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HomeMy WebLinkAboutRes.3122.11-06-2017 BILL NO. 17-166 RESOLUTION NO. 5/c2,? A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A CONTRACT WITH COLONIAL LIFE & ACCIDENT INSURANCE COMPANY FOR EMPLOYEE SUPPLEMENTAL INSURANCE, AND FOR A SECTION 125 CAFETERIA PLAN, AND TO EXECUTE ALL NECESSARY PROGRAM DOCUMENTS BE IT RESOLVED BY THE COUNCIL OF THE CITY OF CAPE GIRARDEAU, MISSOURI, AS FOLLOWS : ARTICLE 1 . The City Manager, for and on behalf of the City of Cape Girardeau, Missouri, is hereby authorized to execute a Contract with Colonial Life & Accident Insurance Company for Employee Supplemental Insurance, and for a Section 125 Cafeteria Plan, and to execute all necessary program documents, including all further necessary regulatory amendments to the plan document recommended by Colonial Life & Accident Insurance Company. Said Contract shall contain the terms set out in the proposal from Colonial Life & Accident Insurance Company. A copy of the proposal information is attached hereto and made apapart ) hereof. PASSED AND ADOPTED THIS _(‘?! DAY OF J1J.cL l' V 2017 . Harry E. R diger, Mayor ATTEST: êecayuty City Clerk . _ ..- N\ „. ... ... . .., ,,, . ,., ,. •-‘.7 •-• CI ,,,,;ii„,„,,,,. ili ;:.,:., '. 1 o _91 -1 Iii 6 \• .. t, �E uA,rO I� 4ee Fi ' ,ri`- . Please check one: (� New account Existing account implementing a flex plan. Indicate existing BCN /,, Federal TaXID# q�& " coos .("7 _3 Plan Initial enrollment dates: Subsequent (future) plan document date: Subsequent (future) enrollment dates: Colonial Life® Start l�_0_j&_1,7Stop iZJ31JzO/7 o L o/ /_Z io Start L (5� lStop l� J�o f Employer Reminder Notice We are pleased you have selected Colonial Life & Accident Insure nce Company (hereinafter called Colonial Life) as a supplier of insurance under the flexible benefits plan that you are implementing within the guidelines of Section 125 of the Internal Revenue Code. As a supplier of currently acceptable insurance coverage, we would like to remind you of several elements of Code Section 125. 1. You should have a written plan document that addressesthe six primary elements listed in the Proposed Regulations. 2. You should realize that as a result of sa [a ry reduction, you, the employer, reduce your FICA (Socia lSecurity) contributions asaresuIt of your employees' reducing their FICA contributions. Both of these reductions may ultimately somewhat reduce the Social Security benefit eventually paid to the employee. 3. You should review state statutes as they pertain to state taxi miatications of employees'sa I a ry reductions under your p [an, In addition, you should check with your workers' compensation insurance carrier to determine if the workers' compensation insurance can be based on the reduced gross pay after salary reductions. 4. Because premiums being paid are considered employer paid, certain claim payments will be subject to 1099 reporting by Colonial Life. S. Payments for the first six months of total disability are subject to FICA tax. Colonial Life wilt withhold the correct FICA taxes from these claim payments and notify you, the employer, of your obligation to pay the employer's portion of the FICA tax and the amount due. You will be required to add the disability payment to the employee's W-2 or provide a separate W-2 for the amount of the payment. 6. Once employee elections are made, they may not be changed during the plan year except under circumstances outlined in the plan document. Any changes must be communicated to Colonial Life in writing by your plan administrator. Since premiums are considered employer paid, all refunds will be made to the employer. The employer will be responsible for any tax withholdings and reporting and for distributing the refunds to employees. 7. 1 he cost of certain insurance coverage is required to be reported bythee mployeron the employees' Form W-2 for information only. Colonial Life's hospital confinement indemnity and specified disease products are required to be reported on Form W-2forthis purpose when all or part of the premiums are paid through salary reduction (pre -taxed) by the employer. The premiums are not considered I o be taxable income to the employee. 8. Certain benefit plans, when pre -taxed, may become subject to the Employee Retirement Income Security Act of 1974 (ERISA). Under ERISA, all employers (other than governmental and church employers) must provide each participant in a welfare or pension benefit plan with a summary plan description. 9. Flexible benefit plans are subject to discrimination rules to ensure highly compensated and key employees are not allowed to benefit from the plan disproportionately compared to other employees. The employer is responsible for complying with the discrimination guidelines. You should consult your professional advisors, lawyers and/or certified public accountants for answers to specific questions. I acknowledge that I have read and understand the Flex Plan Supplemental Form. This also serves as confirmation of existing plan dates, any amend,}}}nts to themif applicable and inclusion of Colonial Life products undertheplan./ nrcount name Colonial Life producer name Authorized officer name Signature of authorized officer Title Date (mm/dd/yyyy) ©2014 Colonial Life &Accident Insurance Company, Columbia, 5C I Colonial Life insurance products are underwritten by Colonial Llfe&Accident Insurance Company, forwhich Colonial Life isthe marketingbrand. 7-16 1 56406-10 .IIte Colonial Ufe,, Making benefits count. Producer Contact: 1.800.43VOICE, Option 2, 2 Fax Forms to 1.800.543.8573 or email to newaccountservicecenterPcoloniallife.com City: l ,f u0'lkcin 2Ci A5 State: 1`.A ID Zip ( 0 t5 /0:- , Phone:I� ��q -(f�.`SC%L� Fax: (S� .�-'39'-i If this account is associated with another Colonial Life or one of its affiliates'accounts, please provide the name and BCN of the account or master group number: Account billing address (if different from above address): f II H''-�� 4Z Contact person for billing and service: [ik i L- f",O C ✓l Cxg ng� i & First Name Middle Initial Last Name Title E-mail address: U li�-pc_n ru G - -+ C_ . • _ D t Are there locations that will be written inl (? ❑Yes ❑No Number of benefit -eligible employees: Exact nature of business:`¢ FederalTaxID: �42-(oc)DC; ] 1.3 Will a third party administer, reconcile and/or remit the premium deductions? []Yes ® No If yes, is the third party a: ❑ Payroll Company ❑ Professional Employer Organization ❑ Please indicate name, address, phone number and contact person *A Premium Services and Administration Agreement may be needed. Will any deductions be made pretax? ®Yes ❑ No If yes, include Flex Plan Supplemental Form. Will the employer be contributing any premium toward the Colonial Life benefits? [-]Yes PNo IMPORTANT COMPENSAnoN DISCLOSURE INFORMATION Colonial Life is committed to helping working Americans andtheir families minimize personal financial riskwith a comprehensive offering of voluntary benefits through the workplace. Colonial Life compensates producers to facilitate the sale and delivery of these valuable benefits.This compensation might include commissions as well as various Incentives and awards. We support the full disclosure of compensation programs for our products, and your insurance advisor can provide you with complete information about these programs. You may also learn additional information about our compensation programs by contacting our Plan Administrator Service Center at 1.800.256.7004. Is employer/account paying a fee to an insurance advisor for this placement of Colonial Life insurance? ❑Yes jPNo Initials o(Authorized Officer If yes, list advisor(s) names A completed Compensation Consent and Disclosure Form 62291 is required for each insurance advisor receiving a fee. If fee is paid in the future, it is the employer's responsibility to notify Colonial Life of the change. The employer account (and/or its assigns) agrees to forward promptly all insurance premiums payroll deducted from its employees to Colonial Life & Accident Insurance Company (hereafter Colonial Life) for payment of employee insurance coverage and to notify Colonial Life promptly of the names of any employees to cease deductions because of termination from employment or otherwise. If the employer fails to notify Colonial Life that an individual's employment has terminated, that an Individual has otherwise ceased deductions or where there is some other misunderstanding between the employer and employee concerning the payroll deductions, Colonial Life agrees to reimbursethe employer up to one (1) month's premium in the event of loss bythe employer as long as a claim has not been paid. Refund of premiums on flexible benefit plan accounts will be made payable to the employer. The issuance of any coverage paid for by payroll deduction pursuant to this agreement does not relieve the employer of the requirements of Workers' Compensation Laws of their state. Signed at: l n lid i k(w I ii Q this �I City and State day of Print Name and Title of Authorized Officer ` Signature of Authorized Officer I Z/ Submitted by �.lU f�lP`Ok .r- Producer # 7 � k2 Producer Telephone Number 3/11 02010 Colonial Life&Accideottmarance Company. Colonial Life is the marketing brand of Colonial Life& Accidentlnsurance Company. 56405-8