R2009-100 ESTABLISHING RETIREMENT HEALTH SAVINGS PLAN

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Plan# 803093 Agreement. Execution,delivery, and performance of this Agreement will not conflict with any law,rule,regulation or contract by which the Employer is bound or to which it is a party. (d) Information required to be retained by the Employer shall be set forth in the RHS plan materials developed by ICMA-RC and provided to the Employer. (e) Employer is responsible for determining that there are no state or local laws that would prohibit it from establishing ICMA-RC's VantageCare RHS program. Employer is also responsible for deternuning that the investments selected for the RHS plan fall within state/local requirements. (� Employer acknowledges that the RHS plan may be treated as a "health plan" for Health Insurance Portability and Accountability Act ("HIPAA") purposes and therefore may be subj ect to HIPAA privacy rules.If it is deternuned that the RHS plan is considered a"health plan", an employer sponsoring RHS would be responsible for complying with the HIPAA privacy and security rules regarding protected health information of RHS plan participants. ICMA-RC has procedures in place to safeguard the protected health information of RHS plan participants. 4. Participation in Certain Proceedin�s The Employer hereby authorizes ICMA-RC to act as agent,to appear on its behalf, and to join the Employer as a necessary party in all legal proceedings involving the garnishment of benefits or the transfer of benefits pursuant to a medical child support order. Unless Employer notifies ICMA-RC otherwise, Employer authorizes ICMA-RC to determine whether disbursement of benefits to a former spouse, spouse or child pursuant to a medical child support order is appropriate. 5. Compensation and Pa� (a) Absent an explicit agreement to the contrary between ICMA-RC and Employer,participant fees and expenses shall be payable from RHS assets,in accordance with the requirements of the RHS Plan as set forth below. (i) Employer with ICMA-RC §401 and §457 retirement plan average participant account balances of$25,000 or more: A $30 annual account fee will be charged to each Accountholder's account upon attainment of Benefit Eligibility by the Accountholder. Benefit Eligibility shall be transmitted electronically to ICMA-RC by Employer through the EZ Link System. Benefit Eligibility shall mean the quarter in which the Accountholder becomes eligible to use of the account for reimbursement of inedical expenses under the - 4 -