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6.2.C. - Page 9 <br />X. Permissible Medical Benefit Payments <br />Benefits eligible for reimbursement consist of: <br />LiY� Medical Expenses eligible under IRC Section 213* other than direct long -term care expenses, and including <br />non - prescription medications allowed under IRS guidance. <br />❑ The following Medical Expenses (select only the expenses you wish to cover under the VantageCare Retirement Health <br />Savings Plan): <br />❑ Medical Insurance Premiums <br />❑ Medical Out -of- Pocket Expenses* <br />❑ Medicare Pan B Insurance Premiums <br />❑ Medicare Pan D Insurance Premiums <br />❑ Medicare Supplemental Insurance Premiums <br />❑ Prescription Drug Insurance Premiums <br />❑ COBRA Insurance Premiums <br />❑ Dental Insurance Premiums <br />❑ Dental Out -of- Pocket Expenses* <br />❑ Vision Insurance Premiums <br />❑ Vision Out -of- Pocket Expenses* <br />❑ Qualified Long -Term Care Insurance Premiums <br />❑ Non - Prescription medications allowed under IRS guidance* <br />❑ Other qualifying medical expenses (describe)* <br />* See Section V.A. for a discussion of nondiscrimination rules which may apply to non - collectively bargained, self- 'insured Plans. <br />XI. Benefits After the Death of the Participant <br />In the event of a Participant's death, the following shall apply: <br />A. Surviving Spouse and /or Surviving Dependents <br />The surviving spouse and /or surviving eligible dependents (as defined in Section XII.D.) of the deceased Participant are <br />immediately eligible to maintain the account and utilize it to fund eligible medical benefits specified in Section X above. <br />Upon notification of a Participant's death, the Participant's account balance will be transferred into the Vantagepoint <br />Money Market Fund* (or another fund selected by the Employer). The account balance may be reallocated by the <br />surviving spouse or dependents. <br />*Please read the current Vantagepoint Mutual Funds prospectus carefully prior to investing. An investment in this fund is neither <br />insured nor guaranteed and there can be no assurance that the Fund will be able to maintain a stable net asset value of $1.00 per share. <br />VantagepointMutual Funds are distributed by ICMA -RC Services, LLC, a wholly -owned broker - dealer affiliate of ICMA Retirement <br />Corporation. Member FINRAISIPC. <br />If a Participant's account balance has not been fully utilized upon the death of the eligible spouse, the account balance <br />may continue to be utilized to pay benefits of eligible dependents. Upon the death of all eligible dependents, the <br />account will revert to the Plan to be applied as specified in Section VIII. <br />- - - -;: <br />e <br />4 <br />c_:i. <br />