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| County of Kern Dependent Care Assistance Program I For Employees in Bargaining Units 1-8, and L |
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"DCAP I" SUMMARY PLAN DESCRIPTION |
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As an employee of the County of Kern ("County"), you may be eligible to participate in the County of Kern Dependent Care Assistance Program I ("DCAP I" or the "Plan") which is a component plan of the County of Kern$Flexible Spending Accounts Plan ("Kern$Flex I"). DCAP I Participants are eligible for reimbursements of eligible dependent care expenses. This document summarizes certain provisions of the official DCAP I plan document. For complete details and information, see the official DCAP I document. I. EMPLOYER AND PLAN ADMINISTRATOR Employer: Kern County, Telephone: (661) 868-3182 Employer I.D. Number: 95-6000925 Plan Administrator: County Administrative Officer Address: 1115 Truxtun Avenue, 5th Floor, Bakersfield, CA 93301 Plan I.D. Number: 501 II. AGENT FOR SERVICE OF LEGAL PROCESS: Name: Ronald M. Errea, County Administrative Officer, Telephone: (661) 868-3198 Address: 1115 Truxtun Ave., 5th floor, Bakersfield, CA 93301 III. ELIGIBILITY To participate in DCAP I an Eligible Employee must work 20 hours or more per week in a regular, budgeted position with the County which is regularly scheduled for half-time or more in the following classifications: employees represented by Kern Law Enforcement Association, Kern County Fire Fighters' Union Local 1301, Kern County Prosecutors' Association and/or Kern County Public Employees' Association (Bargaining Units 1-8, F, and L). IV. BENEFITS AND ENROLLMENT DCAP I provides for reimbursement of eligible dependent care expenses that you incur in order to work as provided under section 129 of the 1986 Internal Revenue Code, as amended ("IRC"). Contributions to DCAP I and reimbursements are made in accordance with your elections under DCAP I. The amount of such contributions is equal to the amount of reimbursements you elect to receive during the Plan Year and to your corresponding payroll deductions. Your reportable County income on your W-2 will be reduced by the amount of your DCAP I contribution for the calendar year. Elections are made during the annual open enrollment period which is the first Tuesday of September through the second Friday of November. Newly Eligible Employees may also enroll during their first 60 days of employment in an eligible position for the applicable Plan Year. A Participant may not revoke a Kern$Flex I/DCAP I election and/or make a new election after commencement of the Plan Year unless both the revocation and the newelection are on account of and consistent with a "change in family status" as described in the Plan. Additionally, Kern$Flex I/DCAP I Participants must re-enroll each year for elections to continue under DCAP I in subsequent Plan Years. Elections do not automatically renew at the end of the coverage period. If you elect to participate in DCAP I for a Plan Year, you must apply to: Hourglass Systems at 2307 N. Fine Ave. Fresno, CA 93727 for reimbursement of eligible expenses incurred by you for the care of an eligible dependent which enables you to be gainfully employed. The maximum amount of dependent care assistance that you may receive for one tax year is lesser of: (a) your earned income, (b) your spouse's earned income, (c) the amount you elect to receive under DCAP I, or (d) your actual payroll deductions under DCAP I. In no event may the maximum election exceed $5,000, or, if you are married and file a separate return, $2,500. If you elect participation in DCAP I, the minimum election is $5 per biweekly payroll period. V. CLAIMS PROCEDURE A claim for benefits under the Plan should be made by completing and filing the appropriate claim form with the flexible spending account administrator. No amount of reimbursement will be paid unless the name, address, and taxpayer identification number of the provider are submitted. Additionally, by participating, Participant agrees to include such information on the Participant's tax return as applicable. Claims for eligible DCAP I expenses paid must be filed on or before March 31 (or within 90 days of termination if participation ceases mid-year) for eligible DCAP I expenses incurred during the preceding Plan Year. Amounts not spent on eligible DCAP I expenses before the end of the applicable Plan Year and claimed by March 31 will be FORFEITED by the Participant. Flexible Spending Account Administrator contact information:
If your claim for benefits is denied, you may appeal to the Plan Administrator. You may appeal within 60 days after receipt of written notice of the denial by submitting a written request for review to the Plan Administrator. Appeals will be reviewed and determined by the Kern$Flex Advisory Committee. The Committee consists of at least three members who are appointed by the Kern County Board of Supervisors. A claimant may also submit a written statement of issues and comments concerning the claim and request an opportunity to review the Plan document, any Component Plan, and other pertinent documents. If so requested, the Plan Administrator shall make applicable documents available to the claimant at a convenient location during regular business hours within 30 days after receipt of such request. Time limits shall be strictly construed. The Advisory Committee shall render its final written decision, with the specific reasons therefor, and transmit it to the claimant by certified mail within 60 days of receipt of the request for review. If special circumstances require an extension of time, written notice of the extension shall be given to the Participant before the end of the original 60 day period, and a decision shall be rendered as soon as possible, but no later than 120 days after receipt of the request for review. VI. STATEMENT OF RIGHTS As a Participant, you are entitled to certain rights and protections. You may examine, without charge, that part of the records under Kern$Flex I and/or DCAP I which pertains to you, at the Plan Administrator's office at reasonable times during normal business hours. Upon written request and payment of photocopying charges, you may obtain a copy of the official plan document. For purposes of the applicable IRC sections, neither the benefits nor contributions provided under Kern$Flex I or DCAP I for any Plan Year shall discriminate in favor of Highly Compensated Employees. VII. OTHER INFORMATION The County makes no representations or warranties as to the tax consequences of your participation in DCAP I. The County advises you to consult your accountant or tax advisor as to your actual tax consequences as the result of your participation in DCAP I. The Plan Year begins January 1 and ends December 31 (calendar year). No assets are accumulated under the Plan. Reimbursements are paid out of the general assets of the County when due. Should any items in this Summary Plan Description conflict with information in the official DCAP I Plan document, the DCAP I Plan document will prevail. |
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