the Participant’s Health Flexible Spending Account shall be debited accordingly.
The aggregate reimbursements made at any time during the Plan Year shall not exceed the Participant's total contributions to the Health Flexible Spending Account for the Plan Year. A Participant’s Medical Reimbursement Benefits shall be uniformly available throughout the Plan Year.
The full amount of the Participant’s annual Health Care FSA election, reduced by amounts previously reimbursed for the applicable Period of Coverage, shall be available
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throughout the Participant’s Period of Coverage for reimbursement of Eligible Medical Care Expenses, without regard to the amount of Salary Reduction contributions actually made by the Participant at the time the expense is incurred.
Any amount carried over from a prior Plan Year pursuant to Section 10.8 shall be available in addition to the Participant’s annual election for the current Plan Year and shall be subject to the terms and limitations of the carryover provision.
10.5 Reimbursement of Eligible Expenses. A Participant shall be entitled to reimbursement of Eligible Medical Care Expenses in an amount that does not exceed his or her total contribution to the Health Flexible Spending Account for the Plan Year. Each payment hereunder shall be a charge to the Participant's Health Flexible Spending Account. An expense in excess of the account balance shall not be reimbursed. Reimbursement shall be provided to any individual only for Eligible Medical Care Expenses incurred while that individual is a Participant; however, such reimbursement may be made after such participation ceases. incurred during the Participant’s Period of Coverage, subject to the terms of this Article X and the Plan’s applicable claims and substantiation procedures.
An Eligible Medical Care Expense shall be considered incurred when the servicesmedical care or service giving rise to suchthe expense areis provided, irrespectiveregardless of when such expenses are billed to the Participant. Reimbursement shall not be made for any amount that does not qualify as an Eligible Medical Care Expense or exceeds the annual contribution is billed for or pays the expense.
Reimbursement shall not be made for an expense that has not been properly substantiated or that is not an Eligible Medical Care Expense. Reimbursement shall be made in accordance with the uniform coverage requirements applicable to health flexible spending arrangements.
A Participant may submit a claim for reimbursement after cessation of participation to the extent the expense was incurred during the Participant’s Period of Coverage and the claim is otherwise timely and properly submitted under the Plan.
10.6 Debit Card and Other Electronic Payment Procedures.
10.6 Limitations on Reimbursement/Forfeiture. The Employer's payment of Benefits from the Health Care Spending Account for any Plan Year will be limited to the lesser of (1) the Participant's Eligible Medical Care Expenses for the Plan Year (including the grace period described in Section
10.8), or (2) the amount of the Participant's annual election to the Health Flexible Spending Account. A Participant shall receive no reimbursement for amounts which are elected but unused during a Plan Year, for any reason. Any balance remaining in the Participant's Health Flexible Spending Account after all Eligible Medical Care Expenses have been paid shall be forfeited by the Participant and the account balance reduced to zero. No amounts shall be reimbursed by the Administrator until after the expense has been properly substantiated in accordance with Section
10.7. (a) Use of Debit Card. The Administrator may make available to Participants a health care flexible spending account debit card or other electronic payment method for the
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payment of Eligible Medical Care Expenses. Use of the debit card or other electronic payment method shall be subject to the terms and conditions established by the Administrator and its designated third-party administrator.
(b) Substantiation. The use of a debit card or other electronic payment method does not eliminate the requirement that each expense be substantiated in accordance with Code Section 125, applicable Treasury Regulations, and other applicable guidance. Transactions may be substantiated through an automated or electronic substantiation process when permitted by applicable law, including through merchant-level substantiation, electronic claims information, explanation-of-benefits information, or other documentation or data that satisfies applicable substantiation requirements.
(c) Additional Documentation. If a transaction cannot be automatically substantiated, the Participant may be required to provide additional documentation or information, including an itemized receipt, explanation of benefits, or other documentation sufficient to establish that the expense is an Eligible Medical Care Expense. (d) Improper or Unsubstantiated Transactions. If a debit card transaction is determined to be ineligible or remains unsubstantiated after reasonable efforts to obtain substantiation, the Administrator may take corrective action permitted under applicable law and the procedures of the third-party administrator, including requiring repayment of the improper payment, offsetting the amount against subsequently submitted Eligible Medical Care Expenses to the extent permitted by law, suspending the Participant’s use of the debit card, or taking other corrective action permitted under applicable law.
(e) Administrative Procedures. The Administrator may establish and periodically modify reasonable administrative procedures governing the use of debit cards, electronic payment methods, automated substantiation, claims submission, documentation, reimbursement, and correction of improper payments, provided that such procedures are consistent with the Plan and applicable law.
10.7 Claims for Benefitsand Substantiation Procedures.
(a) A Participant who pays an Eligible Medical Care Expense without using an approved debit card or other electronic payment method may submit a claim for reimbursement to the Administrator or its designated third-party administrator in the form and manner prescribed under the Plan or applicable administrative procedures of the designated third-party administrator. (b) Claims and payment-card transactions shall be substantiated in accordance with Code Section 125, applicable Treasury Regulations, and applicable administrative guidance.
The Administrator or its designated third-party administrator may require documentation reasonably necessary to establish the nature, date, and amount of the expense and that the expense constitutes an Eligible Medical Care Expense. No reimbursement shall be made unless the expense has been properly substantiated in accordance with applicable law. (c) The Administrator may engage or delegate to a qualified third-party administrator responsibility for receiving, reviewing, adjudicating, substantiating, and processing claims and payment-card transactions pursuant to an administrative services agreement or other
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arrangement. The Administrator and any designated third-party administrator shall administer claims in accordance with the terms of the Plan, applicable administrative procedures of the designated third-party administrator and applicable law. The retention of a third-party administrator shall not relieve the Employer or the Plan of any obligation imposed by applicable law.
(d) The Administrator or its designated third-party administrator shall provide claimants with any notices concerning denied claims and applicable claim review and appeal rights to the extent required by applicable law. The applicable claims and appeals procedures may be set forth in separate administrative materials or procedures maintained by the Administrator or its designated third-party administrator and applied consistently with the Plan and applicable law. (e) A Participant shall not be required to submit a separate claim for a transaction that has been properly paid through an approved debit card or other electronic payment method and has been properly substantiated through an automated or electronic substantiation process in accordance with applicable law. If additional substantiation is required, the Participant shall provide the requested substantiation within the time and in the manner prescribed by the Administrator or its designated third-party administrator.
10.8 Carryover; Run-Out Period; Forfeiture.
(a) To receive reimbursement for Eligible Medical Care Expenses, a Participant must submit a written claim for benefits to the Administrator or the designated claims representative at the times indicated in Section 10.8. Said claim shall include the following:
(a) Carryover. The Plan shall permit a Participant to carry over unused amounts remaining in the Participant’s Health Care FSA at the end of a Plan Year to the immediately following Plan Year, subject to the maximum amount permitted under applicable law. (1) the name of the person or persons on whose behalf Eligible Medical Care Expenses have been incurred;
For Plan Years beginning in 2026, the maximum amount that may be carried over from a Plan Year shall be $680, or such other amount as may be permitted under Code Section 125 and applicable guidance for the applicable Plan Year. The Employer may establish a lower carryover amount, provided that the limitation applies uniformly in accordance with applicable law.
(b) Determination of Carryover Amount. The amount eligible for carryover shall be determined after the end of the Plan Year and after giving effect to all Eligible Medical Care Expenses incurred during the Plan Year and properly submitted during the applicable run-out period. The amount eligible for carryover shall not exceed the applicable carryover limit. (2) a description of the nature and dates of service or expense so incurred; (3) a statement indicating that such expense or expenses have not otherwise been paid through insurance or reimbursed from any other source; and (4) a receipt or other evidence of indebtedness or payment by the Participant of the service or expense.
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(b) The Administrator will review the claim as soon as administratively feasible following the end of each month, and will advise the Participant of any reimbursement amounts to which he is entitled. If a Participant believes he has been incorrectly denied reimbursement or has not been advised of his or her Benefits under the Health Flexible Spending Account, he may submit a written request to the Administrator to provide either an explanation of how Eligible Medical Care Expenses are reimbursed or further information of his or her Benefits. The Administrator must respond to such a request within a reasonable time.
Additionally, the Administrator will provide to every claimant, who is denied a claim for reimbursement, a written notice stating in a format determined to be understood by the claimant:
(1) the specific reason or reasons for the denial; (2) specific reference to pertinent Plan provisions on which the denial is based; (3) a description of any additional material or information necessary for the claimant to perfect the claim; and (4) an explanation of the claim review procedure set forth in Paragraph (c) below,
(c) Within 60 days of receipt by a claimant of a notice denying a claim under Section
10.7(b), the claimant or his or her duly authorized representative may request in writing a full and fair review of the claim by the Administrator or by the Administrator which may be appointed by the Employer for that purpose. The Administrator may extend the 60-day period where the nature of the benefit involved or other attendant circumstances make such extension appropriate. In connection with such review, the claimant or his or her duly authorized representative may review pertinent documents and may submit issues and comments in writing. The Administrator shall make a decision promptly, and not later than 60 days after the Administrator's receipt of a request for review, unless special circumstances (such as the notice to hold a hearing, if the Administrator deems one necessary) require an extension of time for processing, in which case a decision shall be rendered as soon as possible, but not later than 120 days after receipt of a request for review.
The decision on review shall be in writing and shall include specific references for the decision, written in a manner calculated to be understood by the claimant, and specific references to the pertinent Plan provisions on which the decision is based. If the decision on review is not made within such period, the claim will be considered denied.
10.8 Time Limit Grace Period. No expenses shall be reimbursed for any Plan Year unless the Participant applies for such reimbursement within three (3) months after the end of such Plan Year.
However, any Participant who has unreimbursed contributions remaining in his or her Health Flexible Spending Account at the end of the Plan Year may submit claims for Eligible Medical Care Expenses incurred during the period that begins immediately following the close of that Plan Year and ends on the day that is two months plus fifteen (15) days following close of that Plan Year (''Grace Period") under the following conditions:
(a) Applicability. In order for a Participant to be reimbursed for Eligible Medical Care Expenses incurred during a Grace Period from amounts remaining in his or her health care spending account at the end of the Plan Year to which that Grace Period relates, he or she must be either (l) a Participant with Health Flexible Spending Account coverage that is in effect on the last day of that Plan Year; or (2) a Qualified Beneficiary who has COBRA coverage under the Health Flexible Spending Account on the last day of that Plan Year. (b) No Cash Out or Conversion. Prior Plan Year Health Flexible Spending Account amounts may not be cashed out or converted to any other taxable or nontaxable benefit. For example, prior Plan Year Health Flexible Spending Account amounts may not be used to reimburse Eligible Dependent Care Expenses.
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(c) Reimbursement of Grace Period Expenses.Use of Carryover Amounts.
Amounts carried over from a prior Plan Year may be used to reimburse Eligible Medical Care Expenses incurred during a Grace Period and approved for reimbursement in accordance with the Plan's claims procedure for the Health Flexible Spending Account will be reimbursed and charged first against any available Prior Plan Year Health Flexible Spending Account amounts and then against any amounts that are available to reimburse expenses that are incurred during the current Plan Year. All claims for reimbursement under the Health Flexible Spending Account will be paid in the order in which they are approved.the entire subsequent Plan Year, subject to the terms of the Plan. Carryover amounts shall not be cashed out or converted to any other taxable or nontaxable benefit and may be used only to pay or reimburse Eligible Medical Care Expenses. (d) Run-Out Period and Forfeitures. Claims. The Plan shall provide a run-out period following the end of each Plan Year during which Participants may submit claims for Eligible Medical Care Expenses incurred during the immediately preceding Plan Year. The runout period is solely a period for submitting and processing claims for expenses incurred during the Grace Period must be submitted for reimbursement within three (3) months after the end of the Plan Year. Any prior Plan Year Health Flexible Spending Account amounts that remain after all reimbursements have been made for thepreceding Plan Year and its relatedis not a Grace Period shal1 not be carried over to reimburse the Participant for expenses incurred after the Grace Period ends. The Participant will forfeit all rights with respect to such balance.. Expenses incurred during the run-out period shall not be reimbursable from the prior Plan Year’s Health Care FSA merely because the claim is submitted during the run-out period. (e) Order of Reimbursement. The Administrator may establish reasonable administrative procedures governing the order in which current Plan Year amounts and carryover amounts are applied to Eligible Medical Care Expenses, provided that such procedures are consistent with applicable law. The Administrator may, for administrative convenience, apply reimbursements for current Plan Year expenses first against amounts credited for the current Plan Year and thereafter against applicable carryover amounts. (f) Forfeiture. Any unused amount in a Participant’s Healthcare FSA remaining from a Plan Year after completion of the applicable run-out period that exceeds the amount permitted to be carried over under this Section shall be forfeited in accordance with the Plan and applicable law.
(g) No Grace Period. The Health Care FSA shall not provide a Grace Period for any Plan Year. The carryover provision in this Section is intended to replace, and shall be administered in lieu of, any Grace Period provision.
10.9 Continuation Upon Cessation of Participation. Upon termination of participation in the Health Care FSA, reimbursement of Eligible Medical Care Expenses shall be subject to the terms of the Plan and applicable law. Nothing in this Article shall be construed to provide a posttermination reimbursement period or continuation of coverage except to the extent expressly provided under the Plan or required or permitted under applicable law, including applicable COBRA requirements.
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To the extent a Participant or Qualified Beneficiary is entitled to COBRA continuation coverage with respect to the Health Care FSA, such continuation coverage shall be administered in accordance with applicable COBRA requirements and the procedures established by the Administrator or its designated third-party administrator.
10.10 Forfeitures and Plan Administration. Forfeited amounts under the Health Care FSA shall be treated and applied in accordance with the general forfeiture provisions of the Plan and applicable law. Such amounts may be used for purposes permitted under applicable law, including, to the extent permitted, defraying reasonable expenses of administering the Plan.
10.11 Compliance with Applicable Law. The Health Care FSA shall be administered in accordance with Code Sections 105, 125, and 213, the applicable Treasury Regulations, and applicable IRS guidance. If a provision of this Article X is inconsistent with a mandatory requirement of applicable federal tax law, the provision shall be administered in a manner consistent with such requirement, and the Plan shall be amended as necessary.
Nothing in this Article X shall be construed to permit reimbursement of an expense unless the expense constitutes an Eligible Medical Care Expense under this Plan and satisfies the requirements of applicable law.
10.9 No Reversion to Employer. At no time shall any part of Plan assets be used for, or diverted to, purposes other than for the exclusive benefit of Participants or their beneficiaries, or for defraying reasonable expenses of administering the Plan.
ARTICLE XI
CONTINUATION COVERAGE
11.1 In General. The following provisions shall apply to Benefits provided to eligible Employees and to their eligible Dependents under the Plan, but only to the extent that the Benefits selected pertain to health care coverageTo the extent required by applicable law, continuation coverage shall be available under the Plan with respect to Benefits providing medical, surgical, or hospital benefits and to plans providing ancillary medical coverage such as, dental, vision, or prescription drug benefits. This, or other health care coverage shall be continued pursuant to thethat are subject to federal continuation coverage provisions ofrequirements. Such continuation coverage shall be provided in accordance with applicable federal law, including COBRA, the Public Health and Safety Act ("PHSA"), pursuant to 42 U.S.C. § 300bb.Service Act, applicable Treasury regulations, PEMHCA, requirements of the California Public Employees’ Retirement System (“CalPERS”), and the terms and procedures of the applicable health plan.
11.2 Definitions. For purposes of this Article XI, the following words and phrases are intended to supplement, and in some instances replace, the defined terms listed generally in Article III and to the extent of any conflict between the terms set forth herein and those of Article III, the defined terms set forth herein shall control:
11.2 Qualified Beneficiaries and Qualifying Events. A “Qualified Beneficiary” and
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“Qualifying Event” shall have the meanings prescribed under applicable federal law and, to the extent applicable to coverage provided through CalPERS, PEMHCA and CalPERS requirements.
Subject to applicable law, Qualifying Events generally include the death of a covered Employee; termination of employment or reduction in hours resulting in loss of coverage; divorce or legal separation; the covered Employee’s entitlement to Medicare; and a Dependent child ceasing to qualify as a Dependent under the applicable health plan. A registered domestic partner shall be treated in accordance with PEMHCA, CalPERS, and applicable law (a) Dependent. "Dependent" means an individual who meets the definition of dependent under the participating Employer provided health plan covering the eligible Employee. For the purposes of any Health Flexible Spending Account, Dependents will also include individuals who are dependents within the meaning of Section 152(a) of the Code. No person shall be considered a Dependent of more than one Employee. If both an Employee and an Employee’s Spouse are employed by the Employer, Dependents may be covered by either Spouse, but not by both. (b) Election Period. "Election Period" means the sixty (60) day period during which a Qualified Beneficiary who would lose coverage as a result of a Qualifying Event may elect continuation coverage. This sixty (60) day period begins not later than the date of termination of coverage as a result of a Qualifying Event and ends not earlier than the sixty (60) days after the later of such date of termination of coverage or the receipt of notice of the right to elect continuation coverage under this Plan.
(c) Full-Time Student. "Full-Time Student" means a dependent child who is enrolled in, regularly attends and is recognized by the registrar of an accredited secondary school, college or university, institution for the training of registered nurses (R.N.), or any other accredited or licensed school for the minimum number of credit hours required by that institution in order to maintain full-time student status. For purposes of this definition, “college” or “university” means an accredited institution listed in the current publication of accredited institutions of higher education.
(d) Medicare. "Medicare" means the Health Insurance for the Aged and Disabled Act, Title XVIII of Public Law 89-97, Social Security, as amended. (e) Qualified Beneficiary. "Qualified Beneficiary" means an individual who, on the day before the Qualifying Event, is covered under this Plan as the covered Employee, the Spouse of the covered Employee or Dependent of the covered Employee. Qualified Beneficiary shall include a child who is born to (or placed for adoption with) a covered Employee during the coverage period. The term Qualified Beneficiary does not include an individual whose status as a covered Employee is attributable to a period in which such individual is a nonresident alien who received no earned income from the Employer which constituted income from sources within the United States (within the meaning of Code Section 91l(d)(2) and Section 86l(a)(3)). The term Qualified Beneficiary also does not include a covered Employee’s domestic partner regardless of whether such person was a covered Dependent under the Plan prior to the Qualifying Event. If an individual is not a Qualified Beneficiary pursuant to this paragraph, a spouse or dependent of such individual shall not be considered a Qualified Beneficiary by virtue of the relationship to such individual. (f) Qualifying Event. "Qualifying Event" means with respect to a covered Employee, any of the following events which, but for the continuation coverage under this provision, would result in the loss of coverage of a Qualified Beneficiary:
(1) the death of the covered Employee;
(2) the termination (except by reason of such covered Employee’s gross
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misconduct) or reduction in hours of the covered Employee’s employment; (3) the divorce or legal separation of the covered Employee from such covered Employee’s Spouse;
(4) the covered Employee becoming entitled to benefits under Title XVIII of the Social Security Act (Medicare);
(5) a Dependent child who ceases to be a Dependent child under the terms of this Plan;
(6) the Employer's filing for Chapter 11 reorganization as it would affect retiree coverage.
11.3 ContinuationElection and Type of Coverage. To the extent required by Section 11.1 above, a A Qualified Beneficiary who would otherwise lose health coverage under this Plan as a result of a Qualifying Event is entitledshall have the right to elect continuation coverage within the election period under this Plan. Coverage provided under this provision is on a contributory basis. No evidence of good health will be required.period prescribed by applicable law. Each Qualified Beneficiary shall have an independent right to elect continuation coverage to the extent required by applicable law. Continuation coverage shall be substantially identical to the coverage available to similarly situated active Participants, subject to applicable law and the terms of the applicable health plan.
Except as otherwise specified in an election, any election by a Qualified Beneficiary who is a covered Employee or spouse of the covered Employee will be deemed to include an election for continuation coverage under this provision on behalf of any other Qualified Beneficiary who would lose coverage by reason of a Qualifying Event.
If this Plan provides a choice among the types of coverage under this Plan, each Qualified Beneficiary is entitled to make a separate selection among such types of coverage (i.e., single, family, etc.).
11.4 Type of Coverage.
11.4 (a) Coverage Period. Continuation coverage under this provision is coverage which is identical to the coverage provided under this Plan to similarly situated beneficiaries under this Plan with respect to whom a Qualifying Event has not occurred as of the time coverage is being provided. If coverage under this Plan is modified for any group of similarly situated beneficiaries, the coverage shall also be modified in the same manner for all qualified beneficiaries under this Plan in connection with such group.shall be available for the period required by applicable law.
Subject to applicable law, the maximum period generally shall be eighteen (18) months following a termination of employment or reduction in hours resulting in loss of coverage, with applicable extensions, including the disability extension and extension following a second Qualifying Event.
For Qualifying Events other than termination of employment or reduction in hours, continuation coverage may be available for up to thirty-six (36) months. No provision of this Article shall be construed to limit any longer period of continuation coverage or other extension required under PEMHCA, CalPERS requirements, or applicable law
11.5 Premiums. Continuation coverage available to a Qualified Beneficiary under this provision shall apply only to the type and level of health coverage under the Plan that a Qualified Beneficiary was actually receiving on the day before the Qualifying Event. The Qualified Beneficiary may not change his or her election except as otherwise provided under Sections 6.5(d)
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and 6.7(d). shall be contributory. The Qualified Beneficiary shall be responsible for timely payment of the applicable premium, which shall not exceed the maximum amount permitted under applicable law. Premiums shall be paid to CalPERS, the applicable health plan, or another entity designated to administer continuation coverage, in accordance with applicable procedures and applicable law. The timing and manner of premium payments, including applicable rules concerning initial payments, grace periods, and insufficient or deficient payments, shall be administered in accordance with applicable law. Failure to make timely payment may result in termination of continuation coverage as permitted by applicable law. (b) Health Flexible Spending Account. Notwithstanding Section 11.4(a) above, an Employee that was participating in the Plan prior to the Qualifying Event may be eligible to elect continuation coverage under the Employee’s Health Flexible Spending Account, subject to the following:
11.6 Notice and Administration. Notices concerning continuation coverage, including notices of Qualifying Events, election notices, and notices concerning termination of continuation coverage, shall be provided in the manner and within the time periods required by applicable law.
The Administrator, CalPERS, the applicable health plan, or another designated administrator may establish and administer reasonable procedures for the administration of continuation coverage. (1) Unavailability of Continuation Coverage. Continuation coverage under a Health Flexible Spending Account shall not be offered if all of the following three conditions are satisfied:
11.7 Health Care Flexible Spending Account.
(i) Employer provides other health coverage options which are available to the Employee;
(a) General Rule. Notwithstanding any other provision of this Article XI, continuation coverage under the Health Care FSA shall be subject to the special rules applicable to health flexible spending arrangements under Code Section 4980B, the Treasury Regulations thereunder, and other applicable guidance. A Participant who experiences a Qualifying Event and who is otherwise a Qualified Beneficiary with respect to the Health Care Flexible Spending Account shall be offered continuation coverage to the extent required by applicable law. (ii) The maximum amount required under the Plan for a year of continuation coverage under this Article XI equals or exceeds the maximum benefit available under the Plan for the year; and
(iii) The contribution premium for the remainder of the Plan Year in which the Qualifying Event occurred will exceed the maximum benefit still available to the Participant under the Plan as of the date of the Qualifying Event. The determination of whether this condition has been satisfied will be made by the Administrator on a case by case basis at the time of the Qualifying Event.
(b) (2) LimitedAvailability of Continuation Coverage, In the event the Plan satisfies only the first two conditions set forth in subparagraph (1) above, the Employer shall. The Health Care FSA shall not be required to offer continuation coverage under the Health Flexible Spending Account for the remainder of the Plan Year for the year in which the Qualifying Event
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occurred.occurs if, as of the date of the Qualifying Event, the applicable conditions under Treasury Regulation § 54.4980B-2 are satisfied for the Health Care FSA to be excepted from the requirement to offer such continuation coverage. The Administrator shall determine the availability of continuation coverage in accordance with applicable law. (3) Full Continuation Coverage. If the Administrator finds that the Plan does not satisfy the first two conditions set forth in subparagraph (1) above, the Employer must offer continuation coverage under the Plan to the Employee for the duration of the coverage period required under Section 11.5.
11.5 Coverage Period. The coverage under this provision will extend for at least the period beginning on the date of a Qualifying Event and ending not earlier than the earliest of the following:
(a) Initial 18-Month Coverage Period. If the Qualifying Event is a termination of employment (other than for gross misconduct) or a reduction in employment hours of a covered Employee, the coverage period for the Employee and his or her dependents shall extend for eighteen (18) months after the date of the Qualifying Event; (b) Disability Extension. The initial eighteen (18) month coverage period described in (a) above may be extended to twenty-nine (29) months after the date of the Qualifying Event in the event the Qualified Beneficiary was disabled upon termination of employment or during the first sixty (60) days of continuation coverage. The Qualified Beneficiary must provide the Administrator with notice of a disability determination made by the California Public Employees' Retirement System within sixty (60) days of the disability determination and prior to the expiration of the initial eighteen (18) month continuation period provided in (a) above to become eligible for this extension of continuation coverage.
(c) ExtensionAmount of Coverage Period. The initial eighteen (18) month coverage period described in (a) above may be extended to thirty-six (36) months after the date of the Qualifying Event upon the occurrence of a second Qualifying Event prior to the expiration of the initial eighteen (18) month coverage period. TheAvailable. If continuation coverage is available and elected, the Qualified Beneficiary must notify the Administrator of the second Qualifying Event within sixty (60) days of the date of the second Qualifying Event and prior to the expiration of the initial eighteen (18) month period. In no event shallshall be entitled to receive reimbursement for Eligible Medical Care Expenses incurred during the period of continuation coverage extend for a period greater than thirty-six (36) months., subject to the terms and limitations of Article X and applicable law. The maximum amount of benefits available during the remainder of the Plan Year shall be determined in accordance with applicable law and shall take into account any unused amount carried over from the preceding Plan Year under Section 10.8, to the extent required by applicable law.
(d) Carryover Amounts. If the Plan permits a carryover of unused Health Care FSA amounts under Section 10.8, a Qualified Beneficiary who elects COBRA continuation coverage shall be permitted to use any carryover amount on the same terms and conditions applicable to similarly situated Participants, subject to applicable law. A carryover amount shall not be included in determining the applicable premium that may be charged for COBRA continuation coverage.
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(d) 36-Month Coverage Period. In the case of any Qualifying Event causing the loss of coverage, except those Qualifying Events identified in (a) above, the coverage period for the Employee and his or her Dependents shall extend for thirty-six (36) months after the date of the Qualifying Event.
11.6 Notification Requirements.
(a) Notification by Qualified Beneficiary. Each covered Employee or Qualified Beneficiary must notify the Employer of the occurrence of a divorce or legal separation of the covered Employee from such covered Employee's Spouse and/or the covered Employee's Dependent child ceasing to be a dependent child under the terms of this Plan within sixty (60) days after the date of such occurrence. This sixty (60) day time limit shall only apply to those occurrences as described in this paragraph which occur after the date of the enactment of the Tax Reform Act of 1986. (e) COBRA Premium. The premium for continuation coverage under the Health Care FSA shall be determined in accordance with applicable law and shall not exceed the maximum amount permitted under Code Section 4980B and the Treasury Regulations thereunder.
In determining the applicable premium, unused amounts carried over from a prior Plan Year shall not be included.
(b) Notification by Employer. The Employer shall notify the Administrator within thirty (30) days of a Qualifying Event, as required by federal law. (f) Duration. Continuation coverage under the Health Care FSA generally shall continue only through the end of the Plan Year in which the Qualifying Event occurs, except to the extent that applicable law requires or permits continued access to benefits, including through a permitted carryover of unused amounts or other applicable extension. Nothing in this Section shall require the Plan to permit a Qualified Beneficiary to make additional Salary Reduction contributions for a subsequent Plan Year or to receive the Employer Allowance for a subsequent Plan Year, except as otherwise required by applicable law. (c) Notification to Qualified Beneficiary.
(g) Coordination with Article X. The Health Care FSA shall be administered in accordance with Article X, including the Plan’s provisions concerning the annual election, uniform availability of benefits, eligible expenses, substantiation, claims, run-out period, carryover, and forfeiture, except to the extent that a different rule is required for COBRA continuation coverage under applicable law.
(1) The Administrator shall provide written notice to each covered Employee and Spouse of such covered Employee of his or her right to continuation coverage under this provision upon commencement of coverage under a Component Plan providing health coverage, as required by federal law.
(2) The Administrator shall notify any Qualified Beneficiary of the right to elect continuation coverage under this provision within fourteen (14) days of receiving notice of the occurrence of a Qualifying Event, as required by federal law. If the Qualifying Event is the divorce or legal separation of the covered Employee from the covered Employee’s Spouse or a Dependent child ceasing to be a dependent child under the terms of this Plan, the Employer shall only be
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required to notify a Qualified Beneficiary of his or her right to elect continuation coverage if the covered Employee or the Qualified Beneficiary notifies the Employer of such Qualifying Event within sixty (60) days after the date of such Qualifying Event.
Notification of the requirements of this provision to the Spouse of a covered Employee shall be treated as notification to all other Qualified Beneficiaries residing with such Spouse at the time notification is made.
11.7 Termination of Continuation Coverage. The continuation coverage provided hereunder shall be terminated prior to the expiration of the coverage periods provided in Section 11.5 above upon the earlier of the following:
(a) with respect to continuation coverage under a Health Flexible Spending Account, the last day of the Plan Year in which the Qualified Beneficiary experiences the Qualifying Event. (b) the date on which the Employer ceases to provide any Group Health Plan to any Employee;
(c) the date on which the Qualified Beneficiary fails to make timely payment of the required contribution pursuant to this provision provided the deficiency is not an "insignificant amount" as described in Section 11.8(d);
(d) the date on which the Qualified Beneficiary first becomes, after the date of the election, covered under any other Group Health Plan as an employee or dependent. However, if the other Group Health Plan has a preexisting condition limitation, continuation coverage under the Plan will not cease while such preexisting condition limitation under the Group Health Plan remains in effect (taking into account prior creditable coverage under the portability rules of the Health Insurance Portability and Accountability Act of 1996); or (e) the date on which the Qualified Beneficiary becomes entitled to benefits under Title XVIII of the Social Security Act (Medicare).
11.8 Contribution.
(a) A Qualified Beneficiary shall only be entitled to continuation coverage provided such Qualified Beneficiary pays the applicable premium required by the Employer in full and in advance, except as provided in (b) below. Such premium shall not exceed the requirements of applicable federal law. A Qualified Beneficiary may elect to pay such premium in installments as indicated by the Employer.
(b) Except as provided in (c) below, the payment of any premium shall be considered to be timely if made within thirty (30) days after the date due, or within such longer period of time as applies to or under this Plan.
(c) Notwithstanding (a) or (b) above, if an election is made after a Qualifying Event during the election period, this Plan will permit payment of the required premium for continuation coverage during the period preceding the election to be made within forty-five (45) days of the date of the election.
(d) A premium payment received by the Employer which is deficient by an insignificant amount shall be treated as full payment of the premium amount. For purposes of this Section, an insignificant amount is an amount not greater than the lesser of (i) ten percent (10%) of the required
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amount; or (ii) fifty dollars ($50.00). Alternatively, in the event an Employer receives an insufficient payment premium, the Employer retains the option of taking steps to collect the deficient insignificant amount by notifying the Qualified Beneficiary of the deficiency and allowing thirty (30) days after date of the notice for payment of the deficiency.
11.8 11.9 Coordination with PEMHCA and State Law. Continuation Coverage. In the event a Qualified Beneficiary is entitled to less than 36 months of federal continuation coverage as a result of a Qualifying Event, the Qualified Beneficiary will be notified prior to the expiration of federal continuation coverage if he or she is eligible to elect an extension of continuation coverage under the Plan for an additional period of up to 36 months from the date of the Qualifying Event pursuant to the Section 1366.20 et. seq. of the California Health and Safety Code (the "California Continuation Benefits Replacement Act" or "Cal-COBRA Program").coverage provided through CalPERS shall be administered in accordance with PEMHCA, CalPERS requirements, the applicable health plan documents, and applicable federal and state law. Any additional continuation coverage or extension of coverage required or made available under PEMHCA, CalPERS requirements, or applicable state law shall be provided in accordance with the applicable requirements and procedures.
A covered Employee's Dependent who, (1) on the day before the Qualifying Event, is covered under this Plan as the registered domestic partner of the covered Employee and (2) loses health coverage under this Plan as a result of a Qualifying Event shall be entitled to state continuation coverage subject to the eligibility, election and contribution requirements set forth under the Cal-COBRA Program.
11.9 Governing Requirements. If any provision of this Article is inconsistent with applicable federal law, PEMHCA, CalPERS requirements, or the terms of the applicable health plan, the applicable law, requirement, or plan provision shall control. The Administrator may implement procedures and make administrative adjustments necessary to comply with applicable law and the requirements of CalPERS and the applicable health plans without formal amendment of this Article, provided that such procedures and adjustments do not materially reduce a benefit otherwise provided under the Plan.
ARTICLE XII
DISCRIMINATION
12.1 Memorandum of Understanding. This Plan was adopted pursuant to the terms of one or more memorandum of understanding between the Employer and the Employees and hence, is exempt from the discrimination provisions set forth in Section 125 of the Code, as of the Effective Date.
12.2 Methods to Avoid Discrimination. Notwithstanding any other provisions of the Plan, the Administrator may limit the amounts reimbursed or paid with respect to any Highly Compensated Participant to the extent the Administrator deems such limitation advisable to assure compliance with any nondiscrimination provision of the Code. Such limitation may be imposed whether or not is results in a forfeiture.
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12.3 Reimbursement Plans. The Plan is intended not to discriminate in favor of “highly compensated individuals” (as defined in Section 414(q) of the Code with respect to the Dependent Care Flexible Spending Account and as defined in Section 105(h) of the Code with respect to the Health Flexible Spending Account) as to eligibility to participate, contributions, and/or Benefits under the Health Flexible Spending Account and Dependent Care Flexible Spending Account (the “Reimbursement Plans”). If the Administrator determines the operation of either Reimbursement Plan in any Plan Year would result in such discrimination, then the Administrator shall select and exclude from coverage under the applicable Reimbursement Plan such Participants and/or reduce such contributions and/or Benefits to ensure compliance with the nondiscrimination requirements of Section 129 and 105 of the Code.
ARTICLE XIII
CLAIMS PROCEDURE
13.1. Claims for Benefits. Except as otherwise provided under Article IX with respect to payment of Eligible Dependent Care ExpensesFSA benefits and under Article X with respect to payment of Eligible MedicalHealth Care ExpensesFSA benefits, all claims for Benefits that are provided through insurance contracts, whether such contracts are between the insurer and the Employer or the insurer and the Participant, shall be made by filing a claim for Benefits in accordance with the claims procedure set forthprocedures established under the applicable insurance contract or Component Plan document. The Employer does not have the authority or responsibilityshall not be responsible for processing, reviewing, or paying such claims for insured Benefits, except to the extent otherwise required by applicable law or the terms of the applicable Component Plan document. All disputes regarding those claimssuch insured Benefits shall be resolved in accordance with the procedure set forth in the separateprocedures established under the applicable Component Plan document concerning those Benefitsor insurance contract.
13.2 Claims and Reimbursement Procedures for Flexible Spending Accounts. Claims for reimbursement under the Dependent Care FSA and Health Care FSA shall be administered in accordance with Articles IX and X, applicable law, and the procedures established by the Administrator or the third-party administrator designated by the Employer. The Employer may delegate to a third-party administrator responsibility for receiving claims, substantiating expenses, administering payment-card transactions, determining whether expenses qualify for reimbursement, processing reimbursements, communicating claim determinations, and administering applicable claims and appeals procedures; provided that the Plan shall remain administered in accordance with the requirements of Code Section 125 and other applicable law.
The use of a third-party administrator shall not relieve the Employer or the Plan of any obligation imposed by applicable law.
ARTICLE XIV
AMENDMENTS. TERMINATION AND ACTION BY EMPLOYER
14.l Action by Employer. Any action by the Employer under this Plan, including but not limited to, termination of this Plan, shall be by action of the Employer, or by any person or persons duly authorized by action of the Employer to act on its behalf.
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14.2 Amendments. The Employer reserves the right to make, from time to time, any amendment or amendments to this Plan as it deems necessary or desirable, without retroactive effect, unless specifically permitted to comply with the law.
14.3 Right to Terminate. The Employer may terminate this Plan at any time. In the event of the dissolution, merger, consolidation or reorganization of the Employer, the Plan shall terminate unless the Plan is continued by a successor to the Employer in accordance with the Employer’s procedures.
14.4 Plan Termination. Upon the termination of the Plan, the Administrator may determine the best method to make payments to the effected Participants.
ARTICLE XV
HIPAA PRIVACY STANDARDS, SECURITY, AND BREACH NOTIFICATION
15.1 Protection of Individually Identifiable Health Information. The Employer and the Plan have adopted policies and procedures ("Privacy Policy") for the sole and limited purpose of complying with the Standards for Privacy of Individually Identifiable Health Information, 45 CFR § 164.102 et seq., as amended (the "Privacy Rule"). These manner in which these provisions will be administered shall in way affect, or be taken into account in determining, the benefits under the Plan with respect to any individual.
15.1 Purpose. This Article is intended to ensure that the Plan is administered in compliance with the privacy, security, and breach notification requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), as amended by the Health Information Technology for Economic and Clinical Health Act (“HITECH Act”), and the regulations promulgated thereunder, including 45 C.F.R. Parts 160 and 164, as amended. Nothing in this Article shall be construed to alter the Benefits provided under the Plan or to affect eligibility for Benefits.
15.2 Definitions. TheUnless otherwise defined in the Plan, terms and phrases used in this Article shall carry the same meaning and intent set forth under the Privacy Rule, and in some instances may replace the defined terms listed generally in Article III and to the extent of any conflict between the terms set forth herein and those of Article III, the defined terms shall carry the meaning prescribed under the Privacy Rule.have the meanings assigned to them under HIPAA and its implementing regulations, including, without limitation, “Protected Health Information” (“PHI”), “Electronic Protected Health Information” (“ePHI”), “Summary Health Information,” “Plan Administration Functions,” “Payment,” “Health Care Operations,” “Business Associate,” and “Privacy Rule.”
15.3 Identity ofEmployer as Plan Sponsor. The Employer shall beserves as the Plan Sponsor for purposes of the Privacy Rule whenHIPAA. In performing Plan Administration functions or Plan Sponsor functions, when acting on behalf of the Plan with respect to its obligations under the Privacy Rule, and when acting on behalf of the Plan's participants and beneficiaries with respect to Participation and Enrollment Information. The Privacy Official shall act for the Plan Sponsor and shall be entitled to delegate its powers andFunctions, the Plan Sponsor shall comply with this
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Article and all applicable federal privacy and security requirements. The Plan Sponsor shall designate one or more Privacy Officials and Security Officials responsible for administering the Plan’s HIPAA compliance program as it applies to Plan Sponsor. Such officials may delegate responsibilities in accordance with its usual practicesas appropriate.
15.4 Responsibilities and UndertakingsCertification by Plan Sponsor. The Plan Sponsor shall be responsible for making any necessary certificationsmay disclose PHI to the Plan. Such certifications shall be delivered to the Plan's Privacy Official. The Sponsor only after the Plan Sponsor also undertakes and agreeshas certified to the Plan that it:
(a) Shall not use or disclose PHI except as to those uses specifically permitted under the Privacy Rule.
(a) the Plan has been amended to incorporate the provisions required by HIPAA; (b) Shall require any agents or subcontractors to whom it discloses PHI to agree to the samethe Plan Sponsor agrees to the restrictions and conditions on the use and disclosure of PHI as apply to the Plan Sponsorrequired by HIPAA;
(c) the Plan Sponsor agrees to comply with this Article and the Plan’s HIPAA policies and procedures that apply to Plan Sponsor.
15.5 Permitted Uses and Disclosures. The Plan Sponsor may use or disclose PHI received from the Plan solely for Plan Administration Functions permitted under HIPAA. The Plan Sponsor shall not use or disclose PHI:
(a) (c) Shall not use or disclose PHI for anyfor employment-related decisions or actions of Employer;
(b) (d) Shall not use or disclose PHI in connection with any other benefits oremployee benefit plan, or program, or arrangement of Employer. except as expressly permitted by HIPAA; (c) for any purpose not permitted by HIPAA or this Plan; or (d) in any manner inconsistent with the Plan’s HIPAA policies and procedures appliable to Plan Sponsor.
Nothing in this Article shall prohibit disclosures expressly permitted or required by HIPAA.
15.6 Responsibilities of the Plan Sponsor. The Plan Sponsor shall:
(a) use appropriate administrative, physical, and technical safeguards to protect the privacy, security, and confidentiality of PHI and ePHI;; (b) comply with the HIPAA Security Rule with respect to ePHI;
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(c) comply with the HIPAA minimum necessary standard to the extent applicable; (d) require any Business Associate, agent, or subcontractor receiving PHI on its behalf to comply with applicable HIPAA requirements;
(e) Shall(e) promptly report to the Privacy Official any uses or disclosures of PHIPlan any use or disclosure of PHI that is inconsistent with the Plan's Privacy Policythis Article or applicable law of which itthe Plan Sponsor becomes aware.; (f) report breaches of unsecured PHI as required by HIPAA and cooperate with the Plan in satisfying applicable breach notification requirements; (f) Shall make PHI available in accordance with an individual's right of access in accordance with the Plan's Privacy Policy.
(g) Shall make PHI available for amendment and shall incorporate amendments in accordance with the Plan's Privacy Policy.
(h) Shall (g) make informationPHI available to provide anyindividuals as required by HIPAA, including rights of access, amendment, and accounting of disclosures of PHI in accordance with the Plan's Privacy Policy.;
(h) make its books, records, policies, and practices relating to PHI available to the Secretary of the United States Department of Health and Human Services for purposes of determining HIPAA compliance; and
(i) when PHI is no longer needed for the purpose for which it was disclosed, return or securely destroy the PHI if feasible or, if return or destruction is not feasible, continue to protect the information and limit further uses and disclosures to those purposes that make return or destruction infeasible.
15.7 Persons Authorized to Receive Protected Health Information. Only those employees, officers, or other persons designated by the Plan Sponsor whose duties require access to PHI for Plan Administration Functions shall be permitted access to PHI. The Plan Sponsor shall maintain appropriate policies identifying the classes of workforce members authorized to receive PHI and shall ensure that such persons receive appropriate HIPAA training.
15.8 Summary Health Information and Enrollment Information. The Plan may disclose Summary Health Information to the Plan Sponsor for obtaining premium bids, modifying, amending, or terminating the Plan, or for other purposes permitted by HIPAA. The Plan may disclose enrollment, disenrollment, and participation information to the Plan Sponsor as permitted by HIPAA.
15.9 De-Identified Information. Information that has been de-identified in accordance with HIPAA shall not constitute PHI and may be used or disclosed as permitted by applicable law.
15.10 Separation Between the Plan and the Plan Sponsor. The Plan Sponsor shall establish and maintain adequate separation between the Plan and the Plan Sponsor, including administrative safeguards reasonably designed to ensure that PHI is accessed and used only by authorized workforce members for Plan Administration Functions.
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15.11 Other Applicable Law. The Plan shall be administered in accordance with applicable federal and California laws governing the privacy and security of medical information to the extent not preempted by HIPAA.
15.12 Scope of Article. This Article applies only to those components of the Plan that constitute a group health plan or otherwise are subject to HIPAA. It does not apply to benefits or programs that are not subject to HIPAA.
(i) (i) Shall make available to the Secretary of Health and Human Services its internal practices, books, and records relating to the use and disclosure of PHI from the Plan for purposes of determining the Plan's compliance with the Privacy Rule. (j) Shall, if feasible, return to the Plan or destroy any PHI from the Plan that it maintains in any form, and shall retain no copies of the PHI when the PHI is no longer needed for the purpose for which disclosure was originally made. If it is not feasible to return or destroy the PHI, the Plan Sponsor agrees that it shall further limit any uses and disclosures to those purposes that make the return or the destruction of the information not feasible. (k) Shall ensure that adequate separation between the Plan Sponsor and the Plan is established.
15.3 Uses and Disclosures of Protected Health Information. (a) Certification. The Plan, and any Health Insurance Issuer or Health Maintenance Organization with respect to the Plan, may disclose PHI to the Plan Sponsor only following receipt of the Plan Sponsor's certification that the Plan has been amended in accordance with the requirements of the Privacy Rule.
(b) Plan Administration. The Plan Sponsor shall be permitted to the limited use and disclosure of PHI for purposes of plan administration, including all Payment Activities and Health Care Operations, as permitted under the Plan's Privacy Policy. (c) Compliance with Privacy Rule. The Plan Sponsor shall be entitled to those uses and disclosures of PHI as permitted by the Privacy Rule to the extent necessary for compliance, including but not limited to any uses and disclosures permitted (1) without permission from an individual; (2) only with explicit or implicit authorization; or (3) because the PHI has been cleansed.
(d) Participation and Enrollment Information. Participation and Enrollment Information may be disclosed as necessary to the Plan Sponsor.
(e) Summary Health Information. Summary Health Information may be disclosed to the Plan Sponsor for the limited purpose of performing Plan Sponsor functions. (f) Individuals With Access to PHI. The Privacy Official and his or her delegates, if any, are permitted to have access to PHI disclosed to or by the Plan. In addition, the Plan Sponsor shall designate the individual(s) or group(s) of individuals under the direct control of the Plan Sponsor who are permitted to have access to PHI disclosed by or to the Plan. (g) Limitations on Disclosures of Access to and Uses of PHI. PHI may be disclosed from
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the Plan only for Plan Administration Functions performed on behalf of the Plan, and the other purposes identified in the Plan's Privacy Policy.
15.4 Hybrid Entity. The provisions of this Section shall apply only to the health care component of the Plan.
ARTICLE XVI
GENERAL PROVISIONS
16.1 Written Plan. The Administrator shall, upon request, provide each Participant with a copy of the Plan(s) detailing the benefits available to the Participant.
16.2 No Trust Fund Required. The Employer shall have no obligation, but shall have the right, to insure any benefits under the Plan or to establish any fund or trust for the payment of Benefits under the Plan.
16.3 Insured Benefits. The Employer shall have no responsibility for the payment of any Benefits covered under the Component Plans provided by policies of insurance.
16.4 Rights to Employer’s Assets. No Employee or beneficiary shall have any right to, or interest in, any specific asset of the Employer by reason of participation in the Plan. Benefits shall be payable only in accordance with the terms of the Plan and applicable law. Nothing in the Plan shall be construed to create a trust or other separate ownership interest in any assets of the Employer upon termination of employment or otherwise, except as provided from time to time under this Plan, and then only to the extent of the Benefits payable under the Plan to such Employee or beneficiary. All payments of Benefits as provided for in this Plan shall be made solely out of the assets of the Employer and the Administrator shall not be liable therefore in any manner., unless expressly provided otherwise by the Plan or required by applicable law.
16.5 Nonalienation of Benefits. Benefits payable under this Plan shall not be subject in any manner to anticipation, alienation, sale, transfer, assignment, pledge, encumbrance, charge, garnishment, execution, or levy of any kind, either voluntary or involuntary, including any such liability which is for alimony or other payments for the support of a spouse or former spouse, or for any other relative of the Employee, prior to actually being received by the person entitled to the benefit under the terms of the Plan; and any attempt to anticipate, alienate, sell, transfer, assign, pledge, encumber, charge or otherwise dispose of any right to benefits payable hereunder shall not be recognized, except to the extent required by law. The Employer shall not in any manner be liable for, or subject to, the debts, contracts, liabilities, engagements, or torts of any person entitled to benefits hereunder.
16.6 Divestment of Benefits. Subject only to the specific provisions of this Plan, nothing shall be deemed to divest a Participant of a right to the Benefit to which the Participant becomes entitled in accordance with the provision of this Plan.
16.7 Discontinuance of Contributions. In the event of a permanent discontinuance of contributions to the Plan, all Participants shall receive any and all Benefits to which they were entitled as of the date the discontinuance of contributions occurred.
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16.8 Plan Interpretation. This Plan, the Summary Plan Description and the various Component Plans are intended to be read in conjunction with one another. However, to the extent of any conflict, the provisions of the Plan shall control, unless otherwise provided by Sections 125, 129 or 105(b) of the Code or the Regulations issued thereunder.
16.9 Governing Law. The Plan shall be administered in the State of California and its validity, construction, and all rights hereunder shall be governed by the laws of the State of California, unless superseded by the Code or other federal law.
16.8 Severability. If any provision of the Plan shall be held invalid or unenforceable, the remaining provisions shall continue to be fully effective.
16.9 Gender and Number. Words used in the masculine, feminine, or neuter gender shall each be deemed to refer to the other whenever the context so requires. Words used in the singular or plural number shall each be deemed to refer to the other whenever the context so requires.
16.10 Headings. Headings used in the Plan are intended solely for reference and are not intended to explain, modify or place any construction on any of the provisions of the Agreement. Any conflict between such headings and the text shall be resolved in favor of the text.
16.11 Successors and Assigns. The Plan shall inure to the benefit of and be binding upon the parties hereto, their successors and assigns. The right of a Participant to receive reimbursement under the Participant’s Health Flexible Spending AccountFSA or Dependent Care Flexible Spending AccountFSA shall not be assigned or subject to claims by creditors.
16.12 Discharge of Employee. The adoption and maintenance of the Plan shall not be deemed to be a contract between the Employer and the Employee. Nothing herein contained shall be deemed to give any Employee the right to be retained in the employ of the Employer or to interfere with the right of the Employer to discharge any Employee at any time.
16.15. Consolidation With Other Plan Documents. In the event the Plan merges or consolidates with, or transfers the assets and liabilities to, any other plan, no Participant herein shall, solely on account of such consolidation or transfer, be entitled to a Benefit on the day following such event which is less than the Benefit to which he or she was entitled on the day preceding such event. For the purpose of this Section, the benefit to which a Participant is entitled shall be calculated and based upon the assumption that a Plan termination and distribution of assets occurred on the day as of which the amount of the Participant’s entitlement is being determined.
16.16 Counterparts. The Plan may be executed in an original and any number of counterparts by the Employer, each of which shall be deemed an original of one and the same instrument.
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IN WITNESS WHEREOF, the Employer has caused this Restated Section 125 Cafeteria Plan, Health Flexible Spending Account and Dependent Care Flexible Spending Account toPlan to be executed on [**INSERT DATE**].
EMPLOYER:
CITY OF CORONA
By: ______________________________
Jacob Ellis
City Manager
ATTEST:
By: ___________________________
Sylvia Edwards
City Clerk
APPROVED AS TO FORM AND CONTENT:
By: ____________________________
Dean Derleth
City Attorney
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SCHEDULE “A”
SCHEDULE OF BENEFITS
as of August 19, 2026
The following Schedule of Benefits, which may be amended from time to time by the Employer, specifies the Benefits and the Component Plans which set forth the terms, conditions and limitations of the Benefits offered to Participants. The periods of coverage for the Component Plans shall be the same as the Plan Year of the Plan, unless specified otherwise.
The following definitions shall apply for purposes of this Schedule of Benefits. Capitalized terms not otherwise defined in this Schedule of Benefits shall be as defined in Article III of the City of Corona Section 125 Cafeteria Plan.
1. “Base Contribution Rate” shall refer to the rate of contribution applicable to the Employer with respect to each Employee bargaining group as determined under the provisions of Section 22892 of the California Government Code in accordance with the Employer’s resolution filed with the California Public Employees'’ Retirement System.
2. “Confidential Personnel” shall mean Employees who are subject to the terms of the Compensation and Benefits for City of Corona Confidential Employees, as established by resolution of the City Council and as may be amended from time to time.
3. “Executive Personnel” shall mean Employees who are subject to the terms of the Compensation and Benefits for City of Corona Executive Employees, as established by resolution of the City Council and as may be amended from time to time.
4. “Fire Personnel” shall mean Employees who are members of the Corona Firefighters Association IAFF Local 3757 covered under the "“Corona Firefighters Association IAFF Local #3757 Memorandum of Understanding"” in effect from 2025 through 2027, as amended from time to time.
5. “General Personnel” shall mean Employees who are covered under the "“Corona Public Service Employees Association Memorandum of Understanding"” in effect from January 1, 2025 through December 31, 2027, as amended from time to time.
6. “Management Personnel" shall mean Employees who are subject to the terms of the Compensation and Benefits for City of Corona Management Employees, as established by resolution of the City Council and as may be amended from time to time.
7. “Memorandum of Understanding” shall refer to a memorandum of understanding between the Employer and a bargaining unit of Employees.
8. “PEMHCA” shall mean the CalPERS Health Program as governed by the Public Employees’ Medical & Hospital Care Act.
9. “Police Personnel” shall mean Employees covered under the: (i) "“Corona Police
JAMIER\09000.25600\10323009.6
Employees Association Memorandum of Understanding"” in effect from January 1, 2025 through December 31, 2027, as amended from time to time; and (ii) "“Corona Police Supervisors Association Memorandum of Understanding"” in effect from January 1, 2025 through December 31, 2027, as amended from time to time.
10. “Retiree” shall mean Retired Elected Officials or Retired M/C Personnel.
11. “Supervisory Personnel” shall mean Employees covered under the "“Corona Supervisors Association Memorandum of Understanding"” in effect from January 1, 2025 through December 31, 2027, as amended from time to time.
12. “Utilities Personnel” shall mean Employees covered under the "Corona Utilities Employee Association Memorandum of Understanding" in effect from July 1, 2026 through December 31, 2027, as amended from time to time.
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13. FIRE PERSONNEL
14. as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Fire Personnel Plan Year $2,408.95
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Fire Personnel Plan Year N/A N/A
Vision
Insurance
All Fire Personnel Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All Fire Personnel Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Fire Personnel Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
All Fire Personnel Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section 6.3.
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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15. GENERAL PERSONNEL
16. as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All General
Personnel
Plan Year $2,273
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All General
Personnel
Plan Year N/A N/A
Vision
Insurance
All General
Personnel
Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All General
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All General
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
Allowance
All General
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section
6.3. *Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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17. UTILITIES PERSONNEL
as of July 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Utilities
Personnel
Plan Year $2,273
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Utilities
Personnel
Plan Year N/A N/A
Vision
Insurance
All Utilities
Personnel
Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All Utilities
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Utilities
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
Allowance
All Utilities
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section
6.3. *Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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18. CONFIDENTIAL PERSONNEL
19. as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Confidential
Personnel
Plan Year $2,708
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Confidential
Personnel
Plan Year N/A N/A
Vision
Insurance
All Confidential
Personnel
Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All Confidential
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Confidential
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
Allowance
All Confidential
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section
6.3. *Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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CONFIDENTIAL PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Confidential
Personnel
Plan Year $2,708
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Confidential
Personnel
Plan Year N/A N/A
Vision
Insurance
All Confidential
Personnel
Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All Confidential
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Confidential
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
Allowance
All Confidential
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section
6.3. *Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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EXECUTIVE PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Executive
Personnel
Plan Year $2,708
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Executive
Personnel
Plan Year N/A N/A
Vision
Insurance
All Executive
Personnel
Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All Executive
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Executive
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
Allowance
All Executive
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section
6.3. *Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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21. MANAGEMENT PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Confidential
Personnel
Plan Year $2,708
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Management
Personnel
Plan Year N/A N/A
Vision
Insurance
All Management
Personnel
Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All Management
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Management
Personnel
Plan Year
(+Grace
Period)
$3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
Allowance
All Management
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section
6.3. *Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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POLICE PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Police
Personnel
Plan Year $2,273
(Employee+2 or
more)
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Police
Personnel
Plan Year N/A N/A
Vision
Insurance
All Police
Personnel
Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All Police
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Police
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
Allowance
All Police
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section
6.3. *Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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SUPERVISORY PERSONNEL
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MANDTORY BENEFITS (CORE COVERAGE)
Health
Insurance
All Supervisory
Personnel
Plan Year $2,708
(Employee+2 or
more
N/A
OTHER AVAILABLE BENEFITS
Dental
Insurance
All Supervisory
Personnel
Plan Year N/A N/A
Vision
Insurance
All Supervisory
Personnel
Plan Year N/A N/A
Dependent
Care
Flexible
Spending
Account
All Supervisory
Personnel
Plan Year
(+Grace
Period)
$7,500 per
year
$3,750 for
married person
filing separate tax
return
N/A
Health Care
Flexible
Spending
Account
All Supervisory
Personnel
Plan Year $3,400 per
year
$680 Carryover to
next Plan Year*
N/A
CASH-OUT OPTION
Medical
Insurance
Opt-Out
Allowance
All Supervisory
Personnel
Plan Year Family
$600.00/month
Employee +1
$400.00/month
Employee Only
$200.00/month
Available only if
Employee opts-out of
Core Coverage
pursuant to Section
6.3. *Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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RETIREES
as of January 1, 2026
BENEFIT ELIGIBLE
EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL
OF COVERAGE
LIMITATIONS
MAXIMUM CITY CONTRIBUTION - The City will contribute an Employer Allowance of up to a maximum of $1,500 that can be applied to any of the benefits listed below.
Dental Insurance Retiree Plan Year N/A N/A
Vision Insurance Retiree Plan Year N/A N/A
Dependent Care
Flexible Spending
Account
Retiree Plan Year
(+Grace
Period)
N/A N/A
Health Care Flexible
Spending Account
Retiree Plan Year N/A N/A
CASH-OUT OPTION
Medical Insurance
Opt-Out Allowance
Retiree Plan Year Up to $1,500 Available only if a
Retiree elects
benefits having an
aggregate cost less
than his or
her allowance
*Carryover amount subject to annual adjustment as may be permitted under Code Section 125.
Reviewed by: Approved by:
Rebekah Kramer Jacob Ellis
Assistant City Manager City Manager
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I
FIRE PERSONNEL
as of January 1, 2009
BENEFIT ELIGIBLE EMPLOYEE
SUBGROUP
PERIOD OF
COVERAGE
MAXIMUM LEVEL OF
COVERAGE
LIMITATIONS
MANDATORY BENEFITS (CORE COVERAGE)
Health insurance All Fire Personnel Plan Year Capped atsecond highest PERS family plan at the
CalPERS-designated
classification for
Riverside County
See below for Determination of
Core Coverage Allowance
OTHER AVAILABLE BENEFITS - May use the annual Flexible Benefit Allowance of $1,120, Salary Reduction plus any , converted Core Coverage Opt-OutAllowance and Medical Difference, if available, only • , Dental Insurance I
All Fire Personnel Plan Year N/A N/A
. Vision Insurance All Fire Personnel Plan Year NIA NIA Dependent Care
Flexible
Spending
Account
All Fire Personnel
..
Plan Year plus
Grace Period
$5,000 per year*
*$2,500 for married
person filing separate tax
return
NIA
Health
CareFlexibl
e Spending
Account
All Fire Personnel Plan Year plus
Grace Period
$5,000 per year'"’“
*Effective l /1/2010
NIA
CASH-OUT OR CONVERSION OPTIONS
CoreCoverage
'Medical
Insurance OptOut Allowance
All Fire Personnel Plan Year Family•
$770.00/month
Employee +1 •
$592.00/month
Employee Only •
$296.00/month
Available only if Employee
opts-out of Core Coverage
pursuant to Section 6.3. May
be converted to Flexible
Benefit Dollars or Cashed-Out
Medical
Difference
Fire Personnel hired on
or after July 1, 2000
Plan Year Excess, if any, of Core
Coverage Allowance after
purchase of Core
Coverage
May be converted to Flexible
Benefit Dollars or Cashed-Out
Flexible Benefit
Allowance CashOut Option
All Fire Personnel Plan Year Up to $1,120 Available only if Employee elects benefits having an
aggregate cost less than his or
her Flexible Benefit Allowance
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CERTIFICATION OF CITY OF CORONA
TO CITY OF CORONA SECTION 125 CAFETERIA PLAN
The CITY OF CORONA is the sponsor of the CITY OF CORONA SECTION 125 CAFETERIA PLAN. TheCertain benefits provided under the Cafeteria Plan is a hybrid entity within the meaning ofconstitute group health plans or health care components subject to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") which includes non-health care and health care componentsand its implementing regulations. The health care components of the Cafeteria Plan include the following separate group health plans:
• All Group Health Plans offered by CalPERS and in accordance with PEMHCA • The City of Corona Health Flexible Spending Account Plan • Delta Care PMI
• Reliance Standard Dental Insurance
• Eye Med Vision Care
The Cafeteria Plan (excluding the non-health care components) and the health care components included in the Cafeteria Plan are Group Health Plans within the meaning of HIPAA (collectively, the “Plan”). The Plan and the City of Corona desire to exchange health information protected under HIPAA for purposes related to administration of the Plan. The City of Corona, acting in its capacity as plan sponsor of the Plan (“Plan Sponsor”) makes the following certifications for purposes of administering the Plan as required by the “Standards for Privacy of Individually Identifiable Health Information,” 45 CFR § 164.102 et seq. (the “Privacy Rule”):
The plan document of the Plan has been amended to incorporate the following provisions and Plan Sponsor agrees to:
• not use or further disclose any protected health information (“PHI”) received from the Plan (including any health insurance issuer or HMO with respect to the Group Health Plan) except as permitted or required by the Plan documents or required by law; • ensure that any agents or subcontractors to whom it discloses any PHI agree to the same restrictions and conditions that apply to the Plan Sponsor with respect to such information; • not use or disclose PHI for employment-related actions and decisions; • not use or disclose PHI in connection with any other benefit plan, program, or arrangement of the City of Corona except to the extent such other benefit plan, program or arrangement is part of an organized health care arrangement of which the Plan also is a part; • report to the Plan any use or disclosure-of PHI that is inconsistent with the uses and disclosures specified in the Plan of which it becomes aware;
JAMIER\09000.25600\10323009.6
• give individuals access rights to PHI in its possession in accordance with the policies and procedures of the Plan;
• permit individuals to request amendment of their PHI in the Plan Sponsor’s possession, and to make any necessary amendments, in accordance with the policies and procedures of the Plan;
• make information available to provide any necessary accounting of disclosures of PH1 in accordance with the policies and procedures of the Plan; • make its internal practices, books, and records relating to the use and disclosure of PHI from the Plan available to the Secretary of the Department of Health and Human Services for purposes of determining the Plan’s compliance with the Privacy Rule; • if feasible, to return to the Plan or destroy any PHI from the Plan that it maintains in any form, and shall retain no copies of the PHI when the PHI is no longer needed for the purpose for which disclosure was originally made. If it is not feasible to return or destroy the PHI, the Pian Sponsor agrees that it shall further limit any uses and disclosures to those purposes that make the return or the destruction of the information not feasible; and • agrees to ensure that adequate separation between the Plan Sponsor and the Plan is established.
DATE: 08/19/2026
TO: Honorable Mayor and City Council Members
FROM: Planning and Development Department
2026-263
REQUEST FOR CITY COUNCIL ACTION
SUBJECT:
ZONE TEXT AMENDMENT 2026-0001 TO CHAPTER 17.70 OF THE CORONA
MUNICIPAL CODE TO UPDATE WATER-EFFICIENT LANDSCAPE REQUIREMENTS
TO REFLECT CHANGES IN STATE LAW AND TO UPDATE OUTDATED FENCING
REGULATIONS
EXECUTIVE SUMMARY:
This staff report asks the City Council to approve Zone Text Amendment 2026-0001, which amends the water-efficient landscape regulations in Chapter 17.70 of the Corona Municipal Code, to ensure consistency with 2015 and 2025 changes to the State of California’s Model Water Efficient Landscape Ordinance. The amendment also updates fence and wall standards in Chapter 17.70 to reflect advancements in fencing materials and design, providing greater flexibility for property owners.
RECOMMENDED ACTION:
That the City Council:
a. Approve Zone Text Amendment 2026-0001, as recommended by the Planning and Housing Commission.
b. Introduce, by title only, and waive full reading of consideration of Ordinance No. 3431, first reading of an ordinance amending Chapter 17.70 of Title 17 (Zoning) of the Corona Municipal Code to update water-efficient landscape requirements to reflect changes in State law, and to update outdated fence regulations, and amending various other sections in Title 17 to update references to Chapter 17.70 (ZTA2026-0001).
BACKGROUND & HISTORY:
Chapter 17.70 of the Corona Municipal Code (CMC) establishes the City’s landscape and fencing regulations, which are enforced by the Planning and Development Department.
In accordance with California State law, this chapter was previously amended in 2010 to incorporate water-efficient landscape regulations consistent with the State’s Model Water Efficient Landscape Ordinance (“MWELO”). The MWELO underwent revisions in 2015 and again in 2025, with the latest update effective January 2, 2025. Updates to the City’s regulations are necessary to ensure consistency with these recent MWELO revisions.
Fence and wall standards are also being updated to accommodate advancements in fencing materials and design, which give property owners more flexibility. These updates are especially important for properties in the City’s Very High Fire Severity Zone, which will be subject to upcoming State restrictions on fencing materials.
On June 8, 2026, the Planning and Housing Commission recommended approval of the amendments to Chapter 17.70, and adopted Resolution No. 2687 to merge the City’s residential and commercial/industrial landscape guidelines into one Landscape Design Manual (Manual). The Manual provides technical guidance to supplement zoning requirements in Chapter 17.70.
PROPOSED ZONE TEXT AMENDMENT:
Amendments To Chapter 17.70
ZTA2026-0001 amends various provisions of Chapter 17.70 for consistency with the State’s MWELO. The new standards will apply to new landscape installation following the adoption of this amendment, and are as follows:
1. Lower Threshold for Required Landscape Permits. Currently, property owners must submit landscape plans to the City and obtain a landscape permit prior to construction if the project is:
a. Developer-installed landscaping in a new construction or landscape renovation project with at least 2,500 square feet of landscaping; or b. Homeowner-installed landscaping in a new construction or landscape renovation project with a landscape area of at least 5,000 square feet.
These projects are currently subject to the City’s water-efficient landscape requirements. The proposed amendment lowers the applicability thresholds from 2,500 to 500 square feet for new construction projects, and from 5,000 to 2,500 square feet for existing sites undergoing landscape renovations, regardless of whether the installation is completed by a developer or homeowner.
2. Addition of Prescriptive Compliance Option. The existing landscape permit process, used to demonstrate compliance with the City’s water-efficient landscape requirements, is being expanded to include a streamlined compliance option for projects with landscape areas ranging from 500 to 2,500 square feet. This optional
process, referred to as the Prescriptive Compliance Option, is intended to simplify compliance for most homeowners and smaller non-residential developments.
The City’s existing compliance process, referred to as the Performance Compliance Option, remains available and is required for larger or more complex projects that have a landscape area exceeding 2,500 square feet. Table 1 summarizes the key differences between the two options.
Table 1 – Water Efficient Landscape (WELO) Compliance Options Prescriptive
Compliance Option
(Simplified Version)
Performance
Compliance Option
(Comprehensive Version)
Applies To: New construction projects with
a total landscape area
between 500 to 2,500 square
feet.
New construction or landscape
rehabilitation projects with a total
landscape area exceeding 2,500
square feet.
Submittal
Requirement:
A simplified landscape design
plan showing the total square
footage of the landscape area,
and a breakdown of plant
materials (e.g., plant legend).
A professional landscape
documentation package that
includes:
Landscape plan;
Grading plan;
Irrigation plan;
Soil management report;
and
Water usage calculations.
Approval
Process:
Property owner obtains
landscape plan approval and
permit, installs the
landscaping, and passes City
inspection.
Property owner obtains
landscape plan approval and
permit, installs the landscaping,
and passes City inspection.
3. Prohibited Use of Turf in all Non-Residential Development. The City currently prohibits the use of turf in commercial and industrial developments. The proposed amendment simplifies this provision by replacing references to commercial and industrial development with the broader term, “non-residential development.” As a result, the turf prohibition would apply to all non-residential development types, including institutional developments. However, turf may be used in non-residential developments where it serves a recreational or functional purpose. Cemeteries are exempted from this prohibition.
ZTA2026-0001 also amends the standards for residential fencing in Chapter 17.70 as follows:
1. Fencing Standards for Residential Zones. Current standards are being amended to:
a) Increase the maximum height for opaque fences and walls from 3 feet to 4 feet in the front yard for increased privacy, while retaining the 3-foot height limit for fences and walls that are in the corner cut-off area for visibility purposes.
b) Clarify that decorative fixtures (e.g., caps, lights, balls, and similar fixtures) are allowed to be constructed on top of pilasters in the front yard, for a combined maximum height of 6 feet (including the pilaster). Pilasters remain limited to a maximum height of 5 feet.
c) Formally permit wood picket fences in the front yard, which were previously unaddressed, but historically allowed.
d) Expand the range of fencing materials permitted in front, side, and rear yards. Currently, front-yard fencing is limited to decorative block and wrought iron, and side- and rear-yard fencing is limited to block, wrought iron, vinyl, wood, or similar durable materials. The proposed amendment would allow the following additional materials in the front, side, and rear yards:
Decorative or textured masonry (cement, concrete, brick, stone, or other masonry materials);
Wrought iron and tubular steel;
Vinyl and Polyvinyl chloride (PVC);
Metal panels (aluminum and steel);
Fiber cement; and
Other similar durable material, as approved by the Planning Director. e) Existing tennis enclosure regulations for residential properties are being expanded to cover other private outdoor recreation and sport courts, such as pickleball courts, basketball courts, batting cages, and similar facilities.
These regulations will apply only to new installations following the adoption of this amendment.
No other changes are proposed to Chapter 17.70 other than the aforementioned items discussed in this staff report.
Landscape Design Manual
This Zone Text Amendment is associated with the Landscape Design Manual (Manual), which consolidates and replaces two existing Landscape Design Guidelines. The Manual supplements the minimum zoning code requirements in Chapter 17.70 and adopted Specific Plans. The Manual is organized into four chapters (Introduction, Residential Landscape Design, Non-Residential Landscape Design, and Water-Efficient Landscape
Design), with an appendix containing definitions, reference materials, worksheets, and forms, which are required to be completed by the project applicant. The Manual is intended to assist landscape professionals, architects, designers, and homeowners in achieving attractive, water-efficient, and functional landscapes that meet City and State requirements. The Manual is attached as Exhibit 3 for reference. The Planning and Housing Commission is responsible for review and approval of the Manual, which occurred on May 27, 2026.
Other Amendments in Title 17 of the CMC
Several chapters in Title 17 (Zoning) of the CMC currently reference provisions in Chapter
17.70. These cross-references are being updated to reflect the reorganized section numbering within Chapter 17.70. The revisions ensure consistency throughout Title 17 and maintain accurate internal citations. The impacted chapters include:
17.24 – R-3 Multiple Family Residential Zone
17.33 – Commercial & Office Zones
17.35 – Quasi-Public (QP) Zone
17.64 – Lots and Yards
17.72 – Supplemental Site Development Standards For Automotive Related Uses
17.74 – Signs
17.76 – Off-Street Parking
17.79 – Trash Enclosures
17.82 – Planned Unit and Condominium Development
ANALYSIS:
The amendments proposed under ZTA2026-0001 ensure that the City’s local regulations, governing landscaping and irrigation for both residential and non-residential development, comply with State law. The amendments support water conservation by updating compliance thresholds and offering a simplified, less costly option for homeowners and small developments to meet water efficiency standards.
In addition, the updated fencing standards provide greater flexibility for residential property owners to select fencing materials and styles that reflect current market trends and advancements in available products and technologies. These new materials include non-combustible materials, such as concrete and metal, which would help properties located in the City’s Very High Fire Severity Zone meet upcoming Statewide restrictions regarding “Zone Zero,” which regulates fencing material within 5 feet of a residential structure.
PLANNING AND HOUSING COMMISSION ACTION:
At its June 8, 2026 meeting, the Planning and Housing Commission considered the subject matter and took the following action:
Motion was made by Commissioner Woody, seconded by Commissioner Siqueland, and carried with Commissioners Longwell and Vernon absent, that the Planning and Housing Commission recommend approval of ZTA2026-0001 to the City Council, based on the
findings and conditions contained in the staff report. The draft minutes of the Planning and Housing Commission meeting are included as Exhibit 5.
FINANCIAL IMPACT:
ZTA2026-0001 is a City-initiated amendment; therefore, no application fees were paid for the processing of this application.
ENVIRONMENTAL ANALYSIS:
Per Section 15061(b)(3) of the State Guidelines for Implementing the California Environmental Quality Act (CEQA) and Section 3.06 of the City’s Local CEQA Guidelines, a Notice of Exemption has been prepared for this project because a project is exempted from CEQA if the activity is covered by the general rule that CEQA applies only to projects that have the potential for causing a significant effect on the environment. Where it can be seen with certainty that there is no possibility that the activity in question may have a significant effect on the environment, the activity is not subject to CEQA. The proposed amendment involves text revisions to the landscape and fencing regulations in Chapter
17.70 of the Corona Municipal Code. The proposed text revisions will have no significant environmental impact.
PREPARED BY: SANDRA VANIAN, PLANNING MANAGER
SUBMITTED BY: DANNY CASTRO, PLANNING & DEVELOPMENT DIRECTOR ATTACHMENTS:
1. Exhibit 1 – Ordinance No. 3431
2. Exhibit 2 – Amendment to Chapter 17.70 of the Corona Municipal Code (redline version)
3. Exhibit 3 – City of Corona Landscape Design Manual
4. Exhibit 4 – Planning and Housing Commission Staff Report
5. Exhibit 5 – Minutes of the Planning and Housing Commission Meeting of June 8, 2026
6. Exhibit 6 – PowerPoint Presentation
ORDINANCE NO. 3431
AN ORDINANCE OF THE CITY OF CORONA,
CALIFORNIA, AMENDING CHAPTER 17.70 OF TITLE 17
(ZONING) OF THE CORONA MUNICIPAL CODE TO
UPDATE WATER-EFFICIENT LANDSCAPE
REQUIREMENTS TO REFLECT CHANGES IN STATE
LAW AND TO UPDATE OUTDATED FENCING
REGULATIONS, AND AMENDING VARIOUS OTHER
SECTIONS IN TITLE 17 TO UPDATE REFERENCES TO
CHAPTER 17.70 (ZTA2026-0001).
WHEREAS, Article XI, § 7 of the California Constitution authorizes cities to make and enforce, within their jurisdictional limits, ordinances and regulations not in conflict with general laws to protect and promote the public health, safety, and welfare of its citizens; and WHEREAS, Chapter 17.70 of the Corona Municipal Code (“CMC”) establishes minimum landscaping requirements and sets forth the general standards and regulations for the height and location of fences, walls and hedges within the City; and WHEREAS, on June 8, 2026, the Planning and Housing Commission of the City of Corona (“Planning Commission”) conducted a duly noticed public hearing and recommended that the City Council amend: (a) Chapter 17.70 (Landscaping, Fences, Walls, Hedges) of Title 17 (Zoning) of the CMC to update the water-efficient landscape requirements to reflect changes in state law and to update outdated fencing regulations; and (b) various other sections of Title 17 (Zoning) of the CMC to update references to Chapter 17.70 to ensure such sections are consistent with the updated requirements in Chapter 17.70 (ZTA2026-0001) (“Zone Text Amendment”); and WHEREAS, the Planning Commission based its recommendation to adopt the Zone Text Amendment on the findings set forth below; and WHEREAS, on August 19, 2026, the City Council held a duly noticed public hearing at which all persons wishing to testify in connection with this Zone Text Amendment were heard and this Zone Text Amendment was comprehensively reviewed.
NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF CORONA
DOES ORDAIN AS FOLLOWS:
SECTION 1. CEQA Findings. As the decision-making body for this Zone Text Amendment, the City Council finds that this action is exempt pursuant to Section 15061(b)(3) of the Guidelines for the California Environmental Quality Act (CEQA), which states that a project is exempt from CEQA if the activity is covered by the common sense exemption that CEQA applies only to projects that have the potential for causing a significant effect on the environment. Where it can be seen with certainty that there is no possibility that the activity in
2 question may have a significant effect on the environment, the activity is not subject to CEQA. This action involves changes to the text of the Zoning Code to the water-efficient landscape requirements and fencing regulations in Chapter 17.70. This action involves no physical impacts and does not modify density or capacity. As such, there is no possibility that adopting this Ordinance will have a significant effect on the environment. Therefore, no environmental analysis is required.
SECTION 2. Zoning Findings. Based on the entire record before the City Council and all written and oral evidence presented to the City Council, the City Council hereby makes and adopts the following findings:
A. The proposed Zone Text Amendment is consistent with the General Plan and applicable specific plans for the following reason:
(i) ZTA2026-0001 The Infrastructure and Utilities Element and the Environmental Resources Element of the General Plan have goals and policies that promote water conservation, reduce wasteful water use, and support the preservation of water resources.
Additionally, the Land Use Element and the Community Design Element establish goals and policies related to landscaping, fencing, and walls to ensure both new and existing development achieves high aesthetic and safety standards. ZTA2026-0001 advances and supports these objectives by reinforcing efficient water use and high-quality design.
B. The proposed Zone Text Amendment is consistent with Title 17 of the Corona Municipal Code for the following reason:
(i) Title 17 of the CMC governs the development standards of land uses within the City and establishes other regulatory procedures described in the Zoning Code.
ZTA2026-0001 is consistent with Title 17, as it updates the landscape regulations in Chapter 17.70 to align with current state law while continuing to ensure that landscaping, fencing, and walls meet high standards to address interests of aesthetics and safety.
C. The proposed Zone Text Amendment will provide for the public health, safety and welfare for the following reason:
(i) ZTA2026-0001 promotes public health, safety, and welfare by updating the City’s landscape regulations to align with current state law. The proposed Zone Text Amendment supports water conservation and reduces wasteful water use, thereby helping to preserve limited water resources and enhance long-term environmental sustainability. In addition, the regulations maintain and reinforce standards for landscaping, fencing, and walls that contribute to safe, functional, and visually cohesive development. By ensuring high-quality design and efficient water use across residential, commercial, and industrial developments, the Zone Tex Amendment protects community character, preserves natural resources, reduces potential hazards, and advances the overall well-being of the City’s residents and businesses. .
3 SECTION 3. Zoning Text Amendment. ZTA2026-0001 is hereby approved.
SECTION 4. Amendment to Section 17.24.120. Section 17.24.120 (Walls, fences and landscaping) of Chapter 17.24 (R-3 Multiple Family Residential Zone) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“17.24.120 Walls, fences and landscaping.
(A) The provisions of Chapter 17.70 shall apply.
(B) A wall or fence shall be constructed or erected and maintained along all side and rear lot lines.”
SECTION 5. Amendment to Section 17.33.070. Section 17.33.070 (Landscaping, walls, fences) of Chapter 17.33 (Commercial & Office Zones) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“17.33.070 Landscaping, walls, fences.
(A) Front, side and rear yards required for a lot or building shall be fully landscaped in accordance with Chapter 17.70 of the Corona Municipal Code (Landscaping, Fences, Walls, Hedges).
(B) Landscape areas, walls and fences shall be established and maintained in accordance with Chapter 17.70 of the Corona Municipal Code (Landscaping, Fences, Walls, Hedges).”
SECTION 6. Amendment to Section 17.35.090. Section 17.35.090 (Parking) of Chapter 17.35 (Quasi-Public (QP) Zone) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“17.35.090 Parking.
The provisions of Chapter 17.76 shall apply.”
SECTION 7. Amendment to Section 17.64.030. Subsection (A) of Section
17.64.030 (Yard – Permitted projections) of Chapter 17.64 (Lots and Yards) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“(A) Fences, walls, hedges and landscape architectural features, including, but not limited to, patios, open air grills and similar features, may be located in any front, side or rear yard; provided that the fences, walls, hedges and architectural features are constructed in accordance with Chapter 17.70.” SECTION 8. Amendment to Chapter 17.70. Chapter 17.70 (Landscaping, Fences, Walls, Hedges) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as set forth in Exhibit “A” attached hereto and incorporated herein by reference.
4 SECTION 9. Amendment to Section 17.72.030. Subsection (F) of Section
17.72.030 (Service stations) of Chapter 17.72 (Supplemental Site Development Standards for Automotive Related Uses) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“(F) Landscaping.
(1) Landscaping shall be provided on not less than 6% of the station site area, including, but not limited to the entire corner cut-off area as required by §17.70.040, except those pedestrian walkways approved after site plan review.
(2) Non-living landscape materials such as rocks or artificial turf may be utilized, provided these materials do not exceed 20% of the total landscaped area.
(3) Each station site shall have no less than three on- or off-site trees.
Such trees shall be not less than 15 gallon container size when planted. (4) The provisions of Chapter 17.70 shall apply.”
SECTION 10. Amendment to Section 17.74.040. Subsections (G) and (M) of Section 17.74.040 (Exemptions) of Chapter 17.74 (Signs) of Title 17 (Zoning) of the CMC are hereby amended in their entirety to read as follows:
“(G) One real estate sign per street frontage provided such sign:
(1) Is located entirely on the property offered for sale or lease, or other private property with the respective owner's consent;
(2) Does not exceed the height limitations of the zone and is placed outside of any corner cut-off area as defined in § 17.70.040; (3) Does not exceed the following size limitations:
(a) Five square feet in area for properties located within the R-1 or R-2 zones, or properties located within a low density residential designation in a specific plan.
(b) Thirty-two square feet in area for properties located within the C, M, A or R-3 zones, or properties located within similar land use designations in a specific plan.
(4) Is removed upon the close of escrow or when the rental or lease of the premises has been executed whichever occurs first.” “(M) Political signs as defined by § 17.74.030, including their supporting structures, provided that:
(1) No political sign shall be posted on any public property or in the public right-of-way. Political signs posted on public property or on the public right-of-way are subject to immediate removal by city forces without prior written or verbal notification.
(2) No political sign shall be posted in the corner cutoff area, as defined in § 17.70.040, except in accordance with the exceptions described in § 17.70.040. Political signs posted in the corner cut-off areas are subject to
5 immediate removal by city forces without prior written or verbal notification.
(3) All political signs pertaining to a particular election shall be removed within ten days after the date of the election. Any political sign that remains posted for more than ten days after the election to which it pertains shall also be deemed abandoned. The Planning Director may cause the summary removal by city forces of such abandoned signs and any signs which constitute an immediate peril to persons or property without further notice. The removal of abandoned signs by city forces is subject to cost recovery as provided for in this subsection.
(4) All signs that have been confiscated by the city will be stored for a period of ten days from the date of the notification letter. In the event the signs are not reclaimed after the ten-day storage period, the signs will be discarded.
(5) The cost of removal of any sign by city forces pursuant to this section shall be borne by the actual responsible party or the candidate's designated agent. The cost of such removal under this section shall be the actual cost or the standard cost pursuant to an amount as set by resolution of the City Council.
(6) After such removal, the actual responsible party or the candidate's designated agent shall be served with a statement of cost. Notice shall be given that the determination stated in the statement of costs may be appealed pursuant to Chapter 1.09 of this Code. In addition and notwithstanding the provisions of § 1.09.040, the appellant shall be responsible for paying all costs of such appeal.
(7) If no appeal is timely filed, the costs shall become a civil debt owing to the city. An action may be commenced in the name of the city in any court of competent jurisdiction to recover the amount specified. (8) If the appeal is timely filed, the decision of the hearing officer shall be final.”
SECTION 11. Amendment to Section 17.74.080. Subsection (C) of Section
17.74.080 (Flags, banners, pennants and devices to attract attention) of Chapter 17.74 (Signs) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“(C) Feather flag permit.
(1) Feather flags are permitted with the issuance of a feather flag permit for commercial and industrial businesses, and multiple dwelling rentals containing 50 or more units.
(2) Five feather flags are allowed per premises, or for each commercial or business center where the property contains multiple tenants, for a period not to exceed a total of 60 days in a calendar year.
(3) Feather flags shall be spaced no closer than 30 feet from another feather flag on the same property.
6 (4) The feather flag shall advertise a special sale, event, or grand opening and shall not be used to augment other signage for the premises or business.
(5) The feather flag shall be associated with a business on the premises where it is located.
(6) The feather flag shall not be located in the public right-of-way. (7) The feather flag shall be maintained in good condition and shall not be torn or ragged.
(8) The feather flag shall not be placed in the corner cut-off areas described in § 17.70.040.”
SECTION 12. Amendment to Section 17.76.100. Section 17.76.100 (Landscaping requirements) of Chapter 17.76 (Off-Street Parking) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“17.76.100 Landscaping requirements.
The following landscaping requirements for off-street parking areas within the M-1, M-2 and M-3 zones which are not adjacent to public streets or designated as visitors parking shall apply.
(A) Parking areas not visible in the discretion of the city from a public street or adjacent property shall have no landscaping requirement. (B) Parking areas visible in the discretion of the city from a public street or adjacent property shall be provided perimeter landscaping to a minimum width of four feet.”
SECTION 13. Amendment to Section 17.79.050. Subsection (D) of Section
17.79.050 (Design standards) of Chapter 17.79 (Trash Enclosures) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“(D) Location.
(1) Trash enclosures shall not be located in the required minimum front yard or minimum street side yard.
(2) Corner cut-offs shall be in compliance with § 17.70.040. In addition, the corner cut-off for parking stalls shall be ten feet. (3) Trash enclosure doors shall not open into driveways, extend into adjacent parking spaces or obstruct fire hydrants or building exits. (4) Trash enclosures shall be located so that they are accessible to collection vehicles.
(5) Enclosures shall be placed a minimum of ten feet from water or utility lines and outside of any utility easements.
(6) Trash enclosures shall remain at least five feet from any combustible construction or building openings.”
7 SECTION 14. Amendment to Section 17.82.030. Subsection (A)(2) of Section
17.82.030 (Eligibility determination) of Chapter 17.82 (Planned Unit and Condominium Development) of Title 17 (Zoning) of the CMC is hereby amended in its entirety to read as follows:
“(2) Yard requirements. Yards shall be measured from the property lines of individual lots or from the accessways if individual lots are not provided. Yards shall be established as follows. (a) Multiple-family attached dwellings.
1. Front yard. The front yard shall be a minimum of 20
feet for front-on garage setbacks. Corner cut-offs shall be in compliance with § 17.70.040.
(Ord. 1781.)
2. Interior side yards. The interior side yards shall be a minimum of five feet for one-story buildings, ten feet for two-story buildings and 15 feet for three-story buildings, except that an attached patio structure, open on three sides, may extend to within three feet of a side property line.
3. Street side yards. The street side yard setbacks shall be a minimum of ten feet from private and local streets, 15 feet from collector streets and 20 feet from major and secondary streets, except that an attached patio structure, open on three sides, may extend to within ten feet from property line.
4. Rear yard. The rear yard shall be a minimum of ten feet except that an attached patio structure, open on three sides, may extend to within three feet of a rear property line.
5. Building separation. In no case shall buildings be
separated by less than 15 feet for one-story buildings, 20 feet for two-story buildings and 25 feet for three-story buildings. In the case of two buildings of differing heights, the more stringent separation shall apply.
(b) Single-family attached dwellings.
1. Front yard. The front yard shall be a minimum of 20
feet. Corner cut offs shall be in compliance with §17.70.040.
2. Interior side yards. Interior side yards shall be a
minimum of five feet except where attached along a common property line.
3. Street side yards. Street side yards shall be a minimum of ten feet on a local, private or collector street and 15 feet on a secondary or major street. Corona Municipal Code Chapter
17.70 standards applicable to corner cut-offs, key lots and reverse corner lots shall apply.
4. Rear yards. The rear yard shall be an average of 15 feet with no building area closer than ten level feet to the rear property line. An attached patio structure, open on three sides, may extend to
8 within three feet of the rear property line. For accessory buildings see Corona Municipal Code § 17.66.010.
5. Building separation. The minimum building separation shall be ten feet between one-story conditions, 15 feet between a one- and a two-story condition and 20 feet between two-story conditions.
(c) Detached dwellings. The setback requirements of the underlying zone shall apply except that zero side yard set backs may be allowed with a minimum building separation of ten feet upon approval from the Planning Commission.”
SECTION 15. Official Record. The documents and materials that constitute the record of proceedings on which these findings have been based are located at the City of Corona City Hall, 400 S. Vicentia Avenue, Corona, California 92882. The custodian for these records is the Planning and Development Director of the City of Corona.
SECTION 16. Severability. If any provision or clause of this Ordinance or any application of it to any person, firm, organization, partnership or corporation is held invalid, such invalidity shall not affect other provisions of this Ordinance which can be given effect without the invalid provision or application. To this end, the provisions of this Ordinance are declared to be severable.
SECTION 17. Effective Date. The Mayor shall sign this Ordinance and the City Clerk shall attest thereto and shall within fifteen (15) days of its adoption cause it, or a summary of it, to be published in a general circulation newspaper published and circulated in the City of Corona. This Ordinance shall take effect and be in force 30 days after its adoption.
PASSED, APPROVED AND ADOPTED this 2
nd day of September 2026.
___________________________________
Mayor of the City of Corona, California
ATTEST:
____________________________________
City Clerk of the City of Corona, California
9 CERTIFICATION
I, Sylvia Edwards, Clerk of the City of Corona, California, do hereby certify that the foregoing Ordinance was regularly introduced at a regular meeting of the City Council of the City of Corona, California, duly held the 19th day of August 2026, and thereafter at a regular meeting held on the 2
nd day of September 2026, it was duly passed and adopted by the following vote:
AYES:
NOES:
ABSENT:
ABSTAINED:
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the official seal of the City of Corona, California, this 2
nd day of September 2026.
_______________________________________
City Clerk of the City of Corona, California
[SEAL]
10 EXHIBIT “A”
CHAPTER 17.70
LANDSCAPING, FENCES, WALLS, HEDGES
17.70.010 Purpose and intent.
17.70.020 Applicability.
17.70.030 Definitions.
17.70.040 Visibility at Intersections (Corner Cut-off Areas).
17.70.050 Fences, Walls, and Hedges.
17.70.060 Water Efficient Landscape Requirements.
17.70.070 Additional Landscape Requirements.
17.70.080 Violations and Penalties.
17.70.010 Purpose and intent.
The purpose and intent of this chapter is to:
(A) Establish a framework to review landscape and irrigation plans consistently and improve the physical appearance of the City by providing visual and ecological relief in the urban environment;
(B) Establish minimum standards for fences and walls, and for the design, provision and maintenance of landscaped areas, and encourage irrigation methods and suggested plant species to develop a measure of uniformity and quality in overall landscaping design; (C) Promote the value and long-term benefits of landscapes to provide an attractive living, working and recreating environment, while recognizing the need to invest water and other resources as efficiently as possible; and
(D) Establish a structure for designing, installing, and maintaining water efficient landscapes for new and rehabilitation projects.
17.70.020 Applicability.
This chapter applies to all residential, commercial and industrial zones set forth in Title 17 of the Corona Municipal Code and districts of similar classification within specific plans. If there is a conflict between the standards in this chapter and in a specific plan, the specific plan shall prevail unless otherwise noted in the specific plan.
17.70.030 Definitions.
Unless the particular provision of the context otherwise requires, the definitions and provisions contained in this section shall govern the construction, meaning and application of words and phrases used in this chapter. Unless the context otherwise clearly indicates, words used in the singular include the plural and words used in the plural includes the singular. Words and phrases
11 used in this chapter not otherwise defined in this section shall be defined in the Landscape Design Manual adopted pursuant to § 17.70.060(G).
“Certificate of Completion Package” means the documents with the required elements that certifies a landscape project has been installed in accordance with the requirements of § 17.70.060 and the Landscape Design Manual, and as further described in California Code of Regulations, Title 23, Division 2, Chapter 2.7, Section 494, as may be amended. “City Manager” means the City Manager for the City of Corona, or his or her designee. “Director” means the Planning and Development Director for the City of Corona, or his or her designee.
“Landscape Design Manual” means the Landscape Design Manual adopted pursuant to §
17.70.060(G) which describes the procedures, calculations, and requirements for landscape projects that are subject to the requirements in this chapter. “Landscape Documentation Package” means the documents with the elements required by §
17.70.060(D)(2) and § 17.70.060(E)(2) submitted to the City to review compliance with the requirements of § 17.70.060 and the Landscape Design Manual. “Landscape project” means the total landscape area that requires a building or landscape permit, plan check, or design review.
“Mulch” means any organic material such as leaves, bark, straw, or compost, applied to the soil surface for the beneficial purposes of reducing evaporation, suppressing weeds, moderating soil temperature, and preventing soil erosion. Mulch includes inorganic mineral materials such as rocks, gravel, or decomposed granite left loose (i.e., may be used for fire safe landscaping, as approved by the Corona Fire Department).
“New construction” means a new building with landscaping or a landscape-dominated project, such as a park, playground, playing field, or greenbelt or other new landscape, which may or may not have an associated building or structure.
“Parkway” has the same meaning as set forth in § 12.22.030 of this code. “Project applicant” means the person submitting a landscape design plan to the City pursuant to § 17.70.060 and the Landscape Design Manual, to request a permit, plan check or design review from the City for the installation of a landscaping project. The project applicant may be the property owner or their designee.
“Security fencing” means fencing, wall or other authorized physical barrier intended to prevent unauthorized access, deter intruders, and provide protection for properties, assets, and people. “Temporary fencing” means fencing not permanently affixed to the site.
12 “Turfgrass” means a living ground cover surface of mowed grass.
17.70.040 Visibility at Intersection (Corner Cut-off Areas).
(A) Intersection visibility requirements. The following regulations apply to all intersections of streets, alleys, private driveways, and any combination thereof to provide adequate visibility for vehicular and pedestrian traffic.
(1) The corner cut-off area consists of a triangular-shaped area on a corner lot formed by measuring the prescribed distance in Table 1 from the intersection of the front and street side property lines, an intersecting alley, or an intersecting driveway, and connecting the end-points of the lines diagonally across the property, making an approximate 90-degree triangle. (2) No parking or vertical obstructions shall encroach within corner cut-off areas described in Table 1 below except as otherwise provided by this chapter. (3) Vegetation and structures on property located at any corner of intersecting streets, alleys, and/or private driveways shall adhere to the following distance requirements in Table 1.
Table 1
Distances from Intersections by Roadway Type, Alley, or Private Driveway (Corner Cut-off Areas)
Major or secondary street right-of-way 30 feet
Collector street right-of-way 25 feet
Local street right-of-way 20 feet
Alley right-of-way 10 feet
Private driveway 10 feet
(a) Notwithstanding subsection (A)(2) above, light poles, sign supports, fences, roof overhangs, plant materials or other similar structures may be permitted within the corner cutoff area subject to the approval of the Director, the Public Works Director or the Community Services Director, as applicable based upon the location of the structure; provided, however, that:
i. Such structure or obstruction shall not have a horizontal dimension greater than 12 inches (12”) between the elevation of three feet (3’) and ten feet (10’) above the adjacent street, driveway or alley pavement.
ii. The corner cut-off area shall be for pedestrian use or landscaped and maintained subject to the approval of the Director, the Public Works Director or the Community Services Director, as applicable.
iii. Plant material may be located within the corner cut-off area if no part of said structure or plant material exceeds three feet (3’) in height above the adjacent street, driveway or alley pavement.
iv. Overhangs of structures into the corner cut-off area may be permitted in accordance with § 17.74.040(A).
17.70.050 Fences, Walls, and Hedges.
(A) General Provisions.
13 (1) Placement & Height
(a) A fence, wall or hedge may be constructed, installed and maintained in any permitted or required yard along the rear, interior or side lot line, provided the fence, wall or hedge does not exceed seven feet (7’) in height at any point and does not extend into the required minimum front yard setback area.
(b) Entry and vehicular access gates located behind the required front yard setback area shall not exceed eight feet (8’) in height measured at the highest point of the gate. (c) For purposes of this chapter, the height of any fence, gate, wall or hedge shall be measured from the highest ground elevation immediately adjacent on either side of such fence, gate, wall or hedge.
(d) In the case of corner lots where driveways extend into the side yard, fences, hedges or walls shall inset at a 45 degree angle, 15 feet (15’) on each side of such driveway; provided, however, that this subsection shall not apply to any security fence or wall as set forth in § 17.70.050(A)(3), nor the erection of fences, walls or hedges around any building or structure used for providing public utility services.
(2) Outdoor Storage
(a) In industrial zones where outdoor storage is permitted and where such outdoor storage is visible from another property or common area including common drive aisles and parking lots, the outdoor storage use shall be enclosed within a six-foot (6’) to eight-foot (8’) high opaque fence. Opaque fencing includes block, tubular steel with metal mesh screen material, or other durable screen materials as may be approved by the Director. (b) In industrial zones where outdoor storage is permitted and where such outdoor storage is visible from a public or private street, railroad, or highway, the outdoor storage use shall be enclosed within a six-foot (6’) to eight-foot (8’) high decorative block wall. The Director, in his or her discretion, shall determine whether the outdoor storage use is visible from a public or private street, railroad, or highway.
(c) Wood fencing, chain link fencing and chain link fencing with wood or plastic slats are prohibited for outdoor storage uses.
(3) Security Fencing
(a) The height of security fences and walls in commercial, industrial and agricultural zones may be increased by two feet (2’) above what is otherwise permitted by this section, subject to review by the Director. Security fencing may include barbed wire, razor wire, spiked rails, or similar deterrent materials, or may be an extension of the existing permitted wall or fence material. The use of electrified fencing is not permitted unless such fencing is required or allowed by any law or regulation of the City, the State of California, federal government, or other public agency.
(b) In multiple-family residential zones, perimeter fencing can be increased up to a height of eight feet (8’) for security purposes, provided that the fencing is all wrought iron with pilasters or a combination of decorative block not to exceed seven feet (7’) in height and wrought iron with pilasters.
(4) Temporary Fencing
(a) Temporary fencing, such as chain link, shall be permitted on sites under construction but must be removed upon completion of construction. Temporary fencing may also be permitted for vacant lots, agricultural areas, or similar uses for security purposes, subject to the approval of the Director.