[Adopted 5-9-2006 by Ord. No. 2371[1]]
[1]
Editor's Note: This ordinance also adopted the related Integral Part Trust, appointing the Municipality as trustee, authorizing the transfer of $6,000,000 in Municipal retiree benefit funds into the Other Post Employment Benefit ("OPEB") Retiree Benefits Plan Trust. Said ordinance was amended 5-13-2008 by Ord. No. 2421 which formed and named a committee as trustee and included provisions for transfer of funds (which transfer was repealed 12-16-2008 by Ord. No. 2438) and for approval of the investment manager; Ord. No. 2447, adopted 1-13-2009, further established a funding policy and clarified the OPEB Integral Part Trust. Complete copies of the ordinances are on file in the Municipal offices. The Declaration of Trust of the Integral Part Trust is included as an attachment to this chapter.
A. 
Purpose. The purpose of this plan is to help provide life or medical insurance for each participating retiree, his or her spouse, and his or her eligible dependents. It is the intention of the Municipality that this plan qualify as an accident and health plan within the meaning of Internal Revenue Code § 105 and that the benefits payable under the plan be eligible for exclusion from gross income under that section.
B. 
Effective date. The provisions of this plan are effective as of June 1, 2006.
When used herein, the following words shall have the following meanings unless the context clearly indicates otherwise:
COLLECTIVE BARGAINING AGREEMENT
The collective bargaining agreement between the Municipality and a union that covers retiree medical benefits for union employees of the Municipality.
DEPENDENT
An individual who is a dependent as that term is used in IRC § 105(b). As of the date of adoption of this plan, a "dependent" was a dependent as defined in IRC § 152, determined without regard to IRC § 152(b)(1), (b)(2), and (d)(1)(B).
HIPAA
The Health Insurance Portability and Accountability Act of 1996, as amended from time to time. Reference to a specific provision of HIPAA shall include such provision, any valid regulation or ruling promulgated thereunder and any comparable provision of future law that amends, supplements or supersedes such provision.
IRC
The Internal Revenue Code of 1986, as amended.
MUNICIPALITY
The Municipality of Monroeville, Allegheny County, Pennsylvania.
PLAN
This plan as it shall be amended from time to time.
PLAN ADMINISTRATOR
The Municipal Manager or the person or entity designated by the Municipality to carry out administrative services as are necessary to implement the plan.
PLAN YEAR
The twelve-consecutive-month period ending on December 31. The first plan year began on the effective date specified in § 93-38 and ends on December 31, 2006.
RETIREE
An employee of the Municipality who terminated or terminates employment with the Municipality after meeting the conditions set forth in the applicable bargaining agreement (and for nonuniform, nonbargained employees, the applicable salary and benefits ordinance) in order to receive retiree medical insurance or life insurance.
[Amended 1-13-2009 by Ord. No. 2447]
SPOUSE
The retiree's lawful spouse as determined under the laws of Pennsylvania.
TRUST
The integral part trust that holds the assets of this plan.
TRUSTEE
The trustee or trustees of the integral part trust that holds the assets of this plan.
UNION
A union representing employees of the Municipality.
This plan covers retirees, their spouses, and their dependents. No other individual shall be entitled to benefits under this plan; provided that the Plan Administrator may direct that benefits be paid to other individuals if necessary to comply with a court order. Note, no individual shall be eligible for coverage under this plan unless under the applicable collective bargaining agreement (and for nonuniform, nonbargained former employees, the applicable salary and benefits ordinance) he is entitled to employer-provided retiree medical insurance or life insurance benefits.
A. 
The Plan Administrator shall direct the trustee to use trust funds to provide retiree medical, vision, dental, or life insurance benefits to retirees, their spouses, and their eligible dependents. Benefits must be provided through the purchase of insurance.
B. 
A former union employee shall not have any right to benefits under this plan other than retiree medical or life insurance benefits to which he is entitled under the terms of the applicable collective bargaining agreement. A former nonunion employee shall not have any right to benefits under this plan other than retiree medical or life insurance benefits to which he is entitled under the terms of his employment arrangement with the Municipality. Furthermore, notwithstanding the above, no retiree, spouse or dependent shall have any right to benefits under this plan unless there are funds in the trust sufficient to purchase insurance.
C. 
Benefits from another source. Notwithstanding § 93-41A and B, no person shall have any claim for benefits under this plan to the extent that he has received or is entitled to receive the same benefits under another plan, insurance policy, settlement, or other arrangement that is sponsored, funded, or provided by the Municipality.
Claims for benefits under this plan shall be made to the insurance companies on forms maintained by, and in accordance with procedures established by, the insurance companies.
A. 
Plan Administrator. The Plan Administrator shall have authority and responsibility to control and manage the operation and administration of this plan. The Plan Administrator shall have discretion to interpret the terms of the plan, and such interpretation shall be binding on all parties, subject to § 93-46.
B. 
Documents. The Plan Administrator shall keep a copy of this plan document and any other disclosure documents relating thereto (including, but not limited to, summary plan descriptions) that are in the public domain on file at his office where participants may inspect them during the Municipality's regular business hours. Upon request, the Plan Administrator shall provide a retiree, spouse, or covered dependent with copies of such documents. When the Plan Administrator provides such documents, the Plan Administrator may charge the requesting party a reasonable charge for photocopying these materials.
C. 
Conflicts between documents. This document contains all of the operative provisions of this plan. Any conflict between the provisions of this document and any other document purporting to explain the rights, benefits, or obligations of the parties hereunder shall be resolved in favor of this plan document. If there is a conflict between this plan and a collective bargaining agreement, this plan shall govern, but this section does not prevent a retiree (or spouse or dependent) from claiming benefits from the Municipality under an applicable collective bargaining agreement.
D. 
Agents and expenses. The Plan Administrator may employ agents to assist it in its duties and may rely upon the written certificates of any agent, counsel, accountant, investment manager, actuary or physician. The Plan Administrator shall be entitled to reimbursement from the trust (unless the Municipality at its discretion makes reimbursement) for all other proper charges and expenses incurred in carrying out its duties under this plan, including compensation of agents and payment of litigation costs. The Plan Administrator may be paid such reasonable compensation as shall from time to time be agreed upon in writing by the Municipality and the Plan Administrator. However, an individual serving as Plan Administrator who already receives full-time pay from the Municipality or who is a member of the governing body of the Municipality shall not receive compensation from the Trust except for reimbursement of expenses properly and actually incurred.
E. 
Uniformity of discretion. Wherever, under the provisions of this plan, the Plan Administrator is granted discretionary powers which shall affect the rights and benefits of participants, such discretion shall be exercised uniformly so that all participants similarly situated shall be similarly treated.
F. 
Indemnification. The Municipality shall indemnify the Plan Administrator and any individual who may be appointed pursuant to this section against any and all claims, losses, damages, expenses and liabilities arising from their duties and responsibilities pursuant to the provisions of this plan, unless the same is determined to be due to gross negligence or willful misconduct.
A. 
Amendment.
(1) 
Any or all of the provisions of this plan may be amended at any time and from time to time, in whole or in part, by an instrument in writing by the Municipality. No such amendment shall authorize or permit any part of the Trust (other than such part as is required to pay taxes and administration expenses) to be used for or diverted to purposes other than for the exclusive benefit of the retirees, their spouses, or their dependents; no such amendment shall cause or permit any portion of the trust to revert to or become the property of the Municipality; and no such amendment which affects the rights or duties of the trustee may be made without the trustee's written consent.
(2) 
The trust is intended to be an integral part trust in accordance with U.S. Treasury Regulation § 301.7701-1(a)(3). To the extent that any amendment is needed for the trust to be or remain an integral part trust, such amendment will be deemed to have been made on a timely basis.
B. 
Termination. This plan may be terminated at any time by the Municipality and, upon such termination, the trust shall be paid out by the trustee as and when directed by the Plan Administrator or the Municipality, in accordance with the provisions of the trust agreement and the terms of the plan. Notwithstanding § 93-45A, upon termination of this plan and upon the satisfaction of all liabilities under the plan to provide benefits or pay administrative expenses, any assets remaining in the trust shall be returned to the Municipality.
A. 
Source of funds. The trust shall constitute the sole source of funds that may be used to purchase insurance under the plan, and the trustee shall not be liable in any way or in any manner to purchase insurance beyond those monies that have been contributed to the trust.
B. 
Limited effect of plan and trust. Neither the establishment of the plan nor the trust nor any modification thereof, nor the creation of any fund or account, nor the payment of any benefits, shall be construed as giving to any person covered under the plan or other person any legal or equitable right against the trustee, the Municipality, or any officer or employee thereof, except as may otherwise be provided in the plan or in the trust. Under no circumstances shall the term of employment of any employee be modified or in any way affected by the plan or the trust.
C. 
Protective clause. Neither the Municipality nor the trustee shall be responsible for the validity of any contract of insurance issued in connection with the plan or trust or for the failure on the part of the insurer to make payments provided by such contract, or for the action of any person which may delay payment or render a contract null and void or unenforceable in whole or in part.
D. 
Construction of plan. This plan shall be construed and enforced according to the laws of the Commonwealth of Pennsylvania. If any provision of this trust shall be held illegal or invalid for any reason, such determination shall not affect the remaining provisions of the plan.
E. 
Gender and number. Wherever any words are used herein in the masculine, feminine or neuter, they shall be construed as though they were also used in another gender in all cases where they would so apply, and whenever any words are used herein in the singular or plural form, they shall be construed as though they were also used in the other form in all cases where they would so apply.
F. 
Headings. The headings and subheadings of this trust have been inserted for convenience of reference and are to be ignored in any construction of the provisions hereof.
G. 
Spendthrift. The interests and benefits under this plan of any participant, spouse or dependent shall not be subject to assignment, alienation, pledge, attachment, garnishment, sequestration or other legal process, or to the claims of creditors, except as required by law.
A. 
Continuation coverage. All persons whose health benefits would otherwise terminate may have rights to continuation coverage at their own expense due to a qualifying event described in IRC § 4980B. To the extent that the law or regulations require continuation coverage under this plan:
(1) 
Any participant eligible for continuation coverage shall be notified of such eligibility within the period of time that is the maximum allowable;
(2) 
All periods of coverage or election shall be for the minimum required by law; and
(3) 
Premiums may be chargeable at the maximum rate allowed by law.
B. 
HIPAA.
(1) 
Any benefit subject to HIPAA may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if:
(a) 
Such exclusion relates to a condition described in IRC § 9801(a)(1);
(b) 
Such exclusion extends for a period no greater than the period described in IRC § 9801(a)(2); and
(c) 
The period of any such preexisting condition exclusion is reduced by a period no less than the period described in IRC § 9801(a)(3).
(2) 
To the extent required by HIPAA, the Plan Administrator shall provide a certificate of creditable coverage, provide special enrollment periods for eligible participants, their spouses, and their dependents and meet the requirements otherwise mandated by HIPAA.