This Adoption Agreement is required and must be completed by the employer prior to or at the time of enrollment in the Alliance Health Plan. A revised Adoption Agreement must be completed if the Adopting Employer changes any provisions in this Agreement. This Section 125 plan, or cafeteria plan, allows the employer to offer health premiums and health savings account contributions to their employees on a pre-tax basis.

To obtain a complete copy of the Christian and Missionary Cafeteria Plan official document click here. Please keep this in your records for auditing purposes. 

Whereas, the Christian and Missionary Alliance has established the Christian and Missionary Alliance Cafeteria Plan ("Plan") for the provision of certain employee benefits on a tax-favored basis; and

Whereas, the Benefit Board of the Christian and Missionary Alliance wishes to enable any employer participating in the Christian and Missionary Alliance high deductible health plan to establish a cafeteria plan by execution of this Adoption Agreement by such employer (the “Adopting Employer”), subject to acceptance by the Plan Administrator

Whereas, the terms in this Adoption Agreement with initial capital letters have the same meaning as set forth in the Plan document; and

Whereas, the Plan is intended to be a church plan described in section 414(e) of Internal Revenue Code (“Code”) and a cafeteria plan within the meaning of Code section 125.

Now therefore, be it resolved that the Adopting Employer hereby adopts the Plan to provide the benefits for certain Eligible Employees as specified in this Adoption Agreement. The Adopting Employer agrees to be subject to the provisions of the Plan as set forth in the Plan document as may be amended from time to time, and as supplemented by the terms of this Adoption Agreement as follows:

The Benefit Board of The Christian and Missionary Alliance wishes to enable any employer participating in The Christian and Missionary Alliance high deductible health plan to establish a cafeteria plan by the execution of the Adoption Agreement by such employer (“Adopting Employer”), subject to acceptance by the Plan Administrator.

 

Completing the following Adoption Agreement establishes this execution effective for the plan year beginning January 1, 2016 or on the effective date that the Employer is new to the Plan.

Section 1.12 of the Plan document provides that all common-law employees of Participating Employer(s) are eligible to participate in the Plan, except those excluded as follows (please select one of the following):

Note: The Plan must meet certain nondiscrimination requirements under the Code. Therefore, in selecting the employees that will be covered, it is the Adopting Employer’s responsibility to ensure that the Plan does not discriminate as to eligibility or benefits in favor of certain highly compensated employees, key employees or any other persons in whose favor discrimination is prohibited under the Code.

Section 2.1 of the Plan document provides that an Eligible Employee shall become a Participant in this Plan with respect to a particular Benefit Program as of the date he or she becomes a participant in such Benefit Program, provided that the Eligible Employee timely completes any required enrollment form and designations. However, an Adopting Employer may wish to impose different or additional conditions on participation.

 

An Eligible Employee of the Adopting Employer may begin participation in the Plan when he or she has met the following requirements:

Section 3.7 of the Plan document generally provides that a Participant may contribute After-Tax Dollars only in limited circumstances, such as when the Participant has insufficient Compensation to convert part of it to Pre-Tax Dollars. The Adopting Employer may allow Participants the option of contributing After-Tax Dollars instead of or in addition to Pre-Tax Dollars. Check the box below only if Participants are to be given the option of contributing After-Tax Dollars.

1. The Adopting Employer hereby adopts the Plan and agrees to the provisions of the Plan document and  this Adoption  Agreement as administered and interpreted by the Plan Administrator. Except as otherwise agreed to by the Plan  Administrator, the Adopting Employer understands and agrees that the Plan document may be amended only by the  Benefit Board.

2. The Adopting Employer understands that it is solely responsible for the funding of benefits under the Plan and that its responsibilities include remission of any and all contributions to the Plan to the Benefit Board within 30 days of the due date for such contributions as established by the Benefit Board.

3. Notwithstanding the foregoing, the Adopting Employer may from time to time amend the Plan in the manner available to it under the Adoption Agreement. Any change made to the options available under this Adoption Agreement must be effected by the execution of a new Adoption Agreement. Any such change shall not be effective unless the amended Adoption Agreement is accepted by an authorized employee of the Benefit Board.

4. The Adopting Employer shall have the right to terminate its adoption of the Plan document, upon 60 days advance written notice to the Benefit Board, by taking appropriate action through its governing body and informing the Benefit Board and the Participants in the Plan, in writing, of such action.

5. The Adopting Employer understands that it is solely responsible for the Plan's compliance with all applicable laws (including, without limitation, compliance with applicable nondiscrimination rules, and applicable wage reporting and withholding requirements), except with respect to the administrative responsibilities explicitly delegated to the Plan Administrator under the Plan.

Witnesseth, on behalf of the Adopting Employer, the terms and conditions of this Adoption Agreement and the Plan document are hereby adopted and agreed to, and I hereby certify that the necessary corporate actions (if any) required to approve the execution of this Adoption Agreement have been taken in accordance with the requirements of applicable law.