Retirement Plan for Employees of Concord Hospital. Summary Plan Description

Transcription

1 Retirement Plan for Employees of Concord Hospital Summary Plan Description This Summary Plan Description describes the Retirement Plan as of January 1, 2016.

2 TABLE OF CONTENTS Page INTRODUCTION... 1 ABOUT THIS BOOKLET... 1 PLAN AT A GLANCE... 2 ELIGIBILITY... 3 OWNERSHIP OF YOUR ACCOUNT (VESTING)... 3 CONTRIBUTIONS TO YOUR ACCOUNT... 4 Pay Credits... 4 Interest Credit... 5 Special Rules for Certain Participants on December 31, PAYMENT FROM YOUR ACCOUNT... 6 Before Age On or After Age On or After Age HOW BENEFITS ARE PAID... 6 Normal Form of Payment... 6 Your Payment Options... 7 Electing a Form of Payment Taxes on Your Payment SPECIAL SITUATIONS You Have a Break in Service You Are Re-employed You Take a Leave of Absence If You Should Die Before Your Benefit Is Paid If You Become Disabled You Worked for an Employer That Was Acquired by Concord Hospital You Have a Qualified Domestic Relations Order YOUR RIGHTS UNDER THE PLAN Your Right to File a Claim for Benefits Benefits Insured by the PBGC ADDITIONAL PLAN INFORMATION YOUR RIGHTS UNDER ERISA ADMINISTRATIVE INFORMATION Plan Administration and Interpretation Information About the Plan APPENDIX Plan Formula as of December 31, 1997 (Grandfathered Formula) i

3 INTRODUCTION Planning ahead for your retirement years is important, whatever your age. If you re like most people, you will probably receive income from different sources. So it s important to understand what each source can provide. At Concord Hospital, we are committed to helping ensure that your retirement years are financially secure. The Retirement Plan for Employees of Concord Hospital (Retirement Plan) allows you to earn a monthly retirement income based on your pay and years of service. The Retirement Plan offers flexible retirement dates, a variety of payment options and survivor benefits. Plus, these benefits cost you nothing. Concord Hospital pays the full cost. When you combine your Retirement Plan benefits with social security and your savings in the Concord Hospital 403(b) Plan, you are well on your way to a secure retirement. This summary plan description (SPD) will describe your rights and benefits under the Retirement Plan. This information applies to eligible employees who have service on or after January 1, We encourage you to learn more about the Retirement Plan, so you understand what it could provide when you retire. If you have any questions about your benefits, please contact the Human Resources Department. ABOUT THIS BOOKLET This booklet is intended as a non-technical summary of the Plan, so it does not contain all the details. Your benefit is actually determined by the terms of the official Plan documents that govern the Plan s operation. As with all of its benefits, Concord Hospital reserves the right to change or discontinue, at any time, these benefits in the future. While every effort has been made to provide clear and accurate information about the Plan, in the event of a discrepancy between this material and the official Plan documents, the Plan documents will prevail. - Page 1 -

4 PLAN AT A GLANCE The Retirement Plan is designed to provide you with retirement income based on your earnings and service with Concord Hospital. Here is a quick look at the highlights of the Retirement Plan: Your Benefit Your benefit is shown as an account balance, so that you can watch your benefit grow over time. Benefit Based on Pay and Service Each year you work 1,000 hours or more, Concord Hospital makes a contribution to your Retirement Plan account, based on your age, covered pay and service. Interest Earned You also earn interest credits every year based on the value of your account balance. For 2016, the minimum interest credit is 5% (subject to adjustment in future years). When Benefit Payments Begin When you terminate employment or retire and are vested, you are entitled to receive a benefit from the Retirement Plan once you are at least age 55 or, if the lump sum value of your benefit does not exceed $25,000, before age 55. The amount of your benefit is determined by your account balance. Form of Benefit Payment You have a choice of payment options when you retire or leave. You may receive your account in one lump sum payment or you may receive monthly benefits from the Retirement Plan. Vested Benefit Your benefit is vested or nonforfeitable when you complete three years of vesting service. For vesting purposes, you earn a year of service for each calendar year during which you are credited with 1,000 hours of service. Beneficiary Benefits If you should die before you retire, your beneficiary will receive the full value of your account or may elect to receive monthly benefits for his/her lifetime. Disability Benefits If you become permanently disabled or terminally ill, and are vested in your benefit you can retire and receive your benefit before age Page 2 -

5 ELIGIBILITY You are eligible to participate in the Retirement Plan once you: Complete one year of eligibility service, and Are at least age 21. Your participation will take effect on the first day of the month after you meet these requirements. Becoming a Participant means that you will begin receiving pay and interest credits under the Retirement Plan. You are not eligible to participate in the Retirement Plan if you are a leased or contract worker, or if you are treated by Concord Hospital as being an independent contractor. You are credited with one year of eligibility service if you are credited with 1,000 hours of service during your first 12 consecutive months of employment with Concord Hospital. If you have fewer than 1,000 hours of service during that period, you will be credited with one year of eligibility service at the end of any calendar year in which you have at least 1,000 hours of service. OWNERSHIP OF YOUR ACCOUNT (VESTING) You become vested in your benefit after you complete three (3) years of vesting service. For employment ending before January 1, 2008, five (5) years of vesting service is required. If you leave Concord Hospital before you are vested, you will not receive a benefit under the Retirement Plan. You are credited with one year of vesting service if you are credited with 1,000 hours of service during a calendar year. - Page 3 -

6 CONTRIBUTIONS TO YOUR ACCOUNT Your retirement benefit is based on your cash balance account. Your cash balance account grows over time based upon pay credits and interest credits. Pay Credits Your account will be credited with a Basic Contribution Credit and, if applicable, a Supplemental Contribution Credit for calendar years in which you worked at least 1,000 hours, including your year of hire with Concord Hospital and your year of termination or retirement. Your Covered Pay Your covered pay generally includes the amount reported on your Form W-2 for income tax purposes, including all salaries, wages, overtime pay, bonuses and similar payments plus earned-time credit paid in cash on account of your termination and any pre-tax contributions you make toward the cost of your Concord Hospital benefits and the Concord Hospital 403(b) Plan. Covered pay does not include earned-time credit paid in cash (not on account of your termination), severance, imputed income, reimbursed expenses, cost-of-living allowances, death benefits and other unusual payments as determined by the Plan Administrator. The maximum amount of covered pay that may be taken into account under the Retirement Plan is limited under federal law. For 2016, this limit is $265,000. After 2016, the IRS will adjust the amount annually based on changes in the cost of living. Basic Contribution Credit Your Basic Contribution Credit is a percentage of the covered pay you receive during the calendar year. The chart below shows the Basic Contribution Credit you would receive based on your age plus your years of service at the beginning of the calendar year. Age Plus Service on January 1 Basic Contribution Credit as a % of Your Covered Pay Less than 40 4% % % % 70+ 9% Example: Let s assume that on January 1, 2016, you are age 35 and have five years of service with Concord Hospital. Your age plus your years of service equal 40, so your Basic Contribution Credit for 2016 is 5% of your pay. If you terminate employment and receive covered pay in the calendar year following the calendar year in which your termination occurs, the pay will be recognized as earnings in your year of termination for purposes for determining your Contribution Credit. - Page 4 -

7 Supplemental Contribution Credit If your covered pay is greater than the Social Security wage base for the calendar year, you will receive a Supplemental Contribution Credit. (For 2016, the Social Security wage base is $118,500 and is subject to adjustment by the IRS for future years.) The Supplemental Contribution Credit equals the lesser of 5% or your Basic Contribution Credit times your covered pay over the Social Security wage base for that calendar year. Interest Credit An annual interest credit will be added to your account balance, based on your account balance on January 1 of the calendar year. The interest credit to be added to your account shall be equal to the one-year Constant Maturity Treasury Rate for the month of August of the immediately preceding calendar year, plus 1%. However, the interest credit shall equal at least 5% of your account balance each year, but not more than 11% of your account balance each year. Example: Let s assume that the interest credit equals 6% in the calendar year and that your account balance equaled $10,000 at the beginning of the calendar year. In this example, your interest credit for that calendar year would equal $600 (6% of $10,000). Special Rules for Certain Participants on December 31, 1997 Initial Balance for Participants on December 31, 1997 If you were a participant in the Retirement Plan on December 31, 1997, your account was credited with a beginning balance equal to the value of the benefit you earned under the prior benefit formula under the Retirement Plan, converted to a lump sum amount. When your benefit was converted to a lump sum amount, your age, length of service and pay were considered. If you terminated employment with a deferred vested benefit on or before December 31, 1997 and you become reemployed after December 31, 1997, your initial balance will be established upon your reemployment. Minimum Benefit for Certain Grandfathered Participants If your age plus your years of service was equal to or greater than 45 on January 1, 1998, the benefit you will receive when you start payments will be equal to or greater than the benefit you would have received under the formula and provisions in effect on December 31, 1997 the Grandfathered Formula. (See the Appendix for more information.) - Page 5 -

8 PAYMENT FROM YOUR ACCOUNT Before Age 55 If you terminate employment after becoming vested in your Plan account, you can receive your entire account balance at any time after age 55 or, if your account balance does not exceed $25,000, you can receive it before age 55. On or After Age 55 If your employment ends on or after your 55 th birthday (your early retirement age), but before your normal retirement age, you can begin receiving your benefit as early as the first day of the month after your termination of employment. On or After Age 65 If your employment ends on or after your 65 th birthday (your normal retirement age), you can begin receiving your benefit as early as the first day of the month after your termination of employment. If you continue working past age 65, your benefit will be delayed until you discontinue employment at Concord Hospital. If you are impacted by this delay in benefit commencement, a required suspension of benefits notice will be sent in the month in which you reach normal retirement age. HOW BENEFITS ARE PAID Benefits are expressed in terms of a single life annuity at the time payments commence. However, you can request other monthly payment options as described below. Normal Form of Payment Account Balances Equal to or Less than $5,000 If the value of your account balance is $5,000 or less at the time you leave Concord Hospital, you will automatically receive your benefit in a single lump sum payment. If the value of your account balance is $5,000 or less, but greater than $1,000, your payment will be made directly to you, less 20% federal withholdings or may be rolled over into another eligible retirement plan. If you do not elect a single lump sum payment, your funds will automatically be distributed in a tax-free direct rollover to a rollover IRA designated by the Plan Administrator. The funds in your individual retirement account will be invested in a type of investment that is designed to preserve principal and provide a reasonable rate of return and liquidity. Your individual retirement account will be charged for any expenses associated with its establishment and maintenance. If the value of your account balance is $1,000 or less, it will be paid to you automatically in a lump sum as soon as administratively practicable. - Page 6 -

9 Single Life Annuity If you are single, the normal form of payment is a single life annuity. Under this form of payment, you receive a monthly benefit based on your age when benefits begin and continuing for as long as you live. At your death, all payments cease. Qualified Joint and Survivor Annuity If you are married, the normal form of payment is a 50% Joint & Survivor Annuity. Under this form of payment, you receive a monthly benefit during your lifetime and upon your death, your spouse receives a reduced monthly benefit for the remainder of his or her lifetime. Your spouse s monthly benefit is equal to 50% of your monthly benefit. If your spouse should die before you, no additional benefits are payable from the Retirement Plan upon your death. This form of payment results in a reduced income during your lifetime because the funds committed for payment of your retirement income must cover two lives instead of one. The amount of reduction depends on your age and the age of your beneficiary when your payments begin. If you are married, you must have written, notarized consent from your spouse to elect an option other than the normal form of payment or to name a beneficiary other than your spouse. Your Payment Options If the value of your account balance is over $5,000, you may choose to elect to receive your benefit under one of the alternate payment options described below. Lump Sum Payment A lump sum payment is a single cash payment equal to your account balance. If you are eligible for a minimum benefit for certain grandfathered participants, you are entitled to receive a lump sum equal to the value of your grandfathered benefit, if greater than your account balance. Once you receive a lump sum payment, you will not receive any additional benefits from the Retirement Plan. Single Life Annuity The single life annuity form of benefit pays you a monthly benefit for life. After your death, no further benefits will be paid. The amount you actually receive under this payment option will depend on your account balance and your age at the time payments begin. If you are employed by the Hospital and have reached age 55 and completed at least 10 years of vesting service as of January 1, 2016, your estimated monthly single life annuity equals A + B below: - Page 7 -

10 A) Your account balance as of January 1, 2016 accumulated with future interest credits to the time you expect to start monthly payments, divided by Annuity Factor A in the table below that applies to your age when benefits begin, plus B) Your account balance attributable to annual pay credits earned after 2015 plus future interest credits on those pay credits through the time you expect to start monthly payments, divided by Annuity Factor B in the table below that applies to your age when benefits begin: Age Annuity Factor A Annuity Factor B* *Annuity Factor B is based on assumptions prescribed under Section 417(e) of the Internal Revenue Code, and will be updated each year. If you are employed by the Hospital but have not reached age 55 and completed at least 10 years of vesting service as of January 1, 2016, your estimated single life annuity equals the greater of (1) and (2) below: (1) Your account balance as of January 1, 2016 accumulated with future interest credits to the time you expect to start monthly payments, divided by Annuity Factor A in the table above that applies to your age when benefits begin. (2) Your total account balance at the time you expect to start monthly payments, divided by Annuity Factor B in the table above that applies to your age when benefits begin. If you terminated employment prior to January 1, 2016, your estimated single life annuity equals your total account balance at the time you expect to start monthly payment divided by Annuity Factor A in the table above that applies to your age when benefits begin. - Page 8 -

11 Example 1: Let s assume you were 55 years old and had 15 years of vesting service as of January, 1, Further assume your total Retirement Plan account equals $100,000 when you retire at age 65, with $70,000 of that account balance attributable to your January 1, 2016 account balance accumulated with future interest credits until you reach age 65 and $30,000 attributable to pay credits earned after 2015 plus future interest credits on those pay credits. If you elect the life annuity option, you would receive approximately $782 per month from the Retirement Plan until you die ($70,000 divided by 118 plus $30,000 divided by 159). Example 2: Let s assume you were 40 years old and had 5 years of vesting service as of January, 1, Further assume your total Retirement Plan account equals $75,000 when you retire at age 65, with $15,000 of that account balance attributable to your January 1, 2016 account balance accumulated with future interest credits until you reach age 65 and $60,000 attributable to pay credits earned after 2015 plus future interest credits on those pay credits. If you elect the life annuity option, you would receive approximately $472 per month from the Retirement Plan until you die (the greater of $15,000 divided by 118 or $75,000 divided by 159). 50%, 66 2/3%, 75% and 100% Joint and Survivor Annuity The 50%, 66 2/3%, 75% and 100% joint and survivor annuity forms of benefit pays you a reduced monthly benefit for your lifetime, and then pays your designated beneficiary lifetime monthly benefits equal to 50%, 66 2/3%, 75% or 100% (whichever you elect) of your monthly benefit. The amount you and your beneficiary will actually receive under this payment option will depend on your account balance, your age and your beneficiary s age at the time you begin receiving payments, and the percentage you elect to continue to your beneficiary. If you elect a joint and survivor annuity option and your beneficiary dies before you do, your monthly benefit will not change and no additional benefits will be paid after your death. Example: Let s assume that your monthly benefit from the Retirement Plan under the single life annuity option equals $500 and that you decide instead to elect the 50% joint and survivor option. In this example, your monthly benefit would be reduced to $465. When you die, assuming you and your beneficiary are both age 65 when you begin payments, your beneficiary would continue to receive $233 (50% of your benefit) until he or she dies. 10-Year Certain and Continuous Annuity The 10-year certain and continuous annuity form of benefit pays you a reduced monthly benefit for your lifetime, and then pays your designated beneficiary any remaining payments from that 10year guaranteed time period. If you die after receiving 10 years of monthly payments, no additional benefits are payable from the Retirement Plan upon your death. You may name a trust, an organization or your estate as a beneficiary under this payment option. The reduction in your benefit will be determined by your age at the time you begin receiving payments. Social Security Level Income Option The social security level income option form of benefit pays you a reduced monthly benefit for as long as you live. If you begin receiving payments from this Retirement Plan before you begin receiving Social Security benefits, your monthly Retirement Plan benefits will be adjusted so that payments are higher until your Social Security income begins, and then lower during the remainder of your life. In this way, your combined income from the Retirement Plan and Social Security remains about the same - Page 9 -

12 throughout your retirement years. You are not eligible for the Social Security Level Income Option if you have already reached the leveling age (currently, age 62) established by the Plan Administrator. Electing a Form of Payment All payment elections must be made in writing during the 180 day period before you want payments to begin. You may change your payment option at any time before payments begin. If you are married, your spouse must provide his or her written, notarized consent if you elect a benefit option other than a qualified joint and survivor annuity with your spouse as beneficiary. Election forms are available from the Human Resources Department. Taxes on Your Payment Retirement benefit payments are taxable in the year you receive them. You may elect to have federal and/or state taxes withheld from your monthly payments. If you receive a lump sum payment greater than $200, you will automatically have 20% withheld from the amount to cover federal taxes unless the payment is transferred directly to an Individual Retirement Account or another qualified plan. If you receive a lump sum before age 59-1/2, you may also be subject to a 10% early payment tax unless you are age 55 or more when you terminate employment with Concord Hospital or you roll over your payment to another employer s retirement plan or to an Individual Retirement Account. The taxes that apply to distributions from the Retirement Plan are complicated and Concord Hospital cannot provide you with specific tax advice. You are strongly encouraged to consult a tax advisor before you decide how you want your benefit to be paid. Once your benefit payments commence, the method and form of payment cannot be changed. Please review all documents carefully before you submit your distribution request. SPECIAL SITUATIONS You Have a Break in Service A break in service occurs any time you have fewer than 501 hours of service during a calendar year, unless you are deemed to be on an approved absence under the Family and Medical Leave Act (FMLA). If you have at least five consecutive one-year breaks in service, your vesting service before the breaks may be lost. Whether that occurs will depend on whether you are vested: If you are vested, you cannot lose your vesting service for any reason, including a five-year break in service; If you are not vested, your service will be lost if you incur five consecutive one-year breaks in service. If your prior service is not reinstated when you return to Concord Hospital, you will be treated as a new employee for purposes of eligibility, vesting and the pay credit schedule. - Page 10 -

13 You Are Re-employed If you were vested when your employment terminated and you are re-employed, you would once again be eligible to earn benefits under the Retirement Plan. In addition, you would retain the years of service you had earned before the break. If you were not vested when your employment terminated and your break-in-service was less than five years, your prior service would be restored. Otherwise, you will lose any years of service earned before the break. You Take a Leave of Absence Continued Participation on Approved Leave of Absence If you take an approved paid leave of absence, you will continue participating in the Plan as if you were an active employee for purposes of vesting and will continue to earn benefits based on service and earnings, subject to certain limitations. Generally, you will be credited with the earnings which you actually receive while on an approved leave of absence, although special rules apply for military leave. You will also be credited with hours of service for leave periods during which you are entitled to earnings, so long as the leave is designated by Concord Hospital as extended illness hours, earned time hours or other similar paid short-term disability leave. For other types of approved paid leave, hours of service will be capped at 501 hours for any one leave period. If you take an approved unpaid leave of absence, you will not be credited with any hours of service for the period of the leave. However, if you take an unpaid parental or FMLA leave, you will be credited with up to 501 hours of service during one leave period only for purposes of avoiding a break in service. You cannot receive a distribution of your benefit until you terminate employment. Note that if you do not return from a leave of absence within the time period specified in your leave of absence approval, your leave is not considered an approved leave of absence. Generally, this means you would not receive earnings or hours of service credit from the time spent on leave. Military Leave The Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) guarantees certain rights to eligible individuals who enter military service. Generally, if you are on military leave covered under USERRA, you are entitled to the same rights and benefits that Concord Hospital provides to similarly-situated employees on other types of leave. In general, to be eligible for the rights guaranteed under USERRA, you must: Return to work on the first full regularly scheduled work day following your leave, safe transport home, and an eight hour rest period if you are on a military leave of less than 31 days Return to or reapply for reemployment within 14 days of completion of such period of duty, if your absence from employment is from 31 to 180 days Return to or reapply for reemployment within 90 days of completion of your period of duty, if your military service is for over 180 days. An absence under USERRA will not constitute a break-in-service for purposes of this Retirement Plan. You will continue earning service credit and pay credit, based on your regular work schedule, during your leave. For more information on your USERRA rights, contact the Human Resources Department. - Page 11 -

14 Under the Heroes Earnings Assistance and Relief Tax Act of 2008 (the HEART Act), your beneficiaries may be entitled to special rights if your die during qualified military service. In general, if you are called into active duty and you would have been entitled to reemployment rights under USERRA, your benefit will become 100% vested if you die during qualified military service. Please contact the Plan Administrator if you want to learn more about these special rights. Continued Participation While on a Family and Medical Leave The federal Family and Medical Leave Act (FMLA) was designed to extend certain benefits to employees facing issues connected with their own health, or that of an immediate family member, or with the birth or adoption of a child. It provides unpaid leave for up to 12 weeks during a 12-month period, job security, preservation of status, and continuation of benefits during an approved absence from work. If you have at least one year of service and you have worked at least 1,250 hours in the last 12 months at Concord Hospital, you may take FMLA-protected leave. Note than an absence under the FMLA will not constitute a break-in-service for purposes of this Retirement Plan. For more information on your FMLA rights, contact the Human Resources Department. If You Should Die Before Your Benefit Is Paid If you die after you become vested and before your benefit payments begin, the Retirement Plan provides survivor benefits that are payable to your beneficiary. When you begin participating in the Retirement Plan, you will be asked to name a beneficiary. If you are single, you may name anyone (including a trust) as your beneficiary and you may change your beneficiary designation at any time. If you are married, your spouse is automatically your beneficiary. Spousal Survivor Benefit If you are married and do not designate a beneficiary other than your spouse, your spouse is entitled to be paid a survivor benefit equal to your account balance in the form of a single life annuity, unless your spouse elects to receive your account balance in a lump sum option. Non-Spouse Survivor Benefit If you are not married, your beneficiary is entitled to receive your account balance. Your beneficiary can elect to receive a lump sum payment or monthly payments under the single life annuity option. Spousal Survivor Benefits for Certain Grandfathered Participants For participants eligible for the Grandfathered Formula, If you are married, entitled to Grandfathered Benefits calculated under the Appendix and die prior to commencement of benefits, your spouse is entitled to receive a death benefit equal to the greater of (i) your benefit under the cash balance formula (either in an annuity or lump sum form) or (ii) your pre-retirement surviving spouse benefit provided in the Retirement Plan, as in effect on December 31, The Grandfathered formula does not provide pre-retirement death benefits for non-spousal beneficiaries. Please contact the Plan Administrator for more information on the death benefit provided to participants entitled to Grandfathered Benefits. - Page 12 -

15 If You Become Disabled If you become permanently disabled or terminally ill (as determined by the Plan Administrator in accordance with procedures uniformly applicable to all participants) after becoming vested in your Retirement Plan benefit then you may elect to retire before age 55. In this case, you could receive your account balance as a lump sum payment or in any of the monthly forms of payment described earlier in this booklet. For more information about the Plan s disability requirements and benefits, please contact the Plan Administrator. You Worked for an Employer That Was Acquired by Concord Hospital You may receive credit for years of continuous service performed with a prior employer that is acquired by Concord Hospital for purposes of determining your applicable pay credit formula or vesting in your retirement benefit if that service otherwise meets the definition of service under the Retirement Plan. In no event, however, will you accrue additional pension benefits with respect to service occurring before you began participating in the Retirement Plan. Please contact the Plan Administrator for more information. You Have a Qualified Domestic Relations Order A Qualified Domestic Relations Order (QDRO) is a legal judgment, decree, or order that recognizes the rights of an alternate payee under the Retirement Plan with respect to child or other dependent support, alimony, or marital property rights. If you become legally separated or divorced, a portion or all of your benefit under the Retirement Plan may be assigned to someone else to satisfy a legal obligation you may have to a spouse, former spouse, child or other dependent. There are specific requirements the order must meet to be recognized by the Plan Administrator and specific procedures regarding the amount and timing of payments. If you are affected by such an order, you may contact the Human Resources Department for more information. Participants and beneficiaries may obtain, without charge, a copy of the procedures governing QDRO determinations under the Retirement Plan from the Plan Administrator. - Page 13 -

16 YOUR RIGHTS UNDER THE PLAN As a participant in the Retirement Plan, you have certain rights. Your Right to File a Claim for Benefits If you have any questions about the Retirement Plan, or if you wish to make a claim for benefits, you should contact the Human Resources Department. If you feel you have a right to a benefit under the Retirement Plan that you have not received, you may file a claim for the benefit with the Plan Administrator. Time Frame for Claim Determinations If you receive an adverse benefit determination (i.e., any denial, reduction, or termination of a benefit, or a failure to provide or make a payment), the Plan Administrator will notify you of the adverse determination within a reasonable period of time, but not later than 90 days after receiving the claim. This 90-day period may be extended for up to an additional 90 days, if the Plan Administrator both determines that special circumstances require an extension of time for processing the claim, and notifies you, before the initial 90-day period expires, of the special circumstances requiring the extension of time and the date by which the Retirement Plan expects to render a determination. In the event an extension is necessary due to your failure to submit necessary information, the Retirement Plan s time frame for making a benefit determination on review is tolled (i.e., stopped) from the date the Plan Administrator sends you the extension notification until the date you respond to the request for additional information. If You Receive an Adverse Benefit Determination The Plan Administrator will provide you with a notification of any adverse benefit determination, which will set forth: The specific reason(s) for the adverse benefit determination Reference to the specific Retirement Plan provisions on which the benefit determination is based A description of any additional material or information necessary for you to perfect the claim and an explanation of why that material or information is necessary A description of the Retirement Plan s appeal procedures and time limits applicable to such procedures, including a statement of your right to bring a civil action under ERISA after an adverse determination on appeal. Procedures for Appealing an Adverse Benefit Determination You, or your authorized representative, have 60 days following the receipt of a notification of an adverse benefit determination within which to appeal the determination. - Page 14 -

17 You have the right to: Submit written comments, documents, records and other information relating to the claim for benefits Request, free of charge, reasonable access to, and copies of all documents, records and other information relevant to your claim for benefits. For this purpose, a document, record, or other information is treated as relevant to your claim if it: o Was relied upon in making the benefit determination o Was submitted, considered, or generated in the course of making the benefit determination, regardless of whether such document, record or other information was relied upon in making the benefit determination o Demonstrates compliance with the administrative processes and safeguards required in making the benefit determination Request a review that takes into account all comments, documents, records, and other information submitted by you relating to the claim, regardless of whether such information was submitted or considered in the initial benefit determination. The Plan Administrator will notify you of the Retirement Plan s benefit determination on review within a reasonable period of time, but not later than 60 days after receipt of your request for review by the Retirement Plan. This 60-day period may be extended for up to an additional 60 days, if the Plan Administrator both determines that special circumstances require an extension of time for processing the claim, and notifies you, before the initial 60-day period expires, of the special circumstances requiring the extension of time and the date by which the Retirement Plan expects to render a determination on review. In the event an extension is necessary due to your failure to submit necessary information, the Retirement Plan s time frame for making a benefit determination on review is tolled (i.e., stopped) from the date the Plan Administrator sends you the extension notification until the date you respond to the request for additional information. The Plan Administrator s notice of an adverse benefit determination on appeal will contain all of the following information: The specific reason(s) for the adverse determination Reference to the specific Retirement Plan provisions on which the benefit determination is based A statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to your claim A statement describing any voluntary appeal procedures offered by the Retirement Plan and your right to obtain the information about such procedures, and a statement of your right to bring an action under ERISA. - Page 15 -

18 Limitations on Bringing Claims You may not commence a judicial proceeding with respect to a claim for benefits without first exhausting the claims procedures set forth above. Furthermore, no suit or legal action contesting, in whole or in part, any denial of benefits shall be commenced later than the earlier of: the first anniversary of (A) the date of the notice of the Plan Administrator s final decision on appeal, or (B) if you fail to request any level of administrative review within the timeframe permitted under the claims review procedure, the deadline for requesting the next level of administrative review, and the last date on which such legal action would be commenced under the applicable statute of limitations under ERISA (including, for this purpose, any applicable state statute of limitations that applies under ERISA to such legal action). Benefits Insured by the PBGC Your benefits under the Retirement Plan are insured by the Pension Benefit Guaranty Corporation (PBGC), a federal insurance agency. If the Retirement Plan terminates (ends) without enough money to pay all benefits, the PBGC will step in to pay retirement benefits. Most people receive all of the retirement benefits they would have received under their Retirement Plan, but some people may lose certain benefits. The PBGC guarantee generally covers: Normal and early retirement benefits Disability benefits if you become disabled before the Retirement Plan terminates and Certain benefits for your survivors. The PBGC guarantee generally does not cover: Benefits greater than the maximum guaranteed amount set by law for the year in which the Retirement Plan terminates Some or all of benefit increases and new benefits based on Retirement Plan provisions that have been in place for fewer than five years at the time the Retirement Plan terminates Benefits that are not vested because you have not worked long enough for Concord Hospital Benefits for which you have not met all of the requirements at the time the Retirement Plan terminates Certain early retirement payments (such as supplemental benefits that stop when you become eligible for Social Security) that result in an early retirement monthly benefit greater than your monthly benefit at the Retirement Plan s normal retirement age and Non-pension benefits, such as health insurance, life insurance, certain death benefits, vacation pay, and severance pay. - Page 16 -

19 Even if a portion of your benefits is not guaranteed, you still may receive some of those benefits from the PBGC depending on how much money your Retirement Plan has and on how much the PBGC collects from employers. For more information about the PBGC and the benefits it guarantees, ask your Plan Administrator or contact the PBGC s Technical Assistance Division, 1200 K Street N.W., Suite 930, Washington, D.C or call (not a toll-free number). TTY/TDD users may call the federal relay service toll-free at and ask to be connected to Additional information about the PBGC s pension insurance program is available through the PBGC s website on the Internet at ADDITIONAL PLAN INFORMATION Additional information about the Retirement Plan is included in this section. Assignment of Benefits You cannot assign, transfer or convey any of the benefits provided by this Retirement Plan. Your benefits will be exempt from the claims of creditors to the maximum extent permitted by law. However, the law does permit the assignment of all or a portion of your interest in the Retirement Plan to your former spouse or children as part of a Qualified Domestic Relations Order. No Employment Rights Participation in the Retirement Plan does not assure you of continued employment with Concord Hospital or rights to benefits except as specified in this Retirement Plan. Maximum Benefits All benefits and the amount of pay that can be included for calculating your Plan benefits for any year may not exceed the maximum limitations for that year under the Internal Revenue Code. Plan Documents This booklet is intended to help you understand the main features of the Retirement Plan. It should not be considered as a substitute for the Retirement Plan document, which governs the operation of the Retirement Plan. That document sets forth all of the details and provisions concerning the Retirement Plan and is subject to amendment. If any questions arise that are not covered in this booklet or if this booklet appears to conflict with the official Retirement Plan document, the text of the official Retirement Plan document will determine how questions will be resolved Nature of Accounts Retirement Plan accounts are bookkeeping accounts established only for the convenience of determining each employee s benefit. No specific assets or portion of the Retirement Plan trust fund will be set aside or segregated with respect to any such account, and any amount payable based on any such account shall be subject to the assets available in the trust and the PBGC guarantee. - Page 17 -

20 Return of Employer Contributions In certain circumstances, contributions made to the Retirement Plan may be returned to Concord Hospital if made on the basis of a mistake of fact or if held not to be deductible. Future of the Plan Concord Hospital reserves the right to amend or terminate the Retirement Plan at any time. If the Retirement Plan is terminated, you will become 100% vested in the benefit you have earned as of the Retirement Plan s termination date. In the event of Plan termination, Concord Hospital retains the right to receive any and all surplus assets remaining after the distribution of participants and beneficiaries benefits. The amount you actually receive will depend on the Retirement Plan s assets at the time of termination and on whether your benefit is insured by the Pension Benefit Guaranty Corporation (PBGC). Upon plan termination, Federal law mandates that the interest crediting rate will become a fixed rate, based on the average of the annual interest credits over the five year period ending on the proposed date of plan termination (DoPT). This means that your account balance will increase annually but the rate of increase will not vary after the DoPT. Concord Hospital reserves the right to purchase an annuity in full settlement of your benefit. Benefit Restrictions By law, certain restrictions apply if the Plan s funded status decreases below a certain threshold. These restrictions would result in a limitation of the amount to which you are entitled to receive as a lump sum, prohibit the Hospital from improving benefits or, in the event of a severe funding deficiency, cause your benefit to freeze. In no event will benefit restrictions cause your accrued benefit to decrease. In the event that benefit restrictions apply to the Plan, the Plan Administrator will separately notify participants and beneficiaries of the Plan. Change Of Address To make sure you receive your benefits and any benefit communications pertaining to the Plan, if you change your address after you terminate your employment with the Hospital, it is critical you send a written notice to the Concord Hospital, 250 Pleasant Street, Concord, NH The notice should include: your name and new address; your Social Security number; and your beneficiary s name and address. Keeping this information up-to-date will ensure that you (or your beneficiary) receive your benefit payments without undue delay. YOUR RIGHTS UNDER ERISA As a Retirement Plan participant, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all participants shall be entitled to: - Page 18 -

21 Receive Information About Your Plan and Benefits Examine, without charge, at the Plan Administrator s office and at other specified locations, such as worksites, all documents governing the Retirement Plan, and a copy of the latest annual report (Form 5500 Series) filed by the Retirement Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration. Obtain, upon written request to the Plan Administrator, copies of documents governing the operation of the Retirement Plan and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The Plan Administrator may make a reasonable charge for the copies. Receive a summary of the Retirement Plan s annual funding notice. The Plan Administrator is required by law to furnish each participant with a copy of this annual funding notice. Obtain a statement telling you whether you have a right to receive a pension at normal retirement age (age 65 or five years of service whichever is later) and, if so, what your benefits would be at normal retirement age if you stop working now. If you do not have a right to a pension, the statement will tell you how many more years you have to work to get a right to a pension. This statement must be requested in writing and is not required to be given more than once every 12 months. The Plan Administrator must provide the statement free of charge. Prudent Actions By Plan Fiduciaries In addition to creating rights for Retirement Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate your Retirement Plan, called fiduciaries of the Retirement Plan, have the duty to do so prudently and in the interest of you and other Retirement Plan participants and beneficiaries. No one, including your employer or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a pension benefit from the Retirement Plan or exercising your rights under ERISA. Enforce Your Rights If your claim to a pension benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of Retirement Plan documents or the latest annual reports from the Retirement Plan and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Plan Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or a federal court but only after you have exhausted the Plan s claims and appeal procedure. In addition, if you disagree with the Retirement Plan s decision or lack thereof concerning the qualified status of a domestic relations order, you may file suit in a federal court. If it should happen that Retirement Plan fiduciaries misuse the Retirement Plan s money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. - Page 19 -

22 If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous. Assistance With Your Questions If you have any questions about your Retirement Plan, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Plan Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. - Page 20 -

23 ADMINISTRATIVE INFORMATION Plan Administration and Interpretation The Plan Administrator has full discretionary authority to administer and interpret the Retirement Plan and to determine all questions arising in the administration, interpretation, and application of the Plan. Any determination by the Plan Administrator shall be conclusive and binding on all persons. The Plan Administrator has the right to delegate its authority under the Plan to another party. Information About the Plan The information below may be helpful if you need additional details about Retirement Plan administration. Plan Name: Plan Sponsor and Administrator: Plan Administrator: Plan Trustee: Agent for Service of Legal Process: Retirement Plan for Employees of Concord Hospital Concord Hospital 250 Pleasant Street Concord, NH (603) Concord Hospital Pension Management Committee Concord Hospital 250 Pleasant Street Concord, NH (603) ATTN: Human Resources Department Concord Hospital (603) JP Morgan Worldwide Securities Services 4 New York Plaza, 12th Floor New York, NY Concord Hospital 250 Pleasant Street Concord, NH Service of legal process may also be made upon the Plan Trustee Plan Year: January 1 to December 31 Plan Number: 001 Employer I.D. Number: Type of Plan: Funding Medium: Qualified defined benefit cash balance plan The Retirement Plan is funded by employer contributions to a trust fund based on an independent actuary s determination. Contributions are based on the life expectancy, earnings and service of all participants in the Retirement Plan and the benefits they are expected to receive. - Page 21 -