General Administration & Personnel Committee

AGENDA General Administration & Personnel Committee Regular Meeting Village Hall 1900 Hassell Road, Hoffman Estates, IL 60169 November 11, 2024 Council Chambers Immediately Following Planning, Building & Zoning Committee 1. CALL TO ORDER/ROLL CALL 2. APPROVAL OF MINUTES A. General Administration & Personnel Committee 10-14-2024 3. PUBLIC COMMENT 4. OLD BUSINESS 5. NEW BUSINESS A. Approval of an Ordinance amending the Village of Hoffman Estates Health Reimbursement Arrangement (HRA) with Bencor/MidAmerica. 6. REPORTS A. Cable TV Monthly Report B. Human Resources Management Monthly Report C. Legislative Operations & Outreach Monthly Report 7. PRESIDENT'S REPORT 8. ITEMS IN REVIEW 9. OTHER 10. ADJOURNMENT Further details and information can be found in the agenda packet attached hereto and incorporated herein and can also be viewed online at www.hoffmanestates.org and/or in person in the Village Clerk's office. The Village of Hoffman Estates complies with the Americans with Disabilities Act (ADA). For accessibility assistance, call the ADA Coordinator at 847/882-9100. Page 1 Page 1 of 52 Village of Hoffman Estates DRAFT GENERAL ADMINISTRATION & PERSONNEL COMMITTEE MEETING MINUTES October 14, 2024 1. ROLL CALL Members in Attendance: Patrick Kinnane, Chair Gary Stanton, Vice-Chair Karen Arnet, Trustee Karen Mills, Trustee Anna Newell, Trustee Gary Pilafas, Trustee Mayor William D. McLeod Management Team Members in Attendance: Eric Palm, Village Manager Jana Dickson, Asst. Corporation Counsel Jon Pape, Assistant Village Manager Patrick Seger, Director of HRM Peter Gugliotta, Director of Dev. Services Alan Wenderski, Director of Engineering Joe Nebel, Director of Public Works Rachel Musiala, Director of Finance Jennifer Horn, Dir. Planning and Trans. Sonia Zala, St. Transportation Eng. Ric Signorella, Multimedia Production Mgr. Missy Brito, Communications Manager The General Administration & Personnel Committee meeting was called to order at 7:12 p.m. 2. APPROVAL OF MINUTES Motion by Trustee Arnet, seconded by Trustee Mills, to approve the General Administration & Personnel Committee meeting minutes of September 9, 2024. Voice vote taken. All ayes. Motion carried. 3. PUBLIC COMMENT 4. OLD BUSINESS 5. NEW BUSINESS A. Approval of a sales agreement with Revize for redesign and hosting services for the Village of Hoffman Estates website in an amount not to exceed $59,400 over a four-year term. An item summary sheet from Missy Brito was presented to Committee. Missy Brito addressed the Committee and reported that the Village’s website was last substantially refreshed in 2018, but the current web platform is a legacy system that was originally implemented in 2007. Page 2 of 52 General Administration & Personnel Committee -2- October 14, 2024 Motion by Trustee Arnet, seconded by Trustee Pilafas to approve a sales agreement with Revize for redesign and hosting services for the Village of Hoffman Estates website in an amount not to exceed $59,400. Voice vote taken. All ayes. Motion carried. 6. REPORTS (INFORMATION ONLY) A. Cable TV Monthly Report The Cable TV Monthly Report was received and filed. B. Human Resources Management Monthly Report. The Human Resources Management Monthly Report was received and filed. C. Legislative Operations and Outreach Monthly Report. The Legislative Operations and Outreach Monthly Report was received and filed. 7. PRESIDENT’S REPORT 8. OTHER 9. ITEMS IN REVIEW 10. ADJOURNMENT Motion by Trustee Pilafas, seconded by Trustee Stanton, to adjourn the meeting at 7:17 p.m. Voice vote taken. All ayes. Motion carried. Minutes submitted by: Debbie Schoop, Executive Assistant Date Page 3 of 52  AGENDA ITEM REPORT General Administration & Personnel Committee November 11, 2024 ITEM 5A REQUEST: Approval of an Ordinance amending the Village of Hoffman Estates Health Reimbursement Arrangement (HRA) with Bencor/MidAmerica. FROM: Patrick Seger, Human Resources Management Director ITEM TYPE: Ordinance - Committee REQUEST SUMMARY The Village implemented a Health Reimbursement Account (HRA), by adopting an ordinance and related documents on October 16, 2023, for Village non-union employees participating in the new Blue Choice Options (BCO) health insurance plan effective January 1, 2024. Employees who are participating in the BCO plan receive a Village contribution to the account to assist employees in paying for out-of-pocket health care expenses during the benefit year as well as in retirement. Contributions are tax-free and are only to be used for eligible medical expenses as described under section 115 of the Internal Revenue Code. The Village utilizes Bencor/MidAmerica for the administration of the HRA plan, and as Trustee, includes coordinated investment management and administrative services. Currently, the Village Human Resources Management Department administers a section 105 health reimbursement plan for sworn non-union and P. W. non-union employees eligible for the sick leave incentive benefit that was provided to them as union employees. BenCor/MidAmerica provides the third-party service that performs health care reimbursements for those eligible employees similarly to the HRA program that was implemented January 1, 2024. The request before the Board is to expand the current HRA to include the sick leave incentive benefit for those select positions promoted outside the union and thereby having BenCor/MidAmerica administer those future claims. Currently, non-union employees are paid out unused vacation time upon separation. The value of that vacation time upon separation is taxed per IRS regulation, which reduces the value by approximately 25% depending on tax status. Through survey information, non-union employees are interested in a HRA benefit that would contribute their payout into an HRA tax- free that would be used to pay for health insurance expenses in the future. A similar benefit is provided for fire union employees. In addition to the previous request, it is requested to expand the current HRA program administered by BenCor/MidAmerica for non-union employees by adding unused vacation time upon separation to be contributed into an HRA account. Finally, as a result of the collective bargaining process, the Fire Union and the Village agreed to eliminate the PPO plan offerings currently in place for their members (PPO Plans 1,2 and 3) and participate in the new Blue Choice Options (BCO) plan and HRA program. The program concept is similar to what was recently provided to non-union employees effective January 1, 2024, and the contributions to the employees' HRA will be determined by the premium savings from the current PPO plans to the new BCO plan. The request before the Board is to expand the current HRA program to include the Fire Union employees that participate in the BCO plan. Page 1 of 2 Page 4 of 52 As the cost of health insurance continues to increase, evaluating creative options to manage those increases by new plan designs such as the BCO plan as well as implementing and expanding the HRA benefit provides a unique opportunity for Village employees to pay for those health expenses now and into the future. FINANCIAL IMPACT There is no new expense to the Village for the HRA contributions in conjunction with the health insurance change to the BCO plan as the total cost of this program, including the monthly fee per active employee, is off-set by the premium savings. There is no new expense to the Village for the upon separation benefits (vacation and sick leave) as any and all contributions made by the Village on behalf of the employee is employee compensation and is paid out or deposited into the current section 105 program. RECOMMENDATION Amend the current HRA plan that would add Fire Union employees to the HRA benefit program that are enrolled in the Blue Choice Option (BCO) health insurance plan, expand the current HRA benefit for non-union employees to include vacation payout to be contributed to the HRA upon employee separation of service, and add the sick leave incentive benefit into the HRA administered by BenCor/MidAmerica, for those non-union management employees promoted out of the Union (Police, Fire and PW). Recommend Village Board approval. ATTACHMENTS 1. Ordinance - HRA Update 10-2024 (002) 2. Village of Hoffman Estates_IHRA_Active_Plan Amendment_2024 3. Village of Hoffman Estates_rHRA_Retiree_Plan Amendment_2024 Page 2 of 2 Page 5 of 52  ORDINANCE NO. ___________ - 2024 VILLAGE OF HOFFMAN ESTATES AN ORDINANCE AUTHORIZING THE VILLAGE OF HOFFMAN ESTATES TO AMEND AND RESTATE THE TRUST-BASED HEALTH REIMBURSEMENT ARRANGEMENT (HRA) AND SUPPORTING PLAN DOCUMENTS WHEREAS, the Village of Hoffman Estates is a Municipal Corporation, organized as a municipality; and WHEREAS, On October 16, 2023 the Village of Hofman Estates adopted a trust-based health reimbursement arrangement plan (the "Plan") with Bencor/MidAmerica for the use of jurisdictions and offers the Plan for adoption by governmental employers for the benefit of their respective employees and beneficiaries; and WHEREAS, in connection with the adoption of the Plan by the Village of Hoffman Estates, BenCor/MidAmerica has drafted adoption agreement documents that sets forth the terms and conditions of the Plan (including, but not limited to, those employees of the Village of Hoffman Estates who are or who will be eligible to participate), and a corresponding section 115 employee Benefit Trust Adoption Agreement with Bencor/MidAmerica as Trust Administrator and Application and acceptance contract with American Unity Life Insurance as Custodian of the Trust assets (the "Trust Adoption Agreement"); and WHEREAS, the Village of Hoffman Estates is empowered by the laws, rules and regulations of State of Illinois to take on its behalf the actions contemplated by this Ordinance; and WHEREAS, the Village of Hoffman Estates empowers the Village Manager to modify the Plan as needed to incorporate new groups joining the Plan. NOW, THEREFORE, BE IT ORDAINED by the President and Board of Trustees of the Village of Hoffman Estates, Cook County, Illinois, as follows: Section 1: The Village of Hoffman Estates hereby approves the amended Adoption Agreements for Active Employees and Retirees (Attached as Exhibit A), and any other related documents, as such documents may be amended from time to time to comply with any changes in applicable laws, rules and regulations or as otherwise necessary or appropriate. Section 2: The Village of Hoffman Estates hereby authorizes the Village Manager to execute the Adoption Agreements, including without limitation, any resolutions or amendments that may be necessary or that may be requested by the Village Manager from time to time to comply with any changes in applicable laws, rules and regulations or as otherwise necessary or appropriate. Section 3: The Village of Hoffman Estates hereby authorizes and directs the Village Manager or his/her designee to be the coordinator for the Plan; shall receive necessary reports, notices, etc. from Bencor/MidAmerica, and may assign administrative duties to carry out the Plan to the appropriate departments, and is authorized to execute all necessary agreements incidental to the administration of the Plan Section 4: The Village Clerk is hereby authorized to publish this Ordinance in pamphlet form. Page 6 of 52  -2- Section 5: This Ordinance shall be in full force and effect immediately from and after its passage and approval. PASSED THIS ________ day of _________________, 2024 VOTE AYE NAY ABSENT ABSTAIN Trustee Karen V. Mills _____ _____ _____ _____ Trustee Anna Newell _____ _____ _____ _____ Trustee Gary J. Pilafas _____ _____ _____ _____ Trustee Gary G. Stanton _____ _____ _____ _____ Trustee Karen Arnet _____ _____ _____ _____ Trustee Patrick Kinnane _____ _____ _____ _____ Mayor William D. McLeod _____ _____ _____ _____ APPROVED THIS ______ DAY OF _______________, 2024 Village President ATTEST: Village Clerk Published in pamphlet form this _______ day of ____________________, 2024. Page 7 of 52  Exhibit A RESOLUTION TO AMEND AND RESTATE THE MIDAMERICA ADMINISTRATIVE & RETIREMENT SOLUTIONS HEALTH REIMBURSEMENT ARRANGEMENT WHEREAS, Village of Hoffman Estates (the “Employer”) has established and adopted the MidAmerica Administrative & Retirement Solutions Health Reimbursement Arrangement (the “Plan”) for the benefit of its eligible employees and their dependents; WHEREAS, the section of the Plan entitled “Plan Amendments” reserves the right of the Employer to amend the Plan, at any time and in whole or in part, so long as participants are notified and any amendment does not adversely affect the rights of existing participants, and to make changes imposed by the Internal Revenue Service, without notice to participants; WHEREAS, the Employer wishes to amend and restate the Plan; and WHEREAS, a copy of the amended and restated Plan document has been attached; NOW, THEREFORE, BE IT RESOLVED that the Plan is amended and restated by adopting all of the terms of the amended and restated Plan document attached, effective on January 1, 2025 . ******** This Resolution has been executed this day of , 20 Signature Eric Palm, Village Manager Name and Title Village of Hoffman Estates Employer Rev 02082011 v 1 Page 8 of 52  Health Reimbursement Arrangement for Active Employees Health Reimbursement Arrangement for Active Employees ADOPTION AGREEMENT for Village of Hoffman Estates Employer Address: 1900 Hassell Road Hoffman Estates IL 60169 Employer Telephone Number: 847-781-2690 Employer Identification Number: 36-2434131      The undersigned Employer, by executing this Adoption Agreement, hereby adopts and implements the Health Reimbursement Arrangement for Integrated Employees (hereinafter referred to as the “Plan” or the “HRA”) and agrees to abide by the terms of the Plan. With this Adoption Agreement, and by its authorized signature below, the Employer hereby makes the following designations. Effective Date. The Plan’s Original Effective Date is January 1, 2024 . The Plan’s Restated Effective Date is January 1, 2025 . The Plan is available to Employees of the Employer effective January 1, 2024 . Plan Year. The Plan Year ends on December 31 . Eligible Classes. The class or classes of Employees covered by this Plan are: (See attached Class Specifications.) Class ActA: Employees enrolled in group health coverage: Single plan Class ActB: Employees enrolled in group health coverage: Single +1 plan Class ActC: Employees enrolled in group health coverage: Family Class ActD: Fire Union employees enrolled in group health coverage: Single plan Class ActE: Fire Union employees enrolled in group health coverage: Single +1 Class ActF: Fire Union employees enrolled in group health coverage: Family Designation of Plan Administrator. The Employer hereby designates the following initial Plan Administrator: MidAmerica Administrative & Retirement Solutions, Inc. Designation of Individuals to Have Access to Protected Health Information (“PHI”). The following Employees, classes of Employees, or other persons shall be given access to the PHI to be disclosed: Business Office Personnel HR Department Personnel The Employer hereby agrees to the provisions of the Plan and has executed this Adoption Agreement on this day of , 20 . Name of Employer: Village of Hoffman Estates Signature: Print Name: Eric Palm Title: Village Manager Employer CONTACT (print): Sharon Hellstrom Title: Payroll Coordinator E-Mail: Sharon.hellstrom@vohe.org Telephone: 847-843-4808 Ext. Fax: 847-781-2699 IRS Circular 230 Notice: We are required to advise you no person or entity may use any tax advice in this communication or any attachment to (i) avoid any penalty under federal tax law or (ii) promote, market or recommend any purchase, investment or other action. Active HRA Adoption Agreement – Rev. 07.2015 Page 1 of 8 Page 9 of 52  Health Reimbursement Arrangement for Active Employees Employer Representations  Employees are not permitted to make any election or choice between cash, the HRA, and/or any other tax deferred program.  The allocation to the HRA will be expressed in a percent of compensation or dollar amount.  The Employer has discretion in determining classes of Employees eligible to participate in the HRA. Once determined, Employees in the class shall be treated uniformly and be provided a uniform allocation to the HRA. Such class shall remain in effect for the Employer's entire fiscal year for all affected Employees in such year and for all future contributions to such class. Each year, the Employer may reevaluate allocations and classes for new Employees only.  The Employer acknowledges that it has received the Plan document for the HRA and agrees with all the terms therein.  The Employer understands that whether a contribution to the HRA is non-elective for tax purposes is a facts and circumstances determination, and the Employer is responsible for whether the contribution is truly non-elective or not. The Employer understands that MidAmerica Administrative & Retirement Solutions, Inc. and its agents and employees are not tax or legal advisors. They may provide general information regarding the tax treatment of health reimbursement arrangements, but the Employer should consult with its own tax or legal advisors as to how tax and other rules may apply to its own facts and circumstances.  The Employer will not provide any information or forms or enter into any contracts inconsistent with the preceding.  The Employer acknowledges that every Participant must be enrolled in a group health plan, as described in the Declaration of Coverage Under Another Group Health Plan Form, and it is the Employer’s responsibility to ensure that all Participants complete and sign the Form. January 1, 2024 Effective Date Employer Initials Active HRA Adoption Agreement – Rev. 07.2015 Page 2 of 8 Page 10 of 52  Health Reimbursement Arrangement for Active Employees Eligible Class ActA: Employees enrolled in group health coverage: Single plan Defined as: Non-Union employees enrolled in Single coverage with the Village of Hoffman Estates group insurance plan. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Active Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses (Highly Compensated Individuals may receive only premium reimbursements.) HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Employer for active employees. Platform Fees are paid by the Employer. ____________________________________________________________________________________________________________________ $3 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted will be paid by the Participant. Reimbursement Eligibility: A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) January 1, 2024 Effective Date Employer Initials Active HRA Adoption Agreement – Rev. 07.2015 Page 3 of 8 Page 11 of 52  Health Reimbursement Arrangement for Active Employees Eligible Class ActB: Employees enrolled in group health coverage: Single +1 plan Defined as: Non-Union employees enrolled in Single +1 coverage with the Village of Hoffman Estates group insurance plan. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Active Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses (Highly Compensated Individuals may receive only premium reimbursements.) HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Employer for active employees. Platform Fees are paid by the Employer. ____________________________________________________________________________________________________________________ $3 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted will be paid by the Participant. Reimbursement Eligibility: A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2024 Employer Initials Active HRA Adoption Agreement – Rev. 07.2015 Page 4 of 8 Page 12 of 52  Health Reimbursement Arrangement for Active Employees Eligible Class ActC: Employees enrolled in group health coverage: Family Defined as: Non-Union employees enrolled in Family coverage with the Village of Hoffman Estates group insurance plan. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Active Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses (Highly Compensated Individuals may receive only premium reimbursements.) HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Employer for active employees. Platform fees are paid by the Employer. ____________________________________________________________________________________________________________________ $3 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted will be paid by the Participant. Reimbursement Eligibility A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2024 Employer Initials Active HRA Adoption Agreement – Rev. 07.2015 Page 5 of 8 Page 13 of 52  Health Reimbursement Arrangement for Active Employees Eligible Class ActD: Fire Union employees enrolled in group health coverage: Single plan Defined as: Fire Union employees enrolled in Single coverage with the Village of Hoffman Estates group insurance plan. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Active Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses (Highly Compensated Individuals may receive only premium reimbursements.) HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Employer for active employees. Platform Fees are paid by the Employer. ____________________________________________________________________________________________________________________ $3 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted will be paid by the Participant. Reimbursement Eligibility: A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2025 Employer Initials Active HRA Adoption Agreement – Rev. 07.2015 Page 6 of 8 Page 14 of 52  Health Reimbursement Arrangement for Active Employees Eligible Class ActE: Fire Union employees enrolled in group health coverage: Single +1 Defined as: Fire Union employees enrolled in Single +1 coverage with the Village of Hoffman Estates group insurance plan. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Active Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses (Highly Compensated Individuals may receive only premium reimbursements.) HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Employer for active employees. Platform Fees are paid by the Employer. ___________________________________________________________________________________________________________________ $3 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted will be paid by the Participant. Reimbursement Eligibility: A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2025 Employer Initials Active HRA Adoption Agreement – Rev. 07.2015 Page 7 of 8 Page 15 of 52  Health Reimbursement Arrangement for Active Employees Eligible Class ActF: Fire Union employees enrolled in group health coverage: Family Defined as: Fire Union employees enrolled in Family coverage with the Village of Hoffman Estates group insurance plan. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Active Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses (Highly Compensated Individuals may receive only premium reimbursements.) HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Employer for active employees. Platform fees are paid by the Employer. ____________________________________________________________________________________________________________________ $3 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted will be paid by the Participant. Reimbursement Eligibility: A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2025 Employer Initials Active HRA Adoption Agreement – Rev. 07.2015 Page 8 of 8 Page 16 of 52  Exhibit A RESOLUTION TO AMEND AND RESTATE THE MIDAMERICA ADMINISTRATIVE & RETIREMENT SOLUTIONS HEALTH REIMBURSEMENT ARRANGEMENT WHEREAS, Village of Hoffman Estates (the “Employer”) has established and adopted the MidAmerica Administrative & Retirement Solutions Health Reimbursement Arrangement (the “Plan”) for the benefit of its eligible employees and their dependents; WHEREAS, the section of the Plan entitled “Plan Amendments” reserves the right of the Employer to amend the Plan, at any time and in whole or in part, so long as participants are notified and any amendment does not adversely affect the rights of existing participants, and to make changes imposed by the Internal Revenue Service, without notice to participants; WHEREAS, the Employer wishes to amend and restate the Plan; and WHEREAS, a copy of the amended and restated Plan document has been attached; NOW, THEREFORE, BE IT RESOLVED that the Plan is amended and restated by adopting all of the terms of the amended and restated Plan document attached, effective on January 1, 2025 . ******** This Resolution has been executed this day of , 20 Signature Eric Palm, Village Manager Name and Title Village of Hoffman Estates Employer Rev 02082011 v 1 Page 17 of 52  Health Reimbursement Arrangement for Retirees Health Reimbursement Arrangement for Retirees ADOPTION AGREEMENT for Village of Hoffman Estates Employer Address: 1900 Hassell Road Hoffman Estates IL 60169 Employer Telephone Number: 847-781-2690 Employer Identification Number: 36-2434131      The undersigned Employer, by executing this Adoption Agreement, hereby adopts and implements the Health Reimbursement Arrangement for Retirees (hereinafter referred to as the “Plan” or the “HRA”) and agrees to abide by the terms of the Plan. With this Adoption Agreement, and by its authorized signature below, the Employer hereby makes the following designations. Effective Date. The Plan’s Original Effective Date is January 1, 2024 . The Plan’s Restated Effective Date is January 1, 2025 . The Plan is available to Retirees of the Employer effective January 1, 2024 . Plan Year. The Plan Year ends on December 31 . Eligible Classes. The class or classes of Retirees covered by this Plan are: (See attached Class Specifications.) Class RetA: Integrated Rollover (Active Class A, B, C, D, E, F) Class RetB: Non-Union Public Works Management Position (Former Union Employees) Class RetC: Non-Union Police Management Position (Former Union Employees) Class RetD: Non-Union Fire Management Position (Former Union Employees) Class RetE: Non-union Employees Class RetF: Designation of Plan Administrator. The Employer hereby designates the following initial Plan Administrator: MidAmerica Administrative & Retirement Solutions, Inc. Designation of Individuals to Have Access to Protected Health Information (“PHI”). The following Employees, classes of Employees, or other persons shall be given access to the PHI to be disclosed: Business Office Personnel The Employer hereby agrees to the provisions of the Plan and has executed this Adoption Agreement on this day of , 20 . Name of Employer: Village of Hoffman Estates Signature: Print Name: Eric Palm Title: Village Manager Employer CONTACT (print): Sharon Hellstrom Title: Payroll Coordinator E-Mail: sharon.hellstrom@vohe.org Telephone: 847-843-4808 Ext. Fax: 847-781-2699 IRS Circular 230 Notice: We are required to advise you no person or entity may use any tax advice in this communication or any attachment to (i) avoid any penalty under federal tax law or (ii) promote, market or recommend any purchase, investment or other action. Retiree HRA Adoption Agreement – Rev. 07.2015 Page 1 of 7 Page 18 of 52  Health Reimbursement Arrangement for Retirees Employer Representations  The Employer intends to reduce its Retirees' medical expenses by providing reimbursement of such expenses, in a limited capacity. The Employer anticipates that participation in the HRA will encourage prospective Retirees to retire earlier, as they will be better able to afford quality health care prior to the age at which they are Medicare eligible.  The Employer may allow Retirees to participate in both the HRA and the Special Pay Plan (403(b)).  Retirees are not permitted to make any election or choice between cash, the HRA, and/or the Special Pay Plan, or any other tax deferred program.  The Employer will base HRA allocations on its estimates of the costs required to provide a certain amount of medical reimbursements to its Retiree population as that population approaches Medicare age.  The Employer has discretion in determining classes of Employees eligible to participate in the Retiree HRA. Once determined, Retirees in the class shall be treated uniformly and be provided a uniform allocation to the HRA. Such class shall remain in effect for the Employer's entire fiscal year for all affected Retirees in such year and for all future contributions to such class. Each year, the Employer may reevaluate allocations and classes for new Retirees only.  The Employer may gather information from the Retiree to determine the appropriate allocation to the HRA, but individual Participants are not allowed to elect or to determine their allocation.  The Employer will monitor all rehires to ensure that less than two employees are in the Retiree HRA Plan.  The Employer acknowledges that it has received the Plan document for the HRA and agrees with all the terms therein.  The Employer understands that whether a contribution to the HRA is non-elective for tax purposes is a facts and circumstances determination, and the Employer is responsible for whether the contribution is truly non-elective or not. The Employer understands that MidAmerica Administrative & Retirement Solutions, Inc. and its agents and employees are not tax or legal advisors. They may provide general information regarding the tax treatment of health reimbursement arrangements, but the Employer should consult with its own tax or legal advisors as to how tax and other rules may apply to its own facts and circumstances.  The Employer will not provide any information or forms or enter into any contracts inconsistent with the preceding. Effective Date January 1, 2024 Employer Initials Retiree HRA Adoption Agreement – Rev. 07.2015 Page 2 of 7 Page 19 of 52  Health Reimbursement Arrangement for Retirees Eligible Class RetA: Integrated Rollover (Active Class A, B, C, D, E, F) Defined as: Employees that satisfy the terms and conditions of retirement with the Village will have their remaining balances in Active Class A, B, C, D, E, F transfer to Retiree Class A upon retirement. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Retiree Active with no access to benefit until retirement or separation of service Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation or Retirement Pay Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other No further contributions Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Participant for Retired employees. ____________________________________________________________________________________________________________________ $1 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted shall be paid by the Participant. Reimbursement Eligibility A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Upon Retirement or Separation of Service Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2024 Employer Initials Retiree HRA Adoption Agreement – Rev. 07.2015 Page 3 of 7 Page 20 of 52  Health Reimbursement Arrangement for Retirees Eligible Class RetB: Non-Union Public Works Management Position (Former Union Employees) Defined as: Public Works Supervisors, Public Works Superintendents, Assistant Public Works Director, Director of Public Works will receive a sick leave payout upon separation as established by the employer. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Retiree Active with no access to benefit until retirement or separation of service Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation or Retirement Pay Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Participant. ___________________________________________________________________________________________________________________ $1 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted shall be paid by the Participant. Reimbursement Eligibility Immediate Upon becoming 100% vested Upon Retirement or Separation of Service Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2025 Employer Initials Retiree HRA Adoption Agreement – Rev. 07.2015 Page 4 of 7 Page 21 of 52  Health Reimbursement Arrangement for Retirees Eligible Class RetC: Non-Union Police Management Position (Former Union Employees) Defined as: Non-Union Police Management positions (Deputy Chief and Chief) who have previously participated in the Police Union will receive a sick leave payout upon separation as established by the employer. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Retiree Active with no access to benefit until retirement or separation of service Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation or Retirement Pay Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Participant. ____________________________________________________________________________________________________________________ $1 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted shall be paid by the Participant. Reimbursement Eligibility A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Upon Retirement or Separation of Service Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2025 Employer Initials Retiree HRA Adoption Agreement – Rev. 07.2015 Page 5 of 7 Page 22 of 52  Health Reimbursement Arrangement for Retirees Eligible Class RetD: Non-Union Fire Management Position (Former Union Employees) Defined as: Non-Union Fire Management positions (Deputy Chief and Chief) who have previously participated in the Fire Union will receive a sick leave payout upon separation as established by the employer. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Retiree Active with no access to benefit until retirement or separation of service Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation or Retirement Pay Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Participant. ____________________________________________________________________________________________________________________ $1 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted shall be paid by the Participant. Reimbursement Eligibility A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Upon Retirement or Separation of Service Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2025 Employer Initials Retiree HRA Adoption Agreement – Rev. 07.2015 Page 6 of 7 Page 23 of 52  Health Reimbursement Arrangement for Retirees Eligible Class RetE: Non-union Employees Defined as: Non-union employees who are eligible for retirement under their respective pension plan, will have the following amount of vacation deposited into their HRA: 10 years of service up to 14 years of service – 50% of vacation balance contributed to HRA. 15 years of service up to 20 years of service – 75% of vacation balance contributed to HRA. 20 years of service and greater – 100% of vacation balance contributed to HRA. Employment Status Upon the initial contribution to the Plan, Participant employment status shall be: Retiree Active with no access to benefit until retirement or separation of service Contribution Types All funds for the Plan shall come exclusively from the Employer and shall be determined in accordance with the following formula: Dollar Amount Percentage of Compensation or Retirement Pay Contribution Frequency One Time Annually Quarterly Semi-Annually Monthly Other Vesting Schedule Participants shall own their account balance in accordance with the following vesting schedule: 100% Immediate 100% upon Retirement, meeting the Employer’s eligible requirements for retirement 100% upon Separation of Service Other 100% upon death (can be selected in addition to “other” above) Forfeitures Employees who are not 100% vested under the Vesting Schedule at the time of termination shall forfeit their unvested funds. In the event of the death of the Participant, the Participant’s spouse, and all of the Participant's qualifying dependents, any vested funds remaining in the account shall be forfeited. In the event that the Participant opts out of participation in the Plan, all vested and unvested funds shall be forfeited. Forfeitures shall: Reduce future Employer contributions Be redistributed pro-rata at the end of each Plan Year to all Plan Participants who are actively employed as of the end of the Plan Year Run-off Times Participants will be allowed 0 (zero) days to continue incurring expenses after the date that their Participation in the Plan ends. The Run-off time for Participants to submit claims for reimbursement from funds that shall be forfeited will be 90 (ninety) days. The Run-off time for funds that shall be forfeited due to death will be one year. Reimbursements Reimbursements shall be for: All eligible Medical Expenses specified in section 213(d) of the Internal Revenue Code Limited Purpose Post Deductible Premium Only Medical Expenses HRA/FSA Ordering The Employer maintains a Flexible Spending Account (FSA) plan in which Participants may elect to participate. The Plan permits reimbursements for expenses eligible to be reimbursed by the FSA plan and therefore the HRA shall not reimburse before expenses exceeding the dollar amount of any FSA have been paid. The Plan permits reimbursements for Limited Purpose, Deductible or Premium Only expenses which are not eligible to be reimbursed by the FSA plan and therefore the HRA shall reimburse before the Participant’s FSA account is exhausted. Administration Fees: Administrative Fees are paid by the Participant. ___________________________________________________________________________________________________________________ $1 per participant per month, or $75 monthly minimum Manual Claim Fees: A reimbursement processing fee of $5.00 for each hard copy claim form submitted shall be paid by the Participant. Reimbursement Eligibility A Participant shall be eligible for reimbursement of medical expenses at the time selected below. Immediate Upon becoming 100% vested Upon Retirement or Separation of Service Investment Selection Investment Provider: American United Life Insurance Company Type of Investment: Fixed annuity only Variable annuities – Default Forfeiture Default Employer directed Participant directed; restrictions are: None 100% vested At Retirement Account balance in excess of $ Other Funds limited (see attachment) Effective Date January 1, 2025 Employer Initials Retiree HRA Adoption Agreement – Rev. 07.2015 Page 7 of 7 Page 24 of 52 VILLAGE OF HOFFMAN ESTATES NOVEMBER CATV MONTLY REPORT To: Eric Palm From: Ric Signorella Date: November 1, 2024 Citizen Segments This month the Citizen covers: Senior Commission: Senior Prom, I Smelll Bacon BBQ R/C, Frannie Dan Sign Installation, PW Academy Graduation Ceremony, HEFD Open House and the HEFD Swearing In’s. Citizen Segments and Programs in development: Schaumburg & Hoffman Estates Branch Library Programs Airing on HETV HHS Dept. Activities Videos HEPD / HEFD Swearing In’s “In Hoffman” Monthly Show: Communications Dept. First Responder Teen Academy Graduation Engineering Division: Storm Sewer Lining First Responders Academy for Teens WITTS Workout Promotional Video HEPD Citizens Police Academy Community Pride Awards Hispanic Heritage Fiesta Sister Cities Commission: French Evening PW Fleet Outfitting a Squad Car Emergency Management: Lock Down Drill HEFD Electrical Vehicle Extrication Drills Fire Station 21 Ground Breaking Ceremony HEPD CRC Open House / Ribbon Cutting HEPD Cram the Cruiser HEPD Shop with a Cop HEFD Helicopter Crash Simulation - St Alexis Hospital Engineering: Beverly Road Footage - Bridge and New Bike Lane Panasonic Connect Ribbon Cutting Event Veterans Day Ceremony Friendship Tree Lighting Sister Cities Commission “Meet Marie Antoinette” HEPW: Snow & Ice Operations HEPW: Open House HEPD Recruiting Video MAE WEST: Actress Portrayal for the August Senior Commission Entertainment Now airing. Hoffman Estates 65th Birthday Celebration w/ Historian Pat Barch Now airing. COMPASS Kickoff Press Conference & Central Road Project Check Presentation Now airing. Senior Commission Entertainment: Measner Magic Show Now airing. Complaints/Inquiries There was one new inquiry with a landline phone outage. There are no outstanding inquiries. Page 25 of 52 Page 26 of 52 Page 27 of 52 Page 28 of 52 Page 29 of 52 Page 30 of 52 Page 31 of 52 Page 32 of 52 Page 33 of 52 Page 34 of 52 Page 35 of 52 Page 36 of 52 Page 37 of 52 Page 38 of 52 Page 39 of 52 Page 40 of 52 Page 41 of 52 Page 42 of 52 Page 43 of 52 Page 44 of 52 Page 45 of 52 Page 46 of 52 Page 47 of 52 Page 48 of 52 Page 49 of 52 Page 50 of 52 Page 51 of 52  VILLAGE OF HOFFMAN ESTATES TO: GAP Committee Memo FROM: Jennifer Djordjevic, Director of Operations/Outreach – Office of the Mayor and Board RE: Operations/Outreach Highlights PERIOD: October 2024 Muir Holiday Joy Market – working with school administrators to host a “marketplace” event for families at the school. December 7th is the target date. Solidified the following partners: Edge Electric, Minuteman Press, Hilton Garden Inn, World’s Fair, Hoffman Estates Chamber of Commerce, L&M Financial, Ascension St. Alexius Women’s and Children’s Hospital, Target, and Windy City Bulls. Wine Wednesday – World’s Fair (11/20), Poplar Creek Bowl (12/18) General: 10/1 – Celtic Fest Meeting, FF/PM Swearing-In 10/1 – scheduled Gordon Madsen’s Eagle Court of Honor (attended by elected officials) 10/2 – I Smell Bacon Ribbon Cutting, Attended Benefits of Wellness Fair 10/4 – attended ONCC Meeting (Schiller Park) 10/5 – scheduled elected officials to attend NW Suburban Teachers Union Breakfast 10/7 – Trustee Dinner and Public Works Graduation Ceremony 10/8 – attended management team meeting, Frannie’s Star Installation with Mayor McLeod 10/10 – scheduled and attended meeting at Bell Works for event planning meeting with Trustee Pilafas, Mayor 10/11 – attended the Village’s Safety Luncheon 10/13 – attended Diwali Celebration with Trustee Kinnane, Mayor, Clerk Richter 10/15 – attended French Evening 10/16 – organized and attended Wine Wednesday 10/19 – scheduled Eagle Court of Honor for Ryne Priest attended by elected officials 10/23 – assisted with Senior Luncheon, had sponsorship discussion with Linda Scheck, Eric Palm 10/26 – attended WINGS Purple Tie Ball with Mayor McLeod 10/28 – attended POC Collaborative Meeting via Zoom 10/28 – organized Trustee birthday dinner for Trustee Pilafas, attended committee meetings 10/31 – visited with residents Patricia and William Dybas with Mayor McLeod General administrative projects for the Mayor and the Village Board. ______________________________ Jennifer Djordjevic Dir. Of Operations and Outreach / Office of the Mayor and Board Page 52 of 52