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( <br /> x P«miai6k Medicd Benefis Paymeau <br /> Bene6ts digible for mimbu�sement wnsist oE <br /> [ R Medid Fzpenaes eligible uader IRC Secrion 213' otha thm direa loug-cam cas apensa� end induding <br /> noe-prcsaiption mediationa allowed under 1RS guidana. <br /> ❑ T� f M�� �P�es (edect oaly che e:ppensa yau cvu6 m cover under the VwmgeCam Retitemmt HwItL <br /> Savinge Plaa): <br /> ❑ Medid Insurmce Pmmiwns <br /> ❑ Medial Ourof-Pxket Expemn• <br /> ❑ Mediaro Pan B Inawanm Premiuma <br /> ❑ Medicam Pazc D Inauiaana P�emiums <br /> ❑ Medicare Suppkmmnl I��..n.�.-. Premiuma <br /> ❑ Prwcripdon Drug Insuranoe A�emi <br /> ❑ COBRA Inawaam Premiums <br /> ❑ Denral Insurana Pmmiuma <br /> ❑ Dental Outrof-Porket Fapeoae3` <br /> ❑ V'uion Inswana Premiums <br /> ❑ Y�sion Ouaof-Pocka F�eous• <br /> ❑ Quali6ed Long-Term Cue Iniutanm P[�iums <br /> ❑ Non-Presaipdon medications apuwed mder [RS guidanm• <br /> ❑ ��� 9�oB mediral apensr8 (daaibe)• <br /> C •StsSeaion V.A., frir a dirtaaion ofnoridimimnvation rvla w/�id� n+a�' aPP�l' m nan-ro0reticrly ba�inrd re�imured Plaro. <br /> XI. Bme6u Afrct tLe DeatL of the Pattkipant <br /> In the event of a Partidpant's dn[h. rhe following ahall apPly: <br /> a s�a.�s� �� s�.;a� n�p�n <br /> The surviving apouse and/or surviving digible dependenu (u d�ned in Sadoa XII.D.) of the deaaaed Putidpant are <br /> imaxdiately eligible m mainain che accounc and utiliu it w fund digibk medinl benefin spaified in Seaion X above. <br /> Upon uo[i6catioa of a Parcicipanle dea�h, [f�e Parcicpant s aaount balattce wiU be transfefred inm the Vanugepoint <br /> Monry Muica Fund' (or ano�6er fvnd selecced by �he EmP�oyer). The actount balance wy 6e mllocated by ehe <br /> aurviving spoux or depeudenu. <br /> `Plawe xed rbs rwrnrVintaarpoineMxtrelFirndrP"'�'���JP^� m irtw+tin� M inwmamtin tbir frnd 'u eritbsr <br /> 'u�rorrd rw'gwranttrCand dxmm� br ru savmur dmt tbe Fmd wi!lbsabk m meinrao� a mb/e netr'vsmlue ofSL00pn rbon. <br /> Vinlq�rpeineMr�vmfForndror dimi6rttdbylCMA-RCSmuex LlC, s mlro!!y-ewird broM-dealrr ejfi'liatr ofJCMA Retiremmt <br /> Cesperetion. MsmberFINRA/SlPG <br /> If a Partidpant's ac�un[ balance has not ban fully utilized upon the dat6 of the eligibk apouae. [he account b�ln�• <br /> may condnue to be utiliud m pay benefiw af digibk depwdenrs. (Tpon the dnt6 of all digibk dependenu, the <br /> account will xverc m�he Plan w be applisd aa sped6ed in S«tion VIfI. <br /> � <br /> r' x , � . . , _`�� <br /> '�.,' 'n � h a �., � ` > r n f rc —C : 4 <br /> ' ? ..- y � l 4 3 ,j : L > " .J C ` � �. <br /> . t ' i cs :. {avY 3 i- . �t ) <br /> - . . �...._4 .� .� en xA r ) Y <br /> . , _. .. . ., nr , , ..x . ........ _..va:� 5._.. . '£i <br />