IGOE ADMINISTRATIVE SERVICES - Laserfiche WebLink

Home Browse Search

DocuSign Envelope ID: CFCE3443-EF37-4FD4-8DCD-D85D559F77AE 1. Terms and Conditions a. Spending Account Services -Contract Administrative Firm Duties i. In accordance with the terms of this Agreement, including language specific to each component of Client's Spending Account Program as identified in Exhibit B to this Agreement, but excluding language pertaining to components not selected as part of the Client's Spending Account Program or components selected by Client but administered by a third party firm other than Igoe, or by Client itself, the Contract Administrative Firm shall provide the following administrative and clerical functions: I. The Contract Administrative Firm shall consult with the Client on the design of the Client's Spending Account Program. The Contract Administrative Firm shall provide the Client with the following sample documentation in order to initiate the administrative function; a. Data collection forms and/or annual client verification forms that outline the specific details of the Client's Spending Account Program; b. Sample Spending Account documentation corresponding to the component reimbursement accounts comprising Client's Spending Account Program for review and potential adoption by the Client in its capacity as the Plan Administrator/Plan Sponsor as defined by the Employee Retirement and Securities Act of 1971 (ERISA) § 3(16) if applicable; c. Sample written summaries of the reimbursement accounts comprising Client's Spending Account Program explaining the rights and responsibilities of participants thereunder for review and potential adoption by Client in its capacity as the Plan Administrator/Plan Sponsor as defined by ERISA § 3(16) if applicable; d. A master set of spending account participant (Participant) communication and enrollment materials, if applicable, including: I. Election forms to be used during the enrollment process; and ii. Electronic file transfer specifications; and iii. Reimbursement request forms, which include instructions for filing requests. The Client is not required to use the sample election forms or enrollment materials provided, subject to review by the Contract Administrative Firm. The Contract Administrative Firm 4-- AGUE 1... +�lyisnr.nr neirvnt3 STEM V. PW City of Santa Ana Spending Account Administrative Services Agreement Client Initials: PEPM17 Page 3