Medical Reimbursement Plan Document

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CENTENNIAL SCHOOL DISTRICT MEDICAL REIMBURSEMENT PLAN

______TABLE OF CONTENTS

ARTICLE I - INTRODUCTION 1.1 Adoption of the Plan 1.2 Effective Dates 1.3 Purpose

ARTICLE II - DEFINITIONS

ARTICLE III - PARTICIPATION 3.1 Eligibility 3.2 Limited Coverage under this Plan (Spouse covered under an HSA) 3.3 Commencement of Participation 3.4 Term of Participation 3.5 Treatment of Rehired Employees 3.6 Continuation Coverage 3.7 Family Medical Leave Act 3.8 Change in Participant Election 3.9 Medical Child Support Orders

ARTICLE IV – CONTRIBUTIONS AND BENEFITS 4.1 Funding 4.2 Benefits 4.3 Amounts Paid in Error 4.4 Nondiscrimination 4.5 Maximum Benefit 4.6 Forfeiture (Use-it-or-lose-it-Rule) 4.7 Grace Period for Qualified Expenses 4.8 Military Cash Out Option

ARTICLE V - PLAN ADMINISTRATION 5.1 Employer Duties 5.2 Information to be Provided to the Employer 5.3 Interpreting Plan Terms 5.4 Misstatements 5.5 Review Procedures 5.6 Rules to Apply Uniformly 5.7 The Privacy Rule 5.8 The Federal Security Rule

ARTICLE VII - GENERAL PROVISIONS 6.1 Amendment and Termination 6.2 Nonassignability 6.3 Not an Employment Contract 6.4 Participant Litigation 6.5 Addresses 6.6 Required Information 6.7 Severability 6.8 Applicable Law MEDICAL REIMBURSEMENT PLAN

ARTICLE I

INTRODUCTION

1.1 Adoption of the Plan. This Medical Reimbursement Plan has been adopted and executed by the Employer.

1.2 Effective Dates. The provisions of this Plan are effective on July 1, 2011. The Employer’s Medical Reimbursement Plan was originally effective July 1, 1999.

1.3 Purpose. The purpose of the Plan is to provide reimbursement for certain medical expenses of Participants not otherwise covered by insurance or by the Employer. The Employer intends that the Plan qualify as an accident and health plan under Section 105 and 106 of the Code, and that the nontaxable benefits provided under the Plan be eligible for exclusion from Participants' income under Section 105(b) of the Code. ARTICLE II

DEFINITIONS

As used in this Plan document, the following terms will have the following meanings:

2.1 "Change in Status" A Change In Status is an event that allows a Participant to change their contribution election during the Plan Year, and outside of the scheduled open enrollment period. The Employer has elected to allow all of the Change in Status reasons published by the IRS for this type of Plan.

2.2 "Code" the Internal Revenue Code of 1986, as amended.

2.3 "Compensation" all the earned income, salary, wages and other earnings paid by the Employer to a Participant during a Plan Year, including any amounts contributed by the Employer pursuant to a salary reduction agreement which are not includable in gross income under Sections 125, 402(g)(3), 402(h), 403(b) or 457(b) of the Code.

2.4 "Dependent" means an individual who is a dependent of a Participant within the meaning of Section 152(a) as modified by Section 105(b).

2.5 "Eligible Employee" an Employee, as defined below, who is eligible to participate in the Employer's health care program, limited to employees who regularly work at least 40 hours per week, and not including Employees who are Non-Resident Aliens (within the meaning of Section 7701(b)(1)(B) of the Code deriving no earned income (within the meaning of Section 911(d)(2) of the Code) from the Employer which constitutes income from sources within the United States (within the meaning of Section 861(a)(3) of the Code.

2.6 "Employee" a person who is currently or hereafter employed by the Employer, or by any other employer aggregated under sections 414(b), (c), (m), (n) or (o) of the Code and the regulations there under, including a Leased Employee subject to section 414(n) of the Code. Individuals who are not contemporaneously classified as Employees of the Employer for purposes of the Employer's payroll system (including, without limitation, individuals employed by temporary help firms, technical help firms, staffing firms, employee leasing firms, professional employer organizations or other staffing firms whether or not deemed to be "common law" Employees or "Leased Employees" within the meaning of Section 414(n) (o) of the Code) are not considered to be Eligible Employees of the Employer and will not be eligible to participate in the Plan. In the event any such individuals are reclassified as Employees for any purpose, including without limitation, common law or statutory employees, by any action of any third party, including, without limitation, any government agency, or as a result of any private lawsuit, action, or administrative proceeding, such individuals will notwithstanding such reclassification, remain ineligible for participation hereunder. Notwithstanding foregoing, the exclusive means for individuals who are not contemporaneously classified as an Employee of the Employer on the Employer's payroll system to become eligible to participate in this Plan is through an amendment to this Plan, duly executed by the Employer, which specifically renders such individuals eligible for participation hereunder.

2.7 "Employer" Centennial School District or any of its affiliates, successors or assignors which adopt the Plan.

2.8 "Participant" any Employee who has met the eligibility requirements of this Plan and has elected to participate in the Plan.

2.9 ""Plan Year" means the 12-consecutive month period, July 1st through June 30th.

2.10 "Qualified Expenses" medical expenses incurred during a Plan Year, or applicable Grace Period if any, by a Participant, the Participant's Spouse or the Participant's Dependents while the Participant is covered under this Plan. Medical expenses are only reimbursable to the extent allowed under the tax code. For purposes of the Plan, an expense is incurred on the date when the underlying services giving rise to the medical expenses are performed and not on the date that the services are billed by the service-provider or paid by the Participant.

2.11 "Salary Reduction Agreement" the agreement authorizing the Employer to reduce the Employee's Compensation while a Participant for purposes of obtaining Medical Reimbursement Benefits under this Plan.

2.12 "Spouse" an individual who is legally married to a Participant but will not include an individual separated from a Participant under a decree of legal separation. ARTICLE III

PARTICIPATION

3.1 Eligibility. Each Eligible Employee is eligible to participate in the Plan on their date of hire, or the date on which the Employee otherwise becomes eligible to participate as defined in this Plan Document or by applicable law, so long as the Employee is employed by the Employer on the day they are enrolled. The Employee’s election must be delivered to the Employer within 30 days of the date of hire.

3.2 Limited Coverage under this Plan (Spouse covered under an HSA). Section 1201 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, added Section 223 to the Internal Revenue Code to permit eligible individuals to establish Health Savings Accounts (HSAs) for taxable years beginning December 31, 2003. In order to allow an Employee’s Spouse to contribute to an HSA Account, an Employee is required to submit a written request to the Benefits Coordinator requesting “single” or “Parent and Child(ren)” enrollment in this Medical Reimbursement Plan. Qualified Expenses will be limited to covered services or supplies provided to the Employee and dependents that are not covered under the Spouse’s HSA. No claims for family members covered under the HSA can be submitted under this Plan.

3.3 Commencement of Participation. An Eligible Employee is required to execute a Salary Reduction Agreement setting forth the amount of pretax funds to be made available to the Eligible Employee for the immediately following Plan Year or remaining portion of the Plan Year. The Participant must, before the end of the first Plan Year of participation and, before the end of each subsequent Plan Year, provide the Employer with a newly executed Salary Reduction Agreement. Each new agreement will specify the amount to be made available to the Participant for the immediately following Plan Year. Should a Participant fail to execute a valid Salary Reduction Agreement for any Plan Year before the start of the Plan Year, the Participant will be ineligible to participate in the Plan for that Plan Year.

3.4 Term of Participation. Each Participant will be enrolled in the Plan for the entire Plan Year or the portion of the Plan Year remaining after enrollment, or until the earlier of:

(a) the Participant dies, resigns or terminates employment with the Employer;

(b) the Participant fails to make required contributions under the Plan;

(d) the Plan terminates; or,

(e) the Participant revokes their election under a Change In Status.

3.5 Treatment of Rehired Employees. A Participant whose employment terminates and is subsequently re-employed within 30 days of their separation of service and within the same Plan Year will immediately rejoin the Plan with the same Benefit elections.

Should the Participant return within 30 days of their separation of service during the following Plan Year, the Participant will be allowed to change elections through the Open Enrollment process.

A Participant whose employment terminates and who is subsequently re-employed with more than 30 days separation of service will need to re-satisfy Plan eligibility requirements to rejoin the Plan. Any unused reimbursement Benefits Accounts balance prior to the initial separation of service date will be forfeited. 3.6 Continuation Coverage. The Employer shall adopt rules relating to continuation coverage, as provided under the Public Health Services Act or applicable state law, as may be required from time to time, and shall advise affected individuals of the terms and conditions of such continuation coverage.

3.7 Family Medical Leave Act. FMLA leave will not be available to Employees for Plan Years in which the Employer has 50 or fewer Employees. For Plan Years in which the Employer has more than 50 Employees, the Employer is required to make FMLA leave available to eligible employees under circumstances that are prescribed by applicable federal law, including the Family and Medical Leave Act of 1993 (29 U.S.C. 2611) as amended.

Payment Option(s) for coverage while on unpaid Family Medical Leave Act leave for group plans:

(a) Pre-pay before commencement of leave through pre-tax or after-tax Salary Reduction Agreement from any taxable Compensation, including cashing out of unused sick or vacation days, provided all other plan requirements are met.

(b) Pay-as-you-go. Employees may pay their share of premium payments on the same schedule as payments would be made if the employee were not on leave, or under another schedule permitted under Department of Labor regulations.

The Employer will not be required to continue this Plan for an Employee who fails to make required premium payments while on FMLA leave. However, if the Employer chooses to continue the health coverage of an Employee who fails to make required premium payment while on FMLA leave, the Employer is entitled to recoup those payments after the Employee returns from FMLA leave.

If a Participant’s coverage under the Plan ceased while on FMLA leave, the Participant will be entitled to resume coverage upon return from leave on the same participation basis in effect prior to the leave, or as otherwise required under the FMLA. The Participant will be entitled to elect reinstatement in the Plan at the coverage level that was in effect before the FMLA leave, with increased contributions if necessary to reach their annual election. Or, the Participant can continue with the amount withheld from the Participant’s compensation on payroll-by-payroll basis equal to the amount withheld before the FMLA leave.

3.8 Change in Participant Election. No Participant will be allowed to alter or discontinue their annual election during a Plan Year except when due to and consistent with a Change in Status. Change In Status requests must be made within 30 days of the Change In Status event and must be consistent with the actual Change In Status event. A Participant will not be allowed to reduce their contributions below the amount they have already been reimbursed during the current Plan Year.

Upon the occurrence of a Change in Status, the Participant will file a new Salary Reduction Agreement, which will serve to revoke the Participant's previous Salary Reduction Agreement. The new Salary Reduction Agreement, if determined by the Employer to be timely submitted and consistent with the Status Change, will be effective prospectively and apply only to those Benefits accruing to the Participant after the effective date of the new Salary Reduction Agreement. The Employer will determine if the new Salary Reduction Agreement has been timely submitted consistent with the nature of the Change in Status.

3.9 Medical Child Support Orders. The Employer will adhere to the terms of any judgment, decree, or court order (including a court's approval of a domestic relations settlement agreement) which complies with federal or applicable state law. The Employer will comply with the administrative requirements described under 29 USC Sec. 1169 relating to Qualified Medical Child Support Orders (QMCSO), including any federal regulations or state laws relating to the same. When coverage is provided as directed by a QMCSO the Employee will become eligible to participate in this Plan in order to pay their share of the cost of the coverage on a pre-tax basis. ARTICLE IV

CONTRIBUTIONS AND BENEFITS

4.1 Funding. Contributions to the Plan are made and limited in accordance with the Participant’s annual election as stated on the Participant’s Salary Reduction Agreement. Contributions to the Plan will be accounted for as the Employer deems appropriate.

4.2 Benefits. Benefits will only be provided for the reimbursement of Qualified Expenses incurred by a Participant, a Participant's Spouse or a Participant's Dependents during the Plan Year and during the period in which the Employee is a Participant. Benefits are provided from the Employer’s general assets. The amount of the Participant’s annual election is available throughout the Plan Year.

A claim under this Medical Reimbursement Account can only be reimbursed if the Participant provides a written statement from an independent third party stating that the medical expense has been incurred, the amount of the expense, and a written statement that the medical expense has not been reimbursed or is not reimbursable under any other health plan coverage. If claims are submitted electronically, the Participant will sign a certification upon enrollment or acceptance of an electronic card that claims submitted under the card have not been reimbursed by any other insurance or self insured plan, and that the Participant is not seeking reimbursement under any other insured or self insured plan.

Each claim will be substantiated by the submission of a third party statement that shows that the claim is for a Qualified Expense, or by automated means that comply with guidelines established under IRS Rev. Rul. 2003-43.

The Employer will determine whether the claim is covered under the Plan within 30 days of receipt of the claim for reimbursement. To make the determination that a Qualified Expense subject to reimbursement has been incurred, the Employer will require proper evidence of the following:

(a) the name of the person or persons for whom the expenses have been incurred;

(b) the nature of the expenses incurred;

(d) the amount of the requested reimbursement; or

(e) that the expenses have not been otherwise paid through an insurance program offered by the Employer or any other employer, or reimbursed from any other source.

In the event of the death of the Participant prior to the payment of any claims, payment will be made in the following priority:

(a) Executor of the Estate of the deceased Participant,

(b) Spouse, or,

(c) Family member held responsible for payment of deceased's medical bills, 4.3 Amounts Paid in Error. Upon any benefit payment made in error, the Employer will inform the Participant that they are required to repay the amount that has been paid to or on the behalf of a Participant in error. This includes and is not limited to amounts over the Participant’s annual election, amounts for services that are determined not to be Qualified Expenses, or when a Participant does not provide adequate documentation to substantiate a claim upon request. The Employer may take reasonable steps to recoup such an amount including reducing the amount of future benefit reimbursements by the amount paid in error.

4.4 Nondiscrimination. The Plan is not intended to discriminate in favor of highly compensated individuals as to eligibility to participate, contributions and benefits in accordance with applicable provisions of the Code. The Employer may take such actions as excluding certain highly compensated employees from participation in the Plan if, in the Employer 's judgment, such actions serve to assure that the Plan does not violate applicable nondiscrimination rules.

4.5 Maximum Benefit. A Participant will be entitled to benefits under the Plan for a Plan Year in an amount that does not exceed the Participant's annual election. The amount of a Participant's annual election will be uniformly available during the Plan Year. Notwithstanding any other provisions of this Plan, no Participant will receive Medical Reimbursement Benefits in excess of $2500 per Plan Year.

4.6 Forfeiture (Use-it-or-lose-it-Rule). A Participant forfeits the amount of their annual election that is in excess of the amount of claims reimbursed for Qualified Expenses rendered during any Plan Year. A Participant who is covered on the last day of any Plan Year can submit eligible claims up to the last day of the fourth month following the end of the Plan Year. A Participant who terminates coverage prior to the last day of any Plan Year has 120 days from the date of termination to submit eligible claims..

Upon such forfeiture, the Participant's accrual will be reduced to zero.

Forfeited funds can be reallocated to Participants in any reasonable manner that has no relation to prior claims history or applied towards the cost of administering the Plan.

4.7 Grace Period For Qualified Expenses. Claims for Qualified Expenses are eligible for reimbursement when the services are rendered during the Grace Period. The Grace Period extends two and one half months after the last day of the Plan Year. The last day of the Grace Period is the fifteenth day of the third month following the end of the Plan Year. Services that are rendered after the last day of the Grace Period will not be considered for reimbursement under the prior Plan Year.

A Participant must be enrolled on the last day of the Plan Year in order for this Grace Period to apply.

Medical services that qualify for reimbursement and are rendered during the Grace Period will be reimbursed using any remaining amount in the prior Plan Year annual election first, and then reimbursed from any new Plan Year annual election.

If a Participant terminates coverage under the Medical Reimbursement Plan for any reason prior to the last day of the Plan Year, then the Participant will not be able to submit any claims for services that were rendered after the date of termination. The Grace Period rules described above will not be available.

4.8 Military Cash Out Option. A Participant in the Plan will receive a Qualified Reservist Distribution upon written request provided to the Benefits Coordinator. A Qualified Reservist Distribution means a distribution to a Participant of all or a portion of the Balance in the employee’s account under the Plan, if:

(a) a Participant was (by reason of being a member of a reserve component (as defined in section 101 of title 37, United States Code)) ordered or called to active duty for a period in excess of 179 days or for an indefinite period; and, (b) the distribution is requested and made during the period beginning on the date of such order or call and ending on the last date that reimbursements could otherwise be made under the Plan for the Plan Year in which the Participant received the order or call.

The Balance that can be distributed is limited to the amount of the Participant’s actual payroll deductions made as of the date of the request, less any amount that has already been disbursed for valid claims submitted. A request for a Qualified Reservist Distribution after the period defined under Paragraph B will be denied. ARTICLE V

PLAN ADMINISTRATION

5.1 Employer 's Duties. The Employer will have full and complete discretion to determine eligibility for participation and benefits under this Plan, including, without limitation, the determination of those individuals who are deemed Employees of the Employer (or any controlled group member). The Employer 's decision will be final, binding and conclusive on all parties having or claiming a benefit under this Plan. This Plan is to be construed to exclude all individuals who are not considered Employees for purposes of the Employer's payroll system, and the Employer is authorized to do so, despite the fact that its decision may result in the loss of the Plan's tax qualification.

In addition, the Employer has the discretionary authority to interpret the Plan in order to make eligibility and benefit determinations as it may determine at its sole discretion. The Employer also has the discretionary authority to make factual determinations as to whether any individual is eligible and entitled to receive any benefits under the Plan.

The Employer is responsible for the administration of the Plan. In addition to any rights, duties or powers specified throughout the Plan, the Employer will have the following rights, duties and powers:

(a) to interpret the Plan, to determine the amount, manner and time for payment of any benefits under the Plan, and to construe or remedy any ambiguities, inconsistencies or omissions under the Plan;

(b) to adopt and apply any rules or procedures to insure the orderly and efficient administration of the Plan;

(d) to develop appellate and review procedures for any Participant, Spouse, Dependent or beneficiary denied benefits under the Plan;

(e) to provide the Employer with such tax or other information it may require in connection with the Plan;

(f) to employ any agents, attorneys, accountants or other parties (who may also be employed by the Employer) and to allocate or delegate to them such powers or duties as is necessary to assist in the proper and efficient administration of the Plan, provided that such allocation or delegation and the acceptance thereof is in writing;

(g) to report to the Employer, or any party designated by the Employer, after the end of each Plan year regarding the administration of the Plan, and to report any significant problems as to the administration of the Plan and to make recommendations for modifications as to procedures and benefits, or any other change which might insure the efficient administration of the Plan.

However, this is not meant to confer upon the Employer any powers to amend the Plan or change any administrative procedure or adopt any other procedure involving the Plan without the express written approval of the Employer regarding any amendment or change in administrative procedure, or benefit provider. Notwithstanding the preceding sentence, the Employer is empowered to take any actions he sees fit to assure that the Plan complies with the nondiscrimination requirements of Section 105 of the Code. 5.2 Information to be Provided to the Employer . The Employer, or any of its agents, will provide to the Employer any employment records of any employee eligible to participate under the Plan. Such records will include, but will not be limited to, any information regarding period of employment, leaves of absence, salary history, termination of employment, or any other information the Employer may need for the proper administration of the Plan. Any Participant or Dependent or any other person entitled to benefits under the Plan will furnish to the Employer his correct post office address, his date of birth, the names, correct addresses and dates of birth of any designated beneficiaries, with proper proof thereof, or any other data the Employer might reasonably request to insure the proper and efficient administration of the Plan.

5.3 Interpreting Plan Terms. Subject to applicable State or Federal law, any interpretation of any provision of this Plan made in good faith by the Employer and any determination by the Employer as to any Participant's rights or benefits under this Plan is final, shall be binding upon the parties and shall be upheld on review, unless it is shown that such interpretation or determination was an abuse of discretion (i.e., arbitrary and capricious).

5.4 Misstatements. Any misstatement or other mistake of fact will be corrected as soon as reasonably possible upon notification to the Employer and any adjustment or correction attributable to such misstatement or mistake of fact will be made by the Employer as he considers equitable and practicable.

5.5 Review Procedures. In cases where the Employer denies a benefit under this Plan for any Participant, Spouse or Dependent or any other person eligible to receive benefits under the Plan, the Employer will furnish in writing to said party the reasons for the denial of benefits. The Plan Administrator will establish and maintain a procedure that allows for a full and fair review of any adverse benefit determination as specified by the Department of Labor under 29 CFR 2560-503.1.

5.6 Rules to Apply Uniformly. The Employer will perform his duties in a reasonable manner and on a nondiscriminatory basis and will apply uniform rules to all Participants similarly situated under the Plan.

5.7 The Privacy Rule. Protected Health Information (“PHI”): means: information that is created or received by the Employer and relates to the past, present, or future physical or mental health or condition of a Participant; or, the provision of health care to a Participant; or the past, present, or future payment for the provision of health care to a Participant; and that identifies the Participant. The test is whether there is a reasonable basis to believe the information can be used to identify the Participant. PHI includes information of persons living or deceased.

Access To PHI: The Employer’s access to PHI is restricted to the minimum information necessary to administer the Medical Reimbursement Account. This includes obtaining Participant elections and reimbursements for payroll administration. The Employer will have access to PHI that was submitted for claims reimbursement when that claim is on an appeal from an adverse decision. Only the Benefits Coordinator and employees trained in the federal privacy rule will have access to the PHI.

Permitted And Required Uses And Disclosures Of PHI By The Employer: The Employer can only use and disclose PHI for plan administration functions as permitted and required by this Plan Document, or as required by law. The Employer will not use or disclose PHI for employment-related actions or in connection with any other employee benefit plan. When necessary, the Benefits Coordinator will disclose the PHI to consultants and experts as required by the Department Of Labor for a full and fair review or to perform plan non-discrimination testing as required by law.

Complaints: If a Participant has any complaints regarding the way that the Employer has handled PHI they can complain to the Benefits Coordinator. No response from the Benefits Coordinator is required. A copy of this complaint procedure shall be provided to the Participant upon request. The Benefits Coordinator will keep a copy of the complaint, applicable documentation, and disposition if any, for a period of 6 years from the end of the plan year in which the act occurred. No Retaliation: No Employee will intimidate, threaten, coerce, discriminate against, or take other retaliatory action against Participants for exercising their rights, filing a complaint, participating in an investigation, or opposing any improper practice under the federal Privacy Rule.

Firewall: The Employer will implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the protected health information that it creates, receives, maintains, or transmits on behalf of the group health plan; and ensure that any agent, including a subcontractor, to whom it provides this information agrees to implement reasonable and appropriate security measures to protect the information.

Employer will: 1) Ensure that any subcontractors or agents to whom the Plan Sponsor provides PHI agree to the same restrictions described above, 2) report to the health plan any use or disclosure that is inconsistent with this Plan Document or the federal Privacy Rule, 3) make the PHI information accessible to the Participants, 4) allow Participants to amend their PHI, 5) provide an accounting of its disclosures of PHI as required by the Privacy Rule, 6) make its practices available to the Secretary for determining compliance, and, 7) return and destroy all PHI when no longer needed, if feasible.

5.8 The Federal Security Rule This Term is intended to bring the Plan into compliance with the “HIPAA Security Rule” as published on February 20, 2003 by the United States Department of Health and Human Services (HHS), and amended, including the final Security Standards under the Health Insurance Portability and Accountability Act of 1996.

The Electronic Media contemplated by the HIPAA Security Rule includes:

(a) Electronic storage media including memory devices in computers (hard drives) and any removable/transportable digital memory medium, such as magnetic tape or disk, optical disk, or digital memory card; or

(b) Transmission media used to exchange information already in electronic storage media. Transmission media include, for example, the internet (wide-open), extranet (using internet technology to link a business with information accessible only to collaborating parties), leased lines, dial-up lines, private networks, and the physical movement of removable/transportable electronic storage media. Certain transmissions, including of paper, via facsimile, and of voice, via telephone, are not considered to be transmissions via electronic media, because the information being exchanged did not exist in electronic form before the transmission.

In order to send and receive Protected Health Information (“PHI” as defined in the Plan Document) necessary for Plan administration by Electronic Media, the Employer will:

(a) implement reasonable and appropriate safeguards for electronic PHI created, received, maintained or transmitted to or by the Employer on behalf of the group health plan;

(b) ensure that electronic “firewalls” are in place to secure the electronic PHI;

(d) report to the group health plan any security incident of which it becomes aware. ARTICLE VII

GENERAL PROVISIONS

6.1 Amendment and Termination. The Employer may amend or terminate this Plan at any time by legal action of the authorized agents of the Employer, subject to the limitation that no amendment will change the terms and conditions of payment of any benefit to a Participant, Spouse, Dependent or designated beneficiary was entitled to under the Plan at the time of the amendment or termination. The Employer may make amendments apply retroactively to the extent necessary so that the Plan remains in compliance with Section 105 of the Code or any other provision of the Code applicable to the Plan.

6.2 Nonassignability. Benefits under this Plan are nonassignable. Benefits are for the exclusive benefit of Participants, Spouses, Dependents and beneficiaries. No benefit will be voluntarily or involuntarily assigned, sold or transferred.

6.3 Not an Employment Contract. This Plan is not an employment contract, the Employer in no way guarantees employment for any employee or Participant. Participation in this Plan will in no way assure continued employment with the Employer.

6.4 Participant Litigation. In any action or proceeding against the Plan, or the administration thereof, employees or former employees of the Employer or any other person having or claiming to have an interest under the Plan will not be necessary parties to such action or proceeding. The Employer, the Employer, or their registered representatives will be the sole source for service of process against the Plan. Any final judgment which is not appealed or appealable will be binding on the Employer and any interested party to the Plan.

6.5 Addresses. Each Participant will provide the Employer with his or her correct post office address. Any communication, statement or notice addressed to a Participant at his last post office address as filed with the Employer will be binding on such person. The Employer will be under no legal obligation to search for or investigate the whereabouts of any person benefiting under this Plan. Any notice required under the Plan may be waived by such person entitled to such notice.

6.6 Required Information. Each Participant, Spouse or Dependent will furnish to the Employer such documents, evidence or information as the Employer considers necessary or desirable to ensure the efficient operation and administration of the Plan and for the protection of the Employer.

6.7 Severability. In any case where any provision of this Plan is held to be illegal or invalid, such illegality or invalidity will apply only to that part of the Plan and will not apply to any remaining provisions of the Plan, and the Plan will be construed as if such illegal or invalid provision had never existed under the Plan.

6.8 Applicable Law. The Plan will be governed by the Internal Revenue Service Code and the regulations promulgated by the Internal Revenue Service, and other applicable federal laws. Executed this ______day of ______, ______.

Employer: Centennial School District

By: ______Polly Moore, Esq., Director of Human Resources