CARLE FOUNDATION HOSPITAL AND AFFILIATES MATCHING TSA PLAN
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1 CARLE FOUNDATION HOSPITAL AND AFFILIATES MATCHING TSA PLAN SUMMARY PLAN DESCRIPTION APRIL 2010
2 TABLE OF CONTENTS Page INTRODUCTION... 1 PLAN HIGHLIGHTS... 2 ELIGIBILITY AND PARTICIPATION... 4 Eligibility to make Employee Contributions... 4 Eligibility for Matching Contributions... 4 CONTRIBUTIONS AND ACCOUNTS... 5 Employee Contributions... 5 Catch-Up Contributions... 6 Matching Contributions... 6 Rollover Contributions... 7 Transfer Contributions... 7 Military Service... 7 VESTING... 8 FORFEITURES... 8 HOW CONTRIBUTIONS ARE INVESTED... 8 SERVICES AND FEES... 9 DISTRIBUTION OF BENEFITS... 9 Distribution Upon Retirement, Disability, Death or Other Termination of Employment... 9 In-Service Distributions After Age Hardship Withdrawal Withdrawals During Qualified Military Service PLAN TRANSFERS AND ALIENABILITY OF BENEFITS PLAN ADMINISTRATION Plan Administration and Fiduciaries Amendment and Termination of the Plan Participation is no Guarantee of Employment CLAIMS PROCEDURES FEDERAL INCOME TAX CONSEQUENCES YOUR RIGHTS UNDER ERISA Receive Information About Your Plan and Benefits Prudent Actions by Plan Fiduciaries Enforce Your Rights Assistance with Your Questions GENERAL INFORMATION i -
3 INTRODUCTION Carle Foundation Hospital (the Company or the Plan Sponsor ) has established the Carle Foundation Hospital and Affiliates Matching TSA Plan (the Plan ) for the benefit of eligible Employees of the Company and certain affiliated employers that adopt the Plan (together, the Employers ). The Plan is a type of retirement plan known as a 403(b) plan. You may elect to make contributions to the Plan on a pre-tax basis and the Company will match a portion of your contributions if you satisfy the eligibility requirements for matching contribution ( Matching Contributions ). This Plan may also permit you to make certain other types of contributions to the Plan. This booklet is the Summary Plan Description (the SPD ) for the Plan. Its purpose is to explain the most important provisions of the Plan as simply as possible. A complete description of all Plan provisions appears in a separate plan document, a copy of which will be provided to you upon request. This SPD is not meant to interpret or change the provisions of the Plan in any way. In the event of any inconsistencies between the SPD and the Plan document, the terms of the Plan document will control. From time to time, the Plan may be amended or modified due to changes in the law, to comply with regulations or other guidance from the Internal Revenue Service (the IRS ) or the Department of Labor, or for other reasons. If the Plan is amended or modified in a way that changes the provisions of this SPD, you will be notified. This SPD describes the Plan as in effect on April 1, For a copy of the SPD that describes the Plan as in effect prior to April 1, 2010, please contact the Plan Administrator. As you read this booklet, please keep in mind that this is not a contract of employment and in no way changes the rights that you or your Employer have with respect to your employment relationship
4 PLAN HIGHLIGHTS Purpose of the Plan Plan Administration Eligibility to Participate Employee Contributions Company Matching Contributions Rollover Contributions The purpose of the Plan is to allow participants to defer a portion of their compensation on a pre-tax basis and to receive matching contributions from the Company in order to help participants accumulate funds for retirement. The Plan is administered by the Carle Foundation Hospital Employee Benefit Committee (the Committee ) and its designees. If you are an Eligible Employee (as described in the Eligibility and Participation section), you will be permitted to make Employee Contributions to the Plan as of the first pay period following your date of hire. You will be eligible to receive Matching Contributions after meeting the eligibility requirements described in the Eligibility and Participation section. If you are a physician who is part of a recognized residency program, or if you are a physician who performs work for the Employers on a contract basis, you will be eligible to make Employee Contributions to the Plan, but will not be eligible to receive Company Matching Contributions. If you are eligible to make salary reduction contributions under the Carle Profit Sharing Plan (also known as the Carle 401(k) Plan), you are not eligible to participate in the Plan. If you are an Eligible Employee, you may elect to contribute 1% to 95% of your Compensation (as defined in the Contributions and Accounts section) to the Plan as a pre-tax contribution ( Employee Contributions ), subject to certain legal limitations. In order to make Employee Contributions to the Plan, you will need to complete a salary reduction agreement. Because pretax contributions reduce your taxable income and build up tax-free until they are distributed, you can accumulate retirement funds more rapidly by contributing to the Plan than by saving for retirement outside the Plan, assuming the same rate of return. If you will be age 50 or older before the end of the calendar year, you may be eligible to make additional contributions known as Catch-Up Contributions for that calendar year. If you are eligible to receive Matching Contributions, the Company will make a Matching Contribution to the Plan on your behalf equal to 100% of your Employee Contributions for that year, up to 2% of your Compensation. If you receive a distribution from certain retirement plans, you may roll that distribution over into the Plan, subject to certain restrictions
5 Investment Control Benefits Payment of Benefits Beneficiary Designation Tax Consequences Questions You will have several investment fund options available under the Plan. Your available options are explained in separate materials since the available funds are subject to change. You may decide how your accounts are invested by choosing a fund or combination of funds that meets your individual investment goals. If you do not designate how your accounts are invested, your accounts will be invested in the default investment fund(s) selected by the Plan Administrator. Your benefits from the Plan are always 100% vested, although the value of your account may rise or fall depending on your investment elections. In the event your employment ends, your benefits may be distributed to you in a lump sum in accordance with the terms of the Plan. In certain circumstances, you may take a distributions while you are still employed by the Company. See the Distribution of Benefits section for more information. Your account balance cannot be lost even if you die before receiving benefits. You should designate a beneficiary at the time of enrollment. You may change beneficiaries at any time before your death. For married participants, your beneficiary will be your spouse, unless you and your spouse jointly designate another beneficiary on forms as required by the Plan. The Plan provides for tax deferrals on your contributions and on Plan earnings allocated to your account. This can mean substantially higher savings for you. The Federal Income Tax Consequences section briefly outlines general federal income tax consequences of the contributions to, or distributions from, the Plan. You should, however, consult your own tax advisor for specific information relating to your own tax planning. Most questions about the Plan or your account can be answered by contacting Alliance Benefit Group at (888) For any other questions, please contact Human Resources at (217)
6 ELIGIBILITY AND PARTICIPATION Only Employees who satisfy the eligibility requirements may participate in the Plan. You are an Eligible Employee if (1) you are employed by one of the Employers (as defined on page 1 of this SPD), and (2) you are not eligible to make salary reduction contributions under the Carle Profit Sharing Plan (also known as the Carle 401(k) plan). Effective April 1, 2010, Eligible Employees will receive Matching Contributions for a Plan Year if they (1) are at least age 21, (2) have completed at least two Years of Service, and (3) have elected to make Employee Contributions to the Plan for the Plan Year; provided, however, that the following groups are not eligible to receive Matching Contributions: (i) (ii) (iii) physicians who are part of a recognized residency program (they may make Employee Contributions to the Plan, but are not eligible to receive Matching Contributions); physicians who perform work for an Employer on a contract basis (they may make Employee Contributions to the Plan, but are not eligible to receive Matching Contributions); and employees who are eligible to make salary reduction contributions under the Carle Profit Sharing Plan (also known as the Carle 401(k) plan). A Year of Service is a Plan Year in which you have accrued at least 1,000 Hours of Service. An Hour of Service is generally each hour you work for the Employers for which you are paid or entitled to payment, as well as each hour paid on account of back pay (but not with respect to any amounts that would result in a duplication of credit), vacation, holiday, illness, incapacity, disability, layoff, jury duty, military duty or leave of absence. Hours of Service related to certain payments which reimburse you for medically related expenses or which are made under certain workers compensation or disability insurance laws will not be credited. Prior years of service with Carle Clinic Association, P.C. will also be recognized for purposes of determining your Years of Service under the Plan. Once you become a participant in the Plan, your ability to make Employee Contributions to the Plan or to receive Matching Contributions will be subject to the requirements of each type of contribution. Please see the Contributions and Accounts section for additional information. If you were formerly a participant in the Plan and are reemployed by an Employer, you will be eligible to resume participation in the Plan immediately upon your reemployment. You can begin to make Employee Contributions under the Plan effective as of the first pay date following rehire. You also will become eligible for Matching Contributions at that time if you were eligible for Matching Contributions when you ceased participation in the Plan
7 You will be notified of your eligibility to participate in the Plan, and you will be asked to complete certain forms and furnish needed information before enrolling. CONTRIBUTIONS AND ACCOUNTS The Plan provides for different kinds of contributions. If you participate in the Plan, you may make Employee Contributions, Rollover Contributions or Transfer Contributions from another plan, and may be eligible to make additional Catch-Up Contributions if you satisfy certain age requirements. In addition, the Company will make Matching Contributions on behalf of employees who satisfy the eligibility requirements for Matching Contributions. The Plan Administrator will establish separate recordkeeping accounts in your name to keep track of your interest in the Plan based on each type of contribution. For instance, all Employee Contributions and Catch-Up Contributions will be credited to your Employee Contribution Account, all Matching Contributions will be credited to your Matching Contribution Account, and your Rollover Contributions and Transfer Contributions will be credited to your Rollover Account and Transfer Account, respectively. As an Eligible Employee, you may elect to defer from 1% to 95% of your Compensation to the Plan in 1% increments into the Plan as Employee Contributions. If you have not previously enrolled in the Plan, you must complete an enrollment form for new enrollees to make your initial deferral election. Because your Employee Contributions are made on a pre-tax basis, those amounts are not subject to income taxes. By making Employee Contributions, you are able to save for retirement while reducing your current income taxes. However, Employee Contributions are subject to Social Security and Medicare taxes, and the employee portion of these taxes will be withheld from your paycheck and transmitted to the IRS, just like your regular wages. After you have enrolled in the Plan, you may elect to change the rate of your contributions, or stop making contributions, through your Employer s automated self service system, submitting your changes online at or by any other means established by the Plan Administrator. For purposes of Employee Contributions, your Compensation for a given Plan Year generally consists of your regular base salary or wages, commissions and bonuses for sales, production incentive payments, lump sum wage increases, bonuses, fringe benefits and reimbursements that you receive from your Employer during the year that are included in your gross income. Federal tax law limits the total dollar amount of pre-tax contributions that any employee may make in a single year. The limitation for 2010 is $16,500. The dollar limitation may be adjusted annually by the IRS to reflect changes in the cost of living. Certain types of elective employee contributions to other retirement plans (generally pre-tax contributions to other 401(k) plans, tax-sheltered annuity plans, or simplified employee pensions) will count toward this limitation. Your combined pre-tax contributions must not exceed the limitation. To prevent such an excess, the Plan Administrator may modify your elections and will notify you of any such changes. If you exceed that limitation (for example, because you made pre-tax - 5 -
8 contributions to another employer s plan in the same year), you must tell the Plan Administrator by March 1 of the year following the excess deferral. The Plan Administrator will then return that excess deferral amount (and any earnings on it) to you by the following April 15. Federal tax law also has other limitations that apply to highly compensated employees. These rules are intended to ensure that defined contribution plans like the Plan are nondiscriminatory and do not favor certain owners and highly compensated employees. The Plan Administrator may be required to reduce the contribution rates and possibly return contributions to certain highly compensated employees in order to comply with the federal non-discrimination rules. If you are an active participant in the Plan and are at least 50 years of age or will become 50 before the close of the Plan Year, you may be able to make Catch-Up Contributions to the Plan. You can make Catch-Up Contributions if your Employee Contributions to the Plan are limited because of a limitation under the Plan (e.g., because you have reached the IRS annual maximum deferral amount or the 95% rate of deferral limit). The amount of the Catch-Up Contribution you may make is subject to the annual limit set by the IRS. The catch-up contribution limit for 2010 is $5,500, meaning that participants who satisfy the age requirement may contribute up to a total of $22,000 in 2010 on a pre-tax basis. The IRS may adjust this limit from time to time for increases in the cost of living. Catch-Up Contributions will be credited to your Catch-Up Account and will always be fully vested. Example: Matt is 54 years old in Matt earns $90,000 during 2010 and has elected to defer 25% of his Compensation as Employee Contributions ($23,750). Under the IRS dollar limitations imposed for 2010, Matt s Employee Contributions would normally be stopped when his Employee Contributions reach $16,500. Consequently, the amount in excess of this limit ($23,750 - $16,500 = $7,250) will not be contributed to the Plan as Matt originally elected. If Matt elects to make a Catch-Up Contribution under the Plan, however, he may contribute an additional $5,500 on a pre-tax basis in 2010, bringing his total 403(b) deferrals for 2010 to $22,000. As a result, out of the $23,750 originally elected by Matt to be contributed to the Plan, only $1,750 will not be contributed because it is in excess of the combined limit of $22,000. Effective April 1, 2010, the Company will make a Matching Contribution on behalf of each employee who is eligible to receive Matching Contributions (prior to April 1, 2010, Matching Contributions were made at the discretion of the Company). Please see the Eligibility and Participation section for information about the eligibility requirements for Matching Contributions. If you are eligible for Matching Contributions, the Company will match 100% of the first 2% of your Compensation that you defer as Employee Contributions. Example: Sarah s 2010 Compensation is $50,000. Sarah chose to make 2010 Employee Contributions equal to 10% of her Compensation, or $5,000. Therefore, she is - 6 -
9 entitled to a Matching Contribution of $1,000. For purposes of Matching Contributions, your Compensation for a given Plan Year generally consists of your regular base salary or wages, commissions and bonuses for sales, production incentive payments, lump sum wage increases, bonuses, fringe benefits, reimbursements, parsonage allowances, donated leave and Carle Bonus Bucks that you receive from your Employer during the year that are included in your gross income. Your Matching Contribution Compensation will not include allowances for adoption or moving costs, settlement pay, tuition assistance, pension bonuses, non-cash payments and income you may receive from certain deferred compensation plans. Matching Contributions will be credited to your Matching Account, and may be limited to the extent necessary to meet nondiscrimination testing requirements imposed by the IRS. If necessary, Matching Contributions made on your behalf will be trued-up following the last day of the Plan Year to ensure that you are credited with the proper amount of Matching Contributions for such Plan Year. If you are a participant in the Plan, previously participated in a tax-qualified defined contribution plan or 403(b) retirement plan maintained by another employer, and you are entitled to receive a distribution of your benefits from that other plan, you may be able to roll that distribution into the Plan. To make such a Rollover Contribution, you must be either arrange to have such distribution transferred directly (and thereby avoid mandatory income tax withholding on the distribution from the other plan), or, if you receive the distribution in cash, you can contribute it to the Plan provided you do so within 60 days after you receive the amount to be rolled over. The Plan does not allow you to roll over after-tax contributions previously made to another Plan. A Rollover Contribution will not be permitted unless it satisfies all applicable requirements of the Internal Revenue Code (the Code ) and any other requirements that the Plan Administrator may establish. Rollover Contributions will be credited to your Rollover Account and will always be fully vested. In certain circumstances, the Plan Administrator may arrange for a direct transfer of assets from another plan to the Plan for an entire class of employees. A Transfer Contribution will not be permitted unless it satisfies all applicable requirements of the Code and any other requirements that the Plan Administrator may establish. Transfer Contributions will be credited to your Transfer Account and will always be fully vested. If you return to work for an Employer after a leave of absence for military service within the limits specified under the Uniform Services Employment and Reemployment Rights Act of 1994 ( USERRA ), your qualified military service may be considered service with the Employer, and you may be able to make up Employee Contributions and receive Matching Contributions for your period of qualified military service. If you think that you may be affected by this law, contact the Plan Administrator for more information
10 VESTING The term vested refers to the portion of your accounts that is nonforfeitable, and may be distributed to you regardless of the reason or time that you terminate employment with the Company. Your Employee Contributions, Catch-Up Contributions, Rollover Contributions, Transfer Contributions and Matching Contributions are always 100% vested. Vested or not, the value of your accounts may go up or down, depending on the earnings and losses of your Plan investments. Also, being vested does not mean that you can withdraw your accounts at any time. The time and manner of distributions are described in the Distribution of Benefits section. FORFEITURES All of your contributions to the Plan are 100% vested (non-forfeitable) at all times. Nevertheless, there are certain circumstances where benefits that you may have otherwise accrued will be forfeited: (1) if you receive Matching Contributions but are ineligible to receive them because you were admitted into the Plan in error; or (2) if you or your beneficiary are missing at the time of distribution, and cannot be located even after the Plan Administrator makes reasonable efforts to do so. If you or your beneficiary are later located or come forward, the amounts payable to you or your beneficiary will be reinstated. Any forfeited amounts will be used to reduce the amount the Employer would otherwise pay to the Plan in the form of Matching Contributions. HOW CONTRIBUTIONS ARE INVESTED All contributions to the Plan are held in an account maintained by the Plan Administrator with the assistance of the Custodial and/or Insurer. The Custodian is the financial institution selected by the Plan Administrator to hold and invest contributions to the Plan. The Insurer is any insurance company selected by the Plan Administrator to issue annuity contracts under the Plan. You may elect to have the value of your accounts invested in different investment options. You will be informed of the available investment options and may direct that your accounts be invested in one or more of the different funds. The Plan is intended to satisfy the requirements of Section 404(c) of the Employee Retirement Income Security Act of 1974 ( ERISA ) and, as a result, your Employer, the Plan Administrator and the Trustee may be relieved of liability for losses that are the direct result of your investment directions. If you do not make an investment election, your accounts will be invested in an investment fund chosen as the default investment fund. You have the right to transfer your assets into a different investment alternative available under the Plan at any time. Your investment election will be implemented as soon as administratively feasible following the election. Some restrictions, fees, and expenses may apply to such a transfer. The Plan Administrator will establish the procedures you must follow in directing your investments and uniform rules limiting the frequency, amount, or type of investments you may make. Your investment directions will remain in effect until you change or cancel them in - 8 -
11 accordance with the Plan and any additional procedures established by the Plan Administrator. When you direct investments, your accounts are segregated for purposes of determining the gains, earnings or losses on the investments. Your accounts do not share in the investment performance for other participants who have directed their own investments. It is hoped, of course, that the value of your accounts will increase because of earnings and gains on investments. It is possible, however, that the value of your accounts may decrease because of reductions in the market value of investments. In any event, as a result of gains, losses and Plan expenses, the value of your accounts will change from day to day and at any given time may be greater or less than the total contributions that have been made to your accounts. In directing the investments of your account, you should remember that the amount of your benefits under the Plan will depend in part upon your choice of investments. You will receive a written statement of the value of your account balance, which is based on your investment elections, after the close of each quarter or you may go online at www. abglogin.com to access your current account balance on demand. SERVICES AND FEES As permitted by law and as stated in the Plan document, certain reasonable administrative expenses of the Plan may be paid from the Plan s Trust, including certain expenses relating to the various investment funds. Generally, expenses attributable to a particular investment fund, such as investment management expenses within the fund, are paid exclusively from the assets of that fund and are allocated proportionately among the participant accounts invested in that fund. If you would like more information about fees associated with your investments, you may contact Alliance Benefit Group at or by calling (888) DISTRIBUTION OF BENEFITS If you terminate employment for any reason, including retirement, disability or death, you (or your beneficiaries in the event of your death) are entitled to receive distribution of your accounts under the Plan. The Plan provides the same distribution options and applies the same distribution rules to all accounts, regardless of whether the contributions in those accounts were made under the Plan or under a prior plan that merged into the Plan. The Plan Administrator (or its delegate) will review the account balances of participants who have terminated employment. After you terminate employment, you will be given the opportunity to elect to have your accounts distributed directly to you or as a direct rollover. If your total account balances do not exceed $5,000 and you do not make a timely distribution election, then your accounts will be distributed as follows: If the amount totals $1,000 or less, you will automatically receive a lump sum distribution of your vested accounts as soon as administratively feasible following your termination of employment with the Company
12 If the amount totals more than $1,000 but does not exceed $5,000, the Plan Administrator will deposit the amount into an individual retirement account ( IRA ), for your benefit, selected by the Plan Administrator. If your total account balances exceed $5,000 when you terminate employment, then your accounts will not be distributed without your consent, and you may elect to defer the distribution of your accounts until April 1 st of the year following the year in which you attain age 70½ or your severance from employment, whichever is later. You are entitled to receive a distribution of all of your vested account balances at any time after terminating employment with the Company, however, withdrawing your account balances prior to reaching the age of 59½ years may result in additional income tax penalties, unless you elect to roll the amounts over to an IRA or another employer s qualified plan. Under federal law, you must begin receiving distributions from your vested accounts no later than the April 1st of the later of: (1) the Plan Year following the year in which you turn age 70½, or (2) the Plan Year in which you terminate employment. You will be given the opportunity to designate a beneficiary or beneficiaries, who will receive the vested benefits you have not withdrawn from the Plan upon your death. Your beneficiary designation will not be effective unless received by the Plan Administrator before your death. If you are married, your beneficiary is automatically your spouse. If you want to designate a beneficiary other than your spouse, your spouse must consent to this designation by signing a form in front of a notary public. If you do not designate a beneficiary, or no designated beneficiary survives you, your benefits under the Plan will be paid to your eligible spouse, or if you are unmarried at the time of your death, to your estate. Once you have reached age 62, you may elect to receive a distribution of all or any part of your vested accounts, even if you are still employed by the Company or one of its affiliates. This distribution is called an in-service distribution. You may receive an in-service distribution after age 62 by submitting a request in accordance with the procedures the Plan Administrator has established. There is no limit on the number of in-service distributions you may take. If you have a financial hardship, you may be able to withdraw funds from part or all of the portion of your account balance representing your Employee Contributions (excluding certain earnings) before you reach age 62. A hardship withdrawal may be made only if you have an immediate and heavy financial need and the withdrawal is necessary to satisfy that financial need. A hardship withdrawal will be permitted if you have one of the following financial needs as defined by federal tax law: medical expenses incurred by you, your spouse or your dependents; the purchase of your principal residence (excluding mortgage payments); tuition payments, related educational fees, and room and board expenses for the next
13 months of post-secondary education for you or your spouse, children or dependents; payments necessary to prevent your eviction from your principal residence or foreclosure on the mortgage on your principal residence; payments for burial or funeral expenses for your deceased parent, spouse, children, or dependents; or expenses for repair of certain types of damage to your principal residence. You must show that the withdrawal is necessary because of an immediate and heavy financial hardship, that the amount to be withdrawn does not exceed the amount required by the hardship (plus any amounts necessary to pay federal, state or local income taxes or penalties reasonably anticipated to result from the withdrawal), and that such amount is not reasonably available from other sources, including other available distributions and loans from plans maintained by the Employer. To make a hardship withdrawal, you must file a request and complete any forms required by the Plan Administrator. If you make a hardship withdrawal, you may not make Employee Contributions for six months after you receive the hardship withdrawal. Any withdrawal from the Plan made before you reach 59½ years of age may result in additional income tax penalties, even if the withdrawal satisfies the requirements of a hardship withdrawal described above. Income tax withholding, in addition to a 10% penalty tax for early withdrawal, will be deducted from the amount of a hardship withdrawal you receive. WITHDRAWALS DURING QUALIFIED MILITARY SERVICE If you are performing certain qualified service in the uniformed services while on active duty for a period of at least thirty (30) days, you may be eligible to withdraw the portion of your account balance representing your Employee Contributions. If you make such a withdrawal, you may not make Employee Contributions for six months after you receive the withdrawal. PLAN TRANSFERS AND ALIENABILITY OF BENEFITS In general, you do not have the right to transfer all or any portion of your Plan accounts to any other 403(b) plan. However, you are permitted to request a direct rollover of your Plan accounts if you otherwise qualify to do so. Benefits under the Plan are not alienable. This means that you do not have the right to sell, donate, pledge, or otherwise give anyone any rights to your Plan accounts. Among other things, this means that you cannot give your rights under the Plan as security for a loan (other than a loan from the Plan). A court may, however, order that your accounts be paid to your exspouse (as part of a division of marital property) or children (as child support payments) through a Qualified Domestic Relations Order ( QDRO ) under the federal tax laws. Copies of the QDRO procedures for the Plan are available from the Plan Administrator. Absent a QDRO, your interest in the Plan is not subject to garnishment or other legal process for the payment of debt, and generally is not transferable by operation of law in the event of bankruptcy or insolvency. This prohibition on transferring your benefits does not apply to your designation of a beneficiary who will receive your Plan accounts if you die before you receive full distribution of all of your vested account balances
14 PLAN ADMINISTRATION The Plan is administered by the Plan Administrator. The current Plan Administrator is the Employee Benefit Committee. The Plan Administrator has general responsibility for administration of the Plan and for carrying out its provisions. The Plan Administrator has discretionary authority to interpret and apply all Plan provisions, and its decisions are binding on all participants and beneficiaries. The Plan Administrator may delegate one or more of these duties to its agents. Your account will be subject to the terms of a custodial agreement and/or an annuity contract and a Custodian and/or Insurer has been designated to hold and invest your account in accordance with your investment elections. The Company, the Company s Board of Trustees, the Plan Administrator, the individual members of the Committee, and the Chief Executive Officer of the Company are fiduciaries of the Plan. ERISA requires that such fiduciaries act solely in the interests of participants and beneficiaries of the Plan when making fiduciary decisions. The Company reserves the right to amend the Plan from time to time. The Company has delegated authority to the Plan Administrator and the Company s Chief Executive Officer to adopt certain amendments to the Plan. No amendment, however, can take away any of your benefits that you have earned under the Plan as of the date of the amendment or cause the Plan s assets to be used for purposes other than paying benefits to participants and beneficiaries or paying the Plan s reasonable administrative expenses. The Company intends to continue the Plan indefinitely, but reserves the right to terminate it by action of its Committee. If the Plan is terminated, you will become 100% vested in your accounts and Plan Administrator will cause your accounts to be distributed in the manner provided in this SPD as soon as practicable. Neither the Plan nor the SPD constitute a contract of employment, and participation in the Plan does not guarantee any employee the right to remain employed by the Company, nor will the Plan give rise to any right or claim to any benefit under the Plan unless that benefit is specifically provided under the Plan. CLAIMS PROCEDURES If you or your beneficiary believe that you are entitled to a benefit that has not been provided, or to a greater or different benefit than has been provided or you disagree with any other action taken by the Plan Administrator, the Plan provides claims and appeals procedures in compliance with federal law. All claims for benefits must be submitted in writing to the Plan Administrator in a form
15 approved of by the Plan Administrator in a form approved of by the Plan Administrator. The Plan Administrator will approve or disapprove all claims within 90 days unless it notifies you that it needs an additional 90 days due to special circumstances. If the Plan Administrator denies your claim, it will notify you of its reason in plain English. The notification will: (1) state specific reasons for the denial, (2) cite the Plan provisions on which the denial is based, (3) explain the procedure for reviewing the decision, (4) state that you have the right to bring a civil action under ERISA following a final denial on review and (5), if the claim is denied due to a lack of adequate information to reach a decision, state what information is needed to make a decision possible and why it is needed. If your application for benefits is denied, or if you receive less than that to which you think you are entitled, you may appeal to the Plan Administrator. Your appeal must be submitted in writing no later than 60 days after the earliest of the date on which you receive your notice of denial or the expiration of the 90 (or 180) day period within which the Plan Administrator is required to render its decision. You or your representative may submit any documents or written arguments in support of your claim. You may also request reasonable access to copies of documents, records and other information relevant to your claim. The Plan Administrator may hold a hearing, but it is not required to do so. The Plan Administrator will render its decision within 60 days after the appeal is filed, unless it notifies you that it needs an additional 60 days. If the Plan Administrator decides to uphold the denial of your claim, it will notify you of its reason in plain English. The notification will: (1) state specific reasons for the denial, (2) cite the Plan provisions on which the denial is based, (3) state that you have a right to receive upon request and free of charge, reasonable access to, and copies of, all documents relevant to your claims, and (4) state that you have the right to bring a civil action under ERISA following a denial on review. If you do not hear from the Plan Administrator within the 60 (or 120) day period, your appeal will be considered denied. The decision of the Plan Administrator will be final and conclusive. In order to file a lawsuit for benefits or actions under the Plan, you or your beneficiary must first follow the claims procedure described above. The Plan Administrator will address all communications, statements, or notices to you or, as applicable, your beneficiaries entitled to benefits under the Plan to the current post office address which you or, as applicable, your beneficiaries file, in writing, with the Plan Administrator. FEDERAL INCOME TAX CONSEQUENCES Under the tax laws in effect as of the date of this SPD, as long as the Plan complies with the requirements for plans with pre-tax employee contributions and employer contributions, the basic federal income tax consequences for participants are as follows: Contributions to the Plan, including any employee contributions that do not exceed the permissible limitations, are excluded from your taxable income until distributed to you or, as applicable, to your beneficiary(ies). No tax exclusions are allowed for employee contributions that exceed the permissible
16 limitations. Hardship withdrawals are subject to a 10% penalty tax if taken before age 59½. Distributions are subject to tax as ordinary income when received unless they are transferred directly to an IRA or qualified retirement plan or rolled, within 60 days of distribution, into an IRA or qualified retirement plan in accordance with applicable law. In addition, distributions made before the Plan Year in which you reach age 59½ (or age 55 if you have already separated from service) are generally subject to a 10% early distribution tax unless they are properly rolled into an IRA or another qualified plan or made on account of death, disability or another exception. Certain lump-sum distributions are subject to special income averaging rules, and certain distributions will be subject to income tax withholding unless transferred directly to an IRA or qualified retirement plan. You or, as applicable, to your beneficiary(ies), will receive a written explanation of the rules regarding income averaging and tax-free transfers and rollovers before your accounts are distributed. Generally, states do not tax plan distributions, but you should check the law in your state with your tax advisor. Because the tax rules governing distributions are complicated and subject to change, you should always consult your tax advisor concerning the specific tax consequences applicable to you. YOUR RIGHTS UNDER ERISA As a participant in this Plan you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all Plan participants shall be entitled to: Examine, without charge, at the Plan Administrator s office and at other specified locations, such as worksites, all documents governing the Plan, including the Plan document and Trust agreement and a copy of the latest annual report (Form 5500 Series) filed by the 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 all documents governing the operation of the Plan, including the Plan document and copies of the latest annual report (Form 5500 series) and updated version of this SPD. The Plan Administrator may make a reasonable charge for the copies. Receive a summary of the Plan s annual financial report. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report. Obtain a statement of your total accrued benefits and the vested (nonforfeitable) benefits you will be entitled to (if any) or the earliest date on which your benefits will become vested
17 (nonforfeitable). This statement must be requested in writing and is not required to be given more than once every twelve (12) months. The Plan must provide the statement free of charge. In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate the Plan, called fiduciaries of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. Your Employer may not fire you or otherwise discriminate against you in any way to prevent you from obtaining your benefits or exercising your rights under ERISA. Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of Plan documents or the latest annual report from the 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 your claim for a 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. In particular, 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 Federal court. In addition, if you disagree with the Plan s decision or lack thereof concerning the qualified status of a domestic relations order, you may file suit in Federal court. If it should happen that Plan fiduciaries misuse the 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. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous. If you have any questions about your Plan, you should contact Human Resources (acting on behalf of the Plan Administrator) for assistance. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from Human Resources (acting on behalf of 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
18 GENERAL INFORMATION Name of Plan Carle Foundation Hospital and Affiliates Matching TSA Plan Plan ID Number 002 Name and Address of Plan Sponsor Carle Foundation Hospital 611 West Park Street Urbana, IL (217) Employer s Taxpayer ID Number Plan Administrator Plan Administration Agent for Service of Legal Process Insurer/Custodian Recordkeeper Plan Year Carle Foundation Hospital Employee Benefit Committee 611 West Park Street Urbana, IL (217) The administration of the Plan will be handled by the Carle Foundation Hospital Employee Benefit Committee or its delegate(s). Among other responsibilities, the Committee will establish certain procedural rules that may change from time to time. Service of Legal Process may be made on the Carle Foundation Hospital Employee Benefit Committee at the address listed above. Charles Schwab Trust Company 211 Main Street 14 th Floor San Francisco, CA Alliance Benefit Group Twin Towers Office Plaza 456 Fulton Street Peoria, IL (888) January 1 st December 31st CH01/
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