Professional Services Agreement - Infinisource - City's Flexible Spending Account

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1. Adoption of the Plan(s). Infinisource shall assist Employer in evaluating the benefits, terms and conditions of the Plan(s), and shall assist Employer in selecting available benefits and funding options. Infinisource shall be under no obligation to specify benefits or funding options. 2. Communication of Plan to Eligible Employees (FSA Plans only). Infinisource will provide communication and enrollment materials for downloading via Infinisource website at no additional charge. Enrollment "kits" are available for an additional fee as outlined in the Fees and Consideration Appendix. Infinisource will conduct meetings and/or provide audiovisual materials or presentations (for an additional fee as outlined in the Fees and Consideration Appendix), at which time the benefits, terms and conditions of the Plans dictated by Employer shall be described to the eligible employees. 3. General administration of Plan(s). Infinisource will keep a record of each Plan participant and maintain separate notational bookkeeping records and accounts based on the participants' Reimbursement Account elections for each Plan Year. The records shall include the level of coverage, reimbursements and account balances. Infinisource will process midyear election changes under the Plans in accordance with the terms of the Plans and applicable law. Infinisource will examine each claim for benefits under the Plan in accordance with the claim review procedures of the Plans and applicable law, take reasonable steps to verify its validity, compute the amount payable and either disburse the benefit due under the Plan, to the extent Employer has provided sufficient funds as required by this Appendix, or deny the claim In accordance with the provisions of the Plan and the applicable rules and regulations. Infinisource will provide each participant submitting a claim with an explanation of payment or denial in accordance with the Plan's claim review procedures and applicable regulations and an explanation of the year-to-date activity in the participant's account. In the event this Agreement is terminated, all requests for reimbursement submitted to Infinisource after the effective date of termination will be returned to Employer, or at Employer's request, submitted to another third party. Infinisource will have no further responsibility with respect to such claims submitted after the effective date of termination. 4. Nondiscrimination Testing. Infinisource makes available the following nondiscrimination testing required under the Code (collectively referred to as the "Nondiscrimination Tests") with respect to the Plan (s) (to the extent Infinlsource provides related administrative services): (a.) Key Employee Concentration Test required under Code §125. (b.) The 55% Average Benefits Test required under Code §129. (c.) The 25%Shareholder Concentration Test required under Code §129. (d.) The Highly Compensated Individual Eligibility and Benefits Test required under Code § 105. To the extent necessary, Infinisource will prompt Employer to complete the Nondiscrimination Tests. Employer will complete the Nondiscrimination Tests and Infinisource will notify Employer if, based on Infinisource interpretations, any of the tests fall to pass. The results will be based on information received from Employer and/or any information obtained and maintained by Infinisource in the course of performing services required under this Agreement, including but not limited to this Appendix. Infinisource will conduct additional Nondiscrimination Tests required under Code §125, §105 and/or §129 only upon Employer's written request. 5. Plan Documents and Summary Plan Descriptions (SPDs). Based on Employer's completion of a plan design worksheet, Infinlsource shall prepare the text for the initial drafts of the required Plan document(s) and SPD(s) pursuant to information provided by Employer. 6. Form 5500 Data. Infinisource will assist Employer with information to complete Form 5500 for the Health FSA and/or HRA, if applicable, by providing any information maintained in Infinisource database that is required to be included on the Form 5500 with respect to such reimbursement accounts to the extent requested in writing by Employer. 7. Positive Pay Tool. Positive Pay is an automated check fraud detection tool required by some banks. Positive Pay matches key information for each check against a special electronic file provided by Infinisource. This requires special work between Infinisource and its software vendor on an initial and ongoing basis. If Employer's bank requires use of Positive Pay for its banking activity, Infinlsource shall provide the files as and when required, provided that Employer pays the additional fees set forth in the Fees and Consideration Appendix. In the alternative, Employer may require all participants to be reimbursed via direct deposit, thereby eliminating the need for the Positive Pay tool. B. Responsibilities of Employer Employer is responsible for all Plan administration not set forth above, including but not limited to the following: 1. Adoption and Maintenance of the Plans. Employer has the exclusive right and duty, however, to select, implement, amend or modify benefits or funding options adopted in connection with the Plans. 2. General Administration. Employer is responsible for establishing eligibility criteria and determining which employees and/or dependents have met those criteria. Employer will establish a claims appeal procedure for handling disputes regarding claims for benefits or the payment of benefits. Although Infinisource may process claims and handle the initial determination and up to the first level of appeal, Employer has final authority as to the denial or payment of a claim on appeal and is the claim fiduciary responsible for handling the final appeal level set forth under the Plan. 3. Information Provided to Infinisource. Employer shall provide the following information to Infinisource: (a.) Enrollment forms (or enrollment information) for all new participants added to the Plan and a list of participants terminated or deleted from the Plan, including their date of termination. (b.) A confirmation of payroll deductions (contributions) on a per pay period basis for the Flexible Benefit Plan and the Qualified Transportation Fringe Benefit Plan, if applicable. (c.) All other information relating to the Plans and its participants necessary for Infinisource to perform its duties under this Agreement. (d.) With respect to a Code §132 Qualified Transportation Fringe Benefit Plan, information concerning Employer's ability to make cash reimbursements for transit expenses in accordance with Treas. Reg.1.132-9 Q-16. 4. Plan Documents and SPDs. It shall be Employer's obligation to complete the plan design worksheet completely and accurately and ensure that draft documentation provided by Infinisource complies with the applicable laws and regulation in light of the facts and circumstances surrounding Employer and its particular plans and plan designs. 5. Deposit of Funds. Employer shall make sufficient funds available to pay all eligible claims presented to Infinisource in accordance with one of the following methods; however, if claims are paid pursuant to an electronic payment card, Employer must make funds available in accordance with the Electronic Payment Card Service Appendix incorporated into and made a part of this Agreement. Employer will make sufficient funds available from its general assets for amounts allocable to eligible reimbursement benefits under its Plans by depositing funds in amounts specified by Infinisource from time to time in an Employer -owned and named account (the "Account") at a financial institution selected by Employer and grant to Infinisource withdrawal authority over the Account sufficient to enable it to pay benefits under Employer's Plans. Infinisource will provide Employer with monthly check registers for funding and/or reconciliation purposes. Employer bears sole responsibility for any fees imposed with respect to the Account by the financial institution.