HomeMy WebLinkAboutR-2001-057 Medical Savings Account / Voluntary Employees’ Benefit Association (MSA / VEBA) PlanRESOLUTION NO. R-2001- 57
A RESOLUTION authorizing the establishment of a Medical Savings
Account/Voluntary Employees' Beneficiary Association
("MSA/VEBA") Plan for employees of the City of Yakima
represented by Local 469, International Association of Firefighters,
AFL-CIO.
WHEREAS, the Internal Revenue Code, Section 501(c)(9) allows for the creation
of a voluntary employee beneficiary association which is employee sponsored, tax-
exempt health and welfare trust; and
WHEREAS, such tax-exempt plans are available for public sector employees in
the State of Washington; and
WHEREAS, on October 21, 1992, there was established the "Voluntary
Employees' Benefit Association for Public Service Employees in the State of Washington
Trust" ("Trust'); and
WHEREAS, on November 19,1999, the Trust was amended and restated; and
WHEREAS, the City of Yakima ("City") has determined that establishing a
medical expense reimbursement plan, which provides a tax-free account for employees
to pay for medical, dental, vision, and tax -qualified long term care expenses that are not
paid by any other insurance plans, is in the best interest of the City and the employees
represented by Local 469, International Association of Firefighters, AFL-CIO ("Local
469"); and
WHEREAS, the City desires to establish a medical expense reimbursement plan
for said employees; and
WHEREAS, the City desires to use the services of MSA/VEBA Trust to
administer such plan; and
WHEREAS, such medical expense reimbursement plan established by the City
will be administered in accordance with the plan documents provided by the
MSA/VEBA Trust on file with the City, now, therefore,
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF YAKIMA:
1. Effective March 20, 2001, the City hereby elects to participate in the Trust
as presently constituted or hereafter amended using the MSA/VESA Trust as its plan
(1k)res/veba trust/ (ire/ local 469/.pm
administrator, and establishes the MSA/VEBA program for all eligible employees
represented by Local 469.
2. The Plan will be funded by cashouts of eligible employee sick leave
accounts upon retirement.
3. The City Manager of the City of Yakima is hereby authorized to take all
necessary and appropriate actions to effect this Resolution.
ADOPTED BY THE CITY COUNCIL this 20th day of March, 2001.
y Place, Mayor
ATTEST:
h� , ij 2 • ,,-(�-d o C ate -
City Clerk
ft)res/veba trust/fire/loca1469/.pm
IN THE NORTHWEST
What is the MSA VEBA The MSA VEBA Plan is a pre -retirement and post-retirement medical expense
��„ reimbursement account. The NISA VEBA Plan enables your employer to make
$
tax-free contributions into an MSA VEBA Trust account on your behalf. The
ties, cities, towns and special purpose
Plan is available to employees of coun
districts in Idaho, Oregon and Washington.
A I A VEBA is a tax-exempt trust authorized by Internal Revenue Code Section
-What is a tax501(c)(9). The tax objectives of this type of plan are to enable your employer to
what are
objectives the1ail�,r make tax-free deposits on yourbehalf to the Plan, for your account to be credited
with tax-free investment earnings, and to enable you to obtain tax-free
ents.
reimbursements for your medical expenses and insurance premium paym
MSA VEBA contributions are not W-2 reportable.
i
" o � participate p\,n MSA VEBA account provides a tax-free source of funds to pay for the cost
SBA3a?" of health care expenses for you; your spouse, and your qualified dependents.
in the MSS Your MSA VEBA account maybe used to pay any qualified pre- or post-retirement
medical, dental, or vision out-of-pocket expenses (deductibles, co -payments,
I co-insurance, etc.), plus post-retirement medical, dental, or vision insurance
premiums, Medicare supplement plans, and long
premiums, Medicare Part B
term care insurance premiums.
„ f at funding sources I ,There are many potential funding sources of MSA VEBA deposits, such as -
are available for I 1. Sick leave or other leave cash outs.
SA VEBA deposits?" 2, Employer benefit contributions on a periodic basis
3. Contributions in lieu of salary increases, (or salary reductions) for a
group of employees.
4. Pension contribution rate reduction savings (such as PERS savings).
5. Other miscellaneous sources.
"How do I become a When hen you are eligible, you become a participant by completing the attached
participant in the plana" Membership Enrollment Form and delivering it to your benefits' office. Your
MSA VEBA account will then be opened when your employer sends funds to
the MSA VEBA Plan Administrator.
"How do I get money out You may submit an MSA VEBA Medical Claim Form for your qualified out -
of my MSA VEBA of pocket medical, dental, or vision expenses incurred by yourself, your spouse,
account?„ and/or your qualified dependents.
You may file claims for any amount. Benefits will be paid until your account is
used up. You may also arrange to have monthly insurance premiums paid by
using the NISA VEBA Systematic Payment Form. If your spouse or dependents
are covered by different medical plans, their insurance premiums can also be
paid for out of this account. Claims payment is efficient and hassle free.
Fvr more infonnation call the VEBA Service Group, LLC.
or. Western
e stern asIl ngton 1-300-422-4023
30 -((509)5 �t-0600 em rNnshington 1-800-888-VEBA
To order brochures
(PSE03 Rev 4100)
�.�a.n ffie cost of any retiree
medical plan pais from
lsn A V ENA account -
"What
rn� 1.s�taa
happens if I don't
withdraw money from MY .
account dais year, or if I goat
my job or take a leave of
absence?""
MSA VEBA forms may be obtained from your benefits' department or:
by calling: 1-800- JEBA101 or
(509) 534-0600
by e-mail: admin@veba.org
by writing: MSA VERA Plan Administrator
c/o REHN & Associates
130 Box 5433, Spokane, WA 99205-0433
NOTE: Reimbursable health related benefits must beJ for expenses i�c�S VERA
d after
your MSA VERA account is first opened. Withdrazuals front youf
account may be made only for qualified medical, dental, or vision expenses/
.i e xpenses are outlined in IRS Publication 502. Qualified dependents
premiums. (�UcZitf e
are outlined in .IRS Publication 501. you may obtain IRS publications by calling, 1-
800-TAXFORNI or on the Internet at "http:/lwwzU•ers.zistreas.�ov."
Yes. The cost of any qualified medical plan you elect to use after retire-
ment can be paid for out of this account•
hdraw
this
Your
l ble0u0ntil ultimat Funds ly pad out to you you don't it nd/or yourear
will continue to be avai
dependents or heirs, for qualified expenses.
I]used on current cost estimates an average retired couple spends ins
"mow much Medical ical e perase e T $4n
money ���� � -need during dpproxunat..l� �. _..0 per month for their medical plan and relate costs, p
.7. the on -coin costs for dental and vision care. As you bet older, you may also
retirement?" on-going term
face potential
efor their post-retiremen
t medi aI care. Many
retirees will
need over $50,000
ical
„at happens lie before If you are survived by a spouse or dependent children (or other
dependents as defined by the IRS), they will continue
no eligible depend
m account ;s used U.�?r� dent s},
y benefits until your account is used up. Ifya u -
the funds remaining In your account will be paid as medical benefits to the
Iheir(s) of your estate.
„�A„_ . NIQ e VVE A Plan. I REHN & Associates in Spol<ane, WA is th Mee bSA ene its administrator
Y�A Plan
ia�D is aaLc lvxva�
Administrator. REHN is an experience A r
Administrator?”' specializing in the administration of ERISA health and welfare plans. All
correspondence, accounting, and benefit payment services are provided by
REHN & Associates.
t health and welfare
ust
"Who ho is responsible for fh or ed by Trust is a non -pt os nmanag d btax-exemy Trustees who are elect d by
a„�h�rized by IRC 501{c)(9).
managing this Plan”' the Plan participants.
,.What are the Trustees The Trustees are fiduciaries and have a duty to act prudently and in the
responsibilities?" best interest of you and all other Plan participants and beneficiaries.
,Will I receive a statement You will receive a semi-annual statement in January and July detailing
of my account"" activity in your account. You may also call and request additional statements
at any time. If you have questions about your MSA VEBA account, or about
a pending claim, or need claim forms, contact the MSA VEBA Plan
Administrator.
"'Will my account grow?", The net investment earrings (after expenses are deducted) are credited
tax -gree to your account on a monthly basis.
"How is the MSA VEBAfhe Trust offers you three fund options. You may choose to allocate your
money 1n�TeSt�'�rr VISA VEBA account in any of the following funds:
® Stable Value Fund (Conservative)
Balanced Fund (Moderate)
® Growth Fund (Aggressive)
Investments in the Balanced and Growth Funds will fluctuate in value.
Please carefully study the Investment Fund Information and Investment's
Summary on the back of this brochure or contact the MSA VEBA Plan
Administrator and ask for the Investment Fact Sheets
"How ,are expenses paid?" All expenses of administering the Plan are paid by reductions of
investment earnings or, if there are no earnings, charged as a deduction to a
participant's account.
"'How do I find out moTe ( Contact the VEBA Service Group, LLC's regional office nearest you at the
about this Plan?"' phone number listed below.
Plan Consultants - VEBA Service Group, LLC:
Eastern Washington Regional Office
S. 400 Jefferson, Suite 301
Spokane, WA 99204-3143
1-800-888-VEBA
(509) 838-5571
Fax (509) 838-5613
Mark R. Wilkerson, CFP - mark@veba.org
Richard Dickman - rich@veba.org
Western Washington Regional Office
11627 62nd Ave. E.
Puyallup, WA 98373-4339
1-800-422-4023
(253)435-8835
Fax(253)435-8850
Peter J. Laney, CFP - peter@veba.org
John Fulbright - john@veba.org
MSA VEBA flan Administrator:
REHN & Associates
P.O. Box 5433
Spokane, WA 99205-0433
1-800-VEBA101
(509)534-0600
Fax(509)535-7883
Tim Yeager - admin@veba.org
Legal Counsel:
Liebman-Mimbu, PLLC
3223 3rd Ave. So., Ste. 200
Seattle, WA 98132
(206) 381-3375
Henry Liebman - legal@veba.org
. .
A n
�: orl
Investment Risk
rA Will fluctuate in value on a
Accounts invested in the Balanced and Growth Funds are not guurc�rLteew <u w • ---
monthly basis. Benefit withdrawals from these funds may be worth more or less than your original deposit.
v i„� Fund does not fluctuate in value and is invested in interest bearing, guaranteed investment
LILe ILL..,.- . --- - --
contracts.
Prior to submitting your Membership Enrollment Form, please carefully review your selected investment
our
fund choices}. Should your objectives change, you should Remember, anyvinvestmen t which contains (stoc' market
s) and notify e
Plan Administrator n writing of any changes. past in these
;T,-va"tments entails the risk of loss, and there have been numerous est periods
dete s, particularly over of
4 vivo rnii4i slims that _... __-
funds and there will be others izt ll�e =ut`w c•
shorter time horizons, are 1lighly
dependent on trends in various investment markets. Taus, ie Balancca
and Growth Funds are suitable primarily as longer term investments and should not be used fors ort
term investing
Using multiple aT713 Us
You may have your MSA VEBA account allocated to a single fund, twofunds, or to all three funds.
Transfers
® You may transfer among the three funds layi�bfer re g ests mtstbe receivedund Transfer Lintion Form, wr ting bytthe MSAare
VEBA
effective the 1st business day of each mon g
Plan Administrator by the 25th of each month in order to be effective on the 1st business day of the following
month.
Withdrawals
If you have multiple hinds, withdrawals made from your account will be withdrawn prorata based on your
fund allocation percentage on file with the MSA VEBA Plan Administrator.
CONTRIBUTIONS
y interest until the 1st
Contributions are held in a short term investment fund �(STIFe t e participants' nd lted with urorent allocation instructions.
of the month following receipt when
they will L_
allocated r 11
j j� V C51.1'rie l i`a
• Par uciyants are seen"raged to seek advice regarding these investmAdvice ent funds from their personal financial
stees do not give investment advice.
advisor. The MSA VEBA Tru
EXPENSES
Trust administrative expenses have averaged c e as Trust a is grow.sAdministrati.ved as all e expensepercent s vary rage
net assets. These expenses are expected to d auditiz ,
slightly month to month and include legal fees, consulting fees, local servicing, printing, postage,
g
claims payment, etc.
Investment advisory expenses for services provided by The Vanguard Group are .1$% for the Balanced Nona
and .06% for the Growth Fund.
d in the return of each fund the participant has selected.
The effect of the expenses is reflecte
QUALIFIED uses Foga YOUR VEBA ACCOUNT
must request the VEBA Plan Administrator to reimburse you for qualified expenses/premiums. Qualified expenses/premiums are outlined in IRC
.ion 213 and IRS Publication 502. (You can order IRS Publication 502 by calling 1 -800 -TAX -FORM or download from the IRS Website
at http://www.irs.gov)
"Medical care" expenses include amounts paid for the diagnosis, treatment, or prevention of disease, and for treatments affecting any part of or function
of the body. The expenses must be to alleviate or prevent a physical defect or illness Expenses for solely cosmetic reasons generally are not
expenses for medical care. Examples include face lifts, hair transplants, and hair removal (electrolysis). Also, expenses that are merely beneficial
your general health (for example, vacations) are not expenses for medical care.
ne fact or circumstance that often — but not always — indicates that medical care involves the treatment or prevention of disease is whether the care
prescribed by a physician. A mere suggestion by a physician probably is not enough. In addition, there should be a doctor -patient relationship
atween you and the physician prescribing the care.
following is a list of the more common allowable claims (This is not a complete list.)
COMMON QUALIFIED CLAIMS
Medical Insurance
Dental Insurance
Vision Insurance
Health Maintenance Organizations (HMO)
Long Term Care Insurance (Tax Qualified)
Medicare Part B
Medicare Supplement
Insurance Plan Deductibles
Insurance Plan Co-insurance
Office Visit Copays
Physician Services Copays
Prescription Copays
adoption (medical expenses incurred before adoption is finalized)
air conditioning and air filters used for alleviating illness
kicoholism and Drug Treatment Center costs
ambulance hire
krtificial limbs and teeth
4utomobile modifications (hand controls, special equipment,
mechanical lifts)
Birth control pills
Braille books & magazines
Childbirth classes (birth preparation classes, not child rearing classes)
;t Lenses
es - purchased or rented
treatments
gs - for a specific medical condition
hose, medically prescribed
sses or Prescription Sunglasses
Fertility treatments
Fluoridation devise
Food & beverages, for specific diseases
Genetic testing (to determine possible defects)
Halfway house residency
Hearing devices & batteries
infertility treatment
disability (special school or specially trained educator for learning
disabled children recommended by doctor)
Lifetime care at medical facility
Medical Supplies
Norplant insertion or removal
Obstetrical expense
Occlusal Guards - to prevent grinding of teeth
Organ Transplants
Oxygen equipment, rental of medical or healing equipment
Physical Therapy
Private Hospital Room
Radial Keratotomy
Retirement home fees, costs allocable to medical care
Sanitarium or rest home
Seeing -eye dog
Services & Fees:
Acupuncture Anesthetist Chiropractor
Christian Science Dentist Diathermy
Exam, physical Eye Exam Gynecologist
Healing services Hospital Laboratory
Lip Reading Services for the Deaf Medical info plan
Nursing Oral Surgery Osteopath
Physician Practitioners Psychiatrist
Psychoanalyst Psychologist Physiotherapist
Sex therapist Specialists Surgeons
Special television set to receive closed captions
Speech training for a child with dyslexia or other disability
health fee
for corrective devices (Including special mattress and board
for arthritis)
Telephone for deaf
Therapy treatments
Transportation expense relative to illness
For specific questions about your claims, please call the VEBA Plan Administrator at 1-800-VEBA-101 or e-mail at: rehn@ior.com.
Qxa.4fied Uses
Revised 11198
VEBAPARI
�
AS OF MAY 99 2000
Counties/Cities/Towns
Benton County
City ofAurway Heights
City of Arlington
City of Cashmere
City of Grandview
City of'Palouse
City of Post Fails
City of SeaTac
City of Selah
City of Sunnyside
City Ot—nr.:nsnv
Franklin County
Kittitas County
Kootenai County
Town of Odessa
Special Purpose Districts
Aunaoolis Water District
Benton County PUD (*Pending)
Cascade Valley Hospital
Cedar River Water & Sewer Districts
Chelan County PUD
Covington Water District
Douglas County PUD
Ferry County PUD
Franklin County PUD (*Pending)
Grant County PUD
King County Water District No 108
King County Water District No. I I1
King County Water District No. 20
King County Water District No. 49
Kung County Water District, No. 45
Special Purpose Districts (continued)
King County Water District No. 83
K tsap C ;W t C_ur r i�iS1711 tNO. 5
Klickrtat County PUD (*Pending)
Lake Roosevelt Development Assoc.
Lakeliaven Utility District
Mason County PUD 43
Midway Sewer District
Mukilteo Water District
North Perry Ave. Wa.0. DiStrtet
Okanogan County PUD
Olvnmic View Water & Sewer District
Pend Oreille County PUD (*Peaduig)
Pierce County Fire District No. 8
Port of Bremerton
Port of Centralia
Port of Ephrata
Pot of Longview
Port of Port Angeles
Port of Skamama County
Port of Vancouver
Silver Lake Water District
Skamania County PUD
Snohoimsh County Fire District No 26
Snohomish County Fire District No. 5
Southwest Sub urhwa*i Scwer District
Spokane County N02000S Weed Board
Spokane firefighters
Thurston County Fire District No I I
Thurston County Fire No. 14
Valley Water Disinct
Valvue Sewer District
Water Distnet No. 111
. ,.t
wiutworth Water Li�u,...._No �• 2
(*Pending means the employer iters adopted the Plan but hos not yet rrtade u contribution to the Trust.)
Employees of cities, counties, towns, and special purpose tax districts are eligible to participate. L
you have -My yu' i4nnc, or `•uo'- would Ince to discuss adding an MSA VEBA plan to your benefits
package, please give us a call.
VEBA SERVICE GROUP REGIONAL OFFICES:
Western Washington:
John Fulbright
Peter Laney, CFP
Phone: (253)435-8835 or 1-800-422-4023
Fax: (253)435-8850
E-mail: pjlaney@msn.corn
11627 62nd Ave. E
.Puyallup, WA 98373
Eastern Washington:
Richard Dickman
Mark Wilkerson, CFP
cnorSz�R_557i or 1-800-888-VEBA
rnone. �,�,�— _ -. _
Fax: (509)838-5613
E-mail: wiik=n(�ior.com
400 S. Jefferson, Suite 301
Spokane, WA 99204
R..ed 05/09/00
_uBA
MS7ArA�Vfr_l
ME,1VIBIERSFU
j . 1 0L L_,1VVi1JL 1 y ;L FO C1L
Participant Information (Please print clearly.)
Applicant's Name
Address
City
Date of Birth phone No.
VA��aL Fund Selection
MSA VEBA Plan Administrator
c/o REHN & Associates
P O Box 5433
Spokane, WA 99205-0433
1-800-VEBA101 9 (509) 534-0600
Fax (509) 535-7883
Email: admiul@veba.org
Social Security Number
State
Spouse's Name
Please choose the investment fund or fund (s) for your MSA VEBA
account.
Stable Value Fund (Conservative)
Balanced Fund (Moderate)
Growth Fund (Aggressive) %
Total must equal 100 %
Please use whole numbers, we cannot account for fractions.
Hold. Harmless Agreement & Required. Signa
Do. Code
If you do not choose an investment fund,
the total value of your MSA VEBA
account will be allocated to the Stable
Value Fund. Benefit withdrawals from
your funds will be made proportionately.
I hereby become a Member of the MSA VEBA Plan & Trust for Public Employees ali e rtest., or to my
I acknowledge that this Plan will provide benefits payable to me, my spouse, my qdependents
heirs, and that benefits will be paid until -the account is used up.
I hereby acknowledge that my employer is providing no tax advice regarding participation in this Plan. There-
fore, I hereby agree to waive any claims against my Employer relating to participation in this Plan or to taxation of
Plan benefits, and to indemnify and hold the Employer harmless for any taxes, assessments, damages or other costs
that may be incurred.
Signed this day
Signature of Employee
To the Employee: Please make a copy of this form for your personal records. Your employer will also keep a copy
for their records. Your employer will send this form to the MSA VEBA Plan Administrator, along with their check
for your MSA VEBA contribution. Upon receipt of the funds, the MSA VEBA Plan Administrator, REHN &
Associates, will send you a welcome letter confirming the deposit, plus an initial MSA VEBA Claim Form, an MSA
VEBA Systematic Payment Form and a Summary Plan Description. Please use your social security number whenever
communicating with the MSA VEBA Plan Administrator.
To the Employer Personnel/Benefits` Department: Please mail this form to the MSA VEBA Plan Administrator
along with the contribution made payable to the MSA VEBA Trust.
Employer Contact Person:
Phone:
E-mail:
To order brochures or forms: e-mail admin@veba.org or call 1-800-VEBA101 or (509) 534-0600 (Spokane).
(PSE03 Rev 4(00
BUSINESS OF THE CITY COUNCIL
YAKIMA, WASHINGTON
AGENDA STATEMENT
Item No. I
For Meeting Of 3/20/01
ITEM TITLE: Consideration of a Resolution authorizing the Establishment of a
Medical Savings Account/ Voluntary Employee's Beneficiary
Association ("MSA VEBA") Plan
SUBMITTED BY: Dick Zais, City Manager; Al Gillespie, Fire Chief; Richard Andring,
Deputy Fire Chief; Sheryl M. Smith, Deputy Human Resources Manager
CONTACT PERSON/TELEPHONE: Sheryl Smith, x6665
SUMMARY EXPLANATION:
The attached resolution authorizes the establishment of a Medical Savings
Account/Voluntary Employee's Beneficiary Association ("MSA VEBA") Plan as allowed by
IRS regulations. This matter was the subject of collective bargaining with the Fire LEOFF,
Fire PERS and Public Safety Communications bargaining units. The parties agreed to
implement a VEBA plan for sick leave cashouts only at the time of retirement. Individual
employee sick leave cashouts will be deposited in the VEBA Trust account for the specific
use for unreimbursed medical expenses such as insurance premiums, prescription drug co -
pays, deductibles, and other unreimbursed medical expenses.
Resolution X Ordinance Other (Specify)
Contract Mail to (name and address):
Funding Source
APPROVED FOR SUBMITTAL -
Qty Manager
STAFF RECOMMENDATION: Pass resolution.
BOARD/COMMISSION RECOMMENDATION:
COUNCIL ACTION: Resolution adopted. RESOLUTION NO. R-2001-57