ࡱ>  @ Rbjbjʚʚ SJDvLl=:^  <<<<<<<$B?RAz==&=]$]$]$F<]$<]$]$8k<ތ o.C<4<<=0l=w<4B#pBh<B<@C0]$CCC==xDG$ SAMPLE This specimen document has been provided to assist you in drafting a Summary Plan Description (SPD) for our mutual clients that have adopted the ING Life Insurance and Annuity Company 401(k) Prototype Plan Document. Note that this sample is a Profit Sharing Plan only with an allocation formula that is the same dollar amount to all participants and also includes a loan feature. These features should be deleted or revised as needed. Certain areas of the sample SPD have been highlighted in red to draw your attention to the possible need for the revision or addition of information based on the provisions of the plan you are drafting the SPD for, however these highlighted areas are not intended to be all inclusive. This sample SPD should be carefully reviewed and edited to ensure that it properly reflects the provisions of the plan to which it will relate. This sample SPD is not intended as tax or legal advice. We suggest that adopting employers consult with the plans tax advisor and legal counsel to ensure that the SPD properly reflects their own plan provisions before distributing it to plan participants. [Insert Plan name] SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS [Edit Table of Contents as needed]  TOC \L 14\N 12\ \* MERGEFORMAT INTRODUCTION TO YOUR PLAN What kind of Plan is this?  PAGEREF _Toc211674908 \h 1 What information does this Summary provide?  PAGEREF _Toc211674909 \h 1 ARTICLE I PARTICIPATION IN THE PLAN How do I participate in the Plan?  PAGEREF _Toc211674912 \h 1 How is my service determined for purposes of Plan eligibility?  PAGEREF _Toc211674913 \h 2 What service is counted for purposes of Plan eligibility?  PAGEREF _Toc211674914 \h 2 What happens if I'm a participant, terminate employment and then I'm rehired?  PAGEREF _Toc211674915 \h 2 ARTICLE II EMPLOYEE CONTRIBUTIONS What are rollover contributions?  PAGEREF _Toc211674918 \h 3 ARTICLE III EMPLOYER CONTRIBUTIONS What is the Employer profit sharing contribution and how is it allocated?  PAGEREF _Toc211674921 \h 3 How is my service determined for allocation purposes?  PAGEREF _Toc211674922 \h 3 What are forfeitures and how are they allocated?  PAGEREF _Toc211674923 \h 4 ARTICLE IV COMPENSATION AND ACCOUNT BALANCE What compensation is used to determine my Plan benefits?  PAGEREF _Toc211674926 \h 4 Is there a limit on the amount of compensation which can be considered?  PAGEREF _Toc211674927 \h 4 Is there a limit on how much can be contributed to my account each year?  PAGEREF _Toc211674928 \h 4 How is the money in the Plan invested?  PAGEREF _Toc211674929 \h 5 Will Plan expenses be deducted from my account balance?  PAGEREF _Toc211674930 \h 5 ARTICLE V VESTING What is my vested interest in my account?  PAGEREF _Toc211674933 \h 5 How is my service determined for vesting purposes?  PAGEREF _Toc211674934 \h 6 What service is counted for vesting purposes?  PAGEREF _Toc211674935 \h 6 What happens to my nonvested account balance if I'm rehired?  PAGEREF _Toc211674936 \h 6 What happens if the Plan becomes a "top-heavy plan"?  PAGEREF _Toc211674937 \h 7 ARTICLE VI DISTRIBUTIONS PRIOR TO TERMINATION Can I withdraw money from my account while working?  PAGEREF _Toc211674940 \h 7 Can I withdraw money from my account in the event of financial hardship?  PAGEREF _Toc211674941 \h 7 ARTICLE VII BENEFITS AND DISTRIBUTIONS UPON TERMINATION OF EMPLOYMENT When can I get money out of the Plan?  PAGEREF _Toc211674944 \h 8 What happens if I terminate employment before death, disability or retirement?  PAGEREF _Toc211674945 \h 8 What happens if I terminate employment at Normal Retirement Date?  PAGEREF _Toc211674946 \h 8 What happens if I terminate employment due to disability?  PAGEREF _Toc211674947 \h 8 How will my benefits be paid to me?  PAGEREF _Toc211674948 \h 9 ARTICLE VIII BENEFITS AND DISTRIBUTIONS UPON DEATH What happens if I die while working for the Employer?  PAGEREF _Toc211674951 \h 9 Who is the beneficiary of my death benefit?  PAGEREF _Toc211674952 \h 9 How will the death benefit be paid to my beneficiary?  PAGEREF _Toc211674953 \h 10 When must the last payment be made to my beneficiary?  PAGEREF _Toc211674954 \h 10 What happens if I'm a participant, terminate employment and die before receiving all my benefits?  PAGEREF _Toc211674955 \h 10 ARTICLE IX TAX TREATMENT OF DISTRIBUTIONS What are my tax consequences when I receive a distribution from the Plan?  PAGEREF _Toc211674958 \h 10 Can I elect a rollover to reduce or defer tax on my distribution?  PAGEREF _Toc211674959 \h 10 ARTICLE X LOANS Is it possible to borrow money from the Plan?  PAGEREF _Toc211674962 \h 11 What are the loan rules and requirements?  PAGEREF _Toc211674963 \h 11 ARTICLE XI PROTECTED BENEFITS AND CLAIMS PROCEDURES Are my benefits protected?  PAGEREF _Toc211674966 \h 12 Are there any exceptions to the general rule?  PAGEREF _Toc211674967 \h 12 Can the Plan be amended?  PAGEREF _Toc211674968 \h 12 What happens if the Plan is discontinued or terminated?  PAGEREF _Toc211674969 \h 12 How do I submit a claim for Plan benefits?  PAGEREF _Toc211674970 \h 12 What if my benefits are denied?  PAGEREF _Toc211674971 \h 12 What is the Claims Review Procedure?  PAGEREF _Toc211674972 \h 13 What are my rights as a Plan participant?  PAGEREF _Toc211674973 \h 14 What can I do if I have questions or my rights are violated?  PAGEREF _Toc211674974 \h 15 ARTICLE XII GENERAL INFORMATION ABOUT THE PLAN Plan Name  PAGEREF _Toc211674977 \h 15 Plan Number  PAGEREF _Toc211674978 \h 15 Plan Effective Dates  PAGEREF _Toc211674979 \h 15 Other Plan Information  PAGEREF _Toc211674980 \h 15 Employer Information  PAGEREF _Toc211674981 \h 16 Plan Administrator Information  PAGEREF _Toc211674982 \h 16 Plan Trustee Information and Plan Funding Medium  PAGEREF _Toc211674983 \h 16  [Insert Plan Name] SUMMARY PLAN DESCRIPTION INTRODUCTION TO YOUR PLAN [Edit Introduction as needed] tc "INTRODUCTION TO YOUR PLAN" \l 2 What kind of Plan is this? tc "What kind of Plan is this?" \l 3 [Insert plan name] ("Plan") has been adopted to provide you with additional income for retirement. This Plan is a type of qualified retirement plan commonly referred to as a profit sharing Plan. Generally you are not taxed on the amounts we contribute to the Plan on your behalf until you withdraw these amounts from the Plan. What information does this Summary provide? tc "What information does this Summary provide?" \l 3 This Summary Plan Description ("SPD") contains information regarding when you may become eligible to participate in the Plan, your Plan benefits, your distribution options, and many other features of the Plan. You should take the time to read this SPD to get a better understanding of your rights and obligations in the Plan. In this summary, your Employer has addressed the most common questions you may have regarding the Plan. If this SPD does not answer all of your questions, please contact the Administrator or other plan representative. The Administrator is responsible for responding to questions and making determinations related to the administration, interpretation, and application of the Plan. The name and address of the Administrator can be found at the end of this SPD in the Article entitled "General Information About the Plan." This SPD describes the Plan's benefits and obligations as contained in the legal Plan document, which governs the operation of the Plan. The Plan document is written in much more technical and precise language and is designed to comply with applicable legal requirements. If the nontechnical language in this SPD and the technical, legal language of the Plan document conflict, the Plan document always governs. If you wish to receive a copy of the legal Plan document, please contact the Administrator. The Plan and your rights under the Plan are subject to federal laws, such as the Employee Retirement Income Security Act (ERISA) and the Internal Revenue Code, as well as some state laws. The provisions of the Plan are subject to revision due to a change in laws or due to pronouncements by the Internal Revenue Service (IRS) or Department of Labor (DOL). Your Employer may also amend or terminate this Plan. If the provisions of the Plan that are described in this SPD change, your Employer will notify you. Types of Contributions. The following types of contributions may be made under this plan: ( employee rollover contributions ( employer profit sharing contributions ARTICLE I PARTICIPATION IN THE PLAN [Edit this Article as needed] tc "ARTICLE I" \l 1 tc "PARTICIPATION IN THE PLAN" \l 2 How do I participate in the Plan? tc "How do I participate in the Plan?" \l 3 Provided you are not an Excluded Employee, you may begin participating under the Plan once you have satisfied the eligibility requirements and reached your "Entry Date." The following describes the eligibility requirements and Entry Dates that apply. You should contact the Administrator if you have questions about the timing of your Plan participation. Profit Sharing Contributions Excluded Employees. If you are a member of a class of employees identified below, you are an Excluded Employee and you are not entitled to participate in the Plan for purposes of profit sharing contributions. The Excluded Employees are: ( union employees whose employment is governed by a collective bargaining agreement under which retirement benefits were the subject of good faith bargaining ( certain nonresident aliens who have no earned income from sources within the United States Eligibility Conditions. You will be eligible to participate for purposes of profit sharing contributions when you have satisfied the following eligibility condition(s). However, you will actually enter the Plan once you reach the Entry Date as described below. ( attainment of age 21. ( completion of one (1) Year of Service. Entry Date. For purposes of profit sharing contributions, your Entry Date will be the first day of the Plan Year or the first day of the seventh month of the Plan Year coinciding with or next following the date you satisfy the eligibility requirements. How is my service determined for purposes of Plan eligibility? tc "How is my service determined for purposes of Plan eligibility?" \l 3 Year of Service. You will have completed a Year of Service if, at the end of your first twelve months of employment with the Employer, you have been credited with at least 1,000 Hours of Service. If you have not been credited with 1,000 Hours of Service by the end of your first twelve months of employment, you will have completed a Year of Service at the end of any following Plan Year during which you were credited with 1,000 Hours of Service. Hour of Service. You will be credited with your actual Hours of Service for: (a) each hour for which you are directly or indirectly compensated by the Employer for the performance of duties during the Plan Year; (b) each hour for which you are directly or indirectly compensated by the Employer for reasons other than the performance of duties (such as vacation, holidays, sickness, disability, layoff, military duty, jury duty or leave of absence during the Plan Year); and (c) each hour for back pay awarded or agreed to by the Employer. You will not be credited for the same Hours of Service both under (a) or (b), as the case may be, and under (c). What service is counted for purposes of Plan eligibility? tc "What service is counted for purposes of Plan eligibility?" \l 3 Service with the Employer. In determining whether you satisfy the minimum service requirements to participate under the Plan, all service you perform for the Employer will generally be counted. However there are some exceptions to this general rule. Break in Service rules. If you terminate employment and are rehired, you may lose credit for prior service under the Plan's Break in Service rules. For eligibility purposes, you will have a Break in Service if you complete less than 501 Hours of Service during the computation period used to determine whether you have a Year of Service. However, if you are absent from work for certain leaves of absence such as a maternity or paternity leave, you may be credited with enough Hours of Service to prevent a Break in Service. Fiveyear eligibility Break in Service rule. The fiveyear Break in Service rule applies only to participants who had no vested interest in the Plan when employment had terminated. If you were not vested in any amounts when you terminated employment and you have five 1-Year Breaks in Service (as defined above), all the service you earned before the 5year period no longer counts for eligibility purposes. Thus, if you were to return to employment, you would have to resatisfy any minimum service requirements under the Plan. Military Service. If you are a veteran and are reemployed under the Uniformed Services Employment and Reemployment Rights Act of 1994, your qualified military service may be considered service with the Employer. If you may be affected by this law, ask the Administrator for further details. What happens if I'm a participant, terminate employment and then I'm rehired? tc "What happens if I'm a participant, terminate employment and then I'm rehired?" \l 3 If you are no longer a participant because you terminated employment, and you are rehired, then you will be able to participate in the Plan on your date of rehire provided your prior service had not been disregarded under the Break in Service rules and you are otherwise eligible to participate in the Plan. ARTICLE II EMPLOYEE CONTRIBUTIONS [Edit this Article as needed] tc "ARTICLE II" \l 1 tc "EMPLOYEE CONTRIBUTIONS" \l 2 What are rollover contributions? tc "What are rollover contributions?" \l 3 Rollover contributions. At the discretion of the Administrator, a Participant who is currently employed or an Eligible Employee, then you may be permitted to deposit into the Plan distributions you have received from other plans and certain IRAs. Such a deposit is called a "rollover" and may result in tax savings to you. You may ask the administrator or trustee of the other plan or IRA to directly transfer (a "direct rollover") to this Plan all or a portion of any amount that you are entitled to receive as a distribution from such plan. Alternatively, if you received a distribution from a prior plan, you may elect to deposit any amount eligible to be rolled over within 60 days of your receipt of the distribution. You should consult qualified counsel to determine if a rollover is permitted and in your best interest. Rollover account. Your rollover will be accounted for in a "rollover account." You will always be 100% vested in your "rollover account" (see the Article in this SPD entitled "Vesting"). This means that you will always be entitled to all amounts in your rollover account. Rollover contributions will be affected by any investment gains or losses. Withdrawal of rollover contributions. You may withdraw the amounts in your "rollover account" at any time. ARTICLE III EMPLOYER CONTRIBUTIONS [Edit this Article as Needed] tc "ARTICLE III" \l 1 tc "EMPLOYER CONTRIBUTIONS" \l 2 This Article describes Employer contributions that may be made to the Plan and how your share of the contribution is determined. What is the Employer profit sharing contribution and how is it allocated? tc "What is the Employer profit sharing contribution and how is it allocated?" \l 3 Profit sharing contribution. Each year, your Employer may make a discretionary profit sharing contribution to the Plan. Your share of any contribution is determined below. Allocation conditions. In order to share in the profit sharing contribution for a Plan Year, you must satisfy the following conditions: ( If you are employed on the last day of the Plan Year, you will share if you completed a Year of Service during the Plan Year. ( If you terminate employment (not employed on the last day of the Plan Year), you must complete a Year of Service during the Plan Year. ( You will share in the profit sharing contribution for the year regardless of the amount of service you complete during the Plan Year in the year of your death, disability or retirement. Your share of the contribution. The profit sharing contribution will be "allocated" or divided among participants eligible to share in the contribution for the Plan Year. Your share of the profit sharing contribution will be determined by dividing the contribution equally among all participants eligible to share. The Administrator will inform you as to how much will be allocated to your account. For example, suppose the profit sharing contribution for the Plan Year is $100,000. If there are 10 participants eligible to share in the contribution, then each participant's share would be $10,000. How is my service determined for allocation purposes? tc "How is my service determined for allocation purposes?" \l 3 Year of Service. You will have completed a Year of Service for a Plan Year if you have completed at least 1,000 Hours of Service during the Plan Year. Hour of Service. You will be credited with your actual Hours of Service for: (a) each hour for which you are directly or indirectly compensated by the Employer for the performance of duties during the Plan Year; (b) each hour for which you are directly or indirectly compensated by the Employer for reasons other than the performance of duties (such as vacation, holidays, sickness, disability, layoff, military duty, jury duty or leave of absence during the Plan Year); and (c) each hour for back pay awarded or agreed to by the Employer. You will not be credited for the same Hours of Service both under (a) or (b), as the case may be, and under (c). What are forfeitures and how are they allocated? tc "What are forfeitures and how are they allocated?" \l 3 Definition of forfeitures. In order to reward employees who remain employed with the Employer for a long period of time, the law permits a "vesting schedule" to be applied to certain contributions that your Employer makes to the Plan. This means that you will not be "vested" in (entitled to) all of the contributions until you have been employed with the Employer for a specified period of time (see the Article entitled "Vesting"). If a participant terminates employment before being fully vested, then the nonvested portion of the terminated participant's account balance remains in the Plan and is called a forfeiture. Allocation of forfeitures. Forfeitures will be allocated as follows: ( Forfeitures may first be used to pay any administrative expenses. ( Any remaining forfeitures will be added to any Employer discretionary contribution. ARTICLE IV COMPENSATION AND ACCOUNT BALANCE [Edit this Article as needed] tc "ARTICLE IV" \l 1 tc "COMPENSATION AND ACCOUNT BALANCE" \l 2 What compensation is used to determine my Plan benefits? tc "What compensation is used to determine my Plan benefits?" \l 3 Definition of compensation. For the purposes of the Plan, compensation has a special meaning. Compensation is generally defined as your total compensation that is subject to income tax and paid to you by your Employer during the Plan Year. Amounts paid to you after you terminate employment are generally not treated as compensation. If you are a selfemployed individual, your compensation will be equal to your earned income. The following describes the adjustments to compensation that may apply under the Plan. Adjustments to compensation. The following adjustments to compensation will be made: ( salary deferrals to any other plan or arrangement (such as a cafeteria plan) will be included. ( reimbursements or other expense allowances, fringe benefits, moving expenses, deferred compensation, and welfare benefits will be excluded. Is there a limit on the amount of compensation which can be considered? tc "Is there a limit on the amount of compensation which can be considered?" \l 3 The Plan, by law, cannot recognize annual compensation in excess of a certain dollar limit. The limit for the Plan Year beginning in 2008 is $230,000. After 2008, the dollar limit may increase for costofliving adjustments. Is there a limit on how much can be contributed to my account each year? tc "Is there a limit on how much can be contributed to my account each year?" \l 3 Generally, the law imposes a maximum limit on the amount of contributions that may be made to your account and any other amounts allocated to any of your accounts during the Plan Year, excluding earnings. Beginning in 2008, this total cannot exceed the lesser of $46,000 or 100% of your annual compensation. After 2008, the dollar limit may increase for costofliving adjustments. How is the money in the Plan invested? tc "How is the money in the Plan invested?" \l 3 The Trustee of the Plan has been designated to hold the assets of the Plan for the benefit of Plan participants and their beneficiaries in accordance with the terms of this Plan. The trust fund established by the Plan's Trustee will be the funding medium used for the accumulation of assets from which Plan benefits will be distributed. Participant directed investments. You will be able to direct the investment of your entire interest in the Plan. The Administrator will provide you with information on the investment choices available to you, the procedures for making investment elections, the frequency with which you can change your investment choices and other important information. You need to follow the procedures for making investment elections and you should carefully review the information provided to you before you give investment directions. If you do not direct the investment of your applicable Plan accounts, then your accounts will be invested in accordance with the default investment alternatives established under the Plan. The Plan is intended to comply with Section 404(c) of ERISA (the Employee Retirement Income Security Act). If the Plan complies with this Section, then the fiduciaries of the Plan, including your Employer, the Trustee and the Administrator, will be relieved of any legal liability for any losses which are the direct and necessary result of the investment directions that you give. Earnings or losses. When you direct investments, your accounts are segregated for purposes of determining the earnings or losses on these investments. Your account does not share in the investment performance of other participants who have directed their own investments. You should remember that the amount of your benefits under the Plan will depend in part upon your choice of investments. Gains as well as losses can occur and your Employer, the Administrator, and the Trustee will not provide investment advice or guarantee the performance of any investment you choose. Will Plan expenses be deducted from my account balance? tc "Will Plan expenses be deducted from my account balance?" \l 3 Expenses allocated to all accounts. The Plan permits the payment of Plan expenses to be made from the Plan's assets. If expenses are paid using the Plan's assets, then the expenses will generally be allocated among the accounts of all participants in the Plan. These expenses will be allocated either proportionately based on the value of the account balances or as an equal dollar amount based on the number of participants in the Plan. The method of allocating the expenses depends on the nature of the expense itself. For example, certain administrative (or recordkeeping) expenses would typically be allocated proportionately to each participant. If the Plan pays $1,000 in expenses and there are 100 participants, your account balance would be charged $10 ($1,000/100) of the expense. Terminated employee. After you terminate employment, your Employer reserves the right to charge your account for your pro rata share of the Plan's administration expenses, regardless of whether your Employer pays some of these expenses on behalf of current employees. Expenses allocated to individual accounts. There are certain other expenses that may be paid just from your account. These are expenses that are specifically incurred by, or attributable to, you. For example, if you are married and get divorced, the Plan may incur additional expenses if a court mandates that a portion of your account be paid to your exspouse. These additional expenses may be paid directly from your account (and not the accounts of other participants) because they are directly attributable to you under the Plan. The Administrator will inform you when there will be a charge (or charges) directly to your account. Your Employer may, from time to time, change the manner in which expenses are allocated. ARTICLE V VESTING [Edit this Article as needed] tc "ARTICLE V" \l 1 tc "VESTING" \l 2 What is my vested interest in my account? tc "What is my vested interest in my account?" \l 3 In order to reward employees who remain employed with the Employer for a long period of time, the law permits a "vesting schedule" to be applied to certain contributions that your Employer makes to the Plan. This means that you will not be entitled ("vested") in all of the contributions until you have been employed with the Employer for a specified period of time. 100% vested contributions. You are always 100% vested (which means that you are entitled to all of the amounts) in your accounts attributable to the following contributions: ( rollover contributions Vesting schedules. Your "vested percentage" for certain Employer contributions is based on vesting Years of Service. This means at the time you stop working, your account balance attributable to contributions subject to a vesting schedule is multiplied by your vested percentage. The result, when added to the amounts that are always 100% vested as shown above, is your vested interest in the Plan, which is what you will actually receive from the Plan. You will always, however, be 100% vested if you are employed on or after your Normal Retirement Age or if you die or become disabled. Your "vested percentage" in your account attributable to profit sharing contributions is determined under the following schedule. Vesting Schedule Profit Sharing Contributions Years of Service Percentage Less than 2 0% 2 20% 3 40% 4 60% 5 80% 6 100% How is my service determined for vesting purposes? tc "How is my service determined for vesting purposes?" \l 3 Year of Service. To earn a Year of Service, you must be credited with at least 1,000 Hours of Service during a Plan Year. The Plan contains specific rules for crediting Hours of Service for vesting purposes. The Administrator will track your service and will credit you with a Year of Service for each Plan Year in which you are credited with the required Hours of Service, in accordance with the terms of the Plan. If you have any questions regarding your vesting service, you should contact the Administrator. Hour of Service. You will be credited with your actual Hours of Service for: (a) each hour for which you are directly or indirectly compensated by the Employer for the performance of duties during the Plan Year; (b) each hour for which you are directly or indirectly compensated by the Employer for reasons other than the performance of duties (such as vacation, holidays, sickness, disability, layoff, military duty, jury duty or leave of absence during the Plan Year); and (c) each hour for back pay awarded or agreed to by the Employer. You will not be credited for the same Hours of Service both under (a) or (b), as the case may be, and under (c). What service is counted for vesting purposes? tc "What service is counted for vesting purposes?" \l 3 Service with the Employer. In calculating your vested percentage, all service you perform for the Employer will generally be counted. However, there are some exceptions to this general rule. Break in Service rules. If you terminate employment and are rehired, you may lose credit for prior service under the Plan's Break in Service rules. For vesting purposes, you will have a Break in Service if you complete less than 501 Hours of Service during the computation period used to determine whether you have a Year of Service. However, if you are absent from work for certain leaves of absence such as a maternity or paternity leave, you may be credited with enough Hours of Service to prevent a Break in Service. Fiveyear Break in Service rule. The fiveyear Break in Service rule applies only to participants who had no vested interest in the Plan when employment had terminated. If you were not vested in any amounts when you terminated employment and you have five 1-Year Breaks in Service (as defined above), all the service you earned before the 5year period no longer counts for vesting purposes. Thus, if you return to employment after incurring five 1-Year Breaks in Service, you will be treated as a new employee (with no service) for purposes of determining your vested percentage under the Plan. Military Service. If you are a veteran and are reemployed under the Uniformed Services Employment and Reemployment Rights Act of 1994, your qualified military service may be considered service with the Employer. If you may be affected by this law, ask the Administrator for further details. What happens to my nonvested account balance if I'm rehired? tc "What happens to my nonvested account balance if I'm rehired?" \l 3 If you have no vested interest in the Plan when you leave, your account balance will be forfeited. However, if you are rehired before incurring five 1-Year Breaks in Service, your account balance as of your termination date will be restored, unadjusted for any gains or losses. If you are partially vested in your account balance when you leave, the nonvested portion of your account balance will be forfeited on the earlier of the date: (a) of the distribution of your vested account balance, or (b) when you incur five consecutive 1-year Breaks in Service. If you received a distribution of your vested account balance and are rehired, you may have the right to repay this distribution. If you repay the entire amount of the distribution, your Employer will restore your account balance with your forfeited amount. You must repay this distribution within five years from your date of reemployment, or, if earlier, before you incur five 1Year Breaks in Service. If you were 100% vested when you left, you do not have the opportunity to repay your distribution. What happens if the Plan becomes a "top-heavy plan"? tc "What happens if the Plan becomes a \"top-heavy plan\"?" \l 3 Top-heavy plan. A retirement plan that primarily benefits "key employees" is called a "top-heavy plan." Key employees are certain owners or officers of your Employer. A plan is generally a "top-heavy plan" when more than 60% of the plan assets are attributable to key employees. Each year, the Administrator is responsible for determining whether the Plan is a "top-heavy plan." Top-heavy rules. If the Plan becomes top-heavy in any Plan Year, then nonkey employees may be entitled to certain "top-heavy minimum benefits," and other special rules will apply. These top-heavy rules include the following: ( Your Employer may be required to make a contribution on your behalf in order to provide you with at least "top-heavy minimum benefits." ( If you are a participant in more than one Plan, you may not be entitled to "top-heavy minimum benefits" under both Plans. ARTICLE VI DISTRIBUTIONS PRIOR TO TERMINATION [Edit this Article as needed] tc "ARTICLE VI" \l 1 tc "DISTRIBUTIONS PRIOR TO TERMINATION" \l 2 Can I withdraw money from my account while working? tc "Can I withdraw money from my account while working?" \l 3 In-service distributions. You may be entitled to receive an in-service distribution. However, this distribution is not in addition to your other benefits and will therefore reduce the value of the benefits you will receive at retirement. This distribution is made at your election and will be made in accordance with the forms of distributions available under the Plan. Conditions. Generally you may receive a distribution from the Plan prior to your termination of employment provided you satisfy any of the following conditions: ( you have attained age 59.5 Can I withdraw money from my account in the event of financial hardship? tc "Can I withdraw money from my account in the event of financial hardship?" \l 3 Hardship distributions. You may withdraw money for financial hardship if you satisfy certain conditions. This hardship distribution is not in addition to your other benefits and will therefore reduce the value of the benefits you will receive at retirement. Qualifying expenses. A hardship distribution may be made to satisfy certain immediate and heavy financial needs that you have. Generally, a hardship distribution may only be made for payment of the following: ( Expenses for medical care (described in Section 213(d) of the Internal Revenue Code) previously incurred by you, your spouse or your dependents or necessary for you, your spouse or your dependents to obtain medical care. ( Costs directly related to the purchase of your principal residence (excluding mortgage payments). ( Tuition, related educational fees, and room and board expenses for the next twelve (12) months of postsecondary education for yourself, your spouse or your dependents. ( Amounts necessary to prevent your eviction from your principal residence or foreclosure on the mortgage of your principal residence. ( Payments for burial or funeral expenses for your deceased parent, spouse, children or other dependents. ( Expenses for the repair of damage to your principal residence that would qualify for the casualty deduction under the Internal Revenue Code. Conditions. A hardship distribution can only be made if there is an immediate or heavy financial need. In addition to the expenses listed above, a hardship distribution can be made to pay any federal, state, or local income taxes or penalties reasonably anticipated to result from a hardship distribution. The Administrator must determine, based on all relevant facts and circumstances, whether you have other resources available to satisfy the financial need. For this purpose, your resources will generally include property which is owned by your spouse or minor children. You will be asked to certify and provide other documentation as may be necessary to show that the need cannot be met by one of the following alternatives: (a) Through reimbursement or compensation by insurance or otherwise; (b) By selling or otherwise liquidating your assets in a reasonable manner, but only if doing so would not itself increase the amount of the need; (c) By borrowing money from a bank or other commercial lender on terms that would be considered commercially reasonable, but only if doing so would not itself increase the amount of the need; or (d) By electing to receive a distribution or loan from the Plan or any other qualified retirement plan in which you are or were a participant, but only if doing so would not itself increase the amount of the need. Account restrictions. You may request a hardship distribution only from the vested portion of the following accounts: ( accounts attributable to Employer profit sharing contributions ARTICLE VII BENEFITS AND DISTRIBUTIONS UPON TERMINATION OF EMPLOYMENT [Edit this Article as needed] tc "ARTICLE VII" \l 1 tc "BENEFITS AND DISTRIBUTIONS UPON TERMINATION OF EMPLOYMENT" \l 2 When can I get money out of the Plan? tc "When can I get money out of the Plan? " \l 3 You may receive a distribution of the vested portion of some or all of your accounts in the Plan for the following reasons: ( termination of employment for reasons other than death, disability or retirement ( normal retirement ( disability This Plan is designed to provide you with retirement benefits. However, distributions are permitted if you die or become disabled. In addition, certain payments are permitted when you terminate employment for any other reason. The rules under which you can receive a distribution are described in this Article. The rules regarding the payment of death benefits to your beneficiary are described in "Benefits and Distributions Upon Death." You may also receive distributions while you are still employed with the Employer. (See the Article entitled "Distributions Prior to Termination" for a further explanation.) What happens if I terminate employment before death, disability or retirement? tc "What happens if I terminate employment before death, disability or retirement?" \l 3 If your employment terminates for reasons other than death, disability or normal retirement, you will be entitled to receive only the "vested percentage" of your account balance. You may elect to have your vested account balance distributed to you as soon as administratively feasible following your termination of employment. (See the question entitled "How will my benefits be paid to me?" for additional information.) Amounts in your rollover account will be considered as part of your benefit in determining whether the $5,000 threshold for timing of payments described above has been exceeded as well as for determining if the value of your vested account balance exceeds the $5,000 threshold used to determine whether you must consent to a distribution. What happens if I terminate employment at Normal Retirement Date? tc "What happens if I terminate employment at Normal Retirement Date?" \l 3 Normal Retirement Date. You will attain your Normal Retirement Age when you reach your 65th birthday. Your Normal Retirement Date is the date on which you attain your Normal Retirement Age. Payment of benefits. You will become 100% vested in all of your accounts under the Plan if you retire on or after your Normal Retirement Age. However, the actual payment of benefits generally will not begin until you have terminated employment and reached your Normal Retirement Date. In such event, a distribution will be made, at your election, as soon as administratively feasible. If you remain employed past your Normal Retirement Date, you may generally defer the receipt of benefits until you actually terminate employment. In such event, benefit payments will begin as soon as feasible at your request, but not later than age 701/2. (See the question entitled "How will my benefits be paid to me?" for an explanation of how these benefits will be paid.) What happens if I terminate employment due to disability? tc "What happens if I terminate employment due to disability?" \l 3 Definition of disability. Under the Plan, disability is defined as a physical or mental condition resulting from bodily injury, disease, or mental disorder which renders you incapable of continuing any gainful occupation and which has lasted or can be expected to last for a continuous period of at least twelve (12) months. Your disability must be determined by a licensed physician. However, if your condition constitutes total disability under the federal Social Security Act, then the Administrator may deem that you are disabled for purposes of the Plan. Payment of benefits. If you become disabled while an employee, you will become 100% vested in all of your accounts under the Plan. Payment of your disability benefits will be made to you as if you had retired. However, if the value of your account balance does not exceed $5,000, then a distribution of your account balance will be made to you, regardless of whether you consent to receive it. (See the question entitled "How will my benefits be paid to me?" for an explanation of how these benefits will be paid.) How will my benefits be paid to me? tc "How will my benefits be paid to me?" \l 3 Forms of distribution. If your vested account balance does not exceed $5,000, then your vested account balance may only be distributed to you in a single lumpsum payment. In determining whether your vested account balance exceeds the $5,000 threshold, "rollovers" (and any earnings allocable to "rollover" contributions) will be taken into account. In addition, if your vested account balance exceeds $5,000, you must consent to any distribution before it may be made. If your vested account balance exceeds $5,000, you may elect to receive a distribution of your vested account balance in: ( a single lumpsum payment ( installments over a period of not more than your assumed life expectancy (or the assumed life expectancies of you and your beneficiary) Delaying distributions. You may delay the distribution of your vested account balance unless a distribution is required to be made, as explained earlier, because your vested account balance does not exceed $5,000. However, if you elect to delay the distribution of your vested account balance, there are rules that require that certain minimum distributions be made from the Plan. If you are a 5% owner, distributions are required to begin not later than the April 1st following the end of the year in which you reach age 701/2. If you are not a 5% owner, distributions are required to begin not later than the April 1st following the later of the end of the year in which you reach age 701/2 or retire. You should see the Administrator if you think you may be affected by these rules. Medium of payment. Benefits under the Plan will generally be paid to you in cash. ARTICLE VIII BENEFITS AND DISTRIBUTIONS UPON DEATH [Edit this Article as needed] tc "ARTICLE VIII" \l 1 tc "BENEFITS AND DISTRIBUTIONS UPON DEATH" \l 2 What happens if I die while working for the Employer? tc "What happens if I die while working for the Employer?" \l 3 If you die while still employed by the Employer, then 100% of your account balance will be used to provide your beneficiary with a death benefit. Who is the beneficiary of my death benefit? tc "Who is the beneficiary of my death benefit?" \l 3 Married Participant. If you are married at the time of your death, your spouse will be the beneficiary of the entire death benefit unless an election is made to change the beneficiary. IF YOU WISH TO DESIGNATE A BENEFICIARY OTHER THAN YOUR SPOUSE, YOUR SPOUSE MUST IRREVOCABLY CONSENT TO WAIVE ANY RIGHT TO THE DEATH BENEFIT. YOUR SPOUSE'S CONSENT MUST BE IN WRITING, BE WITNESSED BY A NOTARY OR A PLAN REPRESENTATIVE AND ACKNOWLEDGE THE SPECIFIC NONSPOUSE BENEFICIARY. If you are married and you change your designation, then your spouse must again consent to the change. In addition, you may elect a beneficiary other than your spouse without your spouse's consent if your spouse cannot be located. Unmarried Participant. If you are not married, you may designate a beneficiary on a form to be supplied to you by the Administrator. No beneficiary designation. At the time of your death, if you have not designated a beneficiary or your beneficiary is also not alive, the death benefit will be paid in the following order of priority to: (a) your surviving spouse (b) your children, including adopted children in equal shares (and if a child is not living, that child's share will be distributed to that child's heirs) (c) your surviving parents, in equal shares (d) your estate How will the death benefit be paid to my beneficiary? tc "How will the death benefit be paid to my beneficiary?" \l 3 Form of distribution. If the death benefit payable to a beneficiary does not exceed $5,000, then the benefit may only be paid as a lumpsum. If the death benefit exceeds $5,000, your beneficiary may elect to have the death benefit paid in: ( a single lumpsum payment ( installments over a period of not more than the assumed life expectancy of your beneficiary When must the last payment be made to my beneficiary? tc "When must the last payment be made to my beneficiary?" \l 3 The law generally restricts the ability of a retirement plan to be used as a method of retaining money for purposes of your death estate. Thus, there are rules that are designed to ensure that death benefits are distributable to beneficiaries within certain time periods. Regardless of the method of distribution selected, if your designated beneficiary is a person (rather than your estate or some trusts) then minimum distributions of your death benefit will begin by the end of the year following the year of your death ("1year rule") and must be paid over a period not extending beyond your beneficiary's life expectancy. If your spouse is the beneficiary, then under the "1year rule," the start of payments will be delayed until the year in which you would have attained age 70 1/2 unless your spouse elects to begin distributions over his or her life expectancy before then. However, instead of the "1year rule" your beneficiary may elect to have the entire death benefit paid by the end of the fifth year following the year of your death (the "5year rule"). Generally, if your beneficiary is not a person, your entire death benefit must be paid under the "5year rule." Since your spouse has certain rights to the death benefit, you should immediately report any change in your marital status to the Administrator. What happens if I'm a participant, terminate employment and die before receiving all my benefits? tc "What happens if I'm a participant, terminate employment and die before receiving all my benefits?" \l 3 If you terminate employment with the Employer and subsequently die, your beneficiary will be entitled to your remaining interest in the Plan at the time of your death. The provision in the Plan providing for full vesting of your benefit upon death does not apply if you die after terminating employment. ARTICLE IX TAX TREATMENT OF DISTRIBUTIONS [Edit this Article as needed] tc "ARTICLE IX" \l 1 tc "TAX TREATMENT OF DISTRIBUTIONS" \l 2 What are my tax consequences when I receive a distribution from the Plan? tc "What are my tax consequences when I receive a distribution from the Plan?" \l 3 Generally, you must include any Plan distribution in your taxable income in the year in which you receive the distribution. The tax treatment may also depend on your age when you receive the distribution. Certain distributions made to you when you are under age 59 1/2 could be subject to an additional 10% tax. Can I elect a rollover to reduce or defer tax on my distribution? tc "Can I elect a rollover to reduce or defer tax on my distribution?" \l 3 Rollover or Direct Transfer. You may reduce, or defer entirely, the tax due on your distribution through use of one of the following methods: (a) 60-day rollover. The rollover of all or a portion of the distribution to an Individual Retirement Account or Annuity (IRA) or another employer retirement plan willing to accept the rollover. This will result in no tax being due until you begin withdrawing funds from the IRA or other qualified employer plan. The rollover of the distribution, however, MUST be made within strict time frames (normally, within 60 days after you receive your distribution). Under certain circumstances all or a portion of a distribution (such as a hardship distribution) may not qualify for this rollover treatment. In addition, most distributions will be subject to mandatory federal income tax withholding at a rate of 20%. This will reduce the amount you actually receive. For this reason, if you wish to roll over all or a portion of your distribution amount, the direct transfer option described in paragraph (b) below would be the better choice. (b) Direct rollover. For most distributions, you may request that a direct transfer (sometimes referred to as a direct rollover) of all or a portion of a distribution be made to either an Individual Retirement Account or Annuity (IRA) or another employer retirement plan willing to accept the transfer. A direct transfer will result in no tax being due until you withdraw funds from the IRA or other employer plan. Like the rollover, under certain circumstances all or a portion of the amount to be distributed may not qualify for this direct transfer. If you elect to actually receive the distribution rather than request a direct transfer, then in most cases 20% of the distribution amount will be withheld for federal income tax purposes. Automatic IRA Rollover. If a mandatory distribution is being made to you because your vested interest in the Plan does not exceed $5,000 and the amount of the distribution exceeds $1,000, then the law may require that your distribution be directly rolled over to an IRA. If you do not make an affirmative election to either receive or roll over the distribution, then the Plan must roll over your distribution to an IRA. The IRA provider selected by the Plan will invest the rollover funds in a type of investment designed to preserve principal and provide a reasonable rate of return and liquidity (e.g., an interestbearing account, a certificate of deposit or a money market fund). The IRA provider will charge your account for any expenses associated with the establishment and maintenance of the IRA and with the IRA investments. You may transfer the IRA funds to any other IRA you choose. You will be provided with details regarding the IRA at the time you are entitled to a distribution. However, you may contact the Plan Administrator at the address and telephone number indicated in this SPD for further information regarding the Plan's automatic rollover provisions, the IRA provider, and the fees and expenses associated with the IRA. Tax Notice. WHENEVER YOU RECEIVE A DISTRIBUTION, THE ADMINISTRATOR WILL DELIVER TO YOU A MORE DETAILED EXPLANATION OF THESE OPTIONS. HOWEVER, THE RULES WHICH DETERMINE WHETHER YOU QUALIFY FOR FAVORABLE TAX TREATMENT ARE VERY COMPLEX. YOU SHOULD CONSULT WITH QUALIFIED TAX COUNSEL BEFORE MAKING A CHOICE. ARTICLE X LOANS [Edit this Article as needed] tc "ARTICLE X" \l 1 tc "LOANS" \l 2 Is it possible to borrow money from the Plan? tc "Is it possible to borrow money from the Plan?" \l 3 Yes, you may request a participant loan from all your accounts using an application form provided by the Administrator. Your ability to obtain a participant loan depends on several factors. The Administrator will determine whether you satisfy these factors. What are the loan rules and requirements? tc "What are the loan rules and requirements?" \l 3 There are various rules and requirements that apply to any loan, which are outlined in this question. In addition, your Employer has established a written loan program which explains these requirements in more detail. You can request a copy of the loan program from the Administrator. Generally, the rules for loans include the following: ( Loans are available to participants on a reasonably equivalent basis. Loans will be made to participants who are creditworthy. The Administrator may request that you provide additional information, such as financial statements, tax returns and credit reports to make this determination. ( All loans must be adequately secured. You must sign a promissory note along with a loan pledge. Generally, you must use your vested interest in the Plan as security for the loan, provided the outstanding balance of all your loans does not exceed 50% of your vested interest in the Plan. In certain cases, the Administrator may require you to provide additional collateral to receive a loan. ( You will be charged a reasonable rate of interest for any loan received from the Plan. The Administrator will determine a reasonable rate of interest by reviewing the interest rates charged for similar types of loans by other lenders. ( If approved, your loan will provide for level amortization with payments to be made not less frequently than quarterly. Generally, the term of your loan may not exceed five (5) years. However, if the loan is for the purchase of your principal residence, the Administrator may permit a longer repayment term. Generally, the Administrator will require that you repay your loan by agreeing to payroll deduction. If you have an unpaid leave of absence or go on military leave while you have an outstanding loan, please contact the Administrator to find out your repayment options. ( All loans will be considered a directed investment of your account under the Plan. All payments of principal and interest by you on a loan will be credited to your account. ( The amount the Plan may loan to you is limited by rules under the Internal Revenue Code. Any new loans, when added to the outstanding balance of all other loans from the Plan, will be limited to the lesser of: (a) $50,000 reduced by the excess, if any, of your highest outstanding balance of loans from the Plan during the oneyear period ending on the day before the date of the new loan over your current outstanding balance of loans as of the date of the new loan; or (b) 1/2 of your vested interest in the Plan. ( No loan in an amount less than $1,000 will be made. ( The maximum number of Plan loans that you may have outstanding at any one time is 1. ( Loans will only be granted if you incur a financial hardship or have a specified financial need. Examples of financial hardship which would qualify for a loan include significant health expenses or a loss of income due to illness, disability or death of you or your dependents; costs of establishing, avoiding eviction from, or repairing damage to your principal residence; payment of college education expenses, including graduate studies, for you or your dependents; and the cost of funeral expenses for a member of your immediate family. ( If you fail to make payments when they are due under the terms of the loan, you will be considered to be "in default." The Administrator will consider your loan to be in default if any scheduled loan repayment is not made by the end of the calendar quarter following the calendar quarter in which the missed payment was due. The Plan would then have authority to take all reasonable actions to collect the balance owed on the loan. This could include filing a lawsuit or foreclosing on the security for the loan. Under certain circumstances, a loan that is in default may be considered a distribution from the Plan and could be considered taxable income to you. In any event, your failure to repay a loan will reduce the benefit you would otherwise be entitled to from the Plan. ( If you become entitled to a distribution from the Plan (except in the case of a hardship distribution or an inservice distribution), or if you terminate employment, your loan generally becomes due and payable in full immediately. You may repay the entire outstanding balance of the loan (including any accrued interest). If you do not repay the entire outstanding loan balance, your vested account balance will be reduced by the remaining outstanding balance of the loan. The Administrator may periodically revise the Plan's loan policy. If you have any questions on participant loans or the current loan policy, please contact the Administrator. ARTICLE XI PROTECTED BENEFITS AND CLAIMS PROCEDURES [Edit this Article as needed] tc "ARTICLE XI" \l 1 tc "PROTECTED BENEFITS AND CLAIMS PROCEDURES " \l 2 Are my benefits protected? tc "Are my benefits protected?" \l 3 As a general rule, your interest in your account, including your "vested interest," may not be alienated. This means that your interest may not be sold, used as collateral for a loan (other than for a Plan loan), given away or otherwise transferred. In addition, your creditors may not attach, garnish or otherwise interfere with your account. Are there any exceptions to the general rule? tc "Are there any exceptions to the general rule?" \l 3 There are two exceptions to this general rule. The Administrator must honor a "qualified domestic relations order." A "qualified domestic relations order" is defined as a decree or order issued by a court that obligates you to pay child support or alimony, or otherwise allocates a portion of your assets in the Plan to your spouse, former spouse, child or other dependent. If a qualified domestic relations order is received by the Administrator, all or a portion of your benefits may be used to satisfy that obligation. The Administrator will determine the validity of any domestic relations order received. You and your beneficiaries can obtain, without charge, a copy of the QUALIFIED DOMESTIC RELATIONS ORDER PROCEDURE from the Administrator. The second exception applies if you are involved with the Plan's operation. If you are found liable for any action that adversely affects the Plan, the Administrator can offset your benefits by the amount that you are ordered or required by a court to pay the Plan. All or a portion of your benefits may be used to satisfy any such obligation to the Plan. Can the Plan be amended? tc "Can the Plan be amended?" \l 3 Your Employer has the right to amend the Plan at any time. In no event, however, will any amendment authorize or permit any part of the Plan assets to be used for purposes other than the exclusive benefit of participants or their beneficiaries. Additionally, no amendment will cause any reduction in the amount credited to your account. What happens if the Plan is discontinued or terminated? tc "What happens if the Plan is discontinued or terminated?" \l 3 Although your Employer intends to maintain the Plan indefinitely, your Employer reserves the right to terminate the Plan at any time. Upon termination, no further contributions will be made to the Plan and all amounts credited to your accounts will become 100% vested. Your Employer will direct the distribution of your accounts in a manner permitted by the Plan as soon as practicable. (See the question entitled "How will my benefits be paid to me?" for a further explanation.) You will be notified if the Plan is terminated. How do I submit a claim for Plan benefits? tc "How do I submit a claim for Plan benefits?" \l 3 Benefits will be paid to you and your beneficiaries without the necessity for formal claims. However, if you think an error has been made in determining your benefits, then you or your beneficiaries may make a request for any Plan benefits to which you believe you are entitled. Any such request should be in writing and should be made to the Administrator. If the Administrator determines the claim is valid, then you will receive a statement describing the amount of benefit, the method or methods of payment, the timing of distributions and other information relevant to the payment of the benefit. What if my benefits are denied? tc "What if my benefits are denied?" \l 3 Your request for Plan benefits will be considered a claim for Plan benefits, and it will be subject to a full and fair review. If your claim is wholly or partially denied, the Administrator will provide you with a written or electronic notification of the Plan's adverse determination. This written or electronic notification must be provided to you within a reasonable period of time, but not later than 90 days after the receipt of your claim by the Administrator, unless the Administrator determines that special circumstances require an extension of time for processing your claim. If the Administrator determines that an extension of time for processing is required, written notice of the extension will be furnished to you prior to the termination of the initial 90day period. In no event will such extension exceed a period of 90 days from the end of such initial period. The extension notice will indicate the special circumstances requiring an extension of time and the date by which the Plan expects to render the benefit determination. In the case of a claim for disability benefits, if disability is determined by a physician (rather than relying upon a determination of disability for Social Security purposes), then instead of the above, the Administrator will provide you with written or electronic notification of the Plan's adverse benefit determination within a reasonable period of time, but not later than 45 days after receipt of the claim by the Plan. This period may be extended by the Plan for up to 30 days, provided that the Administrator both determines that such an extension is necessary due to matters beyond the control of the Plan and notifies you, prior to the expiration of the initial 45day period, of the circumstances requiring the extension of time and the date by which the Plan expects to render a decision. If, prior to the end of the first 30day extension period, the Administrator determines that, due to matters beyond the control of the Plan, a decision cannot be rendered within that extension period, the period for making the determination may be extended for up to an additional 30 days, provided that the Administrator notifies you, prior to the expiration of the first 30day extension period, of the circumstances requiring the extension and the date as of which the plan expects to render a decision. In the case of any such extension, the notice of extension will specifically explain the standards on which entitlement to a benefit is based, the unresolved issues that prevent a decision on the claim, and the additional information needed to resolve those issues, and you will be afforded at least 45 days within which to provide the specified information. The Administrator's written or electronic notification of any adverse benefit determination must contain the following information: (a) The specific reason or reasons for the adverse determination. (b) Reference to the specific Plan provisions on which the determination is based. (c) A description of any additional material or information necessary for you to perfect the claim and an explanation of why such material or information is necessary. (d) Appropriate information as to the steps to be taken if you or your beneficiary want to submit your claim for review. (e) In the case of disability benefits where disability is determined by a physician: (i) If an internal rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination, either the specific rule, guideline, protocol, or other similar criterion; or a statement that such rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination and that a copy of the rule, guideline, protocol, or other similar criterion will be provided to you free of charge upon request. (ii) If the adverse benefit determination is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the determination, applying the terms of the Plan to your medical circumstances, or a statement that such explanation will be provided to you free of charge upon request. If your claim has been denied, and you want to submit your claim for review, you must follow the Claims Review Procedure in the next question. What is the Claims Review Procedure? tc "What is the Claims Review Procedure?" \l 3 Upon the denial of your claim for benefits, you may file your claim for review, in writing, with the Administrator. (a) YOU MUST FILE THE CLAIM FOR REVIEW NO LATER THAN 60 DAYS AFTER YOU HAVE RECEIVED WRITTEN NOTIFICATION OF THE DENIAL OF YOUR CLAIM FOR BENEFITS. HOWEVER, IF YOUR CLAIM IS FOR DISABILITY BENEFITS AND DISABILITY IS DETERMINED BY A PHYSICIAN, THEN INSTEAD OF THE ABOVE, YOU MUST FILE THE CLAIM FOR REVIEW NO LATER THAN 180 DAYS FOLLOWING RECEIPT OF NOTIFICATION OF AN ADVERSE BENEFIT DETERMINATION. (b) You may submit written comments, documents, records, and other information relating to your claim for benefits. (c) You may review all pertinent documents relating to the denial of your claim and submit any issues and comments, in writing, to the Administrator. (d) You will be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to your claim for benefits. (e) Your claim for review must be given a full and fair review. This review will take into account all comments, documents, records, and other information submitted by you relating to your claim, without regard to whether such information was submitted or considered in the initial benefit determination. In addition to the Claims Review Procedure above, if your claim is for disability benefits and disability is determined by a physician, then the Claims Review Procedure provides that: (a) Your claim will be reviewed without deference to the initial adverse benefit determination and the review will be conducted by an appropriate named fiduciary of the Plan who is neither the individual who made the adverse benefit determination that is the subject of the appeal, nor the subordinate of such individual. (b) In deciding an appeal of any adverse benefit determination that is based in whole or part on medical judgment, the appropriate named fiduciary will consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment. (c) Any medical or vocational experts whose advice was obtained on behalf of the Plan in connection with your adverse benefit determination will be identified, without regard to whether the advice was relied upon in making the benefit determination. (d) The health care professional engaged for purposes of a consultation under (b) above will be an individual who is neither an individual who was consulted in connection with the adverse benefit determination that is the subject of the appeal, nor the subordinate of any such individual. The Administrator will provide you with written or electronic notification of the Plan's benefit determination on review. The Administrator must provide you with notification of this denial within 60 days after the Administrator's receipt of your written claim for review, unless the Administrator determines that special circumstances require an extension of time for processing your claim. If the Administrator determines that an extension of time for processing is required, written notice of the extension will be furnished to you prior to the termination of the initial 60day period. In no event will such extension exceed a period of 60 days from the end of the initial period. The extension notice will indicate the special circumstances requiring an extension of time and the date by which the Plan expects to render the determination on review. However, if the claim relates to disability benefits and disability is determined by a physician, then 45 days will apply instead of 60 days in the preceding sentences. In the case of an adverse benefit determination, the notification will set forth: (a) The specific reason or reasons for the adverse determination. (b) Reference to the specific Plan provisions on which the benefit determination is based. (c) A statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to your claim for benefits. (d) In the case of disability benefits where disability is determined by a physician: (i) If an internal rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination, either the specific rule, guideline, protocol, or other similar criterion; or a statement that such rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination and that a copy of the rule, guideline, protocol, or other similar criterion will be provided to you free of charge upon request. (ii) If the adverse benefit determination is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the determination, applying the terms of the Plan to your medical circumstances, or a statement that such explanation will be provided to you free of charge upon request. If you have a claim for benefits which is denied, then you may file suit in a state or Federal court. However, in order to do so, you must file the suit no later than 180 days after the Administrator makes a final determination to deny your claim. What are my rights as a Plan participant? tc "What are my rights as a Plan participant?" \l 3 As a participant in the Plan you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all Plan participants are entitled to: (a) Examine, without charge, at the Administrator's office and at other specified locations, all documents governing the Plan and a copy of the latest annual report (Form 5500 Series) filed by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration. (b) Obtain, upon written request to the Administrator, copies of documents governing the operation of the Plan, including insurance contracts and collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The Administrator may make a reasonable charge for the copies. (c) Receive a summary of the Plan's annual financial report. The Administrator is required by law to furnish each participant with a copy of this summary annual report. (d) Obtain a statement telling you whether you have a right to receive a pension at Normal Retirement Age and, if so, what your benefits would be at Normal Retirement Age if you stop working under the Plan now. If you do not have a right to a pension benefit, the statement will tell you how many years you have to work to earn a right to a pension. THIS STATEMENT MUST BE REQUESTED IN WRITING AND IS NOT REQUIRED TO BE GIVEN MORE THAN ONCE EVERY TWELVE (12) MONTHS. The Plan must provide this statement free of charge. In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate your Plan, called "fiduciaries" of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your Employer or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a pension benefit or exercising your rights under ERISA. If your claim for a pension benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of Plan documents or the latest annual report from the Plan and do not receive them within 30 days, you may file suit in a Federal court. In such a case, the court may require the Administrator to provide the materials and pay you up to $110.00 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or Federal court. In addition, if you disagree with the Plan's decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, you may file suit in Federal court. You and your beneficiaries can obtain, without charge, a copy of the qualified domestic relations order ("QDRO") procedures from the Administrator. If it should happen that the Plan's fiduciaries misuse the Plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. The court may order you to pay these costs and fees if you lose or if, for example, it finds your claim is frivolous. What can I do if I have questions or my rights are violated? tc "What can I do if I have questions or my rights are violated?" \l 3 If you have any questions about the Plan, you should contact the Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in the telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. ARTICLE XII GENERAL INFORMATION ABOUT THE PLAN [Edit this Article as needed] tc "ARTICLE XII" \l 1 tc "GENERAL INFORMATION ABOUT THE PLAN" \l 2 There is certain general information which you may need to know about the Plan. This information has been summarized for you in this Article. Plan Name tc "Plan Name" \l 3 [Insert full name of plan] Plan Number tc "Plan Number" \l 3 [Insert plan number i.e., 001, 002] Plan Effective Dates tc "Plan Effective Dates" \l 3 [Insert effective date for this plan e] Other Plan Information tc "Other Plan Information" \l 3 Valuations of the Plan assets are generally made every business day. Certain distributions are based on the Anniversary Date of the Plan. This date is the last day of the Plan Year. The Plan's records are maintained on a twelvemonth period of time. This is known as the Plan Year. The Plan Year begins on [Insert beginning and ending date of plan year] The Plan and Trust will be governed by the laws of [Insert name of State] to the extent not governed by federal law. Benefits provided by the Plan are NOT insured by the Pension Benefit Guaranty Corporation (PBGC) under Title IV of the Employee Retirement Income Security Act of 1974 because the insurance provisions under ERISA are not applicable to this type of Plan. Service of legal process may be made upon your Employer. Service of legal process may also be made upon the Trustee or Administrator. Employer Information tc "Employer Information" \l 3 Your Employer's name, address and identification number are: Company name Street address City, State Zip Employer Identification Number: Plan Administrator Information tc "Plan Administrator Information" \l 3 The Plan's Administrator is responsible for the daytoday administration and operation of the Plan. For example, the Administrator maintains the Plan records, including your account information, provides you with the forms you need to complete for Plan participation, and directs the payment of your account at the appropriate time. The Administrator will also allow you to review the formal Plan document and certain other materials related to the Plan. If you have any questions about the Plan or your participation, you should contact the Administrator. The Administrator may designate other parties to perform some duties of the Administrator. The Administrator has the complete power, in its sole discretion, to determine all questions arising in connection with the administration, interpretation, and application of the Plan (and any related documents and underlying policies). Any such determination by the Administrator is conclusive and binding upon all persons. The name, address and business telephone number of the Plan's Administrator are: Name Street address City, State Zip Telephone number: Plan Trustee Information and Plan Funding Medium tc "Plan Trustee Information and Plan Funding Medium" \l 3 All money that is contributed to the Plan is held in a trust fund. The Trustee is responsible for the safekeeping of the trust fund and must hold and invest Plan assets in a prudent manner and in the best interest of you and your beneficiaries. The trust fund established by the Plan's Trustee(s) will be the funding medium used for the accumulation of assets from which benefits will be distributed. While all the Plan assets are held in a trust fund, the Administrator separately accounts for each Participant's interest in the Plan. The name and address of the Plan's Trustee is: Trustees name and address Optional Q&A Section [Insert plan name] COMMON QUESTIONS ABOUT OUR PROFIT SHARING PLAN [Edit Q&As as needed] Introduction The following questions and answers highlight some of the important parts of our Plan. Remember, these are only highlights. The Summary Plan Description ("SPD") describes the Plan in much greater detail. If you have any questions about these highlights, the SPD, or the Plan, you should ask the Plan Administrator. Q. Why is your Employer sponsoring a profit sharing plan? A. Your Employer is sponsoring this Plan so that you may save for retirement. This Plan is a type of qualified retirement plan commonly referred to as a profit sharing plan. Your Employer may make contributions to the Plan on your behalf. Q. How do I participate in the Plan? A. Provided you are not an Excluded Employee, you may begin participating under the Plan once you have satisfied the eligibility requirements and reached your "Entry Date." The following describes the eligibility requirements and Entry Date that apply. Profit Sharing Contributions Excluded Employees. If you are a member of a class of employees identified below, you are an Excluded Employee and you are not entitled to participate in the Plan for purposes of profit sharing contributions. The Excluded Employees are: ( union employees whose employment is governed by a collective bargaining agreement under which retirement benefits were the subject of good faith bargaining ( certain nonresident aliens who have no earned income from sources within the United States Eligibility Conditions. You will be eligible to participate for purposes of profit sharing contributions when you have satisfied the following eligibility condition(s). However, you will actually enter the Plan once you reach the Entry Date as described below. ( attainment of age 21 ( completion of one (1) Year of Service. Entry Date. For purposes of profit sharing contributions, your Entry Date will be the first day of the Plan Year or the first day of the seventh month of the Plan Year coinciding with or next following the date you satisfy the eligibility requirements. Q. When will I receive payments from the Plan? A. The Plan is designed to encourage you to stay with the Employer until retirement. Payment will generally occur at your Normal Retirement Date, unless you postpone your actual retirement. Your Normal Retirement Date is the date on which you attain your Normal Retirement Age. You will attain your Normal Retirement Age when you reach your 65th birthday. Q. How much will I be paid when I retire? A. The amount you are paid when you retire will be based upon the amount of money your Employer has put into the Plan for you, plus or minus any earnings or losses. You should review the Article in the SPD entitled "Employer Contributions" for an explanation of how your Employer makes contributions to the Plan and how they are shared by eligible employees. Q. How will payments be made when I retire? A. If your vested account balance does not exceed $5,000, then your vested account balance may only be distributed to you in a single lumpsum payment. In determining whether your vested account balance exceeds the $5,000 threshold, "rollovers" (and any earnings allocable to "rollover" contributions) will be taken into account. In addition, if your vested account balance exceeds $5,000, you must consent to any distribution before it may be made. If your vested account balance exceeds $5,000, you may elect to receive a distribution of your vested account balance in: ( a single lumpsum payment ( installments over a period of not more than your assumed life expectancy (or the assumed life expectancies of you and your beneficiary) You should review the Article in the SPD entitled "Benefits and Distributions Upon Termination of Employment" for a further explanation of the rules associated with the payment of benefits. Q. What if I stop working before I retire? A. If you stop working before you retire, you will only be entitled to the "vested percentage" of your account balance. 100% vested contributions. You are always 100% vested (which means that you are entitled to all of the amounts) in your accounts attributable to the following contributions: ( rollover contributions Vesting schedules. Your "vested percentage" for certain Employer contributions is based on vesting Years of Service. This means at the time you stop working, your account balance (attributable to contributions subject to a vesting schedule) is multiplied by your vested percentage. The result, when added to the amounts that are always 100% vested as shown above, is your vested interest in the Plan, which is what you will actually receive from the Plan. You will always, however, be 100% vested if you are employed on or after your Normal Retirement Age or if you die or become disabled. Your "vested percentage" in your account attributable to profit sharing contributions is determined under the following schedule. Vesting Schedule Profit Sharing Contributions Years of Service Percentage Less than 2 0% 2 20% 3 40% 4 60% 5 80% 6 100% Q. If I stop working before retirement, when will my vested amount be paid? A. If your employment terminates for reasons other than death, disability or normal retirement, you will be entitled to receive only the "vested percentage" of your account balance. You may elect to have your vested account balance distributed to you as soon as administratively feasible following your termination of employment. (See the question entitled "How will my benefits be paid to me?" for additional information.) Q. What if I die before I retire? A. Your beneficiary will be entitled to 100% of your interest in the Plan upon your death. If you are single, you may name anyone you like to be your beneficiary. If you are married, your spouse is your beneficiary with respect to 100% of your death benefit unless you and your spouse name someone else as your beneficiary. You should review the question entitled "Who is the beneficiary of my death benefit?" in the SPD. Q. Can I withdraw money from the Plan while I'm still working? A. Generally you may receive a distribution from the Plan prior to your termination of employment provided you satisfy any of the following conditions: ( you have attained age 59.5. This distribution is not in addition to your other benefits and will therefore reduce the value of the benefits you will receive at retirement. In certain instances you may also receive an inservice distribution if you incur a financial hardship. This hardship distribution is not in addition to your other benefits and will therefore reduce the value of the benefits you will receive at retirement. There are various rules and restrictions regarding withdrawing money from your accounts in the Plan while you are still employed. Please review the SPD for more information on these rules and restrictions. NOTE: THESE QUESTIONS AND ANSWERS ARE NOT MEANT TO BE A SUBSTITUTE FOR A THOROUGH READING OF THE SUMMARY PLAN DESCRIPTION. THE PROVISIONS OF THE PROFIT SHARING PLAN ARE VERY COMPLEX. IT IS NOT POSSIBLE TO FULLY EXPLAIN ALL ASPECTS OF THE PLAN IN THESE SHORT QUESTIONS AND ANSWERS. YOU SHOULD ALWAYS CONSULT THE SUMMARY PLAN DESCRIPTION IF YOU HAVE ANY QUESTIONS ABOUT THE PLAN. 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