HomeMy WebLinkAboutCity of Tamarac Resolution R-2017-118Temp. Reso. #13020
October 3, 2017
Page 1
CITY OF TAMARAC, FLORIDA
RESOLUTION NO. R-2017- (/ y
A RESOLUTION OF THE CITY COMMISSION OF
THE CITY OF TAMARAC, FLORIDA,
AUTHORIZING THE APPROPRIATE CITY
OFFICIALS TO EXECUTE AN ADDENDUM TO
THE AGREEMENT WITH VOYA RETIREMENT
INSURANCE AND ANNUITY COMPANY (VRIAC)
(FORMERLY KNOWN AS ING LIFE INSURANCE
AND ANNUITY COMPANY) TO PROVIDE A
PERCENTAGE -BASED CONTRIBUTION OPTION
TO THE 457 DEFERRED COMPENSATION PLAN,
ADOPTING THE PERCENTAGE -BASED
CONTRIBUTION OPTION AMENDMENT
ADDENDUM, ATTACHED HERETO AS EXHIBIT 1
AND INCORPORATED; PROVIDING FOR
CONFLICTS; PROVIDING FOR SEVERABILITY;
AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the City of Tamarac ("City") approved an Agreement with ING
Life Insurance and Annuity Company [now known as VOYA Retirement
Insurance and Annuity Company (VRIAC)] to provide a 457 Deferred
compensation Plan and a 401 (a) Retirement Plans to City employees in
February, 2014; and
WHEREAS, the City, at the request of employees, now wishes to add a
percentage -based contribution option to the 457 Deferred Compensation Plan
effective January 1, 2018 which will provide an option for participants to
contribute to the Plan on a percentage based on their annual base pay in
addition to their current option to contribute on a flat dollar based manner; and
Temp. Reso. #13020
October 3, 2017
Page 2
WHEREAS, VOYA Retirement Insurance and Annuity Company (VRIAC)
has agreed to provide a percentage -based contribution option in accordance with
the Sponsor Election for Enrollment and On -going Services Addendum attached
as Exhibit 1; and
WHEREAS, the City Manager and the Director of Human Resources
recommend the approval and execution of the Sponsor Election for Enrollment
and On -going Services Addendum with VOYA Retirement Insurance and Annuity
Company (VRIAC); and
WHEREAS, the City Commission has deemed it to be in the best interest
of the citizens and residents of the City of Tamarac to approve and execute a
Sponsor Election for Enrollment and On -going Services Addendum with VOYA
Retirement Insurance and Annuity Company (VRIAC) to the City of Tamarac
457 Plan Retirement Services Agreement.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION
OF THE CITY OF TAMARAC, FLORIDA:
SECTION 1: The foregoing "WHEREAS" clauses are hereby ratified and
confirmed as being true and correct and are hereby made a specific part of this
Resolution. All exhibits attached hereto are incorporated herein and made a
specific part of this Resolution.
Temp. Reso. #13020
October 3, 2017
Page 3
SECTION 2: That the appropriate City officials are hereby authorized to
execute the Sponsor Election for Enrollment and On -going Services Addendum
with VOYA Retirement Insurance and Annuity Company (VRIAC), substantially
in the form attached hereto as Exhibit 1, and incorporated herein, and to
undertake such acts as are necessary to implement the foregoing resolutions,
subject to final review and approval by the City Manager and City Attorney.
SECTION 3: All resolutions or parts of resolutions in conflict herewith are
hereby repealed to the extent of such conflict.
SECTION 4: If any clause, section, other part of application of this
Resolution is held by any court of competent jurisdiction to be unconstitutional
or invalid, in part or in application, it shall not affect the validity of the remaining
portions or applications of this Resolution.
SECTION 5: This Resolution shall become effective immediately upon its
passage and adoption.
r
PASSED, ADOPTED AND APPROVED this
2017.
ATTEST:
ATRICIA TEUFEL CMC
CITY CLERK
I HEREBY CERTIFY THAT I HAVE
APPROVED THIS RESOLUTION
AS TO FORM
Cjuj'�P4d7j/vv
SAM EL S. GOWN
CITY ATTORNEY
Temp. Reso. #13020
October 3, 2017
Page 4
day of r 914` - ,
r
HARWbRESSLER
MAYOR
RECORD OF COMMISSION VOTE:
MAYOR DRESSLER
DIST 1- COMM. BOLTON
DIST 2- COMM. GOMEZ
DIST 3- COMM. FISHMAN
DIST 4- VICE MAYOR PLACKO
EXHIBIT 1
SPONSOR ELECTION FOR ENROLLMENT AND
ONGOING SERVICES - HEG
INSTRUCTIONS
Voya Retirement Insurance and Annuity Company ("VRIAC") VOVA
A member of the VoyaTA4 family of companies
PO Box 990063 FINANCIAL`
Hartford, CT 06199-0063
Fax: 800-643-8143
As used on this form, the term "Voya," "Company," "we," "us" or "our" refers to your plan's funding agent and/or administrative
service provider. That entity is VRIAC. Contact us for more information.
GOOD ORDER
Good order is receipt at our designated location of this form accurately and entirely completed, and includes signatures from you,
the Plan Sponsor/Trustee. If this form is not received in good order, as we determined, it may be returned to you for correction and
processed upon re -submission in good order at our designated location.
The completed request must be mailed to the address above or faxed to Voya at 800-643-8143. If you choose to fax a request,
please DO NOT mail the original to us.
PURPOSE
The purpose of this form is for Plan Sponsors to elect any of the following Voya services:
• Default Investment Option (DIO)
• Eligibility Tracking
• Automatic Contribution Arrangement
• Contribution Rate Change Service with Participant Directed Contribution Rate Escalator Service feature (participant scheduled)
• Notification Service
• Division/Sub-location Level Reporting and Electronic Notification
FUTURE GUIDANCE
This summary is based on Voya's interpretation of the final regulations on Automatic Contribution Arrangements. It is possible that
future guidance from the Internal Revenue Service or Department of Labor regarding this topic may modify or clarify the
requirements for such arrangements.
INSTRUCTIONS
1. Case Information
Please complete the Plan name and Plan/Billing Group number. Provide a contact name and phone number for the contact.
2. Election of Services
Please check the box(es) of the services you wish to elect.
3. Default Investment Option Description
The Default Investment Option (DIO) Section should be completed by the Authorized Plan Fiduciary to select the Plan's
default investment option, A default fund is used by the Plan for participants that do not make an affirmative investment
selection. Situations where a default investment may be used are automatic enrollment, profit sharing allocations, plan level
investment fund eliminations, immediate deposits, transfer of assets (including mergers and acquisitions), forfeiture allocations,
rollover into the plan, etc.
For ERISA plans, regulations have been issued by the Department of Labor (DOL) to provide "safe harbor" fiduciary relief for
selection of a default fund and the investment of a participant's account into a default fund, for the types of situations described
above. The safe harbor is known as a Qualified Default Investment Alternative (ODIA).
The QDIA regulations name specific types of investments which may be used as a default investment along with other
requirements that must be met for safe harbor relief to apply, including a timely written notice to participants. If a ODIA is
selected as the default investment, in order to obtain "safe harbor" fiduciary relief, all of the requirements of the ODIA
regulations must be met.
DO NOT RETURN TO VOYA
Instructions - Page 1 of 5 Order #155682 12/14/2014
TM: PLANMAINT
INSTRUCTIONS (Continued)
A QDIA generally includes:
• Life Cycle or Targeted Retirement Date fund or account (a fund based on the participant's age, target retirement date or
life expectancy).
• Balanced Fund (a fund that considers a target level of risk based on the participant population in the plan as a whole).
• A Professionally Managed Account (an Investment management service where a participant's account Is Invested based on
the participant's age, target retirement date or life expectancy).
Generally the "safe harbor" relief would be in effect 30 days after the participant notice describing the QDIA is received
by participants.
Of all the situations named above, a default investment is most frequently used for a plan that includes an automatic enrollment
provision. If the plan is an Eligible Automatic Contribution Arrangement (EACA), Qualified Automatic Contribution Arrangement
(QACA) or an Automatic Contribution Arrangement (ACA), you may wish to consider selecting a QDIA, however the plan is not
required to use one.
By completing this form and selecting the default investment option, this election will apply in all situations when a default
investment is used for participants that do not make an affirmative investment selection. This default investment option will
stay in effect until the Plan Sponsor completes a new DIO form.
Please consider these investment options carefully. Contributions to Participant Accounts that are invested in the default investment
will remain until an allocation change is received in Good Order from the participant. The Participant may make an investment
change by visiting www.voyaretirementplans.com or by contacting Customer Service at 800-584-6001.
Please note that if you choose to use a Voya Fixed Account as a DIO for your plan, assets in a Voya Fixed Account could be
subject to a Market Value Adjustment and any applicable windows in force at the time.
IRS Circular 230 Disclosure
Any tax discussion contained in this communication was not intended or written to be used, and cannot be used by the
recipient or any other person, for the purpose of avoiding any Internal Revenue Code penalties that may be imposed on such
person. Any tax discussion contained in this communication was written to support the promotion or marketing of the
transactions or matter discussed herein. Any taxpayer should seek advice based on the taxpayer's particular circumstances
from an independent tax advisor.
Neither Voya or its affiliated companies or representatives offer legal or tax advice. Please seek the advice of a tax attorney
or tax advisor prior to making a tax -related insurance/investment decision.
4. Election of Voya's Eligibility Tracking Service
If elected in the Plan Sponsor Service Profile, Voya will review your Plan document to ensure compatibility with the service,
and evaluate Participant eligibility based on the definition of eligibility and entry dates as outlined in your Plan document.
Voya will establish an electronic interface with you, the Plan Sponsor, for transmission of enrollment/contribution rate
information. An employee will be notified of his eligibility, including information on how to enroll, once all requirements are
completed as outlined in the Plan Document. At the time you transition the Plan to Voya, you will decide whether an employee
is eligible for your Plan. Beginning with the Effective Date of the Plan Services Agreement, Voya will evaluate eligibility for
newly eligible Participants based on the Plan's definition of eligibility and entry dates.
Your Responsibilities
In addition to providing timely and accurate information for this service, you will be responsible for the following:
Upon transition of the Plan to this service, you will provide Voya with anniversary year-to-date and plan year-to-date hours
for all employees through the Effective Date of your Plan Services Agreement. Subsequent submission of hours will be
required on a pay period to date basis.
• You are responsible for monitoring the Plan entry date window.
• You are responsible for notifying Voya of all rehired employees so that employee status can be reflected properly with Voya.
You are responsible for submitting to Voya census data for eligibility tracking for all employees with each payroll. If census
data is not submitted with each payroll, Voya will not provide this service. Therefore, you will be responsible for tracking
eligibility. If census data is not submitted with each payroll, Voya will cease providing this service.
What's Not Covered
This service is not available to you if your Plan document contains any one of the following provisions:
• Entry dates of annual or semi-annual
• Eligibility based on days of employment (e.g., 90 days)
• Eligibility with an entry date immediately after working 1000 hours based on Plan Year (e.g., not require the Participant to
complete the computation period prior to Plan Entry)
• For plans that have different eligibility requirements and/or entry dates for different contribution types (e.g., match, profit
sharing, etc.), this service will be limited to the employee deferral contribution type. You will be responsible for determining
eligibility of any other contribution types.
• Account allocation conditions for a contribution (e.g., last day, 1000 hours, etc.)
nn NnT RETURN TO VOYA
Instructions - Page 2 of 5 v,uci
TM: PLANMAINT
INSTRUCTIONS (Continued)
5. Election of Automatic Contribution Arrangement
5A. Election
From the descriptions below please elect one of the features available:
Automatic Contribution Arrangements (ACAs) Description
• Automatic Contribution Arrangement that does not meet the EACA or QACA rules.
• Does get state preemption if plan is subject to ERISA.
Eligible Automatic Contribution Arrangements (EACAs) Description
• Automatic Contribution Arrangement that meets IRS regulations for an EACA.
• Available under 401(k), 403(b) plans funded through a custodial agreement, and 457(b) plans.
• EACA does not need to cover all eligible Employees, but document must state:
a) Employees who will be covered
b) Whether or not an Employee who makes an affirmative election remains covered under the EACA
• Uniform percentage of compensation automatically deferred unless employee "opts out" (exceptions apply).
• Default fund is no longer required to meet DOL (Department of Labor) Qualified Default Investment Alternative (QDIA)
regulations.
• Employee may elect return of defaulted elective deferrals, i.e. "permissible withdrawals", this must be elected within
90 days from the date of the first deduction if elected within plan document.
• Initial and annual EACA and QDIA (if applicable) notices apply. Each may be combined into one notice.
• ERISA preempts any state withholding law that would restrict or prohibit automatic enrollment.
• Distribution deadline for Excess ADP/ACP contributions under EACA plan extended to 6 months following plan year
end (to avoid 10% excise tax) only if EACA covers all eligible Employees.
• The EACA must be in effect for the full 12-month plan year.
• Effective for plan years beginning in 2008.
Qualified Automatic Contribution Arrangements (QACAs) Description
• Automatic Contribution Arrangement that meets IRS regulations for QACA plus 401(k) safe harbor rules.
• Available under 401(k) plans.
• Must generally include all eligible employees. May exclude current employees (eligible on effective date of QACA)
who have made an affirmative election to participate or not participate.
• Uniform percentage of compensation automatically deferred unless employee "opts out" (exceptions apply).
• Minimum 3% of compensation automatically deferred through the end of the plan year following the year of initial
participation (initial period) unless employee "opts out" (could be as long as 2 full plan years).
• Provides for minimum automatic annual deferral increase of 1% for each of the next three plan years following the
Initial period unless employee "opts out" (maximum 10% automatic deferral).
• Provides for minimum "safe harbor" employer contribution (3% non -elective or minimum matching contribution).
• Default fund is not required to meet DOL QDIA regulations.
• Employee may elect return of defaulted elective deferrals, i.e. "permissible withdrawals", this must be elected within
90 days from the date of the first deduction if elected within the plan document.
• Initial and annual QACA and QDIA (if applicable) notices apply. Each may be combined into one notice.
• ERISA preempts any state withholding law that would restrict or prohibit automatic enrollment.
• The QACA must be in effect for the full 12-month plan year.
• Effective for plan years beginning in 2008.
• The minimum vesting is at least a two-year cliff vesting schedule.
513. Initial Default Elective Deferral
Please provide the default elective deferral % amount that will be deducted from the employee's compensation.
5C. Automatic Rate Escalator (Contribution Rate Change Service must also be elected to offer Automatic Rate Escalation.)
This feature will Increase participant contributions in their elected deferral source based on an annual scheduled rate and
time. This service must be linked with an Automatic Contribution Arrangement Feature.
Please indicate if you wish to offer an Automatic Rate Escalation feature.
If your Plan has a QACA feature, you are required to offer the Automatic Rate Escalation feature. Please complete the
annual increase schedule, affected participants, contribution source, effective date and date of first Automatic Contribution
Increase. If your plan has an EACA or ACA feature, this feature is optional.
Effective Date of Automatic Rate Escalation feature: Please indicate the date you would like the automatic contribution
Increase program to begin. Participants enrolled on or after the effective date will be part of the program.
DO NOT RETURN TO VOYA
Instructions - Page 3 of 5 Order #155682 12/14/2014
TM: PLANMAINT
INSTRUCTIONS (Continued)
5D. Permissible Withdrawals
For EACA or QACA, please select option A or B. For ACA, permissible withdrawals are not available.
5E. Default Investment Option
Please read and complete section 3.
6. Notification Service
Initial and annual notices are required for plans with an EACA, QACA, ACA and Qualified Default Investment Arrangement
(QDIA). The Plan Sponsor or its delegate is responsible for providing these required notices to all covered employees as
defined by the plan. Below is a general overview of these requirements. For the full details of the notice requirements, please
refer to the applicable regulations.
Participant Notices: Voya provides a notification service to assist in providing notices to covered employees for a plan that
offers any combination of the following:
• Qualified Default Investment Alternative (QDIA)
• Voya's Automatic Enrollment Service with or without Automatic Increase
• Voya's Eligibility Tracking Service for a plan with Safe Harbor
Initial Notices provide participants with an explanation of the respective feature and may include the following: the percentage
of employees' pay to be contributed to the Plan, the investment option(s) available, and the default investment if an employee
chooses not to enroll and select an investment option. The notice will also advise employees of their right to revoke the
automatic withholding (if applicable) and their rights to increase, decrease or stop contributions and instruction on how to do
so. Initial notices for plans not using Voya's Auto Enrollment Service, will be included in the enrollment kit,
Annual Notices are required to be provided to participants who have been default enrolled into a QDIA fund and/or are
automatically enrolled. These "Notices" will remind Participants of their deferral amounts and of their right to increase,
decrease or stop these contributions, also including the procedure to do so.
If the service is not selected, as fiduciary, you are required to send both the initial and annual notices.
Note that Voya will not provide:
• Annual notices that meet the Safe Harbor requirements.
• Notices to participants with a QDIA fund that were enrolled prior to the addition of the notification service.
Initial Notice Requirements
For plans with an EACA, QACA, or ACA provision, each newly eligible employee must receive the initial notice no earlier than
90 days before the employee's eligibility date, and no later than the employee's eligibility date, or as soon as practical, but
prior to the pay date of the pay period in which the employee is first eligible. The employee must have reasonable time, after
receiving the notice to opt out or elect a different deferral percentage.
For plans using a Qualified Default Investment Alternative (QDIA), each eligible employee must receive the initial QDIA notice
at least 30 days before their plan eligibility or at least 30 days before their first default investment.
For EACA or QACA plans that have an immediate eligibility provision, the QDIA notice may be distributed on or before the
eligibility date if the plan also includes the permissible withdrawal provision.
It is permissible to distribute the QDIA and automatic enrollment notices together provided the applicable timing requirements
are met.
Annual Notice Requirements
For plans with an EACA, QACA, or ACA provision, each covered employee must receive the annual notice no later than 30
days before the start of each plan year and no earlier than 90 days before the start of each plan year.
For plans using a QDIA, each eligible employee must receive the annual QDIA notice within a reasonable period of time that
Is at least 30 days before the start of each plan year.
It is permissible to distribute the QDIA and automatic enrollment notices together provided the applicable timing requirements
are met.
7. Contribution Rate Change Service with Participant Directed Contribution Rate Escalator Service
Please indicate if you wish to elect Voya's Contribution Rate Change Service with Participant Directed Contribution Rate
Escalator Service feature that allows your participants to change their Contribution Rate or set up a scheduled Contribution
Rate Escalator program.
DO NOT RETURN TO VOYA
Instructions - Page 4 of 5 Order #155682 12/14/2014
TM: PLANMAINT
INSTRUCTIONS (Continued)
Hardship Suspension Reinstatement:
If your plan utilizes a suspension period for Participants who take a hardship withdrawal, Voya will automatically reinstate
Participants to the deferral percentage in effect immediately prior to their hardship withdrawal. A notification will be sent
to the Participant of the reinstatement. (NOTE: This election is required for plans utilizing an Automatic Contribution
Arrangement.) If automatic reinstatement is not desired, you must elect to opt out.
S. Contribution and Enrollment Rate Capture
Please provide the minimum and maximum contribution percentage or dollar amountfor salary deferrals, voluntary contributions
and Roth contributions and also please indicate the maximum contribution percentage or dollar amount allowed for participants.
In addition, you must provide Voya with a file of current participant contribution rates. Voya will provide a sample format.
9. Automated Enrollment Services
If you elect for participants to enroll by internet or by calling Customer Service, complete section 9.
10. Electronic File Delivery for Contribution and Enrollment Service
If you are electing Contribution Rate Change service and/or Auto Enrollment (Automatic Contribution Arrangement) service,
YOU must complete this section. Please choose your delivery method by selecting A, B or C. In addition, you must choose your
reporting frequency by selecting an option.
Voya will send a notification via e-mail once a report is sent or made available. Please complete contact name and e-mail address.
11. Producer, Field Office and Marketing Information
Please complete the agent, broker and salaried enroller information.
12. Acknowledgement and Signature
Please read and sign the form.
DO NOT RETURN TO VOYA
Instructions - Page 5 of 5 uluei
TM: PLANMAINT
SPONSOR ELECTION FOR ENROLLMENT AND
ON -GOING SERVICES - HEG
Voya Retirement Insurance and Annuity Company (" VRIAC") VOVA
A member of the Voya"" family of companies
PO Box 990063 FINANCIAL -
Hartford, CT 06199-0063
Fax: 800-643-8143
1. CASE INFORMATION
Plan Name City of Tamarac
Contact Name Nora Caries
Plan/Billing Group # 666950
Phone (954)597-3605
2. ELECTION OF SERVICES (Complete appropriate section(s).)
❑ Default Investment Option (DIO)
❑ Eligibility Tracking Service
❑ Automatic Contribution Arrangement
[Contribution Rate Change with Participant Directed Contribution Rate Escalator Service
❑ Notification Service
❑ Division/Sub-location Level Reporting and Electronic Notification
3. DEFAULT INVESTMENT OPTION (Complete this section to elect a new DIO option.)
As the Authorized Plan Fiduciary, I hereby designate the following fund as the new DIO option under the Plan. All contributions
made on behalf of participants enrolled after the effective date of the change instruction, as provided below, who have not
exercised the opportunity to self -direct their plan account by providing investment instructions, will be invested in the new default
fund selected below. I have read and understand the new QDIA rules and have selected the investment fund accordingly.
Date of Change Instruction: (mm/dd/yyyy)
within 10 business days of this date.)
Select one of the following:
❑ A. Target Date Funds
(Change will become effective upon processing by Voyo
Note: If you are selecting Target Date Funds you must include the date of birth of each participant on the census file.
Fund Name
I understand that contributions into these portfolios will be based on the Participant's age, not an anticipated
retirement age as they are designed.
❑ B. Asset Allocation Made Easier
Note: This can only be selected if the Asset Allocation Made Easier (AAME) service is included in the plan and if it's
noted as the Qualified Default Investment Alternative below.
❑ C. Other Investment Option (Investment fund option numbers can be found on the Sponsor Web site or by
contacting your field representative.)
Fund Number (4 digit #) Fund Name
Please answer the following (required):
Is the default option elected above intended to be a Qualified Default Investment Alternative? ❑ Yes ❑ No
Note: The fund(s) listed in the option selected above must be available on your Plan. If you wish to choose funds that are not
currently available In your plan, please submit a Plan Investment Option Change Form prior to submitting this form. If we
receive a DIO form and funds not currently available under your plan are indicated, we cannot process the DIO.
I understand that if I select funds that are not QDIA, I may not be afforded the protection under the QDIA regulations. All
contributions made on behalf of participants, who have not exercised the opportunity to self -direct their plan account by providing
Investment instructions will be invested in the default investment option selected on this form.
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TM: PLANMAINT
4. ELECTION OF ELIGIBILITY TRACKING SERVICE
If the Eligibility Calculation in your Plan Document fits in Voya's Eligibility Tracking service underwriting guidelines, Voya will
calculate the Eligibility Date for all your employees and notify them of their Eligibility. Accompanying the notification of eligibility
will be directions on enrolling in your plan.
❑ I elect the Voya Eligibility Tracking Service dependent on the review of my plan's Eligibility Calculation.
Please note: You are responsible to supply the required census information to Voya in a timely basis for Voya to calculate the eligibility.
5. ELECTION OF AUTOMATIC CONTRIBUTION ARRANGEMENT
5A. Election
Choose one of the following three arrangements:
❑ Automatic Contribution Arrangement — ACA (Online Enrollment/EBI Is required)
❑ Eligible Automatic Contribution Arrangement — EACH
❑ Qualified Automatic Contribution Arrangement — QACA
5B. Initial Default Elective Deferral
A default elective deferral of % will be deducted from the compensation of each employee who has not affirmatively
opted out or provided a specified deferral percent and therefore, has been automatically enrolled in the plan.
5C. Automatic Rate Escalator (Contribution Rate Change service required.)
This feature will increase participant contributions in their elected deferral source based on an annual scheduled rate and
time. This service must be linked with an Automatic Contribution Arrangement Feature. For plans with QACA and EACA,
the date for Automatic Rate Escalator Is the first day of the Plan Year.
❑ I elect Voya's Automatic Contribution Rate Escalator (Mandatory under QACA, optional under ACA and EACA:)
• Annual Increase schedule below:
❑ % of Increase
❑ °k of Maximum
• Contribution Source for Automatic Contribution Increase
• What date would you like to apply the increase? (Select one.)
❑ The first day of the next plan year after automatic enrollment. (ACA, EACA, QACA)
❑ The first day of the second plan year following the automatic enrollment. (ACA, EACA, QACA)
❑ The first day of the calendar year after automatic enrollment. (ACA Only)
❑ The first day of the second calendar year following the automatic enrollment. (ACA Only)
5D. Permissible Withdrawals
If allowed under the Plan, an employee who was automatically enrolled may request a return of their defaulted deferrals (as
adjusted for gain or loss) within 90 days of the date the first defaulted elective deferral was deducted from each employee's
pay. Attributable matching contributions (as adjusted for gain/loss) must be forfeited. The Sponsor understands the applicable
IRS regulations for automatic contribution arrangements only allow Permissible Withdrawals of defaulted elective deferrals
under plans where the automatic contribution arrangements meet the EACA requirements.
Please choose one of the following:
❑ A. Yes, the Plan will allow for permissible withdrawals.
❑ B. No, the Plan will not allow for permissible withdrawals.
5E. Default Investment Option (DIO)
If your plan has not elected a DIO, complete the Default Investment Option section. For those plans that have already
selected a DIO, the selected fund will be used for those participants who have not exercised the opportunity to self -direct their
plan account by providing investment instructions. If a plan has an EACA or QACA feature, the Sponsor understands that while
they may consider selecting a QDIA, current guidance does not require they do so.
Page 2 of 5 — Incomplete without all pages Order 9155682 12/14/2U14
TM: PLANMAINT
6. NOTIFICATION SERVICE
If your plan has Automatic Enroll, Automatic Increase, and/or a Qualified Default Investment Alternative, please indicate if you
wish to use Voya's Notification Service. This service only applies to services that are provided by Voya. If the service is not
selected, as fiduciary, you are required to send both the Initial and Annual Notices.
❑ I elect to use Voya's Notification Service. (This Includes both initial and annual notices.)
7. CONTRIBUTION RATE CHANGE WITH PARTICIPANT DIRECTED CONTRIBUTION RATE ESCALATOR SERVICE
[�I elect the Contribution Rate Change Service.
This feature allows participants to make changes to their Contribution Rate or set up scheduled contribution rate changes via
the Voya Participant Internet Web site. Voya's Contribution Rate Change with Participant Directed Contribution Rate Escalator
Service feature includes Automatic Reinstatement Notification and resumption of my participants' deferral rates at the end of
their Hardship Withdrawal Suspension Period.
For those plans that do not have automatic enrollment features, select below to opt out of the Automatic Reinstatement and
Resumption of Participant Deferral Rate.
❑ I elect to not have Voya automatically reinstate participants to the deferral percentage in effect immediately prior to their
hardship withdrawal. Voya will notify participants when the suspension period expires, but will not automatically reinstate
the deferral percentage. NOTE: If this election is selected, the Plan Sponsor is responsible for notifying participants upon
initiation of the hardship withdrawal that they will not be automatically reinstated.
8. CONTRIBUTION AND ENROLLMENT RATE CAPTURE
If you have elected the Contribution Rate Change with Participant Directed Contribution Rate Escalator service, please provide
the minimum and maximum percentages or dollar amounts in your plan:
Salary Deferral Contributions (pre-tax) Minimum Q % OR $ 0.00
Roth Contributions (after-tax) Minimum % OR $
[Allow Catch Up Rates or Amounts to be collected.
Salary Deferral Contributions (pre-tax) Minimum __D —%OR $ 0.00
Maximum 100* % OR $
Maximum % OR $ _
Maximum 1004 % OR $ '!-k
Roth Contributions (after-tax) Minimum % OR $ Maximum % OR $
NloI-k,-.xe0-e(I If S `102 Qnnua him'4.
9. AUTOMATED ENROLLMENT SERVICES
This feature allows your employees to enroll in your plan via Voya Participant Access Web site at www.voyaretirementplans.com
and have access to all required disclosure and fund information. With this service your participants will have access to enroll via
Customer Service.
If you are interested in using this service, please indicate below.
❑ I elect Voya's Automated Enrollment Services.
Page 3 of 5 — Incomplete without all pages Order #155682 12/14/2014
TM: PLANMAINT
10. ELECTRONIC FILE DELIVERY FOR CONTRIBUTION AND ENROLLMENT SERVICE
Voya can provide contribution rate and enrollment reporting data through an automated process. Please select one of the
following delivery types (required):
❑ A. Sponsor Web/Archive: Plan Sponsor will obtain reporting data through the Voya Plan Sponsor Internet Web site.
❑ B. E-mail: We will send files to a specified recipient(s) in an encrypted format and access information will be provided. Please
provide the e-mail address(es):
❑ C. FTP (File Transfer Protocol): We will send a file via FTP. Please provide the FTP Delivery Address, ID and Password:
FTP Delivery Address: ftp://
FTP ID
FTP Password
Note: Voya will send files based on the information selected above until a change is provided, In writing, by the Trustee.
Please provide the following information to assist us with the set-up of this reporting data.
Reporting frequency (One of the following options must be selected.)
❑ Weekly (We recommend a weekly frequency for plans that offer loans so that timely notification will be provided.)
❑ Bi-weekly
❑ Semi-monthly (indicate which days preferred)
❑ Monthly (indicate which day preferred)
Please provide the first date the report is needed. Future reports will be based on this date and the frequency selected above.
First Reporting Date (mm/dd/yyyy):
You must identify an individual to receive notification of when the payroll feedback file is available. It is understood and
acknowledged by the Plan Sponsor and Company that the individual designated below is responsible for accessing the file when
notified of its availability.
Contact Name _
E-mail Address
Contact Name _
E-mail Address
Contact Name _
E-mail Address
Contact Name
E-mail Address
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11. PRODUCER, FIELD OFFICE AND MARKETING INFORMATION
Complete the below Agent, Broker and Salaried Enroller information.
Agent — Career Agent (Voya FP Only) appointed with Voya Retirement Insurance and Annuity Company. Registered representative
of Voya Financial Partners, LLC receive commission -based compensation.
Broker — Broker (Non Voya FP Only) appointed with Voya Retirement Insurance and Annuity Company. Brokers affiliated with a
broker -dealer other than Voya Financial Partners, LLC receive commission -based compensation.
Salaried Enroller — Voya Retirement Insurance and Annuity Company employees who will not receive commission -based salary and
are registered representatives of Voya Financial Partners, LLC.
List names and codes of all Agents, Brokers and Salaried Enrollers enrolling and servicing this case. Check off whether the
.,. — A., n+ P—Lenr nr Calariarl Pnrnller.
❑ Agent ❑ Broker ❑ Salaried Enroller Div Sub
Representative Name
Office Code
Rep. #
❑ Agent ❑ Broker ❑ Salaried Enroller
Representative Name
Office Code Rep. #
❑ Agent ❑ Broker ❑ Salaried Enroller
Representative Name
Office Code
Rep. #
❑ Agent ❑ Broker ❑ Salaried Enroller
Representative Name
Broker/Dealer Affiliation
Participation % Last 4 Digits of SSN
Div Sub
Broker/Dealer Affiliation
Participation _ % Last 4 Digits of SSN
Div Sub
Broker/Dealer Affiliation —
Participation--% Last 4 Digits of SSN
Div Sub _
Broker/Dealer Affiliation
Office Code Rep. # Participation % Last 4 Digits of SSN
12. ACKNOWLEDGEMENT AND SIGNATURE
I understand and agree that it is my responsibility to distribute an enrollment kit to all eligible participants. I understand that I am required
to provide initial and annual notices to participants regarding their elections in accordance with applicable regulations.
I acknowledge that it is my responsibility for ensuring that the automatic contribution arrangement feature (automatic enrollment)
complies with our state laws in regards to wage withholding. The payroll withholding laws of the Sponsor's state should be reviewed
prior to implementation of this program to determine if deductions without an employee's written consent are permitted.
If I have elected a Default Investment Option and indicated it as a QDIA fund, I understand that I am responsible to determine whether
the fund that I have chosen herein qualifies as a QDIA fund under the QDiA regulation, if applicable. Additionally, I understand and
acknowledge that Voya exercises no discretion with respect to these investments and that Voya is not responsible for monitoring
whether an participant exercises his or her investment selection rights.
I authorize Voya to set up a participant account with the DIO identified herein, for participants who have not made an affirmative
investment selection as described under the Default Investment Option (DIO) Description section of this document. I agree to indemnify
and hold Voya harmless from any claim that may arise from investing these funds as directed. I represent that I have the authorization
under the terms of the plan to provide Voya with this direction.
If permitted by the plan, I understand that defaulted elective deferrals can only be distributed in accordance with the permissible
withdrawal provisions.
If I have elected the Contribution Rate Change Service, I understand that this service may facilitate participants increasing their
contribution rates. As such, I acknowledge:
Voya may contact participants about the advantages of increasing their contribution rates via paper -based correspondence or
e-mail as well as by phone.
• I will endorse and assist with the communication of such participant increase program(s).
I also understand that if at any time the Plan wishes to eliminate or change any of these features, I will contact my Plan Manager.
I certify that the information contained herein is accurate and that Voya is entitled to rely exclusively on the information provided in this
form and supersedes any prior elections. I understand that it is my responsibility to determine if the services elected herein are in
accordance with the Plan Document, applicable regulations and to consult my legal counsel.
On behalf of the plan, I hereby direct Voya to implement the elections identified above.
Plan Sponsor/Trustee (Please print. Mic nech —
Plan Sponsor/Trustee Signatur Date
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