VERITY HEALTH SYSTEM SUPPLEMENTAL RETIREMENT PLAN (TSA) SUMMARY PLAN DESCRIPTION December 14, 2015
To Our Associates Verity Health System ( Verity ) is pleased to provide the Verity Health System Supplemental Retirement Plan (TSA) (the Plan ). The Plan has been established to assist you in saving for retirement on a tax-deferred basis. Your personal financial security is one of life s most important objectives. Verity shares your goals and provides this Plan as one way to help you build a strong financial future. The Plan is intended to be a tax-sheltered annuity plan under section 403(b) of the Internal Revenue Code of 1986 (the Code ). Effective as of December 14, 2015, the Plan is subject to Title I of the Employee Retirement Income Security Act of 1974 ("ERISA") and is intended to constitute a plan described in Section 404(c) of ERISA. This booklet, known as a Summary Plan Description (SPD), summarizes the retirement benefits offered under the Plan, effective December 14, 2015.
Table of Contents FEATURES AND HIGHLIGHTS...1 How to Use This Booklet...1 Maintenance of the Plan...1 Plan Administration...1 Overview...1 ELIGIBILITY, PARTICIPATION, AND VESTING...2 Who Is Eligible...2 When May You Start Participating...2 Vesting...2 CONTRIBUTIONS...2 In General...2 How to Start Making Contributions...3 Maximum Contributions...3 Changing Your Contribution Election...3 Rollover Contributions...4 YOUR INVESTMENT CHOICES...4 Investment Managers...4 The Importance of Diversification...5 Keeping Track of Your Investments...6 Changing Your Investment Choices...6 IN-SERVICE WITHDRAWALS AND LOANS...6 Hardship Withdrawals...6 Loans...7 Age 59½...8 PAYMENT OF BENEFITS...8 When You Can Receive Benefits...8 Payment Methods...9 Death Benefits...9 CLAIMS PROCEDURES...10 OTHER THINGS YOU SHOULD KNOW...11 Plan Assets...11 How You Can Lose Benefits...11 Tax Treatment of Benefit Payments...11 Relationship with Social Security...11 Assignment or Transfer of Benefits...12 Your Rights under ERISA...12 Information Available...13 PLAN DIRECTORY...13 Name of Plan...13 Plan Number...13 Plan Year...13
Name and Address of Employer...13 Plan Sponsor...14 Employer Identification Number...14 Plan Administrator...14 Plan Investment Managers and Recordkeepers...14 Agent for Service of Legal Process...14 Type of Plan...14 Pension Benefit Guaranty Corporation...15 Employment Rights...15 More Information...15 -ii-
FEATURES AND HIGHLIGHTS How to Use This Booklet This booklet has been prepared to provide you with information regarding the core benefits you and your spouse or beneficiary may receive under the Plan. This booklet is intended to be a summary of features and highlights of the Plan, as in effect on December 14, 2015. Although care has been taken in the preparation of this booklet, it is not the official text of the Plan. In the event of an inconsistency between this booklet and the terms of the Plan, or to the extent that the Plan contains more complete or detailed information or rules, the terms of the Plan will prevail. Maintenance of the Plan While Verity intends to maintain the Plan indefinitely, it reserves the right at to terminate, amend or otherwise modify all or part of the Plan at any time. However, benefits under the Plan are always 100% vested, and no amendment may take away any benefits to which you are entitled on the date of the amendment. Plan Administration The Plan is administered by the Verity Health System Board of Directors or its delegate (the Administrator ), which is a named fiduciary for purposes of Section 402(a)(1) of ERISA with the authority to control and manage the operations and administration of the Plan and responsibility for complying with the reporting and disclosure requirements of ERISA. The Administrator has full discretionary power and authority to interpret and administer the Plan, in its sole discretion and in all respects, and its decisions will be final, conclusive and binding on all persons having an interest in or under the Plan. Transamerica Retirement Solutions ( Transamerica ), the Plan s investment manager and record keeper, maintains a record of all Plan participants accounts in accordance with the terms of the Plan. These records are maintained on a plan year basis. The plan year runs from January 1 through the following December 31. Overview This Summary Plan Description explains the main provisions of the Plan, as in effect on December 14, 2015. Generally, you can save up to the IRS limit each year by making before-tax contributions to your account under the Plan (your Account ). See Contributions below for more information about the IRS limits. You can direct the investment of your Account among the various investment options made available under the Plan. Any investment earnings accumulate in your Account on a tax-deferred basis. Your Account is payable to you upon your termination from employment with Verity and its affiliates for any reason, including for disability. Your Account is also available to you even -1-
while working if you are age 59½ or older or if you incur a financial hardship (regardless of your age), and is payable to your spouse or named beneficiary upon your death. Who Is Eligible ELIGIBILITY, PARTICIPATION, AND VESTING Only eligible employees may participate in the Plan. For purposes of this description, an eligible employee is an individual who works for pay for Verity or a Verity facility and is treated as a common law employee of Verity or that Verity facility for federal and state employment tax purposes. However, leased employees and persons whose employment is incidental to their educational program are not eligible to participate in the Plan. When May You Start Participating As soon as you begin work as an eligible employee of Verity or a Verity facility, you may start participating in the Plan by electing to make before-tax contributions to the Plan. These contributions are made through payroll deductions and commence only after you complete and submit the necessary salary deferral election forms. Your salary deferral election will become effective as soon as administratively feasible after making the election and will remain in effect until you change it. Vesting Vesting refers to your right to receive all or a portion of your Account balance when you terminate or retire. You are always 100% vested in your Account under the Plan. In General CONTRIBUTIONS Under the Plan, you can at any time choose to contribute either: A percentage of your eligible pay (for example, 5%), or A flat dollar amount of your eligible pay per payroll period (for example, $25). Eligible pay generally includes all cash wages that are included on your annual Form W-2, except that any severance payments made after termination of employment are not eligible pay under the Plan. Your annual contributions may not exceed the IRS limit, which is adjusted annually by the IRS. The general IRS limit is $18,000 for 2016. Plan participants who have reached (or will reach) age 50 before the end of the year may make additional contributions of up to $6,000 for 2016. If you have at least 15-years of service with Verity or one of its affiliates, you may also be able to -2-
make additional contributions of up to $3,000 per year (although any additional contributions you have made under this special rule in prior years may reduce this amount and a $15,000 lifetime maximum also applies). Your contributions will be deducted automatically from your pay each payroll period before state and federal income taxes are withheld, and will be deposited into your Account. Contributions are deducted from your pay before federal and state income taxes and are not considered part of your taxable income. For example, assume you earn $50,000 a year and elect to make a contribution to your Account of 5% of your pay, or $2,500. Your federal and state income taxes for the year would be based on your taxable income of $47,500 ($50,000 less your $2,500 contribution). You do not pay income taxes on your contribution (and associated earnings) as long as it remains in the Plan. While contributions lower your taxable income, they do not affect other benefits that are based on your pay, such as life and disability insurance coverage and retirement benefits under other Verity Health System retirement plans for which you may be eligible. In addition, contributions do not lower your Social Security taxes or your Social Security benefits. How to Start Making Contributions You can start making contributions by completing the necessary salary deferral election forms on-line. To make your salary deferral election, please visit Transamerica at verityhealth.trsretire.com or by calling (800) 755-5801, Monday Friday between 5:00am and 8:00pm PST. Your salary deferral election will become effective as soon as administratively feasible after making the election and will remain in effect until you change it. Maximum Contributions Under certain circumstances there are other contribution limits that apply. For instance, the maximum amount of contributions you can make under this Plan in any calendar year is reduced by contributions you make to any other 403(b) plan or tax qualified plan, such as a 401(k) plan, during the calendar year (this is most likely to happen in the year you are hired by Verity, when you may have already made contributions to another employer s plan in that year). The Plan s investment manager can help you determine the maximum amount that you may contribute in any year (for instance, if you are age 50 or more, or if you have 15 or more years of service with Verity and may be eligible to make additional contributions). But it is your responsibility to ensure that you do not exceed the legal maximum annual calendar limit since it affects your personal income tax returns. Changing Your Contribution Election You may change your contribution election (percentage of pay or flat dollar amount) at any time by notifying the Plan s investment manager and recordkeeper (See Your Investment Choices Investment Managers below). -3-
Rollover Contributions If you have participated in a tax-sheltered annuity program or other tax qualified plan under a previous employer (for instance, another employer s 403(b) plan or 401(k) plan) and you receive a distribution from that plan, you may be able to roll over the payment to the Plan. If you roll over 100% of this payment directly to the Plan from your previous employer's plan, you will defer paying taxes on it until withdrawal. In general, if the payment from the previous employer's plan is sent directly to you, you have 60 days from the date of receipt to roll it over. In accordance with applicable law, if the payment is sent directly to you, your former plan must withhold 20% of the payment amount and send it to the IRS as income tax withholding to be credited against your taxes. You then have the choice to roll over the remaining 80% and pay taxes on the 20% withheld, or if you want to roll over 100% of the payment, you must find other money to replace the 20% that was withheld. Investment Managers YOUR INVESTMENT CHOICES Your Account will be invested as you direct from among the investment options made available by the investment manager or managers selected by the Administrator from time to time. As of December 14, 2015, the Plan s investment manager and recordkeeper is Transamerica. (Certain previously accumulated assets are also held by former investment managers approved by the Administrator, but for simplicity s sake, this booklet refers by name only to Transamerica, and the information provided in this booklet generally applies equally to any former investment manager holding previously accumulated Plan assets.) The Administrator reserves the right to replace Transamerica and change investment managers from time to time. Transamerica will automatically provide you with detailed information regarding your available investment options and the procedures for making your investment selections once you become eligible to participate in the Plan. You may contact Transamerica at (800) 755-5801 or online at verityhealth.trsretire.com. You must make an investment election under this Plan. If you do not select your investment options under this Plan, your Account will be invested in the default investment option selected by the Administrator until you make your investment elections. As of December 14, 2015, the default investment option is the JPMorgan SmartRetirement Fund Select Share Class. You may obtain the following additional information concerning the investment options available under the Plan by contacting Transamerica at (800) 755-5801 or online at verityhealth.trsretire.com: A description of the annual operating expenses of each available investment fund (e.g., investment management fees, administrative fees, transaction costs) which reduce the rate of return to participants and beneficiaries, and the aggregate amount of such expenses expressed as a percentage of average net assets of the designated investment option; -4-
Copies of any prospectuses, financial statements and reports, and of any other materials relating to the investment funds available under the Plan, to the extent this information is provided to the Plan; A list of the assets comprising the portfolio of each investment option which constitute plan assets within the meaning of ERISA regulations, and additional information with respect to fixed income contracts; Information concerning the value of shares or units in each investment fund, as well as past and current investment performance of such alternatives, determined, net of expenses, on a reasonable and consistent basis; and Information concerning the value of shares of a mutual fund held in your Account. You are strongly urged to carefully read all descriptions and disclosure materials relating to the investment options under the Plan before you make your investment decisions. Any voting rights, tender rights, or other similar rights which are incidental to holding any interest in any investment fund will be passed through to you. The Plan intends to meet the requirements of Section 404(c) of ERISA, and accordingly offers you and your beneficiaries the opportunity to exercise control over the assets contributed and accumulated on your behalf under the Plan by allowing you to choose, from a broad range of investment options, the manner in which these assets will be invested and by providing you with information necessary to make informed decisions with respect to the investment options available under the Plan and the ownership rights that arise from those investments. As a result, fiduciaries of the Plan should generally have no liability for any losses that are the direct and necessary result of investment instructions given by you or your beneficiary, and you are responsible for any investment losses. The Importance of Diversification To help achieve long-term retirement security, you should give careful consideration to the benefits of a well-balanced and diversified investment portfolio. Spreading your assets among different types of investments can help you achieve a favorable rate of return, while minimizing your overall risk of losing money. This is because market or other economic conditions that cause one category of assets, or one particular security, to perform very well often cause another asset category, or another particular security, to perform poorly. If you invest too much of your retirement savings in any one company or industry, your savings may not be properly diversified. Although diversification is not a guarantee against loss, it can be an effective strategy to help you manage investment risk. In deciding how to invest your retirement savings, you should take into account all of your assets, including any retirement savings outside of the Plan. No single approach is right for everyone because, among other factors, individuals have different financial goals, different time horizons for meeting their goals, and different tolerances for risk. -5-
Keeping Track of Your Investments Every quarter, you will receive a statement from Transamerica showing your Account value, your contributions, and any withdrawal activity, as well as any gains or losses on your investments. It is important to periodically review your investment portfolio, your investment objectives, and the investment options under the Plan to help ensure that your investments remain adequately diversified and that your retirement savings will meet your retirement goals. Changing Your Investment Choices You may change the way your contributions are invested by visiting Transamerica at verityhealth.trsretire.com or by calling 800-755-5801. Changes received by Transamerica before 1:00 p.m. PST (4:00 p.m. EST) will generally be effective the same day. You may change the way your contributions are invested at any time. Please note that your investment choices under the Plan do not carry over to any other retirement plan offered by Verity. IN-SERVICE WITHDRAWALS AND LOANS Because the Plan is intended to help you save for retirement or other long-term financial goals, your ability to make withdrawals while you are still working is limited. However, the Plan does allow withdrawals of your contributions in the event of severe financial hardship. In addition, subject to the requirements of Transamerica and the rules described below, you may borrow money from your Account. You should be aware that the rules and limits on withdrawals and loans while you are employed by Verity are governed by the Internal Revenue Service and Transamerica. If you are married, your spouse must consent to any in-service or hardship withdrawal or loan before a notary public. Hardship Withdrawals You may request a withdrawal of your contributions (but not including any investment gains on those contributions, other than rollover contributions) if you have a severe financial hardship and you have already exhausted all other distribution and loan options available under the Plan. The following are considered severe financial hardships under the Plan: Purchase of your principal residence (excluding mortgage payments), Payment of uninsured medical expenses for yourself or a dependent, Tuition expenses for the next 12 months of post-secondary education for yourself, your spouse or a dependent, Payment to prevent eviction from or foreclosure on your primary residence, -6-
Payment for burial or funeral expenses for a deceased parent, spouse or dependent, or Certain qualifying expenses for repair or damage to your principal residence. You may only withdraw as much money as you need to meet the financial hardship, although you may include in that amount the local, state and federal income taxes reasonably anticipated to result from the withdrawal. To request a hardship withdrawal, you must complete a hardship withdrawal application. If you are married, your spouse must consent to the hardship withdrawal in writing before a notary public. All requests for hardship withdrawals are subject to the approval of the Administrator, and require proof of the severe financial hardship. You will need to certify the information provided on and with your application, and Verity, the Administrator and Transamerica will be entitled to rely on the accuracy of this information. If you provide any false or fraudulent information on or with your hardship application, Verity may take disciplinary action, including terminating your employment. Hardship withdrawals are generally considered ordinary income for tax purposes. In addition to income taxes, in most cases your withdrawal will also be subject to a 10% federal (and possible California state) penalty tax if you are under age 59½. If you are 59½ or older, you will not be required to pay penalty taxes, but ordinary income taxes will still apply. You should be aware that requests for hardship withdrawals may take several weeks to process. Please note that you will not be allowed to make any contributions under the Plan for a period of 6 months after receiving a hardship withdrawal. To restart your Plan contributions after that 6- month suspension period, you will need to contact Transamerica because your contributions will not restart automatically after the end of the 6-month period. Loans For specific information about your ability to take a loan against your Account, including information about applicable loan fees, you should check with Transamerica. In general, you may take a loan if you are an eligible employee and you may borrow up to 50% of your Account, up to a maximum of $50,000. While you may have up to two loans outstanding at a time, the maximum amount you may borrow will be reduced by your highest outstanding loan balance during the preceding 12-month period. The minimum amount you may borrow is $1,000. You must have an Account balance of at least $2,000 to take out a loan. You may request a loan for any reason by completing a loan application form, which is available from Transamerica. If you are married, your spouse must consent to the loan in writing before a notary public. Generally, you must repay your loan within five years, although your loan repayment period may be extended to 15 years if you use your loan to purchase your principal residence. Loan payments will be suspended if you are on authorized military service. You must repay the amount you have borrowed in full. You will also be charged interest on your loan amount. The interest rate is set and adjusted pursuant to the Plan s Loan Policy. -7-
For loans taken out on or after November 1, 2006, your loan repayments will be made through payroll deduction. If you terminated employment prior to August 1, 2014 at a time when you have a Plan loan outstanding, your unpaid loan balance will accelerate and become immediately due and payable. If you do not pay it back in full, the unpaid loan balance (together with accrued interest) will be deducted from your Account before any distribution of benefits is made. If you terminated employment on or after August 1, 2014 at a time when you have a Plan loan outstanding, your unpaid loan balance will remain subject to the same repayment schedule as in effect at the time of your termination of employment. You will be required to make repayments directly to the Plan through such means as may be permitted by Transamerica or as otherwise provided for in the Verity Loan Policy. If at any time following your termination of employment, you elect a distribution of your Account, any outstanding and unpaid loan balance will accelerate and become immediately due and payable. If you do not pay it back in full, the unpaid loan balance (together with accrued interest) will be deducted from your Account before any distribution of benefits is made. Age 59½ You may request a withdrawal of all or any portion of your Account after you reach age 59½ (without incurring a 10% federal (and possible state) tax penalty), even if you are still working at Verity or a Verity facility. If you are married, your spouse must consent to the withdrawal in writing before a notary public. When You Can Receive Benefits PAYMENT OF BENEFITS You can receive payment of your Account balance after you terminate employment from your facility and all other Verity employers for any reason. You may request payment of your Account as soon as administratively feasible following your last day of work, or you can defer the payment to a later date, as described below. If your total Account balance (including amounts with all investment managers under the Plan) does not exceed $1,000 at the time of your termination of employment, you will automatically receive a distribution of your entire Account balance in the form of a lump sum payment. If your total Account balance is more than $1,000, you can choose to delay a distribution, subject to the minimum required distribution rules which provide that you must begin payment of your Account no later than April 1 of the year following the year in which the later of the following events occurs: you terminate employment with all Verity employers, or you reach age 70½. -8-
To receive payment, you must complete and submit the appropriate forms required by Transamerica. You will need to certify the information provided on and with the forms, and Verity, the Administrator and Transamerica will be entitled to rely on the accuracy of this information. If you provide any false or fraudulent information on your distribution or other Plan forms, Verity may take disciplinary action or adjust your Plan benefits for accuracy. If you leave all Verity employers and later return, you will be eligible to make contributions to the Plan when you are rehired. Payment Methods Payment forms for your Account are subject to such rules, procedures, restrictions and conditions as the Administrator or Transamerica may prescribe. In general, however, you will have the choice of receiving payment in one or more of the following ways: As a single lump sum, In cash installments, payable at least annually, over a period of years selected by you, not to exceed the maximum period of years permitted by law, Purchase of an annuity contract to provide a monthly guaranteed income for a specified period certain, or In the form of an annuity for your life or the joint life of you and your spouse. If you are married, you must receive payment in the form of a joint and survivor annuity unless you elect otherwise and your spouse consents to a different form of payment before a notary public. A joint and survivor annuity pays a lifetime periodic benefit to you (usually this is a monthly payment), and after your death pays a periodic benefit to your surviving spouse during his or her remaining lifetime. The amount of the periodic benefit paid to you is smaller than the equivalent amount of a single lifetime annuity, to allow for payments to continue to your spouse after your death. The amount of the periodic benefit that is paid to your surviving spouse is at least 50% (but not more than 100%) of the periodic benefit payable during your lifetime. You will receive a more detailed explanation of your payment options from Transamerica Retirement Solutions upon your termination of employment. Death Benefits Once you join the Plan, you will be asked to name the person or persons (your beneficiary) who would receive your Account at your death. You do this by completing a beneficiary designation in a form and manner prescribed by the Administrator and Transamerica. Any such beneficiary designation will be effective only when properly completed and submitted during your lifetime. Generally, you can change your beneficiary designation at any time, subject to requirements that may be imposed by the Administrator and Transamerica. Each beneficiary designation that is properly completed and submitted will cancel all previous beneficiary designations. Please note that your beneficiary designation for the Plan does not carry over to any other retirement plan offered by Verity. -9-
If you are married, your spouse is automatically designated as your beneficiary. With your spouse s written consent before a notary public, you may designate someone else as your beneficiary. If you do not designate a beneficiary and you die before the full value of your Account has been paid, the remainder of the value of your Account will be distributed as follows: If you are not married, payment will be made to your estate. If you are married, payment will be made to your spouse; if your spouse is not living, payment will be made to your estate. If you elected an annuity form of payment prior to your death, the terms of that election will govern any payments after your death. The rules regarding the payment and taxation of death benefits are complex. Please check with your tax advisor for more information. CLAIMS PROCEDURES If you believe you are being denied any rights or benefits under the Plan, you may file a claim with the Administrator. If the claim is denied, in whole or in part, the Administrator will notify you, giving the specific reasons for the decision, including specific reference to the pertinent Plan provisions and a description of any additional material or information necessary to perfect the claim and an explanation of why that material or information is necessary. The notice will also advise you of your right to request a review of the claim, the steps that need to be taken if you wish to submit the claim for review, and your right to file suit in state or federal court if your claim on review is denied. The Administrator will notify you of its decision within 90 days after it receives the claim (or within 180 days, if special circumstances exist requiring additional time, and if you have been given a written explanation for the extension within the initial 90 day period). If your claim is denied, you may request an appeal of your denied claim. A request for appeal must be made by you or your duly authorized representative to the Administrator within 60 days after you receive the notice of denial. As part of the request, you (or your authorized representative) may submit issues and comments to the Administrator, review pertinent documents, and request a hearing. The Administrator s decision regarding your appeal will be made within 60 days after the request has been received (or 120 days if a hearing is held or if other special circumstances exist requiring more than 60 days and notice of the extension is provided to you within the initial 60 day period). Again, the decision will include specific reasons, including references to pertinent Plan provisions, and your right to file suit in state or federal court if your claim on review is denied. -10-
OTHER THINGS YOU SHOULD KNOW Plan Assets The assets of the Plan are held either in custodial accounts or under insurance company contracts, which are the sole source of all benefit payments. The custodial accounts and contracts do not belong to Verity or your facility. The assets of the custodial accounts and contracts are held exclusively to pay Plan benefits; they are not commingled with either Verity s or your facility s assets and they cannot revert to or be paid to Verity or your facility. In general, Transamerica or their custodians or trustees hold the assets of the Plan, execute all of the investments, maintain the financial records relating to the custodial accounts and contracts, and make all benefit payments as directed by the Administrator. How You Can Lose Benefits You cannot forfeit any part of your Account, as it is always 100% vested. However, keep in mind that your Account could decrease in value if the funds your Account is invested in suffer losses. Also, if required by a Qualified Domestic Relations Order (QDRO), all or a portion of your Account may be assigned to someone other than you or your beneficiary to satisfy payments for child support, alimony or marital property rights. Tax Treatment of Benefit Payments The Plan has been designed to meet Internal Revenue Code requirements to take advantage of special tax treatment. As a consequence, all amounts contributed to and any investment gains in your Account are not currently taxable to you while they are in the Plan. You are taxed only when you actually receive benefits from the Plan. The tax treatment of these benefits depends on when and how they are paid to you. In general, any payments you receive from the Plan will be subject to ordinary income tax. In addition to income taxes, if you receive payments before age 55 on account of your termination of employment, or before age 59½ while still employed, they may also be subject to a 10% federal (and possible state) early distribution penalty tax. You may be able to defer paying income taxes and the early distribution penalty tax on payments you receive from the Plan by depositing the payment into another employer s plan or an IRA. This is called a rollover, and it must generally be done within 60 days of your receipt of the payment. To avoid a required 20% withholding tax on lump sum distributions, you must elect to have your Account transferred directly to an IRA or another employer s plan. You may obtain from Transamerica a summary of the rules governing rollovers and the tax treatment of distributions. However, the tax treatment of distributions is quite complex and subject to change. Consult your tax advisor before you receive payments. Relationship with Social Security Benefits from the Plan are in addition to any benefits you may receive from Social Security. While Social Security benefits are reduced under current law if your earned income exceeds a -11-
specified limit when you are retired, your benefits under the Plan are not included in earned income, so they should not reduce your Social Security benefit at that time. Assignment or Transfer of Benefits Generally, your benefits, while still in the Plan, are not subject to the claims of creditors and may not be assigned or pledged as security for any loan. However, there is an exception to this general rule, which applies to qualified court orders for payments such as alimony, child support and the like, and as may otherwise be required or permitted by law. To the extent required by such a court order, the Administrator may be required to direct Transamerica to make payments from your account to alternate payees named in such a court order. You may obtain, without charge, a copy of the procedures for determining whether a domestic relations order is a qualified domestic relations order under the Plan. Please visit Transamerica on the internet at verityhealth.trsretire.com or by calling 800-755-5801. You may also contact the Verity Benefit Services Team at 888-333-1316 or veritybenefits@verity.org, or your local Human Resources Department. Your Rights under ERISA As a participant in the 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 Administrator s office and at other specified locations, such as work sites, all documents governing the Plan, including insurance contracts, collective bargaining agreements and copies of the latest annual reports (Form 5500 Series) filed with the U.S. Department of Labor. Obtain, upon written request to the Administrator, copies of all documents governing the operation of the Plan, including insurance contracts and collective bargaining agreements, copies of the latest annual reports (Form 5500 Series) and updated summary plan description. The Administrator may make a reasonable charge for the copies. Receive a summary of the Plan's annual financial report. The Administrator is required by law to furnish each participant with a copy of the summary of the Plan s annual financial report. In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of employee benefit plans. 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. 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 or exercising your rights under ERISA. If your claim for 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 materials 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 Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the -12-
materials were not sent because of reasons beyond the control of the 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 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 the Plan, you should contact the 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 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. 20210. Information Available If you have any questions about your Plan, you should contact Transamerica Retirement Solutions directly or meet with one of their on-site representatives. Transamerica s contact information appears below under the Plan Directory. You may also contact the Verity Benefit Services Team at 888-333-1316 or veritybenefits@verity.org, or your local Human Resources Department. Name of Plan PLAN DIRECTORY Verity Health System Supplemental Retirement Plan (TSA) (formerly known as the Daughters of Charity Health System Supplemental Retirement Plan (TSA)) Plan Number 003 Plan Year January 1 through December 31 Name and Address of Employer Verity Health System (formerly known as Daughters of Charity Health System) 203 Redwood Shores Parkway Redwood City, CA 94065-1199 -13-
Plan Sponsor Verity Health System (formerly known as Daughters of Charity Health System) 203 Redwood Shores Parkway Redwood City, CA 94065-1199 Employer Identification Number 91-2145484 Plan Administrator Verity Health System (formerly known as Daughters of Charity Health System) 203 Redwood Shores Parkway Redwood City, CA 94065-1199 (650) 551-6650 Plan Investment Managers and Recordkeepers Transamerica Retirement Solutions 440 Mamaroneck Avenue Harrison, NY 10528 (800) 755-5801 verityhealth.trsretire.com Lincoln Financial Group (only as to certain assets accumulated before November 1, 2006) P.O. Box 2340 Fort Wayne, IN 46801-2340 800-454-6265 www.lfg.com VALIC (only as to certain assets accumulated before November 1, 2006) 2929 Allen Parkway, L8-10 Houston, Texas 77019 800-448-2542 www.valic.com Agent for Service of Legal Process Legal/General Counsel Verity Health System (formerly known as Daughters of Charity Health System) 203 Redwood Shores Parkway Redwood City, CA 94065-1199 Type of Plan This Plan is a Code section 403(b) tax-sheltered annuity (TSA) plan. Benefits under the Plan are funded by payroll deduction contributions. Prior to December 14, 2015, the Plan was intended to -14-
qualify as a church plan within the meaning of Code Section 414(e) and Section 3(33) of ERISA and accordingly to be exempt from Title I of ERISA. The Plan was amended and restated effective as of December 14, 2015, as of which date Verity was no longer controlled by or affiliated with the Catholic Church. As a result, effective as of December 14, 2015, the Plan is no longer intended to be a church plan as described in Code Section 414(e) and, therefore, is subject to, and intended to comply with, Title I of ERISA. Effective as of December 14, 2015, the Plan is intended to constitute a plan described in Section 404(c) of ERISA. Pension Benefit Guaranty Corporation Benefits provided under the Plan are not insured by the Pension Benefit Guaranty Corporation (PBGC) under Title IV of ERISA because the insurance provisions are not applicable to this type of plan. Employment Rights Neither the Plan nor this summary creates an employment contract or any right to continued employment with Verity Health System or its facilities. More Information If you have any questions or concerns about the Plan, please contact Transamerica, the Verity Benefit Services Team at 888-333-1316 or veritybenefits@verity.org, or your local Human Resources Department. -15-