HomeMy WebLinkAboutAGENDA BACKUP 10-05-89
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Centra :ontra Costa Sanitar~ ..listrict
BOARD OF DIRECTORS
PAGE 1 OF 2
POSITION
PAPER
BOARD MEETING OF
October 5, 1989
NO.
III. CONSENT CALENDAR
11
SUBJECT
QUITCLAIM SEWER EASEMENTS TO V ILLA WOODS, INC.
DBA DANVILLE OAKS, JOB 1603, PARCELS 27, 28, AND
33, DANVILLE AREA
DATE
Septembe r 26, 1989
TYPE OF ACTION
APPROVE QUITCLAIM
OF EASEMENT
SUBMITTED BY
Denni sHall
Assistant Engineer
INITIATING DEPT/DIV.
Engineering Department/
Construction Division
ISSUE: Villa Woods, Inc. has requested the District to quitclaim the subject
easements.
BACKGROUND: The subject easements were granted to the District at no cost in
1965. The easements were created to serve properties on Dyne Court. All of these
properties have now been combined into one ownership and the homes have all been
razed. The combined properties are being redeveloped as Subdivision 7162
(attached town homes) and will not be able to use the existing sewer main. A new
sewer system and new easements will be created during the development of
Subdivision 7162. Villa Woods, Inc. has paid the District's quitclaim processing
fee. The subject easements are no longer needed and may be quitclaimed.
This project has been eval uated by staff and determined to be exempt from the
California Environmental Quality Act (CEnA) under District CEQA Guidelines Section
18.6, since it involves a minor alteration in land use limitations.
RECOMMENDATION: Approve Quitclaim Deed to Villa Woods, Inc., Job 1603, authorize
the President of the District Board of Directors and the Secretary of the District
to execute said Quitclaim Deed, and authorize the Quitclaim Deed to be recorded.
REVIEWED AND RECOMMENDED FOR BOARD ACTION
INITIATING DEPT/DIV.
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1302A-9/85
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JO~UITCLAIM EASEMENTS
1603 PARCELS
DANVILLE AREA 27,28 & 33
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Centre.. Contra Costa Sanitar~ .listrict
BOARD OF DIRECTORS
PAGE 1 OF 2
POSITION
PAPER
BOARD MEETING OF
October 5, 1989
NO.
III.
CONSENT CALENDAR 12
SUBJECT
QUITClAIM SEWER EASEMENTS TO FURMAN PROPERTIES,
JOB 460 - PORTION PARCEL 1, LAFAYETTE AREA
DATE
September 26, 1989
TYPE OF ACTION
APPROVE QUITClAIM
OF EASEMENT
SUBMITTED BY
Denni sHall
Assistant Engineer
INITIATING DEPT/DIV
Engineering Department/
Construction Division
ISSUE: Furman Properties, owner of Lot 23 of Subdivision 6511, has requested the
District to quitclaim the subject easement.
BACKGROUND: The subject easement was granted at no cost to the District in 1955.
A portion of the sewer main which was installed in the easement has been abandoned
and rerouted. This abandonment and sewer relocation was done as part of the site
preparation for new Subdivision 6511.
The developer'S engineers, Schell and Martin, Inc., discovered that the portion of
the existing sewer which will remain in service was not within the subject
easement in Lot 23. Furman Properties has granted a replacement easement in the
proper location and, therefore, the subject easement is no longer required and
should be quitclaimed.
This project has been evaluated by staff and determined to be exempt from the
California Environmental Quality Act (CEQA) under District CEQA Guidelines Section
18.6, since it involves a minor alteration in land use limitations.
RECOMMENDATION: Approve Quitclaim Deed to Furman Properties, Job 460, authorize
the President of the District Board of Directors and the Secretary of the District
to execute said Quitclaim Deed, and authorize the Quitclaim Deed to be recorded.
1302A-9/85
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REVIEWED AND RECOMMENDED FOR BOARD ACTION
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QUITCLAIM
EASEMENT
REPLACEMENT
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Centrc.- Contra Costa Sanitar~ .Jistrict
BOARD OF DIRECTORS
PAGE 1 OF 2
POSITION
PAPER
BOARD MEETING OF
October 5, 1989
NO.
III.
CONSENT CALENDAR 13
APPROVE AGREEMENT RELATING TO REAL PROPERTY WITH
MARRIOTT CORPORATION, JCB 4211 and J CB 4670, SAN
RAMON AREA
DATE
September 29, 1989
TYPE OF ACTION
APPROV E REAL
PROPERTY AGREEMENT
SUBJECT
SUBMITTED BY
Dennis Hall
Associate Engineer
INITIATING DEPT./DIV.
Engineering Department/
Construction Division
ISSUE: The property owner has proposed the construction of a retaining wall over
a District easement.
BACKGROUND: The proposed wall will cross the easement area at right angles, with
a mi nimum cl earance of ei ght feet from the sewer mai n. The sewer mai n was
installed within an 18-inch diameter metal pipe sleeve for added pipe protection
at the retai ni ng wall crossi ng. The property owner has cooperated with Di strict
staff by providing construction drawings of the retaining wall and has paid the
District's fee for processing the subject agreement.
Staff has determined that the improvements will not interfere with the present use
of our sewer; however, if the need should arise, the agreement requires the
property owner to move the wall at his/her expense within 30 days of notice to do
so.
This project (the proposed agreement) has been evaluated by staff and determined
to be exempt from the Cal iforni a Env i ronmental Qual ity Act (CEQA) under Di stri ct
CEQA Guidelines Section 18.6, since it involves a minor alteration in land use
limitations.
RECO~ENDATION: Approve the Agreement rel ati ng to Real Property with Marri ott
Corporati on, Job 4211 and 4670, and authorize the Presi dent of the Board of Di rectors
and the Secretary of the Di stri ct to execute sai d agreement, and authorize the
agreement to be recorded.
REVIEWED AND RECOMMENDED FOR BOARD ACTION
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INITIATING DEPT./DIV.
1302A-9/85
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CentrA Contra Costa Sanitar~ ~istrict
BOARD OF DIRECTORS
PAGE 1 OF 2
POSITION
PAPER
BOARD MEETING OF
October 5, 1989
NO.
IV.
SOL I 0 t~ASTE
1
SUBJECT
PJJ11-iORIZE 11-iE G~ERAL MANJlGER-CHIEF ENGINEER TO ~TER INTO
A PROFESSIONAL SERV ICES JlGREEMENT, fIND AU11-iORIZE $27 ,000
FROM THE G~ERAL IMPROV EMENT PROORAM CONTING~CY ACCOUNT
AS 11-iE DISTRICT'S SHAAE OF A FEASIBILITY STUDY FOR A
PUBLICL Y-Q'iNED TRflNSFER STATION, DISTRICT PROJ ECT NO. 20096
DATE
September 29, 1989
TYPE OF ACTION
AU11-iORIZE FUNDS
SUBMITTED BY
INITIA TING DEPT.lDIV
Paul Morsen, Deputy General Manager
Admi ni strati ve
ISSUE: Board approval is requi red for authorizati on of funds from the General
Improvement Program Contingency Account which exceeds $25,000.
BACKGRWND: At the September 7, 1989 Board Meeti ng, a comprehensive report was
presented on the status of efforts by the District and the cities of San Ramon and
Walnut Creek in pursuing the joint development of a publicly-owned transfer station.
A pub1 ic1y-owned transfer stati on wou1 d provi de an a1 ternative to a commerci a1
transfer station developed by the Acme Fill Corporation.
Although the automated garbage transfer system proposed by Valley Waste Management
would likely reduce the size of the transfer station facility, it is also likely
that it would not eliminate the need for a transfer station. Refuse from self
haulers and certain residential, commercial, and drop box customers not serviceable
by the automated garbage transfer system, and the need for processing of recyclables
and household hazardous waste would still require a transfer station.
The Board adopted a resolution endorsing the concept of a solid waste Joint Powers
Agreement (JPA> to develop a pub1 ic1y-owned transfer station. The cities of San
Ramon and Walnut Creek have adopted similar resolutions. Before entering into the
JPA, staff proposed that a feasibility study be prepared to review the physical,
economic, and operational requirements of a publiCly-owned transfer station and the
potenti a 1 for automated ga rbage transfer. Th e firm of Hil ton, Fa rnkopf and Hobson
was requested to submit a proposal for the feasi bil ity study because of the
famil iarity with sol id waste issues in the county gained by Robert Hilton through
other related engagements by all three public entities while Mr. Hilton was employed
by Price Waterhouse, Certified Public Accountants. The feasibility study will
include the following areas of review at a lump sum cost of $65,000:
o Survey Existing Transfer Stations
o Obtain Automated Garbage Transfer System Costs
o Develop Conceptual Designs
o Estimate Construction Costs for Each Design
o Estimate Financing Costs for Each Design
o Estimate O&M Expenses for Each Design
o Develop Al ternati ve Desi gns whi ch Inc1 ude The Functi on Of Recyc1 i ng,
Household Hazardous Waste And Composting
o Contrast Per Ton Rates of Public and Commercial Transfer Station and
Automated Garbage Transfer
REVIEWED AND RECOMMENDED FOR BOARD ACTION
SUBJECT
J'LJlHORIZE lHE GENERAL MANJlGER-CHIEF ENGINEER TO ENTER INTO
A PROFESSIONAL SERVICES JlGREEMENT, AND AUTHORIZE $27,000
FROM THE GENERAL IMPROVEMENT PROORAM CONTINGENCY ACCOUNT
N3 lHE DISTRICT'S SHAAE OF A FEASIBILITY STUDY FOR A
PUBLIQ Y-G'lNED TRANSFER STATION, DISTRICT PROJ ECT NO
POSITION
PAPER
PAGE OF
DATE
The District will be the contracting entity and will apportion the cost of the
feasibility study to the District and the cities of San Ramon and Walnut Creek. The
District's share of the cost is $27,000. The cost of the feasibility stuqy will be
reimbursed to the three public entities fran the ultimate financing for the
construction of the transfer station. If a publicly-owned transfer station is not
constructed by the J PA, each of the public enti ti es will bear thei r share of the
unreimbursed cost of the feasibility study; in this event, the District would
write-off its share of the feasibility study as an operations and maintenance
expense, and recover the $27,000 expense through the refuse collection franchise fee
over th ree years.
RECOMMENDATION: Authorize the General Manager-Chi ef Engi neer to enter into an
agreement with the fi rm of Hil ton, Farnkopf and Hobson and authorize $27 ,000 fran
the General Improvement Program Conti ngency Account as the Di stri ct' s share of a
feasibility study for a pUblicly-owned transfer station, District Project No. 20096.
SSS/Pos.Papersl3/Feas Study
WF/hb/91 291 89
13028-9/85
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Centrl. Contra Costa Sanitar) ~istrict
BOARD OF DIRECTORS
PAGE 1 OF 2
POSITION
PAPER
BOARD MEETING OF
October 5, 1989
NO.
V.
ADMINISTRATIVE
1
SUBSTITUTION OF COUNSEL FOR THE DISTRICT;
APPOINTMENT OF MR. KENTON L. ALM, ESQUIRE
DATE
September 29, 1989
TYPE OF ACTION
SUBSTITUTION mD
APPOINTMENT OF
COUNSEL
SUBJECT
SUjl~g~E'f:~Y Campbell
Administrative Operations Manager
INITIt-Ji~<3 D,l:PT/DIVt. . I
l\ulIIlnls"tra lve
Risk Management and Safety
ISSUE: The District obtains its primary legal services fran a Counsel for the
District appointed by the Board of Directors. A change in Counsel is done through a
Board resolution.
BACKGROUND: The Board appointed James L. Hazard as Counsel for the District effective
July 1, 1985, and entered into an agreement with the law firm of Sellar, Hazard,
Snyder & Kelly for the legal services in connection with this. This agreement was
renewed on July 7, 1988, for the period through June 30, 1991, under the firm's new
name of Sellar, Hazard, Snyder, Kelly & Fitzgerald.
Mr. Hazard now finds that the growth of the firm, which has caused an increase in his
duties as the managing partner, makes it difficult for him to continue as Counsel for
the District because of the mutual time demands. He is proposing that the agreement
between the District and his firm continue as previously approved but with the substi-
tution of Kenton L. Alm, another partner of the firm, as Counsel for the District,
thereby releasing him fran this position. Mr. Hazard will continue to be available,
however, for District legal matters as required.
Mr. Alm has been devoting the majority of his time for the past several years to the
Central Contra Costa Sanitary District and its legal service requirements. This has
given him di rect experi ence with the Di stri ct which more than meets the requi rements
as contained in Section 2.16.04 of the District Code. He has been providing these
services to both Board and staff on the vari ety of tasks currentl y underway at the
District, and he is, therefore, uniquely qualified to serve as Counsel.
REC04MENDATICII: Adopt the resol uti on appoi nti ng Kenton L. Alm as Counsel for the
Central Contra Costa Sanitary District. Authorize an amendment to the July 7, 1988,
agreement with Sellar, Hazard, Snyder, Kelly & Fitzgerald substituting Mr. Alm as
Counsel for the District in place of Mr. Hazard.
REVIEWED AND RECOMMENDED FOR BOARD ACTION
INITIATING DEPT/DIV.
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PM
Page 2 of 2
RESa..UTION NO. 89-
A RESOLUTION APPOINTING KENTON L. ALM TO lHE
EXEMPT POSITION OF
COUNSa FOR lHE DISTRICT
The Board of Di rectors of the CENTRAL CONTRA COSTA SHHTAAY DISTRICT
does hereby resolve as follows:
THAT, KENTON L. ALM be appoi nted in pl ace of J ames Hazard to the
exempt posi ti on of Counsel for th e Di stri ct in accordance with Chapter
2.16 of the District Code and in accordance with the terms and conditions
of the Agreement for Legal Services between Central Contra Costa Sanitary
District and Sellar, Hazard, Snyder, Kelly & Fitzgerald dated July 7,
1988.
lHAT, the appoi ntment of KENTON L. ALM to the exempt posi ti on of
Counsel for the District shall be effective October 6, 1989.
PASSED AND AOOPTED this 5th day of October, 1989, by the Board of
Di rectors of the CENTRAL CONTRA OOSTA SNHTAAY DISTRICT thi s 5th day of
October, 1989, by the following vote:
AYES: Members:
NOES: Members:
IBSEtn: Members:
President of the Board of Directors,
Central Contra Costa Sanitary District,
County of Contra Costa, State of California
COUNTERSIGNED:
Secretary of the Central Contra
Costa Sanitary District, County
of Contra Costa, State of California
Approved as to Form:
James L. Hazard
District Counsel
.
Centr~ Contra Costa Sanitar) Jistrict
BOARD OF DIRECTORS
PAGE 1 OF 3
POSITION
PAPER
BOARD MEETING OF
Octobe r 5, 1989
NO.
VI.
DATE
ENGINEERING
1
SUBJECT
ADVISE STAFF REGARDING INClUSION OF PROPERTIES
IN FUTURE LOCAL IMPROVE~NT DISTRICTS
Octobe r 2, 1989
TYPE OF ACTION
FORMATION OF
LIDS
SUBMITTED BY
Will iam Gregory
Real Property Specialist
INITIATING DEPT./DIV.
Engineering Department/
Construction Division
ISSUE: District staff requests advice from the Board of Directors on including
and assessing properties in a possible future Local Improvement District (LID) in
Danv ill e.
BACKGROUND: An annexati on of properti es in Danv ill e to th i s Di stri ct is bei ng
processed through the Local Agency Formation Commission (LAFCO). The annexation
is shown on the attached map. Twelve owners in this area have petitioned for
annexation. Owners of some of the adjacent properties have not petitioned and are
not interested in connecting to the public sewer system. The property owners are
proposing that a LID be formed to finance the installation of sanitary sewers.
LAFCO is consi deri ng addi ng ni ne adj acent properti es to the annexati on. Whether
or not these adjacent properties will be included in the LID has bearing on the
decision by LAFCO to include (or exclude) these properties in the annexation. An
opportunity exists for the District to advise LAFCO of the District's preference
on LAFCO adding properties which will be discussed at LAFCO's meeting on October
11, 1989.
Staff has developed options for consideration by the Board. First, there are two
basic options 1) include all properties in the LID, or 2) exclude those
properties which do not wish to participate in the LID (added properties). Then,
there are alternatives under each of the basic options. The options and
alternatives are shown below in outline format.
OPTION 1:
Include all properties in the LID.
AlTERNATIVE lA: Assess all properties in the LID.
OR
AlTERNATIVE IB: Do not assess added properti es. Properti es wh i ch are
included in the LID are assessed all costs. District collects rebates from
owners of added properties when, and if, they connect and di stributes the
rebates in one of the following two ways:
(a) District pays the rebates directly to the original owners of properties
within the LID.
(b) District pays the rebates to the LID thus reducing the LID bonds.
REVIEWED AND RECOMMENDED FOR BOARD ACTION
1302A-9/85
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INITIATING DEPT./DIV.
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SUBJECT
POSITION PAPER
ADVISE STAFF REGARDING INCLUSION OF PROPERTIES
IN FUTURE LOCAL IMPROVEMENT DISTRICTS
PAGE 2 OF 3
DATE
October 2, 1989
OR
ALTERNATIVE Ie: Do not assess added properties. District pays the original
assessments of the added propert1 es. 01 strict coll ects rebates from owners
of added propert1 es when, and if, they connect and deposits the rebates 1 n
the Sewer Construction Fund.
Alternative lB differs from Alternative lC in that the District pays original
assessments under Alternative lC.
OPTION 2: Exclude added properties from the LID. Properties which are included
in the LID are assessed for all costs. District collects rebates from owners of
added properties when, and if, they connect and distributes the rebates in one of
the following two ways:
(a) District pays the rebates directly to the original owners of
properties within the LID.
(b) District pays the rebates to the LID thus reducing the LID bonds.
Alternative lB and Option 2 are virtually identical.
Staff requests that the Board cons1 der the above options and al ternat1ves,
1 nd1 cate the1 r preference, and 1 nstruct staff on how to adv 1 se LAFCO of the
District's preference. The Board will have the opportunity in the future to make
final decisions on this matter. If LAFCO adds properties to the annexation, the
Board will hold a public hearing on the added parcels. If the LID is formed, the
Board will hold a public hearing to address which properties will be assessed and
the amount of the assessments.
RECOM\1ENDATION: Advise staff regarding inclusion of properties in future Local
Improvement Districts.
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13028-9/85
.
Centr~ Contra Costa Sanitar) Jistrict
BOARD OF DIRECTORS
PAGE 1 OF 3
POSITION
PAPER
BOARD MEETING OF
Octobe r 5, 1989
NO.
VI.
DATE
ENGINEERING
1
SUBJECT
ADVISE STAFF REGARDING INClUSION OF PROPERTIES
IN FUTURE LOCAL IMPROVE~NT DISTRICTS
Octobe r 2, 1989
TYPE OF ACTION
FORMATION OF
LIDS
SUBMITTED BY
Will iam Gregory
Real Property Specialist
INITIATING DEPT./DIV.
Engineering Department/
Construction Division
ISSUE: District staff requests advice from the Board of Directors on including
and assessing properties in a possible future Local Improvement District (LID) in
Danv ill e.
BACKGROUND: An annexati on of properti es in Danv ill e to th i s Di stri ct is bei ng
processed through the Local Agency Formation Commission (LAFCO). The annexation
is shown on the attached map. Twelve owners in this area have petitioned for
annexation. Owners of some of the adjacent properties have not petitioned and are
not interested in connecting to the public sewer system. The property owners are
proposing that a LID be formed to finance the installation of sanitary sewers.
LAFCO is consi deri ng addi ng ni ne adj acent properti es to the annexati on. Whether
or not these adjacent properties will be included in the LID has bearing on the
decision by LAFCO to include (or exclude) these properties in the annexation. An
opportunity exists for the District to advise LAFCO of the District's preference
on LAFCO adding properties which will be discussed at LAFCO's meeting on October
11, 1989.
Staff has developed options for consideration by the Board. First, there are two
basic options 1) include all properties in the LID, or 2) exclude those
properties which do not wish to participate in the LID (added properties). Then,
there are alternatives under each of the basic options. The options and
alternatives are shown below in outline format.
OPTION 1:
Include all properties in the LID.
AlTERNATIVE lA: Assess all properties in the LID.
OR
AlTERNATIVE IB: Do not assess added properti es. Properti es wh i ch are
included in the LID are assessed all costs. District collects rebates from
owners of added properties when, and if, they connect and di stributes the
rebates in one of the following two ways:
(a) District pays the rebates directly to the original owners of properties
within the LID.
(b) District pays the rebates to the LID thus reducing the LID bonds.
REVIEWED AND RECOMMENDED FOR BOARD ACTION
1302A-9/85
JSM
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DH
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INITIATING DEPT./DIV.
~
SUBJECT
POSITION PAPER
ADVISE STAFF REGARDING INCLUSION OF PROPERTIES
IN FUTURE LOCAL IMPROVEMENT DISTRICTS
PAGE 2 OF 3
DATE
October 2, 1989
OR
ALTERNATIVE Ie: Do not assess added properties. District pays the original
assessments of the added propert1 es. 01 strict coll ects rebates from owners
of added propert1 es when, and if, they connect and deposits the rebates 1 n
the Sewer Construction Fund.
Alternative lB differs from Alternative lC in that the District pays original
assessments under Alternative lC.
OPTION 2: Exclude added properties from the LID. Properties which are included
in the LID are assessed for all costs. District collects rebates from owners of
added properties when, and if, they connect and distributes the rebates in one of
the following two ways:
(a) District pays the rebates directly to the original owners of
properties within the LID.
(b) District pays the rebates to the LID thus reducing the LID bonds.
Alternative lB and Option 2 are virtually identical.
Staff requests that the Board cons1 der the above options and al ternat1ves,
1 nd1 cate the1 r preference, and 1 nstruct staff on how to adv 1 se LAFCO of the
District's preference. The Board will have the opportunity in the future to make
final decisions on this matter. If LAFCO adds properties to the annexation, the
Board will hold a public hearing on the added parcels. If the LID is formed, the
Board will hold a public hearing to address which properties will be assessed and
the amount of the assessments.
RECOM\1ENDATION: Advise staff regarding inclusion of properties in future Local
Improvement Districts.
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13028-9/85
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Centra~ ~ontra Costa Sanitary ..Jistrict
BOARD OF DIRECTORS
PAGE
OF 2
POSITION
PAPER
BOARD MEETING OF
October 5, 1989
NO.
VI.
ENGINEERING
2
SUBJECT
AUTHORIZE THE GENERAL MANAGER-CHIEF ENGINEER TO EXECUTE
AN AGREEMENT WITH DODSON & YOUNG TO ASSIST THE DISTRICT
WITH THE DESIGN OF THE SLUDGE BLENDING PROJECT
DATE
October 2, 1989
TYPE OF ACTION
AUTHORIZE AGREEMENT
SUBMITTED BY
Jade A. Sullivan
Assistant En neer
INITIATING DEPT.lDIV.
Engineering Department
e 'v'
ISSUE: Authorization by
Manager-Chief Engineer to
$50,000.
the Board of Directors is required for the General
execute professional service agreements greater than
BACKGROUND: The primary and secondary sludges are dewatered in centrifuges and
then burned in the plant I s incinerator. The new centrifuges will operate more
efficiently if they receive a well-blended flow of primary and secondary sludge.
This project consists of constructing a pump mixing system to mix and blend the
primary and secondary sludge prior to being pumped to the centrifuges for
dewatering. The pump mixing system will be installed into the existing centrate
thickener tank.
Several smaller projects having similar construction requirements and located in
the same general area have also been identified for inclusion into the Sludge
Blending Project. These include improvements to the Motor Control Center,
installation of a hoist system on the emergency sludge storage tank,
miscellaneous modifications to the Solids Control Building (DP 20067), Solids
Conditioning Building Control Room HVAC Filtration (DP 10058), and installation of
a centrifuge hot water flush system.
Previously, the District had prepared change order documents for the pump mlxlng
system and requested the existing contractor, Dillingham Contractors, to submit a
quote for the work. However, due to the magnitude of the quote received from
Dillingham, staff believes that competitive bids will result in a lower cost for
the work.
Staff recommends that Dodson & Young provide design services to allow the District
to complete the project plans and specifications. This recommendation is based on
their role as Value Engineer on the sludge blending change order design effort.
The type of contract for this work will be cost reimbursement with a ceiling of
$69,390.. This project is included in the 1989-1990 Capital Improvement Budget
under the title "Dewatering System Improvements-Mixing" beginning on TP-27. A
total project cost is estimated at $1,200,000 which includes $437,000 to construct
the five smaller projects.
JAS
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DRW
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ENG.
REVIEWED AND RECOMMENDED FOR BOARD ACTION
1302A-9/85
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INITIATING DEPT.lDIV.
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SUBJECT
AUTHORIZE THE GENERAL MANAGER-CHIEF ENGINEER TO EXECUTE
AN AGREEMENT WITH DODSON & YOUNG TO ASSIST THE DISTRICT
WITH THE DESIGN OF THE SLUDGE BLENDING PROJECT
POSITION PAPER
PAGE 2 OF 2
DAO~tober 2, 1989
These projects have been evaluated by staff and determined to be addressed under
the Stage 5B Environmental Impact Report of 1982 and exempt from the California
Quality Act (CEQA) under District CEQA guidelines, Section 18.2, since they
involve minor alterations to existing facilities with no increase in capacity.
RECOMMENDATION: Authorize the General Manager-Chief Engineer to execute a
reimbursement agreement with a cost ceiling of $69,390 with Dodson & Young.
13028-9/85
.
Centra. ;ontra Costa Sanitar) Jistrict
BOARD OF DIRECTORS
PAGE 1 OF104
POSITION
PAPER
BOARD MEETING OF
October 5, 1989
NO.
VI!.
DATE
Se tember 29, 1989
TYPE OF ACTION
PERSONNEL
1
SUBJECT
ADOPT THE CAFETERIA PLAN MODIFIED TO BE IN CONFORMANCE
WITH SECfION 125 OF THE IRS OODE AND THE COMPONENT
DEPENDENT CARE ASSISTANCE, PREMIUM CONVERSION AND HEALTH
FLEXIBLE SPENDING ARRANGEMENT PlANS
ADOPT E~OYEE
BENEFIT PlAN
DOCUMENTS
SUBMITTED BY
INITIATING DEPT./DIV.
Paul Morsen, De ut General Mana er
Administratfve
ISSUE: The Internal Revenue Code requires that certain employee benefit programs
be supported by plan documents adopted by the governing board.
BACKGROUND: As part of the Memorandum of Understanding between the Management
Support/Confidential Group (MS/CG) and the District, the District agreed to offer
a Dependent Care Assi stance Pl an under Section 129 of the IRS Code. The
Personnel Officer drafted the plan and sent it to the employee benefits firm of
Mercer-Meidinger-Hansen for review. Upon their inspection of how dependent care
assistance would integrate with the District's Benefit Option Plan, Mercer
informed the District of changes in Internal Revenue Code Section 125 which
require modifications in the structure of our Benefit Option Plan. Although the
scope and cost of these benefits remain the same, these changes are necessary to
continue the non-taxable status of many of our benefits. Consequently, attached
(Attachment 1) are benefit plan documents which have been designed to meet the
mandates of Section 129 and 125. These plans replace the Benefit Option Plan.
They have been prepared by Carol Causey, Esq., of Mercer-Mei dinger-Hansen, and
approved by Richard Tomoda, Esq., of the District's labor law firm of Corbett &
Kane.
Per the exi sti ng Memorandum of Understandi ng, the MS/CG and management group
receive a fixed amount each month to spend on a variety, or "monu", of benefit
options in the Cafeteria Plan. The Cafeteria Plan document is the umbrella plan.
It is the legal tool by which the District may offer the Dependent Care
Assistance Plan, the Health Flexible Spending Arrangement, and the Premium
Conversion Plan. Under these three plans, employees may spend their monthly
benefit allowance on a variety of taxable and non-taxable options or they may
elect to take cash. In the past, employees did not have the option of taking
cash; however, Section 125 requi res that cash be offered as an alternative
spending option.
The plan documents are highly technical and written to meet IRS requirements.
For a more understandable explanation of the plans, please consult the summary
plan description for the Cafeteria Plan (Attachment 2). Highlights of the plans
are summarized as follows:
REVIEWED AND RECOMMENDED FOR BOARD ACTION
1302A-
SUBJECT
ADOPT THE CAFETERIA PLAN MODIFIED TO BE IN CONFORMANCE
WITH SECTION 125 OF THE IRS CODE AND THE COMPONENT
DEPENDENT CARE ASSISTANCE_ PREMIUM CONVERSION AND HEALTH
FLEXIBlE SPENDING ARRANGEMENT PlANS
POSITION PAPER
PAGE
DATE
September 29, 1989
2
OF
104
DEPENDENT CARE ASSISTANCE PlAN
Employees may set aside up to $5,000 of income on a pre-tax basis for the
purpose of dependent care for chi 1 dren thi rteen years 01 d or under, the
elderly living with the employee, or other qualified dependents. The $5,000
limit reduces to $2,500 if the employee is married and files a federal
income tax return separately from his or her spouse. The amount allocated
for dependent care assi stance can be obtai ned from the Cafeteri a Pl an and
pre-tax salary withholdings.
HEALTH FLEXIBlE SPENDING ARRANGEMENT
The employee may elect from a variety of non-taxable health-related
benefits; i.e. out-of-pocket expenses incurred for health or dental care not
otherwise covered by the District's health or dental insurance plan. Other
eligible expenses include vision and hearing care, orthodontia, outpatient
mental health care, cosmetic surgery and prescription drugs.
PREMIUM CONVERSION PlAN
The employee may use his/her pre-tax Cafeteria Plan benefit amount to apply
to the differential between the Prudential health plan premium and the
lower Kaiser Plan premium. This will particularly benefit employees on the
Tier II plan hired after May 1, 1985.
TAXABlE OPTIONS
Employees may designate some or all of their Cafeteria Plan monthly benefit
amount for the following taxable items:
- cash
- individual life insurance
- annual physical examination
- physical fitness/health club fees
- pension credit buyback
- tuition reimbursement
The Cafeteria Plan and its component plans provide substantial benefits for the
employees. They permit employees to allocate a portion of their salary to
non-taxable options, thereby decreasing the employees' taxable income. Also, the
addition of a cash option and allowing employees to designate a portion of their
salaries for non-taxable benefits give employees a variety of benefits tailored
to individual needs at no additional cost to the District.
Commencing May 1, 1990, in accordance with new IRS rules, disadvantages to the
employees and District will occur. Employees must designate the amount
13026-9/85
SUBJ~ THE CAFETERIA PLAN MODIFIED TO BE IN CONFORM-
ANCE WITH SECTION 125 OF THE IRS roDE AND THE COMPONENT
DEPENDENT CARE ASSISTANCE, PREMIUM CONVERSION AND HEALTH
FLEXIBLE SPENDING ARRANGEJENT PLANS
POSITION
PAPER
3
PAGE
OF
104
DATE
September 29, 1989
allocated to each pre-tax option sel ected prior to the beginni ng of each pl an
year, May 1 - April 30. If expenses incurred by the end of the year are less
than the amount the employee pre-sel ected at the beginni ng of the year, the
employee cannot be reimbursed for the amount not used. The employee forfeits the
unused balance to the general funds of the District. While funds may be obtained
from such forfeitures related to pre-tax options, the District may, on the other
hand, not be reimbursed in those cases where employees are reimbursed for claims
early in the plan year and terminate their employment before their monthly
pre-tax benefit had accumul ated insufficient amounts to equal the amount paid
for claims. Effective May 1, 1990, the District must allow employees, by virtue
of Federal law, to be reimbursed for one full year~benefit at the beginning of
the plan year. No allowance is made in the law for employees who receive
reimbursement for the entire year's benefit at the beginning of the year and
terminate.
District staff has met and conferred with the appropriate bargaining units on
this matter.
Carol Causey of Mercer-Meidinger-Hansen met with the Board Personnel Committee to
explain the need for the individual plans and the legal requirements of Section
125 and 129 of the IRS Code.
RECOtI4ENDATION: It is recommended that the Board adopt the Cafeteria Plan
modified to be in conformance with Section 125 of the IRS Code and the component
Dependent Care Assistance, Premium Conversion and Health Flexible Spending
Arrangement Plans.
13026-9/85
".
Attachment 1 4 of 104
CENTRAL CONTRA COSTA SANITARY DISTRICT
SECTION 125 CAFETERIA PLAN
Effective May 1, 1989
5 of 104
TABLE OF CONTENTS
Page
INTRODUCTION 1
ARTICLE I DEFINITIONS 3
ARTICLE II ELIGIBILITY AND PLAN PARTICIPATION 8
ARTICLE III PLAN FUNDING 10
ARTICLE IV BENEFITS 15
ARTICLE V PLAN ADMINISTRATION 17.
ARTICLE VI CLAIMS AND REVIEW PROCEDURES 21
ARTICLE VII MISCELLANEOUS 24
ARTICLE VIII AMENDMENT AND TERMINATION 26
APPENDIX A COMPONENT PLANS 28
SIGNATURE PAGE
6 of 104
CENTRAL CONTRA COSTA SANITARY DISTRICT
SECTION 125 CAFETERIA PLAN
INTRODUCTION
Effective as of May 1, 1989, the Central Contra Costa Sanitary District (hereinafter the
District or the Employer) adopts the Central Contra Costa Sanitary District Section 125
Cafeteria Plan (hereinafter Plan) as a welfare benefit plan to provide benefits for certain
of its employees. This Plan incorporates the Central Contra Costa Sanitary District.
Health Flexible Spending Arrangement, and the Central Contra Costa Sanitary District
Dependent Care Assistance Component Plans covering Eligible Employees of the
Employer, as listed in Appendix A of this Plan.
The Plan is designed to meet the appropriate requirements of Code Sections 105, 106,
125, and 129, and any other Applicable Law. It is specifically designated as a cafeteria
plan under Code Section 125, which allows Eligible Employees of an Employer to
choose among certain IIqualified welfare benefitsll as defined in Code Section 125( e)
and any regulations thereunder. This Plan is designed to meet the applicable
requirements of Code Section 89(k) and other Applicable Law.
This Plan and all Component Plans listed in Appendix A are maintained for the exclusive
benefit of employees. In addition, the terms of this Plan and all Component Plans,
including coverage and benefits, may be legally enforceable by Eligible Employees.
The provisions of this Plan shall apply only to certain employees of the Employer who
are eligible to receive benefits under at least one of the Component Plans listed in
Appendix A. The rights and benefits, if any, of former employees will be determined
in accordance with provisions of the Plan in effect on the date employment terminated.
D1W01-01
1
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Appendix A, Component Plans, attached to this Plan is incorporated herein by reference
and is a part hereof, and may be amended without necessity for other amendment of
this Plan.
OlW01-01
2
8 of 104
ARTICLE I
DEFINITIONS
When used in this Plan document, and in Component Plan documents, the following
words and phrases shall have the following meanings unless the context clearly
indicates otherwise:
1.1 Aoolicable Law
The Code as herein defined. or any other law of the United States or any state
or political subdivision thereof which may apply to this Plan.
1.2 Code
The Internal Revenue Code of 1986. as amended. as it now exists or from time
to time may be amended.
1.3 Comoensation
The total cash remuneration paid during a Plan Year for services rendered to an
Employer. as determined for purposes of Federal Income Tax Form W-2 or any
replacement thereto. For purposes of determining an employee's Compensation.
any election by the employee to reduce his or her regular cash remuneration
under Code Section 125 or 401 (k) shall be treated as if the employee did not
make such election.
DIW01.()1
3
9 of 104
1.4 Component Plan
A separate written plan maintained by the Employer to provide health flexible
spending arrangement benefits or dependent care assistance to employees.
Such Component Plans are listed in Appendix A and incorporated herein. Such
Component Plans may be amended at any time without necessity for other
amendment of this Plan. Each Component Plan is governed by the terms of its
plan document, which terms shall prevail in case of any conflict between this Plan
and a Component Plan.
1.5 Dependent
Any individual who is a dependent of an Eligible Employee as defined in a
Component Plan under which the Eligible Employee has a benefit entitlement.
1.6 Effective Date
May 1, 1989, the date on which this Plan becomes effective. The Effective Date
of each Component Plan is that date stated in each Component Plan document.
1.7 Eliaible Employee
Any employee of the Employer who is eligible to receive benefits under at least
one of the Component Plans.
1.8 Eliaible Expense
DIW01-01
Eligible Expenses are detailed in Article IV.
4
'.
10 of 104
1.9 Employer
The Central Contra Costa Sanitary District, and any organization that is a
successor thereto.
1.10 Employer Credits
Amounts, other than Salary Reduction amounts, credited by the Employer to
Participants' subaccounts to be allocated for Eligible Expenses. The amounts
of Employer Credits are set out in Section 3.2.
1.11 Hiohly Comoensated Emoloyee (HCE) shall mean, in general an individual who:
D1W01'()1
(a) is in the top 20% of all Employees by compensation, and earns more than
$50,000, or as increased by regulations issued by the Secretary of the
Treasury; or
(b) earns more than $75,000, or as increased by regulations issued by the
Secretary of the Treasury, in the current or preceding year; or
(c) is an officer of the Employer who earns more than $45,000, or as
increased by regulations issued by the Secretary of the Treasury; or
(d) is a former Employee and was an HCE any time after age 55.
Additionally, HCE shall mean any other individual included by the provisions of
Code Section 414(q) and regulations thereunder.
5
11 of 104
1.12 Open Election Period
The annual period during which Eligible Employees elect Salary Reduction
amounts, Employer Credits and allocations thereof for the following Plan Year.
For the initial Plan Year, May 1 through May 20 will be the Open Election Period.
Thereafter, the month of April will be the Open Election Period under this Plan.
1.13 Participant
An Eligible Employee who participates in the Plan pursuant to Article II.
1.14 Plan
The Central Contra Costa Sanitary District Section 125 Cafeteria Plan, the terms
of which are set forth herein, as it may be amended from time to time.
1.15 Plan Administrator
The Employer, notwithstanding the fact that certain administrative functions for
this Plan may be delegated to a committee or to any other person, persons, or
entity .
1.16 Plan Year
The twelve month period beginning May 1 and ending the following April 30.
Records of the Plan shall be established and maintained on the basis of the Plan
Year.
DIW01.Q1
6
12 of 104
1.17 Salary Reduction
DIW01..Q1
A specified amount or percentage by which a Participant's Compensation is
decreased, pursuant to a Salary Reduction election, for federal income tax and,
wherever permitted, for state and local income tax purposes. This amount is
credited to the Participant's account, as provided in Article III, for the sole
purpose of paying Eligible Expenses.
7
13 of 104
ARTICLE II
ELIGIBILITY AND PLAN PARTICIPATION
2.1 Eliaibilitv
(a) Eligible Employees covered under the provisions of any of the Component
Plans on the Effective Date shall be eligible to participate in the Plan on
the Effective Date. provided that any such Eligible Employee has not made
an election to cease coverage under all applicable Component Plans.
(b) Other Eligible Employees shall become eligible to participate in the Plan
on the first day of the month following _ date of hire or the first day of the
month following a change in family status as described in Section 3.5 of
the Plan. provided that the employee satisfies the eligibility provisions of
at least one of the Component Plans.
2.2 Participation
DIW01.o1
Participation in this Plan by an Eligible Employee shall begin upon participation
in a Component Plan and upon receipt by the Plan Administrator of such
applications, consents. proofs of birth or marriage, elections, beneficiary
designations. proof of reimbursable expenses and other documents and
information as may be prescribed by the Plan Administrator. Each Eligible
Employee upon participating in the Plan shall be deemed conclusively, for all
purposes, to have assented to the terms and provisions of this Plan and shall
be bound thereby.
8
14 of 104
2.3 Termination of Participation
Participation in the Plan shall terminate as of the earliest of:
(a) the last day of the Plan Year during which the Plan is terminated; and
(b) the date the employee is no longer a Participant under at least one
Component Plan.
An employee shall no longer be a Participant under a Component Plan if the.
Memorandum of Understanding which authorizes the participation of such
employee in any Component Plan expires. without renewal or an extension
agreement, or if a subsequent Memorandum of Understanding of each employee
representation unit eliminates such Component Plan.
2.4 Reinstatement of Former Participant.
A former Participant shall not be entitled to make a new Salary Reduction election
for the remainder of the Plan Year. A former Participant will again become
eligible for Salary Reduction under the Plan if and when the individual meets the
eligibility and participation requirements of Sections 2.1 and 2.2 above, but in no
event earlier than the beginning of the next Plan Year following termination of
participation.
A Former Participant will receive any Employer Credits to which he or she is
entitled in cash for the remainder of the Plan Year.
Orw01 -01
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ARTICLE III
PLAN FUNDING
3.1 Establishment of Accounts
The Employer shall maintain for each Participant a bookkeeping account
comprised of a Health Flexible Spending Arrangement subaccount, a Dependent
Care Assistance subaccount and a Premium Conversion subaccount. The
Employer shall credit each account with the amounts specified in Sections 3.2
and 3.3 in accordance with the Participant's designation(s) made pursuant to.
Section 3.4.
These accounts are for bookkeeping purposes only; any payments under the
Plan shall be made entirely out of the general assets of the Employer.
3.2 Emplover Credits
DIW01 -01
(a)
The District will credit each Participant who is an active employee
represented by the Management Support/Confidential Group with the
amount set out in the current applicable Memorandum of Understanding.
(b)
The District will credit each Participant who is an active employee
represented by the Management Group and the Deputy General Manager
with the amount set out in the current applicable Memorandum of
Understanding.
(c)
The District will credit each Participant who is an active employee and is
in Executive Management with the amount specified in his or her individual
employment contract.
10
16 of 104
3.3 Salary Reduction Credits
Each Participant may make a written Salary Reduction election to have his or her
annual Compensation reduced, but not below zero, by an amount not to exceed
the cumulative total of the maximum Iimitation(s) as stated in Plan Sections 3.7
and 3.8.
. 3.4 Desionation of Salary Reduction and Emolover Credit Amounts to Subaccounts
0IW01.()1
(a) Each Participant who elects Salary Reduction and/or is credited with.
Employer Credits shall also designate the amount (or portion of the total)
to be applied during the Plan Year to' each of the benefits described in
Article IV, and the amounts so designated shall be credited to appropriate
subaccounts within the Participant's account.
(b) No Salary Reduction or Employer Credit amounts shall be credited to a
Participant's account until such designation has been made.
(c) The balance credited to each subaccount except the Health Flexible
Spending Arrangement subaccount shall be reduced during the Plan Year
as payments are made to provide the designated benefits to the
Participant. Amounts designated to each subaccount may not be changed
at any time during the Plan Year except under the circumstances
described in Section 3.6. Such changes shall apply only prospectively.
Reimbursement for Incurred Medical Expenses (as defined in Section 1.5
of the Employer Health Flexible Spending Arrangement Plan) shall be
made in accordance with Section VI of the Employer Health Flexible
Spending Arrangement Plan document. Reimbursement for Incurred
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Expenses (as defined in Section 1.7 of the Employer Dependent Care
Assistance Plan) shall be made in accordance with Article VII of the
Employer Dependent Care Assistance Plan document. Payment of
Member Plan Premiums (as defined in Section 1.5 of the Employer
Premium Conversion Plan) shall be made in accordance with Article V of
the Employer Premium Conversion Plan document.
3.5 Time for Makino Elections
(a) Salary Reduction and benefit designation elections must be made during
the Open Election Period before the first day of each Plan Year if an
Eligible Employee is then currently eligible to participate in a Component
Plan. Elections must be made within thirty (30) days after an individual
is hired after, or first becomes an Eligible Employee after, the beginning
of the Plan Year or experiences a change in family status as described in
Section 3.6 of the Plan.
(b) If an Eligible Employee fails to make a timely election, the individual will
be deemed to have elected to make no election concerning the Employer
Health Flexible Spending Arrangement Plan, the Employer Dependent Care
Assistance Plan, and the Premium Conversion Plan.
3.6 Chanoe or Revocation of Elections
A Participant's Salary Reduction and benefits designation elections for any Plan
Year may not be changed or revoked after the first payroll period to which they
apply, except to the extent that change or revocation is in response to and
consistent with certain changes in family status including and not limited to:
DIW01-o1
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(1) marriage or divorce of the Participant;
(2) the death of the Participant's spouse or Dependent;
(3) the birth or adoption of a child of the Participant;
(4) the termination of employment, or commencement of employment,
of the Participant's spouse;
(5) the switching from part-time to full-time employment status, or from.
full-time to part-time status by the Participant or the Participant's
spouse;
(6) the taking of or return from an unpaid leave of absence by the
Participant's spouse;
(7) those circumstances as specified in Section 4.5 of the Employer
Health Flexible Spending Arrangement Plan document; and
(8) other circumstances approved by the Plan Administrator in a non-
discriminatory manner.
3.7 Limit on Amount Credited to Dependent Care Assistance Plan Subaccount
OIW01-01
The amount credited to a Participant's Dependent Care Assistance Program
(DCAP) subaccount shall not exceed the maximum limit as stated in Section 5.6
of the Employer Dependent Care Assistance Plan document.
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3.8 Limit on Amount Credited to Health Flexible Soendina Arranaement
The annual amount credited to a Participant's Medical Flexible Spending
Arrangement shall not exceed the maximum limit stated in Section 4.8 of the
Employer Health Flexible Spending Arrangement Plan document.
3.9 Limit on Amount Credited to Premium Conversion Account
The annual amount credited to a Participant's Premium Conversion Account shall
not exceed the maximu
20 of 104
3.8 Limit on Amount Credited to Health Flexible Spending Arrangement
The annual amount credited to a Participant's Medical Flexible Spending
Arrangement shall not exceed the maximum limit stated in Section 4.8. of the
Employer Health Flexible Spending Arrangement Plan document.
3.9 Limit on Amount Credited to Premium Conversion Account
The annual amount credited to a Participant's Premium Conversion Account shall
not exceed the maximum limit stated in Section 5.3 of the Employer Premium
Conversion Plan document.
3.10 Plan Administrator's Power to Modify and Suspend Elections
Notwithstanding any other Plan provisions, the Plan Administrator will suspend,
modify, or terminate any Participant's elections under the following circumstances:
(a) If the amount of any reduction agreed to is greater than the Participant's
monthly taxable pay from the Employer.
(b) In compliance with a change or revocation of an election due to a change
in family status as allowed in Section 3.6.
DIW01.Q1 14
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ARTICLE IV
BENEFITS
4.1 General Rule
All benefits except Health Flexible Spending Arrangement benefits shall be
payable or provided under this Article for a Plan Year only with respect to
periods during such Plan Year in which an Eligible Employee is a Participant and
has or is entitled to have amounts credited to his or her account pursuant to.
Sections 3.2 and 3.3, and expenses shall be reimbursed only if incurred during
such periods.
4.2 Health Flexible Soendina Arranaement
Health Flexible Spending Arrangement benefits shall be payable in accordance
with Article V of the Employer Health Flexible Spending Arrangement Plan
document.
4.3 Deoendent Care Exoenses
DIW01-01
Amounts credited to a Participant's Dependent Care subaccount for a Plan Year
shall be payable in accordance with Section 6.2 of the Employer Dependent Care
Assistance Plan document.
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4.4 Premium Conversion Expenses
Amounts credited to a Premium Conversion subaccount for a Plan Year shall be
payable in accordance with Section 5.2 of the Employer Premium Conversion
Plan document.
4.5 Cash Benefits
OIW01.Q1
(a)
A Participant may elect to receive in cash, included in his or her paycheck,
any Employer Credit amounts or amounts which could otherwise be
subject to Salary Reduction.
(b)
A Participant who elects Salary Reduction but fails to elect any benefits
provided in Sections 4.2, 4.3, or 4.4 shall not have any amounts credited
to his or her subaccounts, but shall instead receive as cash, included in
his or her paycheck, any amounts which would otherwise have been
subject to Salary Reduction.
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ARTICLE V
PLAN ADMINISTRATION
5.1 Allocation of Plan Administration Responsibilities
The Plan and each Component Plan thereunder shall be administered by a
Committee consisting of at least two members appointed by and serving at the
pleasure of the Employer's board of directors. The Committee shall have the
authority to control and manage the operation of the Plan and the Component
Plan thereunder as named fiduciary.
The Committee shall have such power to administer the Plan in all of its details,
including, but not limited to, the following powers:
(a) Interpretation of the Plan and Component Plans, such good faith
interpretation to be final and conclusive on all employees, Participants, and
beneficiaries.
(b) Adoption of such procedures and regulations as in the Committee's
opinion are necessary for the proper and efficient administration of the
Plan and Component Plans and are consistent with the terms and
purposes of the Plan and Component Plans;
(c) Enforcement of the Plan and Component Plans according to its terms and
to the rules and regulations adopted by the Employer.
The Committee may delegate to other organizations or persons (who also may
be employees) specific fiduciary responsibilities of the Employer in administering
DIW01-01
17
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24 of 104
this Plan. Any such delegation must be in writing and in accordance with
Applicable Law. Fiduciary duties which may be delegated include (without
limitation) :
(a) The responsibility to administer and manage any Component Plan which
forms a part of the Plan;
(b) The responsibility to prepare, report, file and disclose any forms,
documents and other information required by law to be reported or filed
with any governmental agency, or to be prepared and disclosed to.
employees or other persons entitled to benefits under the Plan; and
(c) The responsibility to review claims or claims denials under one or more
of the Component Plans under the Plan.
5.2 Fiduciary Duties
OIW01.()1
The Employer shall be responsible for the general administration of the Plan,
including:
(a)
notification of employees of eligibility for the Plan,
(b)
provision of Plan enrollment documents and claim forms,
(c)
determination of questions arising under the Plan of the eligibility of
employees under the Plan,
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25 of 104
(d) adoption of the procedures and regulations as are necessary in the
Employer's opinion for the proper and efficient administration of the Plan
and which are consistent with the terms and purposes of the Plan,
(e) enforcement of the Plan according to its terms and to the rules and
regulations adopted by the Employer,
(f) receipt, maintenance and approval of disbursement of Salary Reduction
and Employer Credit amounts, and
(g) filing or disclosure of any information required by law to be reported or
filed with any governmental agency or to be disclosed to employees or
other persons entitled to benefits under the plan.
5.3 Indemnification of Fiduciaries
DIW01-o1
When making a determination or calculation, the Plan Administrator and anyone
acting on its behalf may rely on information furnished by a Participant, the
Employer, actuaries, accountants, or counsel to the Plan, and by the Component
Plans.
The Employer will indemnify and reimburse, to the full extent permitted by law,
all board members, Committee members, and persons to whom Plan
Administrative duties have been delegated, for all expenses. losses, and liabilities
arising from an act or omission in the management of the Plan.
The Employer may self insure or purchase insurance for all Plan fiduciaries
employed by the Employer - and for all persons who are trustees. employees,
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officers, or agents of the Employer -- to cover the potential liability of those
persons with respect to their actions and lack of actions concerning this Plan.
5.4 Discretionarv Power of Plan Administrator
DIW01-D1
All discretion conferred upon the Plan Administrator will be absolute. However,
no discretionary power conferred on the Plan Administrator will be exercised in
a manner that causes discrimination in favor of Highly Compepsated Employees.
The discretionary power of the Plan Administrator will be exercised in a
non-discriminatory manner with regard to all similarly situated employees Of.
Participants.
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ARTICLE VI
CLAIMS PROCEDURES
6.1 Claims Procedures
DIW01-01
The Plan Administrator shall notify each Eligible Employee of his or her
entitlement to receive benefits under this Plan and shall provide appropriate forms
on which application for such benefits may be made.
Each Eligible Employee claiming a benefit under the Plan must complete and file
such application forms with the Plan Administrator. The Plan Administrator shall
review all applications for benefits. It shall notify the claimant in writing of its
decision within ninety (90) days of receipt of the application. If special
circumstances require any extension of time (not to exceed ninety (90) days) for
processing the claim, the Plan Administrator must notify the claimant in writing
of the extension prior to the expiration of the initial ninety (90) day period.
Any denial by the Plan Administrator of a claim for benefits shall be stated in
writing and mailed to the Eligible Employee. The notice shall state clearly in
language calculated to be understood by the Eligible Employee without legal
counsel:
(a)
the specific reason{s) for the Administrator's decision,
(b)
references to the pertinent Plan sections,
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(c) what additional material or information the Participant must provide so the
Plan Administrator will reconsider the claim or pay the premiums from the
Participant's account; and
(d) the Plan's appeals procedures.
6.2 Appeal and Review Procedure
DIW01-01
If a cfaim has been denied by the Plan Administrator, the claimant may appeal.
the denial within sixty (60) days after receipt of written notice thereof by
submitting in writing to the Deputy General Manager a request for review of the
denial of claim. A claimant also may submit a written statement of issues and
comments concerning the claim and may request an opportunity to review the
Plan, any Component Plan, and any other pertinent documents. If so requested,
these shall be made available to the claimant within thirty (30) days after its
receipt of a copy of the request, at a convenient location during regular business
hours.
If a claimant appeals, the final decision, with the specific reasons thereof shall
be rendered in writing, and transmitted to the claimant by certified mail within
sixty (60) days of receipt of the request for review. If special circumstances
require an extension of time, written notice of the extension shall be given to the
Participant before the end of the original 60-day period, and a decision shall be
rendered as soon as possible, but not later than 120 days after receipt of the
request for review.
22
29 of 104
6.3 Aaent for Service of Process
The agent for service of process for the Plan is:
Secretary of the District
Central Contra Costa Sanitary District
5019 Imhoff Place
Martinez, Ca 94553
6.3 Notices
Notices and documents relating to the Plan may be delivered, or mailed by
registered mail, postage prepaid, to the Committee in care of the Personnel
Officer, Central Contra Costa Sanitary District, 5019 Imhoff Place, Martinez, CA
94553. Any notice required under the Plan may be waived by the person entitled
to notice.
6.4 Evidence
Evidence required of anyone under the Plan may be by certificate, affidavit,
document or other information which the person acting on it considers pertinent
and reliable. The evidence may be signed, made or presented by the proper
party or parties.
DIW01-D1
23
30 of 104
ARTICLE VII
MISCELLANEOUS
7.1 Comoonent Plans Control
The detailed coverages provided under a Component Plan are set forth in that
Component Plan; in case of any conflict between the terms of this Plan
document and the terms of a Component Plan, the terms of the Component Plan
shall control.
Certificates or summaries setting forth the details of the coverages provided
under Component Plans have been or will be distributed to Eligible Employees
enrolled for coverage under the Component Plans.
7.2 State of Jurisdiction
Except to the extent superseded by the laws of the United States, this Plan and
each Component Plan and all rights and duties thereunder shall be governed,
construed, and administered in accordance with the laws of the State of
California.
7.3 Severabilitv
DIW01-01
If any provision of the Plan is held invalid or unenforceable, its invalidity or
unenforceability shall not affect any other provisions of the Plan, and the Plan
shall be construed and enforced as if such provision had not been included
herein.
24
31 of 104
7.4 Plan Not An Employment Contract
This Plan is not an employment contract. Any employment rights of an Eligible
Employee are neither enlarged nor diminished by the establishment of the Plan
or any Component Plan.
7.5 Non-Transferability of Interest and Facility of Payment
Except as otherwise expressly permitted by a Component Plan, the interests of
persons entitled to benefits under a Component Plan are not subject to their
debts or other obligations and, except as may be required by the tax withholding
provisions of the Code or any state's income tax act, may not be voluntarily or
involuntarily sold, transferred, alienated, assigned, or encumbered. When any
person entitled to benefits under the Plan is under legal disability or in the
Employer's opinion is in any way incapacitated so as to be unable to manage
his affairs, the Employer may cause such person's benefits to be paid to such
person's legal representative for his benefit, or to be applied for the benefit of
such person in any other manner that the Employer may determine.
7.6 Mistake of Fact
Any mistake of fact or misstatement of fact shall be corrected when it becomes
known and proper adjustment made by reason thereof. The Employer shall not
be liable in any manner for any determination of fact made in good faith.
7.7 Cost of Administerina the Plan
DIW01..()1
The costs and expenses incurred by the Employer in administering the Plan shall
be paid by the Employer.
25
32 of 104
ARTICLE VIII
AMENDMENT AND TERMINATION
8.1 Amendment
OIW01.()1
Subject to any obligation to meet with employee groups, any part or all of the
Plan or of any Component Plan may be amended in writing by the Employer at
any time or from time to time; any contract providing insured benefits may be
so amended by the Employer with the agreement of the insurance company or
service company at any time or from time to time; and any insurance company
or service company may be removed or changed by the Employer at any time
and from time to time.
Any part or all of the Plan or any Component Plan may be retroactively amended
in writing by the Employer if such amendment has the effect of an expansion of
the eligibility, participation of benefit provisions and if such amendment does not
discriminate in favor of one of more Highly Compensated Employees as defined
in Code Section 414(q). In addition, such retroactive amendment must continue
in effect for no less than a twelve consecutive month period after its adoption.
Specific notice procedures consistent with applicable federal law and regulation
will be complied with.
Any amendment to the Plan or any Component Plan prior to the completion of
a twelve consecutive month period from its adoption must be for a substantial
business purpose, and may not discriminate in favor of one or more Highly:
Compensated Employees as defined in Code Section 414(q). No amendment
shall operate to reduce the amount of any benefit payment otherwise payable
26
33 of 104
under the Plan for changes incurred prior to the effective date of such
amendment.
8.2 Termination
DIW01-o1
Any Component Plan may be terminated at any time by action of the Employer
if the Memorandum of Understanding of each employee representation unit which
has established such Component Plan has expired without renewal or an
extension agreement, or if a subsequent Memorandum of Understanding of each
employee representation unit eliminates such Component Plan. No termination.
or substitution shall operate to reduce the amount of any benefit payment
otherwise payable under the plan for charges- incurred prior to the effective date
of such termination or substitution.
Notwithstanding the above, the Employer reserves the right to terminate or
amend the Plan at any time if the Plan is deemed not to be in compliance with
Applicable Law.
27
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Appendix A
Component Plans
To
Central Contra Costa Sanitary District
Section 125 Cafeteria Plan
As of the Effective Date, the following are the Component Plans included in the Plan:r
1.
The Central Contra Costa Sanitary District Health Flexible Spending Arrangement
Plan
, 2.
The Central Contra Costa Sanitary Distri~ D~pendent Care Assistance Plan
3.
The Central Contra Costa Sanitary District Premium Conversion Plan
OlW01-o1
28
35 of 104
ADOPTION OF THE SECTION 125 CAFETERIA PLAN
As evidence of its adoption of this Section 125 Cafeteria Plan, the Central Contra Costa
Sanitary District has caused this instrument to be signed by its officers thereunder duly
authorized hereto this day of . 198_,
By:
Susan McNulty Rainey
(Date)
For: THE CENTRAL CONTRA COSTA SANITARY DISTRICT
Susan McNultv Rainev
(Print Name and Title)
President of the Board
ATTEST:
By:
(Sign Name)
(Date)
Jovce McMillan. Secretary of the District
(Print Name and Title)
(Seal)
Approved as to form
James L. Hazard
District Counsel
DIW01-o1
29
..
.
~ttachment 1 36 of 104
CENTRAL CONTRA COSTA SANITARY DISTRICT
PREMIUM CONVERSION PLAN
(A Component Plan of
the Central Contra Cost Sanitary District
Section 125 Plan)
Effective May 1, 1989
37 of 104
TABLE OF CONTENTS
flat
INTRODUCTION 1
ARTICLE I DEFINITIONS 2
ARTICLE II SCOPE OF THE PLAN 4
ARTICLE III ELIGIBILITY AND PLAN PARTICIPATION 5
ARTICLE N PLAN FUNDING 7
ARTICLE V BENEFITS 9
ARTICLE VI GENERAL PROVISIONS 10
APPENDIX A 12
SIGNATURE PAGE
38 of 104
CENTRAL CONTRA COSTA SANITARY DISTRICT
PREMIUM CONVERSION PLAN
INTRODUCTION
Effective as of May 1, 1989, the Central Contra Costa Sanitary District (hereinafter
(Employer) adopts the Central Contra Costa Sanitary District Premium Conversion Plan
(hereinafter Premium Conversion Plan) to allow Eligible Employees of the Employer to,
elect to pay their share of the cost of the Employer Health Plan on a pre-tax basis, as
provided herein and in accordance with the te~s of. the Central Contra Costa Sanitary
District Section 125 Plan (hereinafter Section 125 Plan).
This Premium Conversion Plan is a Component Plan of the Section 125 Plan and,
except to the extent otherwise expressly provided herein, is governed by the rules and
regulations of the Section 125 Plan. The Premium Conversion Plan is intended to
convert employee premiums to employer paid premiums within the meaning of Section
106(b) of the Code and to meet the requirements of any other applicable provisions of
the law.
Appendix A, Member Plans, attached to this Premium Conversion Plan is incorporated
herein by reference and is a part hereof and may be amended without necessity for
other amendment of this Premium Conversion Plan.
DIW01-04
1
Ml9
39 of 104
ARTICLE I
DEFINITIONS
The definitions in the Section 125 Plan apply to this Component Plan as well as the
following additions.
1.1 Dependent
Any individual who meets the definition of Dependent in a Member Plan under
which the Eligible Employee has a benefit entitlement.
1.2 Eliaible Emplovee
An employee who is eligible to participate in at least one of the Member Plans
and who is required to pay a Member Plan Premium for participation.
1.3 Eligible Expense
Any premium or other payment required by an Eligible Employee for participation
in a Member Plan.
1.4 Member Plan
A separate written plan maintained by the Employer which provides health care ,
including medical and hospital benefits. Such Member Plans are listed in
Appendix A, which may be amended without necessity for other amendment of
this Plan. The terms of the plan documents of such plans shall govern the
DIW01.()4
2
8189
...
40 of 104
operation of the Member Plans, and in case of any conflict between the terms
of the Member Plans and this Premium Conversion Plan or the Section 125 Plan,
the terms of the Member Plan shall govern.
1.5 Member Plan Premium. Premium
The amount an Eligible Employee is required to pay as a condition of coverage
under the Member Planes) to which an employee and Dependents, if any, are
entitled.
1.6 Section 125 Plan
0IW0144
Central Contra Costa Sanitary District Section 125 Plan.
3
8189
41 of 104
ARTICLE II
SCOPE OF THE PLAN
Subject to the conditions and limitations set forth in this Premium Conversion Plan
document and in the Section 125 Plan, each Participant shall have his or her share of
Eligible Expenses paid under the Premium Conversion Plan in lieu of an equal amount
of Compensation.
D1W01-04
4
8J89
42 of 104
ARTICLE III
ELIGIBILITY AND PLAN PARTICIPATION
3.1 Eligibility
(a) Eligible Employees covered under the provisions of any of the Member"
Plans on the Effective Date shall be eligible to participate in the Premium
Conversion Plan on the Effective Date, provided that any such Eligible
Employee has not made an election to cease coverage under all
applicable Member Plans.
(b) Other Eligible Employees shall be eligible to participate in the Premium
Conversion Plan following date of hire, provided that the employee satisfies
the eligibility provisions of at least one of the Member Plans.
3.2 Particioation
DIW01-D4
(a) Subject to the conditions and limitations set forth in this Premium
Conversion Plan document and in the Section 125 Plan, each Eligible
Employee may elect to have his or her Member Plan Premiums paid under
the Premium Conversion Plan in lieu of an equal amount of compensation.
(b) If a Participant is on a paid Authorized Leave of Absence and his or her
Salary Reduction elections remain effective, s(he) shall continue to:
participate in the Premium Conversion Plan.
5
1189
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3.3 Termination of Particioation
Participation in this Premium Conversion Plan shall terminate on the last day of
the Plan Year. An employee shall no longer be a Participant Linder the Plan if
the Memorandum of Understanding which authorizes the participation of such
employee in the Plan expires without renewal or an extension agreement, or if
the subsequent Memorandum of Understanding of each employee representation
unit eliminates such Component Plan.
3.4 Reinstatement of Former Particioant
Former Participants of the Premium Conversion Plan shall be reinstated
consistent with the provisions of Section 2.4 of the Section 125 Plan.
D1W01.04
6
8189
44 of 104
ARTICLE IV
PLAN FUNDING
4.1 Establishment of Accounts
Section 3.1 of the Section 125 Plan which provides for the establishment of
accounts and subaccounts shall also apply to this Premium Conversion Plan
document.
4.2 Salary Reduction Credits
Each Participant must make a written Salary Reduction election to have his or
her annual Compensation reduced. but not below zero. by the amount of
Member Plan Premium such employee is required to payor a portion thereof.
The amount of Salary Reduction will be credited to the Participant's account until
it is paid out for such coverage. In the event an Eligible Employee does not
request to participate in this Plan, s(he) shall receive his or her Compensation
without any reduction for this Plan and will be required to pay any required
Member Plan Premium through payroll withholding.
4.3 Time for Salary Reductions to Begin
(a) The Salary Reduction for a Participant of the Premium Conversion Plan
shall begin on the date of the first payroll period of the Plan Year.
(b) The Salary Reduction for an individual hired after the beginning of the Plan
Year shall begin as soon as practicable.
DM'01.04
7
1189
45 of 104
4.4 Chance or Revocation of Salary Reduction Elections
A Participant's Salary Reduction election for any Plan Year may not be changed
or revoked after the first payroll period to which it applies, except under the
circumstances described in Section 3.5 of the Section 125 Plan or, additionally,
except as a result of a change in Member Plan enrollment which is in response
to and consistent with the circumstances described below:
(a) A significant change in the health care coverage of the Participant.
(b) The substantial increase in the Member Plan Premium, or significant
curtailment or cessation of coverage under a Member Plan provided by
an independent third party. Under such conditions, Participants may elect
to receive on a prospective basis coverage under another Employer
maintained health plan with similar coverage and eligibility provisions.
4.5 Plan Administrator's Power to Modify Elections
Section 3.10 of the Section 125 Plan which provides the Plan Administrator with
the power to modify Salary Reduction elections shall also apply to this Premium
Conversion Plan. In addition, the Plan Administrator may modify Salary
Reduction elections if the Member Plan Premium is increased or decreased
during the Plan Year.
~
0IW01-04
8
1189
46 of 104
ARTICLE V
BENEFITS
5.1 General Rule
The provisions of Section 4.1 of the Section 125 Plan document shall also apply
to this Premium Conversion Plan.
5.2 Emplovee's Share of the Cost of Group Health Care Coveraae
Amounts credited to a Participant's Premium Conversion Plan subaccount shall
be applied to pay the amount of any Member Plan Premium for employee and
Dependent coverage otherwise payable by the Participant during the Plan Year
under the applicable Member Plans.
5.3 .Limit on the Amount of Salary Reduction to be Credited to the Premium
Conversion Plan
DlW01-G4
The annual Salary Reduction of a Participant under the Premium Conversion Plan
shall not exceed the cumulative total of all Member Plan Premiums under all
Member Plans in which the Participant, spouse and Dependents, if any, are
covered.
9
8189
47 of 104
ARTICLE VI
GENERAL PROVISIONS
6.1 Administration of the Premium Conversion Plan
The Premium Conversion Plan shall be administered in accordance with the
provisions set forth in Article V of the Section 125 Plan.
..
6.2 Claims Procedures
The claims procedures set forth in Article VI of the Section 125 Plan shall also
apply to this Premium Conversion Plan.
6.3 Miscellaneous Provisions of the Premium Conversion Plan
The miscellaneous provisions described in Article VII of the Section 125 Plan shall
also apply to this Premium Conversion Plan.
6.4 Amendment and Termination of the Premium Conversion Plan
The Employer reserves the right to amend or terminate this Premium Conversion
Plan in whole or in part at any time, subject to the terms of Article VIII of the
Section 125 Plan. In addition, if a Member Plan is terminated and replaced with
another plan that provides similar benefits, Salary Reduction amounts that were"
designated to pay Member Plan Premiums for the terminated plan will be applied
instead to pay Premiums for the new plan. If a Member Plan is terminated and
not replaced with another plan that provides similar benefits, Salary Reduction
DIW01.()4
10
8189
DIW01-04
'.
48 of 104
amounts will terminate as of the end of the month in which the Member Plan is
terminated.
This Plan may be terminated at any time by action of the Employer if the
Memorandum of Understanding of each employee representation unit which has
established the Plan has expired without renewal or an extension agreement, or
if a subsequent Memorandum of Understanding of each employee representation
unit eliminates the Plan.
;;.
11
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49 of 104
APPENDIX A
Member Plans
To the
Central Contra Costa Sanitary District
Premium Conversion Plan
As of May 1, 1989, the following is a Member Plan included in the Premium Conversion
Plan:
The Central Contra Costa Sanitary District Indemnity Plan
D1W01.04
12
IIB9
50 of 104
ADOPTION OF THE PREMIUM CONVERSION PLAN
As evidence of its adoption of this Premium Conversion Plan, the Central Contra Costa
Sanitary District has caused this instrument to be signed by its officers thereunder duly
authorized hereto this day of . 198_0
ArreST:
By:
(Seal)
DlW01~
By:
Susan McNulty Rainey
(Date).
For: THE CENTRAL CONTRA COSTA SANITARY DISTRICT
Susan McNultv Rainev
(Print Name and Title)
President of the Board
(Sign Name)
(Date)
Joyce McMillan. Secretary of the District
(Print Name and Title)
Approved as to form
James L Hazard
District Counsel
13
8IB9
~achment 1
CENTRAL CONTRA COSTA SANITARY DISTRICT
HEALTH FLEXIBLE SPENDING ARRANGEMENT
(A Component Plan of
the Central Contra Costa Sanitary District
Section 125 Cafeteria Plan)
Effective May 1, 1989
51 of 104
"-
52 of 104
TABLE OF CONTENTS
Page
INTRODUCTION 1
ARTICLE I DEFINITIONS 2
ARTICLE II SCOPE OF THE PLAN 7
ARTICLE III ELIGIBILITY AND PLAN PARTICIPATION 8
ARTICLE W PLAN FUNDING 10
ARTICLE V BENEFITS 13
ARTICLE VI CONTINUATION COVERAGE 15
ARTICLE VII CLAIMS PROCEDURES 19
ARTICLE VIII GENERAL PROVISIONS 23
SIGNATURE PAGE
53 of 104
CENTRAL CONTRA COSTA SANITARY DISTRICT
HEALTH FLEXIBLE SPENDING ARRANGEMENT PLAN
INTRODUCTION
Effective as of May 1, 1989, the Central Contra Costa Sanitary District (hereinafter
Employer) adopts the Central Contra Costa Sanitary District Health Flexible Spending
Arrangement Plan (hereinafter Health FSA Plan) to allow Eligible Employees of the
Employer to elect to receive health care reimbursement benefits which are excludible
from gross income under Section 213{d} of the Internal Revenue Code of 1986, ~
amended (hereinafter Code), as provided herein and in accordance with the terms of
the Central Contra Costa Sanitary District Section 125 Cafeteria Plan (hereinafter Section
125 Cafeteria Plan).
This Health FSA Plan is a Component Plan of the Section 125 Cafeteria Plan and,
except to the extent otherwise expressly provided herein, is governed by the rules and
regulations of the Section 125 Cafeteria Plan.
Dl'N0142
1
54 of 104
ARTICLE 1
DEFINITIONS
The definitions in the Section 125 Cafeteria Plan apply to this Component Plan as well.
as the following additions:
1.1 Deoendent
Any individual who falls within the definition of Dependent in Section 152 of the
Code including but not limited to:
(a) A Participant's spouse not legally separated from the Participant;
(b) Each of a Participant's unmarried children who has not attained the age
of 19;
(c) Each of a Participant's unmarried children who is a full-time student and
has not attained age 23.
::::
(d) Each of a Participant's unmarried children who became incapacitated
prior to attainment of age 19 and who is dependent on the Participant
for support.
1.2 Eliaible Emolovees
Any employee of the Employer represented by the Management Support
Confidential Group or the Management Group or the General Manager - Chief
[IW0142
2
-.
55 of 104
Engineer, the Secretary of the District, or the Deputy General Manager. Any
person who is covered by a collective bargaining agreement which does not
provide for inclusion in this Health Flexible Spending Arrangement shall not be
an Eligible Employee. Any person who performs service for the Employer solely
as an independent contractor shall not be an Eligible Employee.
1.3 Exoerience Gain
The excess of Required Premiums paid and income (if any) of the Plan ove~
the Plan's total claims reimbursements and reasonable administrative costs for
the Plan Year.
1.4 Health Flexible Soendina Arranaement Plan
The Central Contra Costa Sanitary District Health Flexible Spending Arrangement .
Plan. A Health FSA Plan is a benefit program that provides Eligible Employees
with coverage under which specified, Incurred Medical Expenses may be
reimbursed (subject to the Maximum Reimbursement and other reasonable
conditions) .
1.5 Incurred Medical Exoenses
DIW014i!
Medical Expenses rising from medical care provided to the Participant or
Dependent during the Participant's Period of Coverage. Expenses are treated
as having been incurred on the date that services are rendered. Expenses are-
not treated as having been incurred:
3
".
56 of 104
(a) when the Participant is formally billed or charged for or pays for the
medical care; or
(b) during a Period of Coverage under the Health FSA Plan if such expenses
are incurred before the later of the Effective Date of the Plan or the date
on which the Participant first becomes enrolled under the Health FSA Plan;
or
(c) during the Period of Coverage if such expenses are incurred after
participation has terminated under the Health FSA plan.
1.6 Maximum Reimbursement
The total of Required Premiums and Experience Gains elected by a Participant
for reimbursement during a Period of Coverage.
1.7 Period of CoveraQe
DIW01.Q2
The twelve month period coincident with the Plan Year during which Qualifying
Medical Expenses incurred by a Participant are eligible for coverage under the _
Health FSA Plan. The Period of Coverage under this Health FSA Plan shall be
the twelve month period beginning May 1 and ending April 30.
The Period of Coverage for a Participant shall end prior to the end of the twelve
month period if the Participant fails, at any time, to pay Required Premiums.
4
57 of 104
1.8 Premium Pavers
The Participants from whom Required Premiums are paid by Salary Reduction
and Employer Credits.
1.9 Qualifyina Medical Exoenses
(a) Amounts paid for medical care within the meaning of Internal Revenue
Code 213(d) and regulations and rulings thereto published by the Internal
Revenue Service:
(1) for which the Participant is not reimbursed pursuant to any medical
policy or program, and
(2) which have been incurred and paid by or on behalf of the
Participant or a Participant's spouse or Dependent.
(b) Qualifying Medical Expenses shall not jnclude expenses not verifiable
under Section 6.1 of this Health FSA Plan.
(c) Effective the first day of the first Plan Year beginning after December 31,
1989, Qualifying Medical Expenses shall not include premiums paid by a
Participant or Dependent for coverage under the Employer's or any other
employer's group health plan or under an individual plan; or
DIW014l 5
1.10 Reauired Premium. or Premium
58 of 104
The total of Employer Credits and Salary Reduction amounts elected by the
Participant for the Period of Coverage under the Health FSA Plan.
1.11 Section 125 Cafeteria Plan
DIIIIID1-G2
The Central Contra Costa Sanitary District Section 125 Cafeteria Plan.
6
59 of 104
ARTICLE II
SCOPE OF THE PLAN
Subject to the conditions and limitations set forth in this Health Flexible Spending
Arrangement Plan document and in the Section 125 Cafeteria Plan, each Participant
may elect to receive payment under the Health FsA Plan for his or her Qualifying
Medical Expenses in lieu of an equal amount of cash.
DIW014i!
7
"0
60 of 104
ARTICLE III
ELIGIBILITY AND PLAN PARTICIPATION
3.1 Eliaibilitv
The eligibility provisions of Section 2.1 of the Section 125 Cafeteria Plan shall'
apply to this Health FSA Plan.
3.2 Election for Participation
Eligible Employees may elect to participate in the Health FSA Plan by submitting
annually a Salary Reduction election form to the Employer in accordance with
Article III of the Section 125 Cafeteria Plan, and by designating the amount of
Salary Reduction and Employer Credits to be allocated to the Health FSA Plan
subaccount for the Period of Coverage, as provided in Sections 3.2 and 3.3 of
the Section 125 Cafeteria Plan.
3.3 Termination of Participation
Prior to the first day of the first Plan Year beginning after December 31, 1989,
participation in this Health FSA Plan shall terminate on the last day of the Plan
Year during which employment terminates.
Effective the first day of the first Plan Year beginning after December 31, 1989, ,-
participation in this Health FSA Plan shall terminate on earlier of the last day of
the period for which the last Required Premium is paid by the Participant to the
Health FSA Plan or the end of the Plan Year during which employment
DIWD14!
8
61 of 104
terminates. Medical Expenses incurred after such date shall not be eligible for
reimbursement.
An employee shall no longer be a Participant under the Plan if the Memorandum
of Understanding which authorizes the participation of such employee in the Plan
expires without renewal or an extension agreement.
3.4 Reinstatement of Former Participants
Former Participants of the Health FSA Plan shall be reinstated consistent with
the provisions of Section 2.4 of the Sedion 125 Cafeteria Plan.
DIW0142
9
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ARTICLE IV
PLAN FUNDING
4.1 Establishment of Accounts
Section 3.1 of the Section 125 Cafeteria Plan which provides for the
establishment of accounts and subaccounts shall also apply to this Health FSA
Plan.
4.2 Emolover Credits
Employer Credits provided under Section 3.2 of the Section 125 Cafeteria Plan
shall be available under this Health FSA Plan.
4.3 Salary Reduction Election Procedures
In accordance with Section 3.6 of the Section 125 Cafeteria Plan, each Participant
shall designate the amount of Salary Reduction Contributions and Employer
Credits amounts to be available during the Period of Coverage for Qualifying
Medical Expense reimbursements under the Health FSA Plan.
4.4 Time for Makino Salary Reduction Elections
The timing for Salary Reduction elections under the Health FSA Plan shall be
consistent with the timing outlined in Section 3.4 of the Section 125 Cafeteria
Plan.
DIW01.Q2
10
63 of 104
4.5 Chance or Revocation of Elections
Section 3.5 of the Section 125 Cafeteria Plan which provides for a change or
revocation of a Salary Reduction election shall also apply to this Health FSA Plan.
Upon separation from the service with the Employer, a Participant will cease
coverage as outlined in Article VI of this Health FSA Plan.
Effective the first day of the first Plan Year beginning after December 31, 1989,
if the Participant revokes his or her existing elections, the Plan Administrator sha!1
reimburse the Participant for any amount previously paid for coverage or benefits
relating to the period after the date of the Participant's separation from service
regardless of the Participant's claims or reimbursements as of such date.
4.6 Continuation of Reauired Premiums uoon Seoaration from Service
DIW01..Q2
Effective for the first day of the first Plan Year beginning after December 31,
1989, a Participant who separates from the service of the Employer during the
Period of Coverage may elect to continue his or her existing benefit elections and
continue to receive benefits for Qualifying Medical Expenses incurred during the
remaining portion of the Period of Coverage as outlined in Article VI of this Health
FSA Plan.
If, after separation from service, the Participant fails to elect COBRA continuation
under the Plan, the Period of Coverage for the Participant shall end as of the end
of the period for which Premiums were last paid, and expenses incurred after the .
end of such period shall not be eligible for reimbursement.
11
64 of 104
4.7 Exoerience Gains
If the Plan has an Experience Gain with respect to a Period of Coverage, such
Experience Gain shall be returned to the Running Expense Fund of the
Employer.
4.8 Umit on Amount Credited to Health Flexible SoendinQ Arrangement Plan
The annual Salary Reduction amount aedited to a Participant's Health Flexible
Spending Arrangement Plan subaccount shall not exceed $3.000.
4.9 Plan Administrator's Power to Modify Elections
DMI01.02
Section 3.10 of the Section 125 Cafeteria Plan which provides the Plan
Administrator with the power to modify Salary Reduction elections shall also apply
to this Health FSA Plan.
--
12
.
65 of 104
ARTICLE V
BENEFITS
5.1 General Rule
DIW0142
(a) Prior to the first day of the first Plan Year beginning after December 31,
1989, all benefits shall be payable or provided under this Article for a
Plan Year only with respe~ to periods during such Plan Year in which.
an Eligible Employee is a Participant and has or is entitled to have
amounts credited to his or her. Health FSA subaccount pursuant to
Sections 3.2 and 3.3 of the Section 125 Cafeteria Plan. Expenses shall be
reimbursed only if incurred during such periods.
(b) Effective the first day of the first Plan Year beginning after December 31,
1989, a Participant's Maximum Reimbursement (properly reduced as of any
particular time for prior reimbursements during the same Period of
Coverage) shall be available at all times during the Period of Coverage in
which an Eligible Employee is a Participant and has or is entitled to have
amounts credited to his or her Health FSA subaccount pursuant to
Sections 3.2 and 3.3 of the Section 125 Cafeteria Plan. Expenses shall be
reimbursed only if incurred during the Period of Coverage.
Qualifying Medical Expenses shall not be reimbursed for any Period of
Coverage unless the Participant applies for such reimbursement within :
thirty (30) days after the end of such Period of Coverage.
13
66 of 104
5.2 Reimbursements
DMI01-G2
Amounts credited to a Participant's Health FSA account shall be used to
reimburse the Participant for all medical and dental expenses (as defined in
Section 213(d) of the Code), including deductibles and co-insurance payments,
to the Maximum Reimbursement amount. These medical and dental expenses
must be not otherwise paid or reimbursed under any other. medical or dental
plan or policy or by any governmental agency or other agency.
14
67 of 104
ARTICLE VI
CONTINUATION COVERAGE
Federal legislation (COBRA) requires that certain Participants (Qualified Beneficiaries)
be given the opportunity to elect to retain coverage under this Health FSA Plan when
a Qualifying Event occurs.
6.1 Definition of Qualified Beneficiary:
(a) A Qualified Beneficiary is any individual who was a Participant in this
Health FSA Plan on the day before a Qualifying Event.
(b) A Qualified Beneficiary shall not include any Dependent who was enrolled
in this Health FSA Plan under the provisions of COBRA after the date of
the initial Qualifying Event, or any Qualified Beneficiary who declined
COBRA coverage when first eligible and who was later enrolled in this
Health FSA Plan during a COBRA period.
6.2 Definition of a Qualifying Event:
For eligible Participants, the following constitute Qualifying Events which give a
Qualified Beneficiary the right to retain coverage under this Health FSA Plan and
which would cause such coverage to otherwise end:
(a)
Voluntary or involuntary termination of employee's employment for any.-
reason including retirement other than gross misconduct, or reduction of
hours to a level at which the employee or Dependents are no longer
DIW01~
15
.
".
68 of 104
eligible for coverage under the same terms and conditions of Section 3.1
of this Health FSA Plan.
(b) Death of an employee Participant.
(c) Divorce or legal separation of an employee Participant.
(d) Cessation of a child's dependent status under the Plan in accordance with
Section 1.1 of this Health FSA Plan.
6.3 Termination of COBRA Coverage - Once-elected, COBRA coverage will continue
until the earliest of the following dates:
(b)
(c)
(d)
(e)
DIW0142
(a)
The date 18 months after the Qualifying Event, for the events described
in 6.2(a) above; or
The date 36 months after the Qualifying Event, for the events described
in 6.2(b), 6.2(c) and 6.2(d) above; or
The date all Employer-sponsored health flexible spending arrangements
are terminated; or
The date the Employer does not receive timely payment of any
contribution; or
The date the Participant on COBRA coverage becomes covered under any
other health flexible spending arrangement (this date may vary for different
members of the same family); or
16
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(f) The date a Participant becomes entitled to Medicare coverage. (Medicare
entitlement terminates coverage only for the Medicare-eligible individual.)
6.4 Second Qualifyina Event - If one of the events described in 6.2{b), 6.2{c), or
6.2{d) above occurs while a Qualified Beneficiary is on COBRA coverage due to
the event described in 6.2{a) above, such Qualified Beneficiaries enrolled under
the Plan shall have the right to extend their COBRA coverage period for up to
36 months from the date of the first Qualifying Event described in 6.2{a) above.
6.5 Plan Changes - If during the period of any COBRA coverage, as set forth above,
this Health FSA Plan coverage is cha~ged. for Eligible Employees, the same
changes will be applied to similarly situated persons participating in this COBRA
coverage program.
6.6 Cost of COBRA Coverage - The cost of COBRA coverage shall be paid by (or
on behalf of) the Participant or Qualified Beneficiary who elects such coverage.
The required monthly cost will be 102<>>-' of the amount of the monthly Salary
Reduction and Employer Credit elected by the Participant at the beginning of his
or her Period of Coverage.
6.7 Notice Reauirements - To elect COBRA coverage
DIW014i!
(a)
A Participant must notify the Employer within 60 days if one of the events
described in 6.2{c) or 6.2{d) above occurs.
(b)
The Employer shall notify the affected parties of their right to elect COBRA
coverage. Specific notice and administrative procedures have been
17
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adopted by the Employer and are consistent with Applicable Federal Law
and regulations.
6.8 Election of COBRA Coveraae - A Qualified Beneficiary has a minimum of 60 days
to elect the COBRA coverage. Such election period will begin on or before the
date of a Qualifying Event and end 60 days after the later of (1) the date that
coverage under this Health FSA Plan would otherwise end because of the
Qualifying Event, or (2) the date the Qualified Beneficiary is sent notice of his or
her right to elect COBRA coverage. Coverage will terminate after the Qualifying
Event and then will be reinstated retroactively if the Qualified Beneficiary elects
COBRA coverage.
6.9 Chances in Aoolicable Law - If Applicable Law subsequently requires that
COBRA coverage be extended, financed, or offered in a different manner than
as specified in this Health FSA Plan, the Health FSA Plan shall be deemed
amended to comply with the minimum requirements of Applicable Law and shall
be administered in accordance thereof. This provision is not intended to
implement changes in Applicable Law any earlier than the latest date required
by such law.
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ARTICLE VII
CLAIMS PROCEDURES
In addition to the provisions outlined in the Sections below, the claims procedures in
Article VI of the Section 125 Cafeteria Plan shall apply for this Health FSA Plan as well.
7.1 Claims Substantiation
Effective the first day of the first Plan Year beginning after December 31, 1989,
the Health FSA Plan shall reimburse a Qualifying Medical Expense only if the
Participant provides a written statement from an independent third party stating
when the expense was incurred and the amount of such expense. In addition,
the Participant must provide a written statement that the Qualifying Medical
Expense has not been reimbursed or is not reimbursable under any other health
plan coverage.
Claim forms which are not accompanied by properly documented expense
vouchers may be returned to the Participant by the Plan Administrator for further
documentation. Each Participant who fails to supply additional documentation
by May 30th of the following Plan Year shall be deemed not to have requested
reimbursement for the amounts in question. No Participant shall have any rights
or be entitled to any reimbursement under the Health FSA Plan unless a claim
form is submitted as specified.
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7.2 General Reimbursement Procedures
Participants may claim reimbursement by submitting a request for reimbursement
form to the Plan Administrator or designated third-party administrator. In the
event that a Participant does not qualify for reimbursement of the amount elected
during the Plan Year, the difference between the amount elected and the actual
reimbursement shall be forfeited at the end of the Plan Year. Participants have
until the date specified in Section 5.1 (b) herein of the following Plan Year to
submit claims for reimbursement of Qualifying Medical Expenses incurred during
a Plan Year.
7.3 Reimbursement Procedures for Plan Years Beainnina Prior to the First Davof
the First Plan Year Beainnina after December 31. 1989
(a) The Plan Administrator shall pay reimbursements offered under Section 5.2
of this Health FSA Plan only to the extent permitted by a Participant's
account balance and the maximum reimbursement elected. The Plan
Administrator shall pay reimbursements as soon as practicable after receipt
of each claim form.
(b) Premium contribution amounts elected by a Participant and not applied
as reimbursement payments for Qualifying Medical Expenses incurred
during the Plan Year shall be forfeited and returned to the general assets
of the Employer. Participants have until the date specified in Section
5.1 (b) herein of the following Plan Year to submit claims for reimbursement :.
of Qualifying Medical Expenses incurred during the Plan Year.
~1.Q2 20
73 of 104
7.4 Reimbursement Procedures for Plan Years Beainnina After the First Dav of the
First Plan Year Beainnin~ after December 31. 1989
(a) The Maximum Reimbursement elected by the Participant under the Plan
shall be available at all times during the Period of Coverage (properly
reduced as of any particular time for prior reimbursements for the same
Period of Coverage). The Health FSA Plan shall not make advance
reimbursements of Mure or projected Qualifying Medical Expenses.
--
The Maximum Reimbursement at any particular time during the Period of
Coverage shall not relate to the extent to which the Participant has paid
the Required Premiums for coverage under the Health FSA Plan. Similarly.
the payment schedule for the Required Premiums for coverage under the
Health FSA Plan shall not be based on the rate or amount of Incurred
Expenses during the Period of Coverage.
Reimbursement shall be paid no more than monthly or later when the total
amount of claims to be submitted is at least $50 or such reasonable
minimum amount as specified in Applicable Law.
(b) Participants have until the date specified in Section 5.1 (b) herein of the
following Plan Year to submit claims for reimbursement of Qualifying
Medical Expenses incurred during a Period of Coverage.
DIW01.Q2 21
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7.5 Documentation Processing
DIW01.Q2
The Plan Administrator will process and review all claim forms that are submitted
by Participants. The scope of the Plan Administrator's review with respect to this
Health FSA Plan is to determine:
(a) whether the Participant's expenses appear to be Qualifying Medical
Expenses, and
(b) whether the Participant's claim form is accompanied by the required
documentation.
The Plan Administrator may request any reasonable information needed to
substantiate a claim. The Plan Administrator shall not be responsible for
undertaking any independent inquiry into the truth of statements made in the
Participant's claim form.
22
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ARTICLE VIII
GENERAL PROVISIONS
8.1 Administration of the Health Flexible Soendina Arranaement Plan
The Health FSA Plan shall be administered in accordance with provisions set
forth in Article V of the Section 125 Cafeteria Plan.
8.2 Miscellaneous Provisions of the Health Flexible Soendina Arranaement Plan
The miscellaneous provisions described in Article VII of the Section 125 Cafeteria
Plan shall also apply to this Health FSA Plan.
8.3 Amendment and Termination of the Health Flexible Soendina Arranaement Plan
The Employer reserves the right to amend or terminate this Health FSA Plan in
whole or in part at any time, subject to the terms of Article VIII of the Section 125
Cafeteria Plan. The Health FSA may be terminated only as of the end of any
Plan Year. Any elections made for the next Plan Year will be null and void.
The Plan may be terminated at any time by action of the Employer if the
Memorandum of Understanding of each employee representation unit which has
established the Plan has expired without renewal or an extension agreement, or :
if a subsequent Memorandum of Understanding of each employee representation
unit eliminates the Plan.
DIW01~
23
&.
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ADOPTION OF THE HEALTH FLEXIBLE SPENDING
ARRANGEMENT PLAN
As evidence of its adoption of this Health Flexible Spending Arrangement Plan, the
Central Contra Costa Sanitary District has caused this instrument to be signed by its
officers thereunder duly authorized hereto this day of , 198_" ....
By:
Susan McNulty Rainey
(Date)
For: THE CENTRAL CONTRA COSTA SANITARY DISTRICT
Susan McNulty Rainey
(Print Name and Title)
President of the Board
ATTEST:
By:
(Sign Name)
(Date)
Jovce McMillan. Secretary of the District
(Print Name and Title)
(Seal)
Approved as to form
James L Hazard
District Counsel
DM0142
24
tachment 1
CENTRAL CONTRA COSTA SANITARY DISTRICT
DEPENDENT CARE ASSISTANCE PLAN
(A Component Plan of
the Central Contra Costa Sanitary District
Section 125 Cafeteria Plan)
Effective May 1, 1989
77 of 104
78 of 104
TABLE OF CONTENTS
Page
INTRODUCTION 1
ARTICLE I DEFINITIONS 2
ARTICLE II SCOPE OF THE PLAN 5
ARTICLE III ELIGIBILITY AND PLAN PARTICIPATION 6
ARTICLE IV DEPENDENT CARE EXpeNSES 8
ARTICLE V PLAN FUNDING 10
ARTICLE VI BENEFITS 13
ARTICLE VII CLAIMS PROCEDURES 14
ARTICLE VIII GENERAL PROVISIONS 17
SIGNATURE PAGE
79 of 104
CENTRAL CONTRA COSTA SANITARY DISTRICT
DEPENDENT CARE ASSISTANCE PLAN
INTRODUCTION
Effective as of May 1, 1989, the Central Contra Costa Sanitary District (hereinafter
Employer) adopts the Central Contra Costa Sanitary District Dependent Care Assistance
Plan (hereinafter DCAP) to allow Eligible Employees of the Employer to elect to receive
dependent care assistance benefits which are excludible from gross income under
Section 129(a) of the Internal Revenue Code of 1986, 8S amended (hereinafter Code),.
as provided herein and in accordance with the terms of the Central Contra Costa
Sanitary District Section 125 Cafeteria Plan (he~einatter Section 125 Cafeteria Plan).
This DCAP is a Component Plan of the Section 125 Cafeteria Plan and, except to the
extent otherwise expressly provided herein, is governed by the rules and regulations
of the Section 125 Cafeteria Plan. The DCAP is intended to qualify as a dependent care
assistance program within the meaning of Section 129(d) of the Code and to meet the
requirements of any other applicable provisions of the law.
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ARTICLE I
DEFINITIONS
The definitions in the Section 125 Cafeteria Plan apply to this Component Plan as well,
with the following additions.
1.1 Deoendent
An individual who is either:
(a) a child who is under the age of 13 and with respect to whom an
employee or his or her spouse is entitled to a dependency exemption
under Section 151 (c) of the Code, and who is in the custody of the
Participant for more than half of the year;
(b) a relative or household member of an employee who receives over half
of his or her support from the employee and who is physically or mentally
incapable of caring for himself or herself; or
(c) the spouse of an employee who is physically or mentally incapable of
caring for himself or herself.
1.2 Deoendent Care Assistance Plan Contributions
The total of Employer Credits and Salary Reduction Contributions elected by
the Participant to be directed to the Dependent Care Assistance subaccount.
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1.3 Deoendent Care Exoenses
The expenses specified in Article IV herein that qualify as Eligible Expenses.
1.4 Earned Income
Wages, salaries, tips and other employee compensation, plus net earnings from
self-employment, computed without regard to any community property laws. It
does not include any amounts received as a pension or annuity, as
reimbursement of Eligible Expenses under this DCAP or any other employer's
dependent care assistance program. ~ er:nployee's spouse who is either a
student or incapable of caring for himself or herself shall be deemed, for each
month during which such spouse is either a full-time student at an educational
institution or a Dependent, to be gainfully employed and to have Earned Income
of not less than:
(a) $200 per month, if the employee has only one Dependent for the Plan
Year, or
(b) $400 per month, if the employee has two or more Dependents for the Plan
Year.
1.5 Eligible Emplovees
Any employee of the Employer represented by the Management Support_.
Confidential Group, the Management Group or the General Manager - Chief
Engineer, the Secretary of the District, or the Deputy General Manager. Any
person who is covered by a collective bargaining agreement which does not
D1W01-03
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provide for inclusion in this DCAP, shall not be an Eligible Employee. Any
person who performs service for an Employer solely as an independent
contractor shall not be an Eligible Employee.
1.6 Exoerience Gain
The excess of DCAP Contributions paid over the Plan's total claim
reimbursements and reasonable administrative costs for the Plan Year.
1.7 Incurred Exoenses
Dependent Care Expenses incurred by the Participant during the Plan Year.
Expenses are not treated as having been incurred when the Participant is
formally billed or charged for or pays for the dependent care assistance. In
addition, expenses are not treated as incurred during a Plan Year under the Plan
if such expenses are incurred before the later of the Effective Date of the Plan
or the date on which the Participant first becomes enrolled under the Plan.
1.8 Premium Pavers
The Participants from whom DCAP Contributions are paid by Salary Reduction
or with Employer Credits.
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ARTICLE II
SCOPE OF THE PLAN
Subject to the conditions and limitations set forth in this Dependent Care Assistance
Plan document and in the Section 125 Cafeteria Plan, each Participant may elect to
receive reimbursement under the DCAP for his or her Dependent Care Expenses in lieu
of an equal amount of cash.
01 W01.o3
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ARTICLE III
ELIGIBILITY AND PLAN PARTICIPATION
3.1 Eliaibilitv
The eligibility provisions of Section 2.1 of the Section 125 Cafeteria Plan shall
apply to this DCAP.
3.2 Election for Particioation
Eligible Employees may elect to participate in the DCAP by submitting annually
a Salary Reduction election form to the Employer in accordance with Article III
of the Section 125 Cafeteria Plan, and by designating the amount of Salary
Reduction and Employer Credits to be allocated to the DCAP subaccount, as
provided in Sections 3.2 and 3.3 of the Section 125 Cafeteria Plan.
3.3 Termination of Particioation
Participation in this DCAP shall terminate on the last day of the Plan Year.
Dependent Care Expenses incurred after such date shall not be eligible for
reimbursement.
An employee shall no longer be a Participant under this DCAP if the
Memorandum of Understanding which authorizes the participation of such ,
employee in the DCAP expires without renewal or an extension agreement.
D1W01-03
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3.4 Reinstatement of Former Participant
D1 W01.()3
Former Participants of the DCAP shall be reinstated consistent with the provisions
of Section 2.4 of the Section 125 Cafeteria Plan.
7
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ARTICLE IV
DEPENDENT CARE EXPENSES
4.1 Dependent Care Expenses are amounts paid by a Participant for expenses for
the care of a Dependent which are incurred to enable the Participant to be
gainfully employed by the Employer for any period for which he or she has one
or more Dependents, provided that:
(a) if such expenses are incurred for services outside a Participant's
household, they are incurred for the care of a child as defined in Section
1.1 (a), or of another Dependent defined in Section 1.1 (b) or (c) who
regularly spends at least eight hours each day in the Participant's
household,
(b) if such outside services are provided by a dependent care center, such
center:
(i) receives a fee, payment or grant for providing services for any of
the individuals (regardless of whether such facility is operated for
profit), and
(ii) provides for not more than six individuals, or
(iii) provides care for more than six individuals (other than individuals.
who reside at the facility) and complies with the applicable State
and local government laws and regulations, and
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(c) if such expenses are for household services they are attributable in part
to the care of a Dependent and are necessary to the maintenance of the
household.
4.2 Dependent Care Expenses shall in no event include amounts paid by a
Participant to an individual:
(a) with respect to whom a deduction is allowable to the Participant or the
spouse under Section 151 (c) of the Code (relating to personal exemptions
for dependents). or
(b) who is a child (within the meaning of Section 151 (c}(3) of the Code) of the
Participant under the age of 19 at the close of the Plan Year in which such
amounts are paid.
4.3 Dependent Care Expenses shall in no event include amounts paid by a
Participant for the overnight camp expenses of a Dependent.
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ARTICLE V
PLAN FUNDING
5.1 Establishment of Accounts
Section 3.1 of the Section 125 Cafeteria Plan which provides for the
establishment of accounts and subaccounts shall also apply to this DCAP.
5.2 Emolover Credits
Employer Credits provided under Section 3.2 of the Section 125 Cafeteria Plan
shall be available under this DCAP.
5.3 Salary Reduction Election Procedures
In accordance with Article III of the Section 125 Cafeteria Plan, each Participant
shall designate the amount of Salary Reduction contributions to be available
during the Plan Year for Dependent Care Expense reimbursements under the
DCAP.
5.4 Time for Makino Salary Reduction Elections
The timing for Salary Reduction elections under the DCAP shall be consistent
with the timing outlined in Section 3.4 of the Section 125 Cafeteria Plan.
01 W01.()3
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5.5 Chanqe or Revocation of Salary Reduction Election
Section 3.5 of the Section 125 Cafeteria Plan which provides for a change or
revocation of a Salary Reduction election shall also apply to this DCAP.
5.6 Limit on Amount Credited to the Dependent Care Assistance Plan
The Salary Reduction amount elected by a Participant for reimbursement during
the Plan Year, combined with any other dependent care assistance received
through an employment-related plan by the Participant or his or her spouse,
may not exceed the lesser of:
(a) $5,000 ($2,500 if the Participant is married and files a Federal
Income Tax return separately from his or her spouse), or
(b) the Participant's annual Compensation, or
(c) annual compensation earned by the Participant's spouse, if the
Participant is married. However. the applicable special limit in Code
Section 21 (d) applies if the Participant's spouse is a full-time student
or is physically or mentally incapable of caring for himself or herself.
5.7 Experience Gains
If the Plan has an Experience Gain with respect to a Plan Year, such Experience
Gain shall be returned to the Running Expense Fund of the Employer.
0' WO,..()3
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5.8 Plan Administrator's Power to Modify Elections
Section 3.10 of the Section 125 Cafeteria Plan which provides the Plan
Administrator with the power to modify Salary Reduction elections shall also apply
to this DCAP.
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ARTICLE VI
BENEFITS
6.1 General Rule
The provisions of Section 4.1 of the Section 125 Cafeteria Plan document shall
also apply to this DCAP.
6.2 Deoendent Care Exoense Reimbursements
Amounts credited to a Participant's DCAP subaccount for a Plan Year may be
applied to reimburse the Participant, up to the maximum allowable amount
specified in Section 5.6 for Dependent Care Expenses incurred during such Plan
Year and not otherwise reimbursed or paid under any other plan or program.
On or before January 31 of each year, the Employer shall furnish a written
statement to any Participant who received Dependent Care Expense
reimbursements under this Article during the preceding calendar year, showing
the amount of such benefits during such year.
6.3 Limitation of Benefits for Certain Individuals
The benefits provided under this DCAP may be limited for certain Participants in
accordance with the non-discrimination provisions contained in Code
Section 129(d)(2) and 129(d)(3).
01W01-03
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ARTICLE VII
CLAIMS PROCEDURES
In addition to the provisions outlined in the Sections below, the claims procedures in
Article VI of the Section 125 Cafeteria Plan shall apply for this DCAP as well.
7.1 Claims Substantiation
Effective the first day of the first Plan Year beginning after December 31, 1989,
the DCAP shall reimburse a Dependen~ Ca(e Expense only if the Participant
provides a written statement from an independent third party stating when the
expense was incurred and the amount of such expense. In addition, the
Participant must provide a written statement that the De~endent Care Expense
has not been reimbursed or is not reimbursable under any other dependent
care assistance plan.
Claim forms which are not accompanied by properly documented expense
vouchers may be returned to the Participant by the Plan Administrator for further
documentation. Each Participant who fails to supply additional documentation
by May 30th of the following Plan Year shall be deemed not to have requested
reimbursement for the amounts in question. No Participant shall have any rights
or be entitled to any reimbursement under the DCAP unless a claim form is
submitted as specified.
01 W01-03
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7.2 Reimbursement Procedures
(a) Participants may claim reimbursement by submitting a request for
reimbursement form to the Plan Administrator. The Plan Administrator shall
pay reimbursements offered under Section 6.2 only to the extent permitted
by a Participant's account balance, the maximum reimbursement elected,
and the maximum allowed by Ia~. The Plan Administrator shall pay
reimbursements as soon as practicable after receipt of each claim form.
(b) In the event a Participant does not qualify for reimbursement of the
amount elected during the Plan Ye~, tt)e difference between the amount
of Salary Reduction elected and actual reimbursements shall be forfeited
at the end of the Plan Year and returned to the Runn I ng Expense Fund
of the Employer as provided In Section 5.7 of this OCAP. ,
(c) Participants have until May 30th of the following Plan Year to submit claims
for reimbursement of Dependent Care Expenses incurred during a Plan
Year.
7.3 Documentation Processing
The Plan Administrator will process and review all claim forms that are submitted
by Participants. The scope of the Plan Administrator's review with respect to this
DeAP is to determine:
(a) whether the Participant's expenses appear to be Dependent Care '.
Expenses, and
(b) whether the Participant's claim form is accompanied by the required
documentation.
D1W01~
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M9
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The Plan Administrator may request any reasonable information needed to
substantiate a claim.
The Plan Administrator shall not be responsible for undertaking any independent
inquiry into the truth of statements made in the Participant's claim form.
D1W01.Q3
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ARTICLE VIII
GENERAL PROVISIONS
8.1 Administration of the Dependent Care Assistance Plan
The DCAP shall be administered in accordance with provisions set forth in Article
V of the Section 125 Cafeteria Plan.
8.2 Miscellaneous Provisions of the Deoendent Care Assistance Plan
The miscellaneous provisions described in Article VII of the Section 125 Cafeteria
Plan shall also apply to this DCAP.
8.3 Amendment and Termination of the Deoendent Care Assistance Plan
The Employer reserves the right to amend or terminate this DCAP in whole or
in part at any time, subject to the terms of Article VIII of the Section 125 Cafeteria
Plan.
The DCAP may be terminated at any time by action of the Employer if the
Memorandum of Understanding of each employee representation unit which has
established such DCAP has expired without renewal or an extension agreement,
or if a subsequent Memorandum of Understanding of each employee
representation unit eliminates such DCAP.
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ADOPTION OF THE DEPENDENT CARE ASSISTANCE PLAN
As evidence of its adoption of this Dependent Care Assistance Plan, the Central Contra
Costa Sanitary District has caused this instrument to be signed by its officers
thereunder duly authorized hereto this day of , 198_"
By:
Susan McNulty Rainey
(Date)
For: THE CENTRAL CONTRA COSTA SANITARY DISTRICT
Susan McNulty Rainev
(Print Name and Trtle)
President of the Board
ATTEST:
By:
(Sign Name)
(Date)
Joyce McMillan. Secretary of the District
(Print Name and Title)
(Seal)
Approved as to form
James L Hazard
District Counsel
01 W01-o3
18
8189
,_"_._,__~____._~_.____._. "__~"'____"_'_"____~"_'"__~____~_"_""_'.__^__'____._____.__"_"'_____~...___."___.__.~._,_..,~_._____.. _ .___..___n_ . .__._.......__..__....._._...__._._,._,__.,.._...~__..._..."..__.".._._.____.._."'________ ..,..,.__._._,.~_.__m...__..___,..,""._
. ~achment 2
CENTRAL. CONlRA COSTA SANITARY DISlRICT
CAFETERIA PlAN
S~ary Plan Descrtptton
May, 1989
97 of 104
98 of 104
/BOOT YQUR CAFETERIA PlAN
The District has designed its Cafeteria Plan to conform wfth regulatfons
under Sectfon 125 of the Internal Revenue Code. Accordfngly, the Plan
gfves you the freedom to choose different taxable and pre-tax benefits to
suit your fndfvidual needs. It also provides for new benefits such as
the dependent care assistance plan. If you do not wish to select any of
the pre-tax benefits, you may choose a cash option instead. The cash
option may be used as additional taxable income or spent on a variety of
taxable benefits such as individual term life insurance premiums,
educatfon tuition, fitness club fees, annual physicals, and military or
public service retirement credit buy-back.
You wl1l be required to complete a selection form at the beginning of
each plan year indicating the type of benefit selected and the amount of
contr1butfon for such benefits.
1800T THIS SUf4i4ARY PLAN DESaUPTION
Thfs summary is desfgned to descrfbe the hfghlfghts of the Plan 1n plafn
1 anguage and 'to summarfze the 1 ega 1 prov f sf ons that govern the Pl an. The
text of the actual pl an documents are on file fn the Personnel Offfce.
They are available upon request for your inspection.
HQf THE CAFETERIA PLAN WmKS
The Cafeteria Plan appltes to three employee categorfes: the Management
SupportlConf1dent1 al Group, the Management Group and the Deputy General
Manager. The Distrfct wl1l provide each employee represented by the
Management SupportlConffdenti al Group (MS/OO) wfth $86 per month for use
1n the Cafeterfa Plan. Employees represented by the Management Group and
'the Deputy General Manager rece1ve $150 per month fran 'the District for
use in the Cafeteria Plan. In order 'to be qualified as an "el1g1ble
participant" for these District contributions. you must be an employee
represented by MS/CG or Management, or the Deputy General Manager.
Members of Executfve Management also recefve Dfstrict contrfbut1ons
1 ncl uded 1 n the Pl an by separate contracts w 1th 'the Board of 01 rectors.
The Cafeteria Plan provfdes three major "options":
1) You may select "cashin and/or
2) You may choose fran a vari ety of 'taxabl e benefftsi and/or
3) You may es'tabl ish one or 1I0re spending accounts to use 'tax-free
dollars for one or both of 'the following:
A) Health Care Spending Account: for qua11fying health care
expenses not covered by District health plans
B) Dependent Care Spendfng Account: for qua11fyfng dependent care
expenses such as nursing. day or preschool care
Each of 'these optfons 1s outlined 1n thfs summary. If you have further
ques't10ns, please do not hesitate to contact the Finance Officer.
-2-
99 of 104
TAX18LE CASH m BENEfITS
An employee may choose ~o ~ake all or par~ of the Ois~ri~'s con~ribution
~o ~he Cafeteria Plan as cash. In ~his instance. federal and state
wi~holding and other payroll ~axes will be dedu~ed and the full amount
of the cash received w111 be reported on ~he employee's W-2. Cash
received in this manner will have no effe~ on over~ime compensation or
any employee benefit which is based on compensation. incl uding reti rement
benef its.
In lieu of. or in addtion ~o cash. the employee may ele~ from a variety
of uxable benefits. The benefits in ~his category provided by the
Oistri~ include:
Individual Term Life Insurance
Regardless of age. but subje~ ~o carrier requirements,
incl uding campl e~i on of a heal th statemen~ for evidence of
insurabl1ity, partici pants who select this benefit w111 be
provided a $75.000 individual tenn life insurance policy in
addition ~o ~he insurance presen~ly provided by the Oistri~'s
group coverage. Panicipants se1e~ing this option w111 need
~o complete Evidence of Insurability "forms promptly ~ initiate
coverage. The insurance premium paid under this option must be
reported on the participant's form W-2 as earnings, but is not
subje~ ~o payroll income tax withholding.
- Physical fitness Program
A par~icipant who selects ~his option may receive reimbursement
for the panicipant's membership in a physical fi~ness center
af~er submitting evidence of payment of lnembership fees. This
option is reportable on form W-2 as earnings, but is not
subject ~o payroll income ~ax withholding.
- Annual Physical Examination
Under this option, the par~icipant may allocate funds for a
comprehensive annual physical examination for the employee by a
doctor of the panicipant's choosing. Panicipants w111 be
requi red ~o submit evidence of having received ~he physical
examination by submitting ~he physician's invoice to receive
reimbursement or ~ initiate direct payment. This option is
reportable on form W-2 as earnings. but is no~ subject ~o
payroll income tax withholding.
_ Purchase Prior Military and Public Service Credi~s
The Ois~rict's retirement system permits participating
employees ~o make additional contributions in order ~o receive
longevity credits for allowed prior military or public service
employment. Contributions to the retirement system are
required ~o be made in a lump sum payment or in installments
over a period not ~o exceed five years.
Employees with prior ml1i~ary or public service employment who
are interested in ~his option must schedule an appointment with
the Contra Cos~a County Employees' Retirement Association
(phone number: 646-4137) ~o determine the contrib~ion amount
requi red and ~o compl ete the necessary documen~s. A form 00214
will be required ~ support the term of prior mi1i~ary service.
-3-
100 of 104
:
This option is reportable on Form W-2 as earnings, but is not
subject to payroll income tax withhold1ng.
- Tu1t1on Reimbursement
Under this option, the participant would be able 'to allocate
funds for reimbursement of tuition for coursework in pursuit of
an associ ate, bachelor, master, or doctorate degree from an
accred1ted college or university. Evidence of enrollment would
be requ1red to receive 'tuition reimbursement. This option is
repor'tabl e on Form W-2 as earni ngs, but is not subj act 'to
payroll income tax withholding.
IEAllH CARE SPENDII<<3 AanlNT: TAX FREE DOllARS
The District has added this benefit for the Cafeteria Plan. It allows
you 'to use District contributions plus your own pre-tax income, "via
payroll deductions, to pay for non-covered health expenses. Based on an
annual el ect1 on, District contributions or employee contributions, or
both, can be deposited into a Health Care Spending Account on a monthly
basis. From this Account, you may spend 'tax free dollars for
out-Of-pocket expenses incurred for health o~ dental care not otherwise
covered by the District's health or den"tal insurance plan. Health or
den'tal care covered by this benefit may 1ncl ude such items as (a) payment
of deductibles or co-insurance, and (b) payment for health care that is
not reimbursed by th~ District's health or dental plans.
To be covered by the He"alth Care Spending Account, the health or dental
care must be received by a) the employee, his spouse, or an eligible
dependent b) be rendered during the plan year and c) meet 'the definition
of "medical care" contained in Section 213(d)(1) of the Internal Revenue
Code. Eligible expenses include vision and hearing care, orthodontia,
outpatient mental health care, cosmetic surgery and prescription drugs.
District and/or employee contributions made to 'the Health Care Spending
Account will not accrue interest and can only be used 'to pay cl aims
incurred within the pl an year. Cl aims Ilust be submitted within 'thi rty
days following 'the close of the pl an year. C1 aims not submitted within
this per10d will be den1ed.
RE~teER: The Health Care Spend1ng Account is subject to a .use it or
lose it" ru1 e. If expenses incurred are less 'than the amount you have
pre-selected, you cannot receive a reimbursement of the unused amount,
and 'the unused amount cannot be applied to the following year's expenses.
Benefits will be paid when 'the F1nance Officer receives proof that
covered health expenses have been incurred. You will be required to
complete a claim form.
Also, the Plan will not reimburse you for any expenses 'that have been
reimbursed by any other benefit p1 an. lastly, you may not cl aim a tax
deduction for any expenses reimbursed under this Plan.
-4-
101 of 104
DEPEtl)ENT CARE SPENDltIi ACXXXJNT: TAX FREE DOllARS
The District has provided this new benefit which allows an employee to
use tax free doll ars for out-of-pocket expenses incurred for dependent
care as defined in Section 21(b)(2) of the Internal Revenue Code. Based
on an annual election, you may deposit into the Dependent Care Spending
Account District contributions plus your own pre-tax income, via payroll
deduction on a monthly basis. from this Account, you will be reimbursed
for your eligible dependent care expenses only to the extent they do not
exceed your deposits into the Account. The maximum dollar amount that
may be deposi ted 1 nto the Account w ill be the 1 esser of $416.66 per month
or your spouse's earned income, if you are married and filing a joint tax
return. If you are married and filing separate returns, the max1mlll1
dollar contribution allowed is the lesser of $208.33 per month for each
individual or your spouse's earned income.
The Dependent Care Spending can be used for a variety of expenses. The
Account is designated to cover charges for:
a. babys1tters, nurses, housekeepers, or companions in your home
if their service benefits the el.1gib.1e dependent, or
b. an eligible day care center which meets state and local laws,
provides care for more than six nonresident individuals (other
than 1ndivtdua1s who reside at the center) and receives a fee
for such servi~es, whether or not for profit, or
c. preschool care, before or after school care; day camp dur1 ng
school vacati on
Expenses must only involve "dependents" who are defined as:
a. a dependent child of the emp1~ee under age 13, or
b. a spouse or dependent of the emp1~ee, regardless of age, who
is physically or mentally incapable of self-care and regularly
spends at least eight hours a day in the emp1 ~ee' s househol d.
The Dependent Care Spendi ng Account has a nllllber of restrictions.
Reimbursement from the Account will be limited to expenses which must be
incurred to enable you to remain gainfully empl~ed. If you are married,
your spouse must be a full time student or emp1 ~ed, or unabl e to care
for your child or dependent due to a mental or physical disability.
Un1 ess your spouse qualifies under anyone of these requ1 rements, you
will not be eligible for the Dependent Care Spending Account.
Certain expenses do!2! qualify for reimbursement. Some examples are:
expenses reimbursed through another plan of the empl~ee, or if
married, the empl~ee's spouse
expenses incurred before enrollment in the Dependent Care
Spending Account
-5-
102 of 104
..
expenses cl aimed as Dependent Care Tax Credits on an
individual's tax return
expenses not elig1 bl e for Dependent Care Tax Credits, as for
examp1 e:
.
educational expenses for a ch11d in the first grade or
above,
amounts paid to your children who are 18 or younger
overnight care by a convalescent nursing heme for a
dependent spouse or relative
overnight camps
lessons, tutoring, or transportation
.
.
.
.
Dependent Care reimbursement must be for expenses incurred duri ng the
Plan Year only. No interest w111 accrue on the money deposited into the
Account. Only claims for expenses which are submitted within thi~ days
following the close of the plan year will be paid. lastly, claims will
be paid when the Account balance is sufficient to cover the claim or at
the end of the Pl an year, to the extent of the Account bal anee.
RE~M3ER: The Dependent Care Spending Account. is subject to a "use it or
lose it" rule. If expenses incurred are less than the amount you have
preselected, you cannot receive a reimbursement of the unused amount, and
the unused amount can~ot be applied to the following year's expenses.
To properly excl ude reimbursements from the Dependent Care Spendi ng
Account, emp1~ees must include on their tax returns the name, address,
and taxpayer identification number of the dependent care provider. Also,
the employee must incl ude a taxpayer identification nllDber for any
dependent claimed as an exemption if the dependent is at least two years
old. The District w111 include on the W-2 forms the amount reimbursed to
amp10yees from the Dependent Care Spendi ng Account.
If you terminate emp1 ~ment, you lIIay request reimbursement for covered
expenses up to the balances remaining in your Dependent Care Spending
Account, providing the expense was incurred within the plan year and you
request reimbursement within thi~ (30) days after termination.
ItoPmTANT RESlRICTIONS fOR 11E HEAL 1H CARE SPENDIt<<3 AanJNT AND DEPENDENT
~ SPENDlt<<2 NX:OONT
Federal regu1 ations impose two illlportant restrictions on District and
empl~ee contributions made into the Health and Dependent Care Spending
Accounts. First, each employee lIIust make his/her contribution into each
Account on an irrevocable basis for the entire plan year. The selection
lIIust be made before the begi nni ng of the pl an year, May 1, and lIIuSt
designate (a) Account(s) selected and (b) the monthly dollar amount to be
allocated to each Account. Second, any IIIOney in the Account which is
not used during the plan year lIIust be forfeited to the District at the
end of the plan year. This so-called "use it or lose it" rule requires
the err)loyee to anticipate his/her expenditures from the Health and/or
Dependent Care Spending Accounts for an entire plan year.
-6-
103 of 104
aw<<iE IN FAMILY STATUS
The IRS regulations provide for an exception to the rule that ~p1oyee
elections are be irrevocable for the entire plan year. The exception is
based on a "change in faml1y status." In effect, you may reconfigure
your benefit coverage under the Cafeteria Plan if any of the following
occur:
1. You get married or divorced.
2. You acquire a new dependent by birth or adoption or you lose a
dependent by death.
3. Your spouse gains or loses employment.
Other situations may qualify as a change 1n family status. The District
w111 review each situation based on 1ts individual facts and
circumstances. The District will also make the necessary determination
concerning the reconfiguration required by a change 1n family status, if
any. This exception may be important, for example, for an employee with
dependent children whose spouse gains employment. The election of the
Dependent Care Spending Account may be appropriate.
.
Should you experience a change in family status and desire a reconfigura-
tion of your benefit selection, see the Finance Officer immediately.
Changes in elections are only allowed within 30 days of the event
necessitating the cha~ge.
OISlRICT QW<<;ES IN THE CAFETERIA PlAN
The Cafeteria Plan is intended to comply with various sections of the
Internal Revenue Code. Therefore, as the Code is amended in the future,
regulations governing the Cafeteria Plan may change. The Distr1ct has
the obligation to ensure that the P1 an conforms to the Code and its
regu1at10ns. All affected Bargain1ng Units and individually represented
employees wl1l be notified of any mandatory changes in the Pl an.
WI1K>RAWAL FROM THE CAFElERIA PlAN
Once you have enrolled fn the Cafeteria Plan, you will remain a
part1cipant fn the Plan until the ear11est of the following dates:
the date of your termination fran the D1strict
the date of your death
the date you are no longer an "eligible participant" as
described herein
the date the Pl an term1nates
However. any District or employee contr1butions made before any of the
above dates wl1l remain in your account and be available for your use
until th i rty days after any of the ci rcumstances descr1 bed above.
If you elect District and/or employee contributions to pay premiums for
dependent coverare under the Health Care Spending Account, this election
will automatically terminate on the date you are no longer eligible for
the health plan under which dependent coverage is provided.
-7-
104 of 104
HQf 10 FILE A Q.AIM
Claims may be filed as soon as possible after the expense has been
incurred. or claims may be submitted at one time. You must complete the
approved claim form and sign it for all claims that you submit. The
claim form. along with the supporting documents (i.e.. bills. inVOices.
evidence of other insurance or receipts for dependent care) should be
sent to the Finance Officer.
Claims submitted by the tenth (lOth) of each month will be paid within
~hir~ (30) days of receipt of the claim. All claims incurred in a plan
year must be submitted no later than thi~ (30) days following the end
of the pl an year.
After reviewing the request. the Finance Officer will issue a check for
the appropriate benefit. If a claim is denied for any reason. you will
receive written notification within thi~ (30) days of the date the
claim was submitted. If you disagree with a decision. you may appeal the
decision as outlined in the Plan Document.
MISCELLANEOUS
This Cafeteria Plan shall be effective as of May 1. 1989.
This Plan shall not ~ deemed to constitute a separate contract between
the District and any participant or to be a consideration or an
inducement for the employment of any partici pant or employee. Nothing
contained in this Plan shall be deemed to give any participant or
employee the right to be retained in the service of the District or to
interfere with the right of the District to discharge any participant or
employee at any time regardless of the effect which such discharge shall
have upon h 1m as I. pa rti ci pant of th i s Pl an. Such personne 1 and
employment matters are governed by the applicable Memorandum of
Understanding or employment agreement or District policy.. rule or
regul ati on.
This Plan shall be construed and enforced according to the laws of the
United States Government. and State of California. to the extent not
pre-empted by federal law.
The District does not assume any individual liability for the tax
consequences of participating in the Health Care Spending Account and/or
Dependent Care Spending Account by an employee and/or. employee's
dependent. Employees are advised to consult a qualified tax advisor to
determine if participation in the Plan is in the employee's best
financial interests.
-8-
.
Centra. ~ontra Costa Sanitary .Jistrict
BOARD OF DIRECTORS
PAGE 1 OF 4
POSITION
PAPER
BOARD MEETING OF
October 5, 1989
NO.
VIII. LEGAL/LITIGATION
DATE
September 29, 1989
TYPE OF ACTION
APPROVE PARTIAL
ALLOt'ImCE OF CLAIM;
DENY BALmCE
1
SUBJECT
APPROV E lHE PARTIAL ALLOt'ImCE OF CLAIM FROM DALTON
CONSTRUCTION COMPANY; DENY lHE BALmCE OF THE QAIM
SU.f~H~Elf~Y Campbell
Administrative Operations Manager
INITIATING DEPT/DIV.
Administrative/Risk Management
ISSUE: The Dalton Construction Company has filed a claim for $308,593.95 against
the District. An action to partially allow a claim but to reject the balance
requires Board of Directors' approval.
BACKGROUND: Dalton Construction Company (Dalton) was the general contractor for
Phase I of the I-680/SR-24 Sewer Relocation Project which was completed on May 31,
1989. The location of the project is shown on Attachment I. Dalton has filed a
claim relative to the construction work alleging that they are entitled to addi-
tionalpayment in the amount of $308,593.95 primarily for extra work because of
differing site conditions, delays caused by those conditions, the District's with-
holding of information, and the District's alleged failure to pay a contract
balance due of $57,200.00 (included in the total claim amount).
These allegations center on Change Order No.1 for the original contract whereby
Dalton Construction requested and received approval to substitute boring and
jacking in place of open cut trenching for a portion of a sewer installation in
South Mai n Street, Wal nut Creek. Attachment II is a copy of Change Order No.1.
Under this Change Order, which was signed by Dalton Construction, they agreed to
accept responsibility for costs associated with this change in the original
contract-specified construction method including the determination of the
suitability of the subsurface conditions for this proposed boring and jacking.
They also agreed to bear all additional costs resulting from this change order and
to maintain the original contract's overall price and completion date. The claim
is for work which Dalton alleges to be extra to the original contract; however, the
majority of this claimed work is included under the Change Order No. 1.
Di stri ct staff has eval uated the cl aim and has determi ned that the actual amount
still owed to Dalton Construction for contract work is $13,800 not $57,200; and
that there is no extra work for which additional compensation should be paid.
Staff recommends that Dalton Construction be paid $13,800 but that the balance of
the claim be denied. A closed session has been scheduled in order that additional
background on this claim can be presented to the Board.
RECOMMENDATION: Approve partial allowance of Dalton Construction Company claim in
the amount of $13,800; deny the balance of the claim.
INITIATING DEPT/DIV.
~C
/Jft(
ARD ACTION
1302A-
JEC
JSM
PM
KA
Page 2 of 4
," ACHMENT I
-<
,.
Q
SUNNY CT.
CASTLE HILL ROAD
Approximately 1,000 feet
of 39" RC pipe by bore and
jack method per Change Order
No . 1.
~fr
I --
...
! .
,~c.
LOCATION MAP
N.T.S.
TTACHr~ENT I I
<X.WmAcr' awa: CEDER R). 1
CCCSD Contract No.
4428
Date September 28, 1988
Project Name
1-680/SR-24 Sewer Relocations
Contractor
Dalton Construction Company
Sheet 1 of 2
I. DE'.OCRIPrI~
The subject Contract is herein changed to incorporate the
following:
Fran Station l7+l4:!: to Statim 27+l2:!:, change the design of trunk
sewer pipe installation fran q>en trench to bore and jacking.
II.CCln'Et&TIOO
No cost to the District.
III. <XH>l'l'ICH;
A. All work to be performed and all materials to be furnished by
the Contractor for the above-described work shall conform with
all applicable requirements of the Contract, except as
otherwise noted herein.
B. '!he Contract CCJIq)letioo date, Contract price and all other
items, covenants and canditioos of the above-referenced
Contract, except as specifically IOOdified by this and previous
Olange Orders, if any, remain in full force and effect.
C. Contractor shall be responsible for the adequacy of design,
engineering, and constructioo of the entire boring and jacking
system.
D. Contractor's shop drawing subnittal No. 7A, Rev. No. 1 dated
9/8/88, in_conjunction with Engineer's comments dated 9/22/88
to the sul:mi.ttal, shall be incorporated to this Change Order.
E. All aCkii tional cost as a result of this Change Order shall be
borne by the Contractor.
F. All other specified requiranents, including rot rot limited to
the following, shall ranain unchanged except as otherwise
noted herein:
1. SUitability of subsurface conditioos for pipe
installatioo by boring and. jacking design and method
shall be determined by and be the total responsibility of
the Contractor.
Page 3 of 4
OCCSD Contract No. 4428
Contract Change Order No. 1
Sheet 2 of 2
2. Field verification of existing utilities by excavation per
SC-g and 150020 shall be the total responsibility of the
Contractor.
3. Contractor shall provide dewatering and ventilation systems
subject to review by the Engineer.
4 . Contractor shall grout the annular space outside of the bored
and jacked pipe, subject to review by the Engineer.
5. Contractor shall canply with ar:plicable noise and traffic
regulations.
6. Roadway slurry seal and striping on South Main Street shall be
in accordance with the Contract Documents and as ShCMn on the
plans.
7. Specific details of the boring and jacking pipe installation
shall be reviewed by the Engineer prior to work beginning.
G. OC-42 and SC-2l on Liquidated Damages shall remain unchanged.
Amount Of Change Order Not To Exceed:
Addition $
-0-
Credit $
-0-
Original Cmtract ADnmt $
1,088,600.00
Total Change Orders To Date
$
-0-
1,088,600.00
Date .3...?e - bP~
~
ApprOl1al Recaunended ~
Design Engineer: / U/f
ApprOl1ed By: ~;z;:~-
Date
c;h g~g
I
rh;/lg...
I {
Date
HT/RH :maa
<n11
Page 4 of 4
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