JPS Industries, Inc. SUMMARY PLAN DESCRIPTION For The Flexible Benefits Program Dependent Care Spending Account Program Health Care Spending Account Program Amended and Restated Effective January 1, 2004
The
Flexible Benefits Program
Expenses for insurance,
health care, or day care costs may consume a significant portion of your yearly
budget. JPS Industries, Inc. (“JPS”) has
adopted several benefit plans which, taken together, are designed to help
provide you and your family with financial assistance in meeting these
expenses.
JPS sponsors three
related benefit plans for its employees:
JPS
Industries, Inc. Flexible Benefits Program
JPS
Industries, Inc. Dependent Care Spending Account Program
JPS
Industries, Inc. Health Care Spending Account Plan
This booklet describes
the terms and benefits of these plans as of January 1, 2004. The JPS Industries, Inc. Flexible Benefits
Program acts as an "umbrella" over several pretax benefit options,
such as coverage under one of the Corporation's Group Medical Plans or Other
Group Insurance Plans. The JPS
Industries, Inc. Dependent Care Spending Account Program and the JPS
Industries, Inc. Health Care Spending Account Program, which are under the
umbrella, offer you the option to use before-tax dollars to pay certain
expenses which you would otherwise pay with after-tax dollars. This plan structure provides you with a
substantial reduction in the cost of each benefit. For purposes of this summary plan description, the JPS
Industries, Inc. Flexible Benefits Program and its underlying expense
reimbursement plans will be collectively referred to as the "Flexible Benefits
Program" or the "Plan," unless the context indicates reference
to a specific plan.
Under the Plan, you will
be able to choose benefits that best fit your needs and those of your
family. You may purchase benefits or be
reimbursed for benefit expenses with a portion of your income before federal income
or social security taxes are withheld.
The money you set aside is also exempt from most state income taxes and,
in some cases, local income taxes.
Because your taxable income is reduced, you pay less in taxes--and that
can mean more money for you to spend or save.
JPS wants you to be able
to take advantage of every available benefit under the Plan to the extent
appropriate for your situation. To do
this, you must understand the many options available to you. This summary plan
description is intended to present a general and informative overview of the
Plan. You should read it carefully so
that you understand the provisions of the Plan and the benefits available to
you. We want you to be fully informed
before you enroll in the Plan and while you are a Participant. You should direct any questions you have to
the Plan Administrator.
There are Plan documents on file with the Plan Administrator
which you may review if you desire. All
matters of Plan administration are, in all respects, governed by the Plan
documents. In the event there is a
conflict between this summary plan description and the Plan documents, the Plan
documents will control. JPS Industries, Inc. reserves the right to change or
discontinue the Plan at any time.
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Table of
Contents |
Flexible Benefits Program at a Glance........................................................................... 1
Joining the Plan........................................................................................................................ 3
Who is eligible to join the Plan?................................................................................................ 3
When may I join the Plan?........................................................................................................ 3
When are the election periods for our
Plan?.............................................................................. 4
What is the enrollment procedure?............................................................................................ 4
May I change my elections during the plan
year?....................................................................... 4
When will my participation in the Plan
end?............................................................................... 7
What happens if my employment ends during
a plan year?......................................................... 7
Contributions............................................................................................................................. 8
How are Group Medical Plan and Other
Group Insurance Plan contributions made?.................. 8
How are health care spending account and
dependent care spending account
contributions made?............................................................................................................. 8
How much may I elect to contribute to the
Plan?....................................................................... 8
Do limitations apply to participants who
are highly compensated?.............................................. 9
Will my reimbursement accounts earn
interest?........................................................................ 10
What if I don’t spend the entire amount in
my reimbursement accounts?................................... 10
Qualified Expenses................................................................................................................ 11
Health Care Spending Account............................................................................................... 11
Dependent Care Spending Account........................................................................................ 12
Pretax Premium Payment........................................................................................................ 13
Request for Reimbursement.............................................................................................. 14
How do I request reimbursement of health
care or dependent care expenses?......................... 14
What if my request for reimbursement is
denied?..................................................................... 15
COBRA Continuation Coverage..................................................................................... 18
What is “COBRA continuation coverage”?............................................................................. 18
Who are “Qualified Beneficiaries”?......................................................................................... 18
What is a “Qualifying Event”?................................................................................................. 18
Which Qualified Beneficiaries are eligible
for COBRA continuation coverage?......................... 19
What notices are required for COBRA
continuation coverage?............................................... 19
How do I elect COBRA continuation
coverage?..................................................................... 19
How long can a Qualified Beneficiary
continue COBRA coverage?......................................... 19
Your Rights Under ERISA................................................................................................. 20
Summary.................................................................................................................................... 22
Plan Summary List................................................................................................................ 23
Flexible Benefits
Program at a Glance
Who Can Join
The Plan is generally for individuals
who: (a) are active full-time or
part-time employees of JPS Industries, Inc. and affiliated employers that adopt
the Plan ("your employer"); and (b) normally work (or are paid) for at
least 30 hours a week.
Elections
Before the beginning of each plan year, your
employer will announce an election period.
During the election period, you must complete an election form on which
you may elect to set aside part of your pay to cover your estimated
out-of-pocket costs for the benefits offered through the Flexible Benefits
Program for the coming year. Your
employer will set aside the amount you designate from your pay before federal
and state income taxes and Social Security taxes are calculated.
Benefits You May Choose
You may choose to receive your entire
salary in cash, or to have your employer apply a portion of your before-tax pay
to one or more of the flexible benefits: