Agreement 801218

City of Chandler — Study Session (2023-07-17)

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Resolution 5716 
Exhibit B
Plan 801218

XI.
Benefits After the Death of the Participant
In the event of a Participant's death, the following shall apply:
A. Surviving Spouse and/or Surviving Dependents
Upon the death of a Participant, the surviving spouse and/or surviving eligible dependents (as defined
in Section XII.D.) of the deceased Participant are immediately eligible to maintain the Participant's RHS
account and utilize the remaining balance to fund eligible medical benefits specified in Section X
above. The account balance may be reallocated* by the surviving spouse or dependents.
* Before investing, please read the applicable fund disclosure materials carefully for a complete summary of all fees, expenses, 
investment objectives and strategies, and risks. This information is available when you log in at www,missionsq.org, or upon 
request by calling (800) 326-7272. 
If a Participant's account balance 
not been fully utilized upon the death of the eligible spouse, the 
account balance may continue to 
utilized to pay benefits of eligible dependents. Upon the death of 
all eligible dependents, the account will revert in accordance with the Employer's election under 
Section VIII of the MissionSquare RHS Adoption Agreement. 
B.
No Surviving Spouse or Surviving Dependents
If there are no living spouse or dependents at the time of death of the Participant, the account will
revert in accordance with the Employer's election under Section VIII of the MissionSquare RHS
Adoption Agreement.
XII.
The Plan Will Operate According to the Following Provisions:
A.
Employer Responsibilities
1.
The Employer will submit all MissionSquare Retirement Health Savings Plan enrollment and
contribution data via electronic submission.
2.
The Employer will submit all MissionSquare Retirement Health Savings Plan Participant status
updates or personal information updates via electronic submission. This includes but is not limited
to termination notification, benefit eligibility, and vesting notification.
B.
Participant account administration and asset-based fees will be paid through the redemption of
Participant account shares, unless agreed upon otherwise in the Administrative Services Agreement.
C. Assignment of benefits is not permitted. Benefits will be paid only to the Participant, his/her survivors,
the Employer, or an insurance provider (as allowed by the claims administrator). Payments to a third­
party payee (e.g., medical service provider) are not permitted with the exception of reimbursement to
the Employer or insurance provider (as allowed by the claims administrator).
D. An eligible dependent is (a) the Participant's lawful spouse, (b) the Participant's child under the age of
27, as defined by IRC Section 152(f)(1) and Internal Revenue Service Notice 2010-38, or (c) any other
individual who is a person described in IRC Section 152(a), as clarified by Internal Revenue Service
Notice 2004-79.
E. The Employer will be responsible for withholding, reporting and remitting any applicable taxes for
payments which are deemed to be discriminatory under IRC Section 105(h), as outlined in the
Employer Manual.

Approved as to form
_________________________________________ 
City Attorney

ATTACHMENT A 
EMPLOYER VANTAGECARE RETIREMENT HEALTH SAVINGS (RHS) 
ADOPTION AGREEMENT 
Plan No. 801218: City of Chandler Employee Retirement Health Savings Plan 
VI.B.1 Direct Employer Contributions
Employer contribution of $900 per year of service. Upon: (1) separation from service on 
the Chandler City Council with a minimum of five (5) years served and immediate retirement 
into the Elected Officials Retirement Plan (EORP) or Arizona State Retirement System (ASRS), 
or (2) approval for disability through the EORP or ASRS, Employer will contribute $900 per 
12-month year of service on the Chandler City Council, prorated for any partial year.
For City Council Members whose death occurs before completion of five years of eligible 
service on the Chandler City Council, if such Council member has a surviving spouse and/or 
eligible dependents to receive withdrawals from the RHSP Account, such Council Member’s 
spouse and qualified dependents shall be entitled to $900 per 12-month year of decedent's 
Chandler City Council service pro-rated for any partial year. 
Between March 1, 2006, and December 31, 2007, certain employees were authorized and 
did voluntarily contribute $15.00 per pay period to the RHS Plan. All such contributions are 
100% vested at all times. 
VII.B. Vesting for Direct Employer Contributions
Retirement is separation from service on the Chandler City Council with a minimum of five 
(5) years served and immediate retirement into the Elected Officials Retirement Plan (EORP) 
or Arizona State Retirement System (ASRS),
IX.C. 
A Participant who becomes totally and permanently disabled
For purposes of this section, "totally and permanently disabled" means:  While serving on 
Chandler City Council, employee (Council Member), after completing five (5) years of service 
on the Chandler City Council, becomes disabled and is entitled to a disability retirement 
pension under the Elected Officials’ Retirement Plan (EORP) or Arizona State Retirement 
System (ASRS). 
XI.A. Benefits After the Death of the Participant
The amended Plan is subject to the provision in the Internal Revenue Code Revenue Ruling 
2006-36 that for reimbursement plans containing a provision on or before August 14, 2006 
stating that upon the death of the deceased employee’s surviving spouse and last 
dependent, or upon the death of the employee, if there is not surviving spouse or 
Amended and Restated Plan: July 2023

Amended and Restated Plan: July 2023 
dependents, any unused reimbursement amount will be paid as a reimbursement of 
substantiated medical care expenses of a beneficiary designated by the employee, which is 
effective with respect to plan years beginning after December 31, 2008.