On the agenda: Goddard meeting — DATA CENTER (Aug 17)

REGULAR MEETING
GODDARD CITY COUNCIL
118 NORTH MAIN ST.
GODDARD, KANSAS
August 17, 2026
A)

CALL TO ORDER

B)

PLEDGE OF ALLEGIANCE AND INVOCATION

C)

APPROVAL OF THE AGENDA

D)

CITIZEN COMMENTS

E)

EX PARTE AND CONFLICT OF INTEREST DECLARATION

F)

APPOINTMENTS, PROCLAMATIONS, RECOGNITIONS, & NOMINATIONS

G)

CONSENT AGENDA:
1. Minutes
a. 07.01.2026 – Special City Council Meeting
b. 07.06.2026 – Regular City Council Meeting
2. Accounts Payable
a. 08.05.2026 - $1,306,499.21
b. 08.05.2026 - $182,737.02
c. 08.12.2026 - $1,107,810.40
3. Empower Flex Spending Resolution Plan Update
4. July 2026 Financial Report
5. August 2026 Monthly Water Consumption Report

H)
I)

UNFINISHED BUSINESS
None
1.
2.
3.
4.

NEW BUSINESS
Sedgwick County Rural Electric Co-Op Rebate Agreement for Rachel Brooke Estates Electric
Change Order for 2026 Street Maintenance Contract
Consider Purchasing Building Inspector Replacement Vehicle
Strategic Growth Zone Overlay District

J)

CITY MANAGER’S REPORT

K)

GOVERNING BODY COMMENTS

L)

EXECUTIVE SESSION

M)

ADJOURNMENT (Next meeting will be Tuesday, August 25, 2026, at 12:00PM at City Hall.)

Next Assigned Numbers for:
Charter Ordinance No. 23
Ordinance No. 1051
Resolution No. 26-47

NOTICE: SUBJECT TO REVISIONS
It is possible that sometime between 6:30 and 7:00 PM immediately prior to this meeting, during breaks, and directly after the meeting, a majority of the
Governing Body and/or Planning Commission may be present in the council chambers or lobby of City Hall. No one is excluded from these areas during those
times.

Goddard City Council
Special City Council Meeting Minutes
Wednesday, July 1, 2026
Call to Order
The Special City Council Meeting was held at Goddard City Hall on Wednesday, July 1, 2026.
Mayor Liebe called the meeting to order at 7:00 pm. Council members present were George
Liebe, Amanda White, Krista Hall, Corey Dir, and Naomi Leonard.
Also, present was Craig Crossette, City Manager; Ryan Shrack, Deputy City Manager; Jason
Cauley, Public Works Director; Lance Beagley, Police Chief; Micah Scoggan, Community
Development Director; Brooke Carroll, Chief Financial Officer, and Dani Mueting, Community
Engagement Director.

Pledge of Allegiance and Invocation
The Pledge of Allegiance was recited, followed by an invocation.

Approval of the Agenda
Staff requested to amend the agenda by adding item G.2 for a street closure on 4th St for a
neighborhood fireworks show.
MOTION:

Councilmember Hall moved to approve the agenda. Councilmember
White seconded the motion. The motion carried 5-0.

Citizen Comments
None

Ex Parte and Conflict of Interest Declaration
None

Appointments, Proclamations, Recognitions, & Nominations
Consent Agenda
1. Street Closure 4th St for Neighborhood Fireworks Show
2. Street Closure in St Andrew for Neighborhood Fireworks Show
MOTION: Councilmember Leonard made a motion to approve the consent
agenda. Councilmember Liebe seconded the motion. The motion
carried 5-0.

Unfinished Business

City Council Meeting
July 1, 2026

None

New Business
Draft Resolution Discussion Related to Two Family Structures
Community Development Director Micah Scoggan presented a review of a draft resolution
establishing design standards for two-family (duplex) structures. He summarized eight key
concerns raised by the Wichita Area Builders Association (WABA) and its representatives
following prior meetings. Mayor Liebe noted that WABA's representation from the previous
meeting did not necessarily reflect the full range of views within the approximately 900member organization, and that several developers had privately expressed general support for
the design standards while raising specific concerns.
Item 1 – Garage Door Facade Percentage
The current draft required that garage doors occupy no more than 50% of the front facade of
a structure. Staff and council discussed the practical difficulty of this requirement, noting that
most existing duplexes and even single-family homes in Goddard likely exceed 50%. An
engineer previously consulted by the city indicated that the 50% rule would effectively
require either very wide or two-story structures, limiting duplex construction to higher-rent
units on large lots. Council members acknowledged that the intent of the standard was to
prevent garage-dominated streetscapes, similar to what exists along portions of Main Street.
After discussion, council reached a consensus to adjust the threshold to 60%, with
clarification that the calculation should be based on total frontal facade area (including gables
and upper elements), not just linear width. Additionally, an exception was agreed upon for
structures featuring a recessed facade element—such as a breezeway, common entry corridor,
or covered porch that extends in front of the garage—on the grounds that in such cases the
garage is not the dominant visual element from the street.
Items 2 & 3 – Duplex Ratio by Development and by Phase
The draft resolution had proposed limiting duplexes to no more than 40% of a total
development, as well as 40% of any individual phase. Councilmember Hall reaffirmed the
governing body’s longstanding commitment to the 60/40 single-family to duplex ratio, which
has been consistently applied over the past two and a half years. Discussion acknowledged
that while developers may wish to front-load duplex construction for financial and
engineering reasons, the restrictive covenant tied to the land provides a durable mechanism to
ensure single-family completion regardless of ownership changes. Council noted that special
assessments and carrying costs provide organic financial incentives for developers to
complete developments as platted. The per-phase ratio restriction was left in place, though
council acknowledged it may create phasing layout challenges in some circumstances.
Amenities Requirement
Council discussed the requirement for on-site amenities in duplex developments. The prior
draft had required multiple amenities, including at least one active amenity. After discussion,
council reached consensus to require one meaningful active amenity, with a single exception:
if a development has a direct trail or sidewalk connection to an existing public amenity such
as a park or pool, the on-site amenity requirement may be waived. It was further clarified that
a retention pond with a walking path around it could qualify as an amenity, but a retention
pond alone (e.g., with fishing access only) would not. The half-acre reserve requirement was
retained.
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City Council Meeting
July 1, 2026

Design Variety – Number of Required Elevations
The draft had previously proposed requiring six distinct architectural elevation designs to
prevent monotonous streetscapes. After discussion, council settled on five required elevation
designs, noting that an odd number is aesthetically preferable and that five designs provide
sufficient variety while remaining achievable for builders. With respect to the prohibition on
repeating the same elevation within a certain proximity, council acknowledged that the prior
language was mathematically difficult to enforce, particularly on cul-de-sacs and curvilinear
streets where repetition becomes geometrically inevitable. The standard was softened so that
the same elevation design may not repeat within two adjacent lots, but is not prohibited from
appearing across the street.
Windows / Glazing Requirement
The draft had proposed a minimum 10% glazing requirement on the front facade. Council
discussed allowing sidelights and glazed architectural elements adjacent to entry doors to
count toward this percentage, in addition to standard windows. The council also noted that
porch openings (the unglazed framed spaces between porch columns and railings) should not
count toward the glazing calculation. The intent was preserved: homes must have visible
windows that contribute to residential character.
Trees
Discussion arose regarding the practical difficulty of requiring tree planting at the time of
certificate of occupancy when construction is completed in winter months. Council reached
consensus that if a developer is unable to plant required trees due to seasonal conditions, the
developer shall pay the city the full cost (including labor) to have the trees planted in the
spring. The city will not absorb any cost associated with this provision.
Storm Shelters
Council discussed and agreed to retain the storm shelter requirement for slab-on-grade duplex
units, citing Goddard's location in tornado alley. The requirement would be satisfied by a
FEMA/ICC-compliant safe room or closet within the structure. An exemption would apply to
units with a below-grade basement or similar shelter space. Staff acknowledged that the cost
per unit is estimated at approximately $4,000–$6,000 and noted that a similar requirement
may be considered for slab-on-grade single-family homes in the future through the
comprehensive plan process.
Curvilinear Street Design
Council discussed the original draft requirement discouraging visual repetition on curvilinear
streets. Scoggan explained that the as-written language was practically unworkable: on a culde-sac, the same elevation will inevitably end up across the street from itself due to geometric
constraints. The council determined that this provision would be softened and addressed
through the revised elevation repetition standard (no same design within two adjacent lots),
and that the curvilinear street language would not be retained in its prior form.
Water Softener Rough-In
Council briefly discussed a proposal to require that units be plumbed or spatially
accommodated for a future water softener installation. No formal requirement was adopted,
in part due to practical challenges with slab-on-grade construction and the city's near-term
plans to implement centralized water treatment and softening through its capital improvement
program.
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City Council Meeting
July 1, 2026

General Remarks
Councilmember Leonard addressed the tone and conduct of the prior meeting where WABA
representatives were present, expressing that productive collaboration requires mutual respect
and that the council's decisions are guided by community interest. The city attorney noted
that while the council retains the right to grant exceptions to any adopted standard, those
exceptions must be applied consistently and based on articulable, non-arbitrary criteria to
withstand legal challenge.
Scoggan indicated that a revised draft of the resolution incorporating all agreed-upon changes
would be distributed to council the following day (July 2) in advance of the July 6 meeting, at
which the resolution was anticipated to be formally adopted.

R-4 Strategic Growth Zone Overlay District
Community Development Director Micah Scoggan presented a concept map illustrating a
proposed Strategic Growth Zone Overlay District, designated as R-4, intended to identify
areas where the city would look favorably upon future rezoning applications for higherdensity development. The map depicted Goddard's current boundaries in blue, the City of
Wichita in green, and the proposed strategic growth zone in purple—covering areas generally
located between 167th and 183rd Streets to the south and east of Goddard's current limits,
where large tracts of undivided rural land remain available for annexation and development.
Scoggan explained that the overlay does not automatically rezone any property or guarantee
approval of any rezoning application; rather, it signals to the development community that the
city would be more favorably predisposed to rezoning requests within that zone, encouraging
developers to approach Goddard rather than Wichita. A secondary purpose is to allow the city
to potentially waive the design standard provisions discussed under Item I-1 for
developments within this zone, so as not to drive development activity across the city limits
to Wichita, where no such standards apply.
Council discussed the rationale for targeting the southern and southeastern areas over
expansion to the north, with staff noting that the selected zone contains larger, undivided
agricultural tracts that are more amenable to annexation and development, while the land to
the north is already developing more rapidly at higher values. Council expressed enthusiasm
for the concept, while also voicing a desire to be thoughtful about which standards might be
retained even within the growth zone, suggesting that design standards might be preserved
even if the duplex ratio requirement is relaxed.
City Manager Craig Crossette noted that the comprehensive plan process currently underway
would provide additional structure for mapping land uses and potentially creating a new
zoning classification tailored to this strategic growth area. He expressed confidence that the
city's recent investments in water supply infrastructure, including a new well, rural water
district pump station, and planned water reuse and softening programs, position Goddard well
to serve growth in these areas.
Staff explained that the expressway serves as a natural boundary, with areas to the west held
to Goddard's established standards, while the area to the east is expected to blend more
closely with Wichita's development patterns. The overlay is intended to cast a vision for that
area and give the city a competitive foothold in capturing development and associated tax
revenue before Wichita annexes or develops the corridor on its own terms.
The Council agreed in concept to proceed with publication and to route the matter through
the Planning Commission before returning to the full Council. There was consensus that the
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City Council Meeting
July 1, 2026

comprehensive plan engagement process would serve as an appropriate venue for broader
community input on this topic, including during the upcoming July open houses.
MOTION: Councilmember Leonard moved to publish the R-4 Strategic Growth
Zone Overlay District in the City Newspaper and place the item on the
Planning Commission agenda. Councilmember Hall seconded the
motion. The motion carried 5-0.

City Administrator's Report
Executive Session
Adjournment
MOTION: Councilmember Liebe moved to adjourn the meeting. Councilmember
Hall seconded the motion. The motion carried 5-0.

The Meeting adjourned at 9:13pm.
Sarah Simon, City Clerk

________________________________
George Liebe, Mayor

5

Goddard City Council
City Council Meeting Minutes
Monday, July 6, 2026
Call to Order
The City Council Meeting was held at Goddard City Hall on Monday, July 6, 2026. Mayor
Liebe called the meeting to order at 7:00 pm. Council members present were George Liebe,
Amanda White, Krista Hall, Corey Dir, and Naomi Leonard.
Also, present was Craig Crossette, City Manager; Ryan Shrack, Deputy City Manager; Jason
Cauley, Public Works Director; Lance Beagley, Police Chief; Sarah Simon, City Clerk; Micah
Scoggan, Community Development Director; Brooke Carroll, Chief Financial Officer, and Dani
Mueting, Community Engagement Director.

Pledge of Allegiance and Invocation
The Pledge of Allegiance was recited, followed by an invocation.

Approval of the Agenda
MOTION:

Councilmember Liebe moved to approve the agenda. Councilmember
Leonard seconded the motion. The motion carried 5-0.

Citizen Comments
The Mayor opened citizen comments, noting in advance that a number of residents were
likely present regarding special assessments and the public hearing later on the agenda. He
reminded the public that citizen comments are an opportunity for the community to speak to
the Council without dialogue, and directed residents with questions to City Administrator
Craig and Community Development Director Micah Scoggan following the meeting.
Linda Geeseman offered positive feedback regarding the 2026 roadway resurfacing project.
She noted that while work on her block was paused due to rain, the contractor, Apex, had
been communicative and professional, and she appreciated that they were avoiding running
heavy equipment unnecessarily on the street. Mayor Liebe confirmed that an additional layer
of asphalt was still planned for that area.

Ex Parte and Conflict of Interest Declaration
None

Appointments, Proclamations, Recognitions, & Nominations
Recognition of High School Neighbors United Co-Chairs
The City recognized the student co-chairs of the 10th Annual Neighbors United event.
Community Engagement Director Dani Mueting spoke on behalf of the program, thanking
community partners including Pathway Church, Ace Hardware, Goddard Public Schools,

City Council Meeting
July 6, 2026

Goddard Lions Club, Goddard Community Garden, the Goddard Women's Club, Goddard
Scouts, and numerous other businesses, churches, and volunteers.
Two high school students, Riley Schoen and Brandon Johnson, were recognized for their
extraordinary contributions to the 10th anniversary event. Brandon was credited with
designing the official anniversary logo and shirts, updating spreadsheets and forms, and
assisting with countless behind-the-scenes details. Riley was recognized for her
organizational leadership in volunteer coordination, event logistics, and sponsorship efforts.
Director of the Goddard Education Foundation Dane Baxa, who has served in a leadership
role with Neighbors United for ten years, added remarks about both students. She described
Riley's professionalism and servant leadership as "far beyond your years," and noted that she
would be continuing to work alongside her in a community relations capacity. Brandon was
praised for his creativity, vision, humility, and video production work, and was
acknowledged as he prepared to graduate and begin his next chapter.
The program's lead organizer, Dane Baxa, was also formally recognized for founding the
Neighbors United program a decade ago and for his sustained investment in developing
young community leaders. Mueting credited Dane's leadership style as one that identifies
individuals' strengths and empowers them to lead rather than fitting them into predefined
roles. She described his greatest legacy as not the projects completed, but the leaders the
program continues to develop.
Staff member Dani Mueting was recognized as well, having coordinated the 2026 event from
beginning to end for the first time and doing so with organization, steadiness, and dedication.
The Mayor and Council expressed appreciation for the continued partnership with the
community and the investment in servant leadership that Neighbors United embodies.

Library Board Appointment
Mayor Liebe introduced Kristi Smith as his nomination for appointment to the Library Board,
noting her background in church leadership, law enforcement, and community involvement.
The mayor expressed appreciation for her willingness to serve, highlighting the library's
important role for both the City of Goddard and the broader Goddard School District.
MOTION:

Councilmember Liebe made a motion to appoint Kristi Smith to the
Library Board. Councilmember Hall seconded the motion. The motion
carried 5-0.

Consent Agenda
1.
2.
3.
4.
5.

Approval of Senior Transportation Program Guidelines
Trails End SWS & Paving Bid Award
Sound Waiver & Fireworks Display Summer Ball Showdown
Resolution Amending the Water Leak Adjustment Policy
Accounts Payable
a. 06.24.2026 - $825,092.18
b. 06.30.2026 - $324,258.54
6. Minutes
a. 05.11.2026 - Regular Meeting Minutes
b. 06.01.2026 - Regular Meeting Minutes
c. 06.15.2026 - Regular Meeting Minutes
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City Council Meeting
July 6, 2026

d. 06.23.2026 - Regular Meeting Minutes
MOTION:

Councilmember Liebe made a motion to approve the consent agenda.
Councilmember White seconded the motion. The motion carried 5-0.

Unfinished Business
None

New Business
Public Hearing of Special Assessments & Ordinance
Bond Counsel Kevin Cowan provided background on the special assessment process,
explaining that this hearing represented the next step in converting temporarily financed
public infrastructure improvements to permanent long-term financing through the issuance of
general obligation bonds. The improvements at issue covered two developments: Arbor
Creek Addition Phase 3 and Bridger at Maple Addition Phase 1, both of which were
originally authorized pursuant to petitions submitted by 100% of property owners at the time,
with authorizing resolutions that spelled out project scope, estimated costs, and methods of
assessment.
Cowan outlined the final costs for each project, all assessed at 100% to the improvement
districts:
● Arbor Creek Phase 3: Water distribution ($74,857), water main improvements
($74,857), sanitary sewer ($158,000), paving improvements ($393,100), and paving
collector improvements ($296,100).
● Bridger at Maple Phase 1: Sanitary sewer ($864,100), stormwater drainage
($996,100), street improvements ($963,100), and water line improvements
($683,100).
Cowan noted that all final costs had been verified against original petition estimates and
confirmed to be within acceptable statutory parameters. He explained that following the
hearing and adoption of the ordinance, property owners would have a 30-day window
through August 6th to prepay their assessments in whole or in part. Any amounts not prepaid
would be financed through general obligation bonds payable over 20 installments beginning
in 2028.
MOTION:

Councilmember Liebe made a motion to open the public hearing.
Councilmember Hall seconded the motion. The motion carried 5-0.

The mayor opened the public hearing. A resident, Tara Burkhart of the Bridger at Maple
development, addressed the Council. She explained that she had purchased her home
approximately one year ago and received notice of the special assessment with only about
one week's notice. She expressed frustration that the builder and the realtor—who she noted
were married to one another—had not disclosed the assessments at the time of sale, despite
the obligation having been in place for approximately two years prior to her purchase. She
described the financial burden of a roughly $29,125 assessment on a 1,200 square-foot
duplex as significant, particularly given existing HOA fees. She also raised concerns about
the development's stalled buildout and the impact on property values, and she called on the
Council to be good stewards of residents' trust.
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City Council Meeting
July 6, 2026

Other residents in attendance indicated by a show of hands that they also had not been
informed of the special assessments by their realtors.
Council members acknowledged the residents' concerns. Councilmember White asked staff to
follow up on whether affected residents shared the same realtor. Council members were
emphatic that while they were sympathetic, the statutory process could not be stopped at that
stage, but committed to pursuing earlier notice in future assessment cycles. The City Manager
Craig Crossette noted that special assessments are a standard practice for new development in
Kansas and that legal obligations for disclosure exist at the realtor and title company level.
He referenced a prior instance in another Goddard development where a realtor faced
litigation for failing to disclose assessments. He also acknowledged that there is sometimes a
timeline pressure to close temporary notes that compresses the notice window, and
committed to getting notices out earlier when possible.
MOTION:

Councilmember White made a motion to close the public hearing.
Councilmember Leonard seconded the motion. The motion carried 50.

The Council then considered the ordinance approving the assessment roll.
MOTION:

Councilmember Leonard made a motion to waive the reading of the
ordinance. Councilmember Hall seconded the motion. The motion
carried 5-0.

MOTION:

Councilmember Leonard made a motion to approve the ordinance.
Councilmember Hall seconded the motion. The motion carried 5-0.

Ordinance #1049

Notice of Intent to Exceed Revenue Neutral Rate
Chief Finance Director Brooke Carroll presented the annual Notice of Intent to Exceed the
Revenue Neutral Rate (RNR) as required by Kansas statute. He explained that the City's total
assessed valuation for 2026 increased by approximately 8.34%, resulting in a revenue neutral
rate of 36.274 mills. The City's currently adopted mill levy of 39.299 mills is 3.025 mills
above the RNR, generating approximately $286,000 in additional property tax revenue above
what the RNR would allow.
Carroll clarified that the RNR is not the same as a revenue neutral tax bill—individual
property tax bills are also affected by changes in a home's appraised value and by other
taxing jurisdictions. She provided an illustrative example using a $270,000 home with a 4.5%
appraisal increase, showing that at the RNR the city portion of the tax bill would decrease by
approximately $43 per year, while at the proposed levy it would increase by approximately
$54 per year.
Carroll noted that the statutory deadline for submitting the notice of intent to the Sedgwick
County Clerk is July 20, 2026, and that filing the notice preserves the Council's option to set
the mill levy above the RNR all the way through the budget hearing scheduled for September
8, 2026. Failure to file would require the City to remain at the RNR.
Mayor Liebe clarified that through the budget process, the Council's current direction is to
hold the mill levy at 39.299 mills without raising it further, utilizing other revenue sources—
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City Council Meeting
July 6, 2026

including increased developer fees, insurance savings, and growth-driven revenue—to fund
the ongoing 5-and-5 street program rather than imposing an additional mill increase as had
been discussed in prior years. The City Administrator added that filing the notice does not
itself increase taxes; it simply preserves the option.
MOTION:

Councilmember Hall moved to submit the Notice of Intent to Exceed
the Revenue Neutral Rate to the Sedgwick County Clerk.
Councilmember Dir seconded the motion. The motion carried 5-0.

Justice Center (Police Station) Preliminary Design & Staffing Study Services
City Manager Craig Crossette presented a two-part request related to the planning and design
of a new Justice Center, also referred to as the Police Station. He provided context from the
City's Capital Improvement Program (CIP) adopted the prior year, which had identified the
police station as a facility project coming in the near term. Given that the preliminary
budgetary figure had come in quite high, staff sought to refine the building program to
produce a "Phase 1" or 25-year facility designed with future expansion in mind.
Part 1 – Preliminary Design Services: Staff solicited proposals from three vendors. Hutton
Design Build, partnering with Goldberg Group Architects, submitted the lowest cost proposal
and was recommended based on both their pricing and Goldberg's extensive portfolio of
public safety facility design. Crossette and Police Chief Lance Beagley noted they had been
touring comparable police stations in the region to gather information and cost efficiencies.
Part 2 – Staffing Study Services: Staff recommended engaging McGrath Consulting Group, a
human resources firm specializing in public safety municipalities, to conduct a concurrent
current and future staffing study. The two workstreams—design programming and staffing
analysis—would run in parallel and inform one another, with the goal of advertising for full
architectural and engineering services in late 2026 in advance of a planned construction start
in 2028.
Councilmember Dir expressed appreciation for the staff’s proactive approach, noting the
urgency of addressing the department's severely constrained facility while also being
thoughtful about fiscal responsibility.
MOTION:

Councilmember Dir moved to select Hutton Design Build in
partnership with Goldberg Group Architects to perform additional
preliminary programming and concept refinement services for the
planned Goddard Justice Center for a fixed fee of $9,500, and to
authorize the City Manager to execute the necessary agreement.
Councilmember Hall seconded the motion. The motion carried 5-0.

MOTION:

Councilmember Dir moved to approve the proposal from McGrath
Consulting Group to conduct the police current and future staffing and
Justice Center feasibility study for $15,470 plus actual travel expenses,
and to authorize the City Manager to execute the necessary agreement,
was made by Council Member Hall and seconded by a Council
member. Councilmember Leonard seconded the motion. The motion
carried 5-0.

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City Council Meeting
July 6, 2026

199th & Kellogg Traffic Modification Discussion
Deputy City Manager Ryan Shrack presented a proposed interim traffic improvement at the
intersection of 199th Street and Kellogg (Highway 54), which staff identified as one of the
most dangerous intersections in Goddard. He noted that the City partnered with KDOT last
year on a traffic engineering study (TEAP Study) to identify long-term solutions, but results
had not yet been received. In the interim, city staff worked with engineer Harlan Foraker of
CED to develop short-term options.
The recommended solution is the construction of a traffic island on the southwest corner of
the intersection, at the northern private drive entrance near Enterprise Bank. The island would
restrict eastbound traffic exiting that drive to a right-turn-only movement. The City consulted
with Enterprise Bank and the adjacent tenants, and Enterprise Bank agreed to install a gate on
the west side of their building and the City offered to place temporary concrete barriers to
prevent through-traffic from circling the building.
Shrack explained that fully closing the northern entrance was considered but rejected after
legal counsel advised that doing so could be deemed a taking due to an existing
ingress/egress easement benefiting neighboring properties, potentially exposing the City to
litigation. The traffic island approach respects that easement while still meaningfully
restricting the most dangerous movements.
A presentation walked through the revised traffic flow patterns for businesses south of
Kellogg, including McDonald's, Pizza Hut, and Taco Bell, showing that multiple access
options would remain available under the new configuration. New signage and pavement
markings were included in the plan.
The project would be funded from the Special Highway and Street Fund within the existing
$250,000 annual street capital improvements allocation. Shrack clarified that the actual cost
of the island itself is modest—potentially only a few thousand dollars for concrete, signs, and
pavement markings—and that public works would batch the concrete pour with other small
pending concrete projects.
Councilmember White raised a concern that drivers coming northbound on 199th might route
into the parking lot via the southern entrance rather than proceeding to Cedar Street,
potentially relocating traffic conflicts into the parking area near the ATM. Shrack
acknowledged the concern and noted that signage directing one-way traffic around the ATM
lane could be discussed with Enterprise Bank. Both staff and Council expressed confidence
that driver behavior would adapt over time and that even a partial reduction in conflicts at the
intersection would justify the effort. Staff confirmed that Enterprise Bank would receive
ample advance notice before any construction begins.
MOTION:

Councilmember Hall moved to approve the traffic island design as
presented and authorize staff to move forward with implementation.
Councilmember Dir seconded the motion. The motion carried 5-0.

Two Family Restrictive Covenant & Resolution
Community Development Director Micah Scoggan presented the revised Two Family
Restrictive Covenant and Resolution, which had been developed following a special meeting
held July 1, 2026, and a prior discussion at the May 11, 2026, meeting. The resolution
establishes design standards, amenity requirements, and density ratios applicable to new
rezoning applications for duplex, three-family, and four-family residential development on
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City Council Meeting
July 6, 2026

greenfield parcels. It does not apply to existing developments or previously approved
entitlements.
One notable change from the prior draft was the removal of a provision related to sound
separation for common walls in two-family, three-family, and four-family structures. Staff
determined this provision was redundant given that the sound separation standard was already
being addressed as a standalone ordinance under Agenda Item I-7, and removing it also
prevented the possibility of individual applicants arbitrarily seeking to waive it through the
resolution process.
Mayor Liebe reflected on the Council's approach, noting that while some community
members believe no further duplexes should be built, the 60/40 ratio that has been established
over the past two and a half years represents a reasonable balance. He expressed that market
forces may naturally slow duplex construction and emphasized the importance of maintaining
quality and livability standards—including amenities such as pools, parks, and playgrounds—
that have been requested by the community.
Vice Mayor Hall acknowledged the effort of city staff in preparing for the special meeting
and facilitating open public deliberation, and expressed optimism that the resolution would
serve as a workable starting framework.
MOTION:

Councilmember Hall moved to adopt the Two-Family Restrictive
Covenant and Resolution as presented. Councilmember Dir seconded
the motion. The motion carried 5-0.

Resolution 26-36

Governing Body Manual & Code of Meeting Procedure Adoption
Deputy City Manager Ryan Shrack presented two governance documents for formal
adoption: a Governing Body Manual and a Code of Meeting Procedure. Both documents
were developed in collaboration with the Wichita State University Public Policy Management
Center and legal counsel. The Governing Body Manual replaces the handbook previously
published by the League of Kansas Municipalities with a Goddard-specific document, while
the Code of Meeting Procedure establishes formal guidelines for conducting city council
meetings, including rules for public engagement, voting procedures, and member conduct.
The Mayor noted the value of consistency and formality that these documents provide. He
also acknowledged that while the Council has at times engaged in informal dialogue with
residents during hearings, the Code of Meeting Procedure serves as an important reminder
that the Council cannot selectively choose when to allow interactive dialogue without risking
content-based distinctions in public participation. Both documents will be published on the
City's website following adoption.
MOTION:

Councilmember Leonard moved to adopt the Governing Body Manual
and Code of Meeting Procedure as presented. Councilmember Dir
seconded the motion. The motion carried 5-0.

Revised Sound Barrier for Two Family, Three Family, & Four Family Structures
Community Development Director Micah Scoggan presented a revised sound separation
ordinance applicable to common walls in two-family, three-family, and four-family
structures. The ordinance repeals and replaces a previously adopted standard. Under the prior
7

City Council Meeting
July 6, 2026

ordinance, a single 2x6 stud wall was prohibited, but both a staggered stud and a double stud
configuration were permitted. After review, staff—in consultation with the City's new
Building Inspector—determined that the double stud wall with a one-inch air gap and batt
insulation provided a significantly superior sound transmission coefficient (STC) compared
to a staggered stud configuration, and that this method was already becoming standard
practice among many area builders. Accordingly, staff recommended elevating the double
stud with air gap to the new minimum standard.
Vice Mayor Hall expressed support for the revision, noting he had raised questions about the
original standard early on and that the revised ordinance better addressed the sound
separation concerns heard from renters in the community.
MOTION:

Councilmember Dir moved to waive the reading of the ordinance.
Councilmember Hall seconded the motion. The motion carried 5-0.

MOTION:

Councilmember Dir moved to approve the ordinance repealing and
replacing the previous sound separation standard as a supplemental
construction code, establishing the double stud wall with air gap as the
new minimum standard for common walls in two-family, three-family,
and four-family structures. Councilmember Hall seconded the motion.
The motion carried 5-0, followed by a roll-call vote.

Ordinance #1050

City Administrator's Report
City Manager Craig Crossette provided the following updates:
Upcoming Meetings: Budget Workshop #3 is scheduled for Thursday, July 9, 2026 at 6:00
PM to cover water, sewer, and stormwater utility funds, as well as reserve and tourism
promotion funds. Budget Workshop #4 is scheduled for Wednesday, July 22, 2026 at 6:00
PM to address the capital improvement fund, equipment reserves, and remaining smaller
funds.
Comprehensive Plan: A public open house and visioning work session for the Goddard
Comprehensive Plan is scheduled for July 16, 2026 from 6:00–7:30 PM. City leadership,
Council, and the Planning Commission are also expected to participate in earlier sessions that
day.
Council Chamber AV Upgrade: Crossette presented cost information for a proposed AV
upgrade to the council chamber and asked for Council direction on whether to bring it
forward as a near-term agenda item or incorporate it into the FY2027 budget process. After
brief discussion, the Council agreed to address the topic at the July 9th budget workshop.
Strategic Road Overlay District: A public hearing before the Planning Commission is
scheduled for August 10, 2026, with Council consideration anticipated at the August 17, 2026
regular meeting. The overlay is intended to signal to developers and property owners that the
City is open to a broader range of residential densities within the designated area, subject to
appropriate design standards, when land is annexed from the unincorporated county.
Public Works Facility: The main structural frame is nearing completion, with garage doors
being hung and cross-bracing installed in preparation for siding.
8

City Council Meeting
July 6, 2026

Legacy Bank Park: Site clearing and tree debris removal are substantially complete. The
contractor is progressing on the pickleball and dog park areas, and the pavilion slab has been
brought to grade with compaction testing scheduled for the following week.
Hawkins Lane: The project is close to completion. Irrigation issues and well-related hiccups
have been resolved, and trees and the monument sign are in place with plantings remaining.
Water Loop Project: Potholing and pipe installation have begun, with wet-tapping underway.
Open trenching on Oak Street is visible, and the city's internal Spruce Street water line
project is also progressing.
2026 Roadway Project: An update was received from Apex. KDOT is also replacing a
stormwater pipe at the North Frontage Road access point.
Trails End 3rd Addition: Sanitary sewer and water mains are complete. A bid was awarded at
this meeting for stormwater and paving, and a preconstruction conference will be scheduled.
Rachel Brook Estates: Preconstruction conference held the prior week; work is expected to
begin soon.
Villas at Pleasant Ridge Creek: Stormwater system work is continuing, with ongoing
dewatering challenges.
Willow's Ridge: Sanitary sewer and water distribution work is continuing with backfilling of
water lines underway.
Sanitary Sewer Backup on Main Street: Public works staff identified a sanitary sewer issue
near the library involving significant debris accumulation and a deteriorating clay pipe.
Televising and cleaning have been performed. Crossette indicated he may authorize an
emergency expenditure for sewer main relining under the financial policy prior to the next
Council meeting, given that the affected main carries all wastewater from Old Town to the
treatment plant. He noted that adequate reserves and budgeted operating funds are available
and committed to notifying the Council promptly if such authorization is exercised.
Bridger at Maple Phase 2: Paving is expected to begin soon.
Micromobility Device Ordinance: The City Manager, Police Chief, and City Attorney are
working on a micromobility ordinance to address safety concerns around scooters and similar
devices, drawing on existing ordinances from peer communities.
167th & 23rd Street Sanitary Sewer Lift Station: A bid has been awarded. Staff is pushing for
a preconstruction conference given that 13 building permits have already been issued for the
project area.

Governing Body Comments
Councilmember Leonard - Thanked the resident who provided positive feedback about the
roadway project and the APAC contractor at the beginning of the meeting. She echoed
appreciation for the Neighbors United recognition and noted that the 4th of July was a
wonderful community event, with neighbors gathering throughout Goddard. She thanked
staff for their continued hard work.
Vice Mayor Hall - Echoed appreciation for Neighbors United and for the recognition of the
student leaders and Dane. She welcomed Kristi Smith to the Library Board. She also
acknowledged the residents who attended the public hearing and noted the importance of the
9

City Council Meeting
July 6, 2026

disclosure issue that was raised, expressing hope that the City can work toward better
communication with incoming residents on special assessment obligations.
Councilmember White - Described a positive 4th of July experience with neighbors gathering
on the street and noted that moments of community connection are what make Goddard
special
Councilmember Dir - Thanked Linda for coming forward with positive feedback about the
road contractor. He echoed praise for Neighbors United and expressed hope that the program
continues for many more years. He also thanked the Lions Club and the City for the 4th of
July celebration and extended appreciation to staff for their work on the two-family
resolution, expressing confidence that it will serve as a strong starting framework
Mayor Liebe - noted that the second half of the year has begun and, with 172 days remaining
until Christmas, encouraged continued momentum. He thanked Dane for his decade-long
investment in Neighbors United and acknowledged Dani's leadership in continuing to elevate
the program. He expressed optimism about the direction of the community.

Executive Session
Adjournment
MOTION: Councilmember Liebe moved to adjourn the meeting. Councilmember
White seconded the motion. The motion carried 5-0.

The Meeting adjourned at 8:46pm.
Sarah Simon, City Clerk

________________________________
George Liebe, Mayor

10

CITY OF GODDARD
ACCOUNTS PAYABLE LIST: AUGUST 5, 2026
COUNCIL REVIEW: AUGUST 17, 2026
VENDOR NAME

CONCO CONSTRUCTION

DESCRIPTION
BATTERY FOR 2020 RAM 2500 AND BLOWER MOTOR FOR CHEVROLET
IMPALA
PROFESSIONAL ENGINEERING SERVICES FOR BRIDGER AT MAPLE PH. II,
PROJECT #2025-09, 167TH WEST ADDITION, PROJECT #2024-04, AND 23RD
STREET SOUTH ADDITION, PROJECT #2024-02
JUNE 2026 P-CARD PURCHASES: SIMON
CONSTRUCTION ADMINISTRATION & INSPECTION FOR GODDARD
GALLERIA, PROJECT #2024-06
PAY REQUEST #2 - LEGACY BANK PARK, PROJECT #2020-03

DIESEL POWER LLC

REPAIR/MAINTENANCE FOR 2018 CHEVROLET SILVERADO 3500 DIESEL

$

1,463.51

EVERGY

MONTHLY ELECTRIC SERVICE - STREET LIGHTS
DISCLOSURE FEES: 2025-A, 2023-A, TEMPORARY NOTE 2023-2, AND
TEMPORARY NOTE 2024-5 - RUSTIC CREEK PH. II, PROJECT #2023-09
Q3 2026 POSTAGE METER RENTAL
PROFESSIONAL ENGINEERING SERVICES THROUGH 06.26.26 FOR LEGACY
BANK PARK, PROJECT #2020-03; WATER LOOPING, PROJECT #2025-10;
BRIDGER AT MAPLE PH. II, PROJECT #2025-09; HAWKINS LANE, PROJECT
#2025-07; VILLAS AT PLEASANT RIDGE CREEK PH. I, PROJECT #2025-06;
23RD STREET SOUTH ADDITION, PROJECT #2024-02; 167TH WEST
ADDITION, PROJECT #2024-04; AND WILLOW RIDGE ADDITION PH. I,
PROJECT #2025-08
MONTHLY PHONE/INTERNET SERVICE - CITY HALL/POLICE, POOL, PUBLIC
WORKS/WWTF, AND COMMUNITY CENTER
INSTALL TELEPHONE JACK AND WIRES - CITY HALL, AUGUST 2026
MICROSOFT LICENSING, 25% PROGRESS LABOR - TYLER MIGRATION, 8%
PROGRESS LABOR - PUBLIC WORKS FACILITY, PROJECT #2025-11
TRAINING, EOP RESEARCH AND WRITING EMERGENCY OPERATIONS PLAN
05.30.26 THROUGH 06.26.26
(1) EACH STREET SIGNS - MAIN ST AND KELLOGG
BLOWER REPAIR - WWTF
JULY 2026 LOCATE FEES: 186 LOCATES
(22) PICNIC TABLE RENTAL INCLUDING SET UP & TEAR DOWN - FALL
FESTIVAL
LAB ANALYSIS - DRINKING WATER, WASTE WATER
PROFESSIONAL ENGINEERING SERVICES THROUGH 07.04.26 FOR RACHEL
BROOKE ESTATES, PROJECT #2026-01 AND VILLAS AT PLEASANT RIDGE
CREEK, PROJECT #2025-06
(4) "NO SEMI TRUCKS" STREET SIGNS
PROFESSIONAL SERVICES THROUGH 07.11.26 FOR THE 2026
COMPREHENSIVE PLAN UPDATE
HAND HELD MAGNET, GASKET SCRAPER, AND VEHICLE PARTS
AUGUST 2026 CODE COMPLIANCE FEE
REPAIR/MAINTENANCE FOR POLICE VEHICLE: V-53 & V-44
ROTARY HAMMER & 23" BIT
PEST CONTROL - POLICE
2026 LEAGUE ANNUAL CONFERENCE REGISTRATION - SHRACK, LEONARD,
AND LIEBE
4 WEEK BILLING INVOICE - COMPRESSOR AND AIR HOSE RENTAL FOR
SERVICE BORING. WATER LOOPING, PROJECT #2025-10
WWTF LAB SUPPLIES
MONTHLY GPS SERVICE - POLICE
MONTHLY CELL PHONE/DATA SERVICE
A/C REPAIR PARTS - CITY HALL

$

3,283.17

$

2,304.00

$

194.85

$

55,334.40

$

1,518.17

$

5,983.02

$

2,821.25

$
$
$

109.90
493.92
247.38

$

705.80

$

1,037.00

$

11,968.65

$

131.40

$

9,696.59

$
$
$
$
$

111.96
3,000.00
266.42
754.16
40.00

$

825.00

$

1,081.00

$
$
$
$

32.57
308.35
1,678.53
138.00

AUTOZONE
BAUGHMAN COMPANY
CARD SERVICES
CERTIFIED ENGINEERING DESIGN

FACTSET RESEARCH SYSTEMS, INC.
FP MAILING SOLUTIONS

GARVER

IDEATEK
IMAGINE IT
iPARAMETRICS, LLC
JB428 LLC
KAESER COMPRESSORS
KANSAS ONE-CALL SYSTEM, INC.
MARTINEZ PARTY RENTALS, LLC
MERIDIAN ANALYTICAL LABS, LLC
MKEC ENGINEERING, INC.
NATIONAL SIGN COMPANY, LLC
OLSSON
O'REILLY AUTO PARTS
PROFESSIONAL CODE COMPLIANCE
RAUSCH REPAIR
SALISBURY SUPPLY CO., INC.
SWANEE GENERAL PEST CONTROL
THE LEAGUE OF KANSAS
MUNICIPALITIES
UNITED RENTALS
USA BLUEBOOK
VERIZON CONNECT
VERIZON WIRELESS
WASHER SPECIALTIES CO.

Page 1 of 2

AMOUNT
$

635.25

$

640,600.00

$

5,139.93

$

198,817.53

$

347,713.79

CITY OF GODDARD
ACCOUNTS PAYABLE LIST: AUGUST 5, 2026
COUNCIL REVIEW: AUGUST 17, 2026
VENDOR NAME
WEX BANK

DESCRIPTION
JULY 2026 FLEET FUEL

Page 2 of 2

AMOUNT
$
8,063.71
TOTAL $ 1,306,499.21

CITY OF GODDARD
ACCOUNTS PAYABLE LIST: AUGUST 5, 2026
COUNCIL REVIEW: AUGUST 17, 2026
VENDOR NAME
STATE OF KANSAS - KDOT

DESCRIPTION
REMITTANCE OF GRANT OVERPAYMENT - KA 7629-01, GODDARD
GALLERIA, PROJECT #2024-06

Page 1 of 1

AMOUNT
$

182,737.02

TOTAL $

182,737.02

CITY OF GODDARD
ACCOUNTS PAYABLE LIST: AUGUST 12, 2026
COUNCIL REVIEW: AUGUST 17, 2026
VENDOR NAME
AIRGAS USA
AMERICAN BOILER & MECHANICAL
AT&T FIRSTNET

BHC

CARD SERVICES
CENTENO, MONIQUE
CK POWER
CORE & MAIN
COX BUSINESS
CULLIGAN OF WICHITA
DEATON-PURKEY, BETH
DJ CARBON LLC
GALLS

DESCRIPTION
CYLINDER LEASE RENEWAL 09.01.26 THROUGH 08.31.31
START UP POOL BOILER FOR 2026 SEASON
CELL/DATA SERVICE, POLICE PRIORITY LINES, CITY PLANNER, TABLET, AND
PUBLIC WORKS TABLETS
WATER LINE IMPROVEMENTS INSPECTION FROM 07.04.26 THROUGH
07.31.26 FOR TRAILS END FINAL ADD., PROJECT #2025-05 AND PAVING
IMPROVEMENTS INSPECTION FROM 07.04.26 THROUGH 07.31.26 FOR
RACHEL BROOKS ESTATES, PROJECT #2026-01
JUNE 2026 P-CARD PURCHASES: CROSSETTE, FULCHER, BEAGLEY, AND
ROMERO. JULY 2026 P-CARD PURCHASES: CARROLL, DEATON-PURKEY,
NICKELSON, SHELITE, CAMPBELL, SHRACK, AND BEAGLEY
COURT APPOINTED ATTORNEY FEES - 07.14.26 AND 07.28.26
GENERATOR INSPECTION/LOAD BANK - WWTF
CHECK VALVE AND PARTS FOR WWTF EQUIPMENT AND WATER PARTS
FOR WATER LOOPING, PROJECT #2025-10
MONTHLY INTERNET SERVICE: PUBLIC WORKS
BOTTLED WATER FOR WWTF
MILEAGE REIMBURSEMENT THROUGH 08.11.26
MUSCIAL PERFORMANCE - 2026 NATIONAL NIGHT OUT
CLOTHING/UNIFORM ACCESSORIES - POLICE

$
$

AMOUNT
924.80
287.00

$

2,695.47

$

18,239.70

$

7,032.97

$
$

200.00
1,100.00

$

2,288.10

$
$
$
$
$

139.89
55.80
79.17
600.00
189.05

GARVER

PROFESSIONAL ENGINEERING SERVICES THROUGH 06.26.26 FOR PUMP
STATION & FORCE MAIN AT 167TH WEST ADDITION, PROJECT #2024-04

$

514.00

GUY, STEPHANIE

JULY 2026 MILEAGE REIMBURSEMENT

$

46.21

HEARTLAND COCA-COLA BOTTLING CO.

CONCESSION ITEMS FOR RESALE: POOL

$

594.80

$

504.54

$
$
$
$
$
$

236,630.75
1,174.25
2,738.86
8,385.00
1,007.44
77,583.18

$

5,178.00

$
$

732.00
55,994.90

$

7,309.03

$

200.00

$

627,959.68

$

1,269.64

$

39,413.50

$

701.43

$

432.09

IMAGINE IT
KANSAS PAVING
KANSAS STATE TREASURER - COURT
KANZA COOP
MAYER SPECIALTY SERVICES
MCCONNELL & ASSOCIATES
MCCULLOUGH EXCAVATION
MCGRATH CONSULTING GROUP, INC
MERIDIAN ANALYTICAL LABS
MIES CONSTRUCTION
MUNICIPAL SUPPLY, INC.
ORR, MARK
PEARSON CONSTRUCTION
RAUSCH REPAIR
RUSTY ECK FORD

TROUBLESHOOTING NETWORK CONNECTION AND (1) 27' VIEWSONIC
MONITOR
PAY REQUEST #1 - BRIDGER AT MAPLE PHASE II, PROJECT #2025-09
JULY 2026 COURT FEES
JULY 2026 FLEET DIESEL FUEL
RAISE MANHOLE 24" AT WWTF
(56) COLD PATCH - 50 LB BAG
PAY REQUEST #3 - WILLOW RIDGE ADDITION, PROJECT #2025-08
PAY REQUEST #1 - PROJECTING STAFFING AND ORGANIZATIONAL NEEDS
FOR NEW POLICE AND JUSTICE CENTER, PROJECT #2026-08
LAB ANALYSIS - WASTEWATER
PAY REQUEST #1 - TRAILS END FINAL, PROJECT #2025-05
WATER PARTS - WATER LOOPING, PROJECT #2025-10 AND PARTS FOR
NEW WATER SAMPLING STATIONS
COURT APPOINTED ATTORNEY FEES - 07.14.26 AND 07.28.26
PAY REQUEST #2 - VILLAS AT PLEASANT RIDGE CREEK, PROJECT #2025-06.
PAY REQUEST #1 - WILLOW RIDGE ADDITION, PROJECT #2025-08. PAY
REQUEST #7 (FINAL) HAWKINS LANE, PROJECT #2025-07
REPAIR/MAINTENANCE FOR POLICE VEHICLES: V-54, V-49, V-42, AND V-41
PURCHASE NEW 2026 FORD RANGER FOR PUBLIC WORKS
APPROVED BY COUNCIL 08.03.26

SEDGWICK COUNTY - DEPT. OF FINANCE JULY 2026 PRISONER HOUSING FEES: 227 HOURS
SEDGWICK COUNTY ELECTRIC COOP

MONTHLY ELECTRIC SERVICE - HAWKINS LANE STREETLIGHTS, ELK RIDGE
SEWER LIFT STATION, LEGACY BANK PARK, AND SPRING HILL
STREETLIGHTS

Page 1 of 2

CITY OF GODDARD
ACCOUNTS PAYABLE LIST: AUGUST 12, 2026
COUNCIL REVIEW: AUGUST 17, 2026
VENDOR NAME
SMH CONSULTANTS
SPACEMAN LLC
THE DATA CENTER
WASTE MANAGEMENT
WATERWISE ENTERPRISES LLC
WATNEY, JOSIAH
WAXENE PRODUCTS COMPANY
WORKSTEPS, INC.

DESCRIPTION
AMOUNT
PROFESSIONAL SERVICES THROUGH 07.31.26 FOR NW EXPRESSWAY
$
974.70
CORRIDOR AND LAND ACQUISITION
SPACE RACE MOON BOUNCE OBSTACLE COURSE RENTAL - 2026 NATIONAL
$
365.92
NIGHT OUT
PRINT/MAIL (393) DELINQUENT NOTICES, (1422) UTILITY BILLS, AND
$
1,673.80
(1281) NEWSLETTERS. REPLACE POSTAGE USED IN JULY 2026
PUBLIC WORKS DUMPSTER PER DIEM CHARGE. WASTE DISPOSAL FOR
$
1,033.39
COMMUNITY CENTER, CITY HALL, WWTF, AND PUBLIC WORKS
CHLORINE BUILDING CHEMICALS
$
1,330.00
EXPENSE REIMBURSEMENT THROUGH 08.10.26
$
21.34
WIPING RAGS - PUBLIC WORKS
$
135.00
PRE-EMPLOYMENT EXAM - WATNEY
$
75.00
TOTAL $ 1,107,810.40

Page 2 of 2

City of Goddard
City Council Meeting
August 3, 2026
TO:
SUBJECT:
PREPARED BY:
AGENDA:

Agenda Item G.3

Mayor and City Council
Empower Flex Spending Resolution-Plan Update
City Cler, Sarah Simon; HR Director, Gina Campbell
New Business

Background: The EMPOWER Flexible Spending Account program allows City employees to
pay for qualified medical and dependent care expenses with pre-tax dollars, reducing their tax
burden and increasing take-home value.
Analysis: Staff is requesting an amendment that increases the Medical FSA annual election limit
from $3,300 to $3,400 and the Dependent Care FSA limit from $5,000 to $7,500. These changes
provide employees with greater opportunities to save on taxes while addressing increasing
healthcare and dependent care expenses. The enhancement strengthens the City's benefits
package and supports our efforts to attract and retain a quality workforce
Financial: There is a one-time $250 plan amendment fee.
Legal Considerations: approved as to form.
Recommendations/Actions: It is recommended the City Council: adopt the amending resolution
for the Empower Flex Spending Plan and authorize the City Manager or Mayor to sign any
relating documents.
Attachments: Exhibit A FSA Plan Document and Resolution, Exhibit B FSA Summary Plan
Description

CITY OF GODDARD
FLEXIBLE SPENDING ACCOUNT PLAN
AND ALL SUPPORTING FORMS HAVE BEEN PRODUCED FOR
FAMILY HEALTH AMERICA, L.C.

Copyright 2025 FIS Capital Markets US LLC
All Rights Reserved

CITY OF GODDARD
FLEXIBLE SPENDING ACCOUNT PLAN

TABLE OF CONTENTS
ARTICLE I
DEFINITIONS
ARTICLE II
PARTICIPATION
2.1

ELIGIBILITY ................................................................................................................................................................................. 2

2.2

EFFECTIVE DATE OF PARTICIPATION ................................................................................................................................... 2

2.3

APPLICATION TO PARTICIPATE .............................................................................................................................................. 2

2.4

TERMINATION OF PARTICIPATION ........................................................................................................................................ 3

2.5

TERMINATION OF EMPLOYMENT .......................................................................................................................................... 3

2.6

DEATH ........................................................................................................................................................................................... 3
ARTICLE III
CONTRIBUTIONS TO THE PLAN

3.1

SALARY REDIRECTION ............................................................................................................................................................. 3

3.2

APPLICATION OF CONTRIBUTIONS ....................................................................................................................................... 4

3.3

PERIODIC CONTRIBUTIONS ..................................................................................................................................................... 4
ARTICLE IV
BENEFITS

4.1

BENEFIT OPTIONS ...................................................................................................................................................................... 4

4.2

HEALTH FLEXIBLE SPENDING ACCOUNT BENEFIT ........................................................................................................... 4

4.3

DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT BENEFIT ........................................................................................ 4

4.4

HEALTH INSURANCE BENEFIT ............................................................................................................................................... 4

4.5

DENTAL INSURANCE BENEFIT ............................................................................................................................................... 5

4.6

CANCER INSURANCE BENEFIT ............................................................................................................................................... 5

4.7

VISION INSURANCE BENEFIT .................................................................................................................................................. 5

4.8

ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE BENEFIT........................................................................... 5

4.9

NONDISCRIMINATION REQUIREMENTS ............................................................................................................................... 5
ARTICLE V
PARTICIPANT ELECTIONS

5.1

INITIAL ELECTIONS ................................................................................................................................................................... 6

5.2

SUBSEQUENT ANNUAL ELECTIONS ...................................................................................................................................... 6

5.3

FAILURE TO ELECT .................................................................................................................................................................... 6

5.4

CHANGE IN STATUS................................................................................................................................................................... 6
ARTICLE VI
HEALTH FLEXIBLE SPENDING ACCOUNT

6.1

ESTABLISHMENT OF PLAN ...................................................................................................................................................... 9

6.2

DEFINITIONS ............................................................................................................................................................................... 9

6.3

FORFEITURES .............................................................................................................................................................................. 9

6.4

LIMITATION ON ALLOCATIONS ............................................................................................................................................. 9

6.5

NONDISCRIMINATION REQUIREMENTS ............................................................................................................................... 10

6.6

COORDINATION WITH CAFETERIA PLAN............................................................................................................................. 10

6.7

HEALTH FLEXIBLE SPENDING ACCOUNT CLAIMS ............................................................................................................ 10

6.8

DEBIT AND CREDIT CARDS...................................................................................................................................................... 11

6.9

QUALIFIED RESERVIST DISTRIBUTIONS .............................................................................................................................. 11
ARTICLE VII
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT

7.1

ESTABLISHMENT OF ACCOUNT ............................................................................................................................................. 12

7.2

DEFINITIONS ............................................................................................................................................................................... 12

7.3

DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTS ....................................................................................................... 13

7.4

INCREASES IN DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTS ........................................................................... 13

7.5

DECREASES IN DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTS .......................................................................... 13

7.6

ALLOWABLE DEPENDENT CARE REIMBURSEMENT ......................................................................................................... 13

7.7

ANNUAL STATEMENT OF BENEFITS...................................................................................................................................... 13

7.8

FORFEITURES .............................................................................................................................................................................. 14

7.9

LIMITATION ON PAYMENTS .................................................................................................................................................... 14

7.10

NONDISCRIMINATION REQUIREMENTS ............................................................................................................................... 14

7.11

COORDINATION WITH CAFETERIA PLAN............................................................................................................................. 14

7.12

DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT CLAIMS ......................................................................................... 14

7.13

DEBIT AND CREDIT CARDS...................................................................................................................................................... 15
ARTICLE VIII
BENEFITS AND RIGHTS

8.1

CLAIM FOR BENEFITS ............................................................................................................................................................... 16

8.2

APPLICATION OF BENEFIT PLAN SURPLUS ......................................................................................................................... 16
ARTICLE IX
ADMINISTRATION

9.1

PLAN ADMINISTRATION........................................................................................................................................................... 17

9.2

EXAMINATION OF RECORDS ................................................................................................................................................... 17

9.3

PAYMENT OF EXPENSES .......................................................................................................................................................... 18

9.4

INSURANCE CONTROL CLAUSE ............................................................................................................................................. 18

9.5

INDEMNIFICATION OF ADMINISTRATOR ............................................................................................................................. 18
ARTICLE X
AMENDMENT OR TERMINATION OF PLAN

10.1

AMENDMENT .............................................................................................................................................................................. 18

10.2

TERMINATION ............................................................................................................................................................................. 18
ARTICLE XI
MISCELLANEOUS

11.1

PLAN INTERPRETATION ........................................................................................................................................................... 18

11.2

GENDER, NUMBER AND TENSE .............................................................................................................................................. 18

11.3

WRITTEN DOCUMENT ............................................................................................................................................................... 18

11.4

EXCLUSIVE BENEFIT ................................................................................................................................................................. 18

11.5

PARTICIPANT'S RIGHTS ............................................................................................................................................................ 19

11.6

ACTION BY THE EMPLOYER .................................................................................................................................................... 19

11.7

EMPLOYER'S PROTECTIVE CLAUSES .................................................................................................................................... 19

11.8

NO GUARANTEE OF TAX CONSEQUENCES .......................................................................................................................... 19

11.9

INDEMNIFICATION OF EMPLOYER BY PARTICIPANTS ..................................................................................................... 19

11.10

FUNDING ...................................................................................................................................................................................... 19

11.11

GOVERNING LAW ....................................................................................................................................................................... 19

11.12

SEVERABILITY ............................................................................................................................................................................ 19

11.13

CAPTIONS ..................................................................................................................................................................................... 19

11.14

CONTINUATION OF COVERAGE (COBRA) ............................................................................................................................ 20

11.15

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) ................................................................ 20

11.16

UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT (USERRA) .......................................... 20

11.17

COMPLIANCE WITH HIPAA PRIVACY STANDARDS ........................................................................................................... 20

11.18

COMPLIANCE WITH HIPAA ELECTRONIC SECURITY STANDARDS................................................................................ 21

11.19

MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT ............................................................................................... 21

11.20

GENETIC INFORMATION NONDISCRIMINATION ACT (GINA) .......................................................................................... 21

11.21

WOMEN'S HEALTH AND CANCER RIGHTS ACT .................................................................................................................. 21

11.22

NEWBORNS' AND MOTHERS' HEALTH PROTECTION ACT ................................................................................................ 21

CITY OF GODDARD
FLEXIBLE SPENDING ACCOUNT PLAN
INTRODUCTION
The Employer has amended this Plan effective September 1, 2026, to recognize the contribution made to the Employer by its
Employees. Its purpose is to reward them by providing benefits for those Employees who shall qualify hereunder and their Dependents and
beneficiaries. The concept of this Plan is to allow Employees to choose among different types of benefits based on their own particular
goals, desires and needs. This Plan is a restatement of a Plan which was originally effective on October 1, 2018. The Plan shall be known
as City of Goddard Flexible Spending Account Plan (the "Plan").
The intention of the Employer is that the Plan qualify as a "Cafeteria Plan" within the meaning of Section 125 of the Internal
Revenue Code of 1986, as amended, and that the benefits which an Employee elects to receive under the Plan be excludable from the
Employee's income under Section 125(a) and other applicable sections of the Internal Revenue Code of 1986, as amended.
ARTICLE I
DEFINITIONS
1.1
"Administrator" means the Employer unless another person or entity has been designated by the Employer pursuant
to Section 9.1 to administer the Plan on behalf of the Employer. If the Employer is the Administrator, the Employer may appoint any
person, including, but not limited to, the Employees of the Employer, to perform the duties of the Administrator. Any person so appointed
shall signify acceptance by filing written acceptance with the Employer. Upon the resignation or removal of any individual performing the
duties of the Administrator, the Employer may designate a successor.
1.2
"Affiliated Employer" means the Employer and any corporation which is a member of a controlled group of
corporations (as defined in Code Section 414(b)) which includes the Employer; any trade or business (whether or not incorporated) which
is under common control (as defined in Code Section 414(c)) with the Employer; any organization (whether or not incorporated) which is a
member of an affiliated service group (as defined in Code Section 414(m)) which includes the Employer; and any other entity required to
be aggregated with the Employer pursuant to Treasury regulations under Code Section 414(o).
1.3
Section 4.1.

"Benefit" or "Benefit Options" means any of the optional benefit choices available to a Participant as outlined in

1.4
"Cafeteria Plan Benefit Dollars" means the amount available to Participants to purchase Benefit Options as provided
under Section 4.1. Each dollar contributed to this Plan shall be converted into one Cafeteria Plan Benefit Dollar.
1.5

"Code" means the Internal Revenue Code of 1986, as amended or replaced from time to time.

1.6

"Compensation" means the amounts received by the Participant from the Employer during a Plan Year.

1.7
"Dependent" means any individual who qualifies as a dependent under an Insurance Contract for purposes of
coverage under that Contract only or under Code Section 152 (as modified by Code Section 105(b)).
"Dependent" shall include any Child of a Participant who is covered under an Insurance Contract, as defined in the
Contract, or under the Health Flexible Spending Account or as allowed by reason of the Affordable Care Act.
For purposes of the Health Flexible Spending Account, a Participant's "Child" includes his/her natural child, stepchild,
foster child, adopted child, or a child placed with the Participant for adoption. A Participant's Child will be an eligible Dependent until
reaching the limiting age of 26, without regard to student status, marital status, financial dependency or residency status with the Employee
or any other person. When the child reaches the applicable limiting age, coverage will end at the end of the calendar year.
The phrase "placed for adoption" refers to a child whom the Participant intends to adopt, whether or not the adoption has become final, who
has not attained the age of 18 as of the date of such placement for adoption. The term "placed" means the assumption and retention by such
Employee of a legal obligation for total or partial support of the child in anticipation of adoption of the child. The child must be available
for adoption and the legal process must have commenced.
1.8

"Effective Date" means October 1, 2018.

1.9
"Election Period" means the period immediately preceding the beginning of each Plan Year established by the
Administrator, such period to be applied on a uniform and nondiscriminatory basis for all Employees and Participants. However, an
Employee's initial Election Period shall be determined pursuant to Section 5.1.
1.10

"Eligible Employee" means any Employee who has satisfied the provisions of Section 2.1.

An individual shall not be an "Eligible Employee" if such individual is not reported on the payroll records of the
Employer as a common law employee. In particular, it is expressly intended that individuals not treated as common law employees by the
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Employer on its payroll records are not "Eligible Employees" and are excluded from Plan participation even if a court or administrative
agency determines that such individuals are common law employees and not independent contractors.
1.11
"Employee" means any person who is employed by the Employer. The term Employee shall include leased employees
within the meaning of Code Section 414(n)(2).
1.12
"Employer" means City of Goddard and any successor which shall maintain this Plan; and any predecessor which has
maintained this Plan. In addition, where appropriate, the term Employer shall include any Participating, Affiliated or Adopting Employer.
1.13

"Insurance Contract" means any contract issued by an Insurer underwriting a Benefit.

1.14
"Insurance Premium Payment Plan" means the plan of benefits contained in Section 4.1 of this Plan, which provides
for the payment of Premium Expenses.
1.15

"Insurer" means any insurance company that underwrites a Benefit under this Plan.

1.16

"Key Employee" means an Employee described in Code Section 416(i)(1) and the Treasury regulations thereunder.

1.17
"Participant" means any Eligible Employee who elects to become a Participant pursuant to Section 2.3 and has not
for any reason become ineligible to participate further in the Plan.
1.18

"Plan" means this instrument, including all amendments thereto.

1.19
"Plan Year" means the 12-month period beginning September 1 and ending August 31. The Plan Year shall be the
coverage period for the Benefits provided for under this Plan. In the event a Participant commences participation during a Plan Year, then
the initial coverage period shall be that portion of the Plan Year commencing on such Participant's date of entry and ending on the last day
of such Plan Year.
1.20

"Premium Expenses" or "Premiums" mean the Participant's cost for the Benefits described in Section 4.1.

1.21
"Premium Expense Reimbursement Account" means the account established for a Participant pursuant to this Plan
to which part of his Cafeteria Plan Benefit Dollars may be allocated and from which Premiums of the Participant shall be paid or
reimbursed. If more than one type of insured Benefit is elected, sub-accounts shall be established for each type of insured Benefit.
1.22
"Salary Redirection" means the contributions made by the Employer on behalf of Participants pursuant to Section
3.1. These contributions shall be converted to Cafeteria Plan Benefit Dollars and allocated to the funds or accounts established under the
Plan pursuant to the Participants' elections made under Article V.
1.23
"Salary Redirection Agreement" means an agreement between the Participant and the Employer under which the
Participant agrees to reduce his Compensation or to forego all or part of the increases in such Compensation and to have such amounts
contributed by the Employer to the Plan on the Participant's behalf. The Salary Redirection Agreement shall apply only to Compensation
that has not been actually or constructively received by the Participant as of the date of the agreement (after taking this Plan and Code
Section 125 into account) and, subsequently does not become currently available to the Participant.
1.24

"Spouse" means spouse as determined under Federal law.
ARTICLE II
PARTICIPATION

2.1

ELIGIBILITY

Any Eligible Employee shall be eligible to participate hereunder as of the date he satisfies the eligibility conditions for the
Employer's group medical plan, the provisions of which are specifically incorporated herein by reference. However, any Eligible Employee
who was a Participant in the Plan on the effective date of this amendment shall continue to be eligible to participate in the Plan.
2.2

EFFECTIVE DATE OF PARTICIPATION

An Eligible Employee shall become a Participant effective as of the entry date under the Employer's group medical plan, the
provisions of which are specifically incorporated herein by reference.
2.3

APPLICATION TO PARTICIPATE

An Employee who is eligible to participate in this Plan shall, during the applicable Election Period, complete an application to
participate in a manner set forth by the Administrator. The election shall be irrevocable until the end of the applicable Plan Year unless the
Participant is entitled to change his Benefit elections pursuant to Section 5.4 hereof.

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An Eligible Employee shall also be required to complete a Salary Redirection Agreement during the Election Period for the Plan
Year during which he wishes to participate in this Plan. Any such Salary Redirection Agreement shall be effective for the first pay period
beginning on or after the Employee's effective date of participation pursuant to Section 2.2.
Notwithstanding the foregoing, an Employee who is eligible to participate in this Plan and who is covered by the Employer's
insured Benefits under this Plan shall automatically become a Participant to the extent of the Premiums for such insurance unless the
Employee elects, during the Election Period, not to participate in the Plan.
2.4

TERMINATION OF PARTICIPATION
A Participant shall no longer participate in this Plan upon the occurrence of any of the following events:
(a)
Section 2.5;

2.5

Termination of employment. The Participant's termination of employment, subject to the provisions of

(b)

Death. The Participant's death, subject to the provisions of Section 2.6; or

(c)

Termination of the plan. The termination of this Plan, subject to the provisions of Section 10.2.

TERMINATION OF EMPLOYMENT

If a Participant's employment with the Employer is terminated for any reason other than death, his participation in the Benefit
Options provided under Section 4.1 shall be governed in accordance with the following:
(a)
Insurance Benefit. With regard to Benefits which are insured, the Participant's participation in the Plan shall
cease, subject to the Participant's right to continue coverage under any Insurance Contract for which premiums have already been
paid.
(b)
Dependent Care FSA. With regard to the Dependent Care Flexible Spending Account, the Participant's
participation in the Plan shall cease and no further Salary Redirection contributions shall be made. However, such Participant
may submit claims for employment related Dependent Care Expense reimbursements for claims incurred up to the date of
termination and submitted within 90 days after termination, based on the level of the Participant's Dependent Care Flexible
Spending Account as of the date of termination.
(c)
COBRA applicability. With regard to the Health Flexible Spending Account, the Participant may submit
claims for expenses that were incurred during the portion of the Plan Year before the end of the period for which payments to the
Health Flexible Spending Account have already been made. Thereafter, the health benefits under this Plan including the Health
Flexible Spending Account shall be applied and administered consistent with such further rights a Participant and his Dependents
may be entitled to pursuant to Code Section 4980B and Section 11.14 of the Plan.
2.6

DEATH

If a Participant dies, his participation in the Plan shall cease. However, such Participant's spouse or Dependents may submit
claims for expenses or benefits for the remainder of the Plan Year or until the Cafeteria Plan Benefit Dollars allocated to each specific
benefit are exhausted. In no event may reimbursements be paid to someone who is not a spouse or Dependent. If the Plan is subject to the
provisions of Code Section 4980B, then those provisions and related regulations shall apply for purposes of the Health Flexible Spending
Account.
ARTICLE III
CONTRIBUTIONS TO THE PLAN
3.1

SALARY REDIRECTION

Benefits under the Plan shall be financed by Salary Redirections sufficient to support Benefits that a Participant has elected
hereunder and to pay the Participant's Premium Expenses. The salary administration program of the Employer shall be revised to allow
each Participant to agree to reduce his pay during a Plan Year by an amount determined necessary to purchase the elected Benefit Options.
The amount of such Salary Redirection shall be specified in the Salary Redirection Agreement and shall be applicable for a Plan Year.
Notwithstanding the above, for new Participants, the Salary Redirection Agreement shall only be applicable from the first day of the pay
period following the Employee's entry date up to and including the last day of the Plan Year. These contributions shall be converted to
Cafeteria Plan Benefit Dollars and allocated to the funds or accounts established under the Plan pursuant to the Participants' elections made
under Article IV.
Any Salary Redirection shall be determined prior to the beginning of a Plan Year (subject to initial elections pursuant to Section
5.1) and prior to the end of the Election Period and shall be irrevocable for such Plan Year. However, a Participant may revoke a Benefit
election or a Salary Redirection Agreement after the Plan Year has commenced and make a new election with respect to the remainder of
the Plan Year, if both the revocation and the new election are on account of and consistent with a change in status and such other permitted
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events as determined under Article V of the Plan and consistent with the rules and regulations of the Department of the Treasury. Salary
Redirection amounts shall be contributed on a pro rata basis for each pay period during the Plan Year. All individual Salary Redirection
Agreements are deemed to be part of this Plan and incorporated by reference hereunder.
3.2

APPLICATION OF CONTRIBUTIONS

As soon as reasonably practical after each payroll period, the Employer shall apply the Salary Redirection to provide the Benefits
elected by the affected Participants. Any contribution made or withheld for the Health Flexible Spending Account or Dependent Care
Flexible Spending Account shall be credited to such fund or account. Amounts designated for the Participant's Premium Expense
Reimbursement Account shall likewise be credited to such account for the purpose of paying Premium Expenses.
3.3

PERIODIC CONTRIBUTIONS

Notwithstanding the requirement provided above and in other Articles of this Plan that Salary Redirections be contributed to the
Plan by the Employer on behalf of an Employee on a level and pro rata basis for each payroll period, the Employer and Administrator may
implement a procedure in which Salary Redirections are contributed throughout the Plan Year on a periodic basis that is not pro rata for
each payroll period. However, with regard to the Health Flexible Spending Account, the payment schedule for the required contributions
may not be based on the rate or amount of reimbursements during the Plan Year.
ARTICLE IV
BENEFITS
4.1

BENEFIT OPTIONS
Each Participant may elect any one or more of the following optional Benefits:
(1)

Health Flexible Spending Account

(2)

Dependent Care Flexible Spending Account

In addition, each Participant shall have a sufficient portion of his Salary Redirections applied to the following Benefits unless the
Participant elects not to receive such Benefits:

4.2

(3)

Health Insurance Benefit

(4)

Dental Insurance Benefit

(5)

Cancer Insurance Benefit

(6)

Vision Insurance Benefit

(7)

Accidental Death and Dismemberment Insurance Benefit

HEALTH FLEXIBLE SPENDING ACCOUNT BENEFIT
Each Participant may elect to participate in the Health Flexible Spending Account option, in which case Article VI shall apply.

4.3

DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT BENEFIT

Each Participant may elect to participate in the Dependent Care Flexible Spending Account option, in which case Article VII
shall apply.
4.4

HEALTH INSURANCE BENEFIT
(a)
Coverage for Participant and Dependents. Each Participant may elect to be covered under a health
Insurance Contract for the Participant, his or her Spouse, and his or her Dependents.
(b)
Employer selects contracts. The Employer may select suitable health Insurance Contracts for use in
providing this health insurance benefit, which policies will provide uniform benefits for all Participants electing this Benefit.
(c)
Contract incorporated by reference. The rights and conditions with respect to the benefits payable from
such health Insurance Contract shall be determined therefrom, and such Insurance Contract shall be incorporated herein by
reference.

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4.5

DENTAL INSURANCE BENEFIT
(a)
Coverage for Participant and/or Dependents. Each Participant may elect to be covered under the
Employer's dental Insurance Contract. In addition, the Participant may elect either individual or family coverage under such
Insurance Contract.
(b)
Employer selects contracts. The Employer may select suitable dental Insurance Contracts for use in
providing this dental insurance benefit, which policies will provide uniform benefits for all Participants electing this Benefit.
(c)
Contract incorporated by reference. The rights and conditions with respect to the benefits payable from
such dental Insurance Contract shall be determined therefrom, and such dental Insurance Contract shall be incorporated herein by
reference.

4.6

CANCER INSURANCE BENEFIT
(a)
Coverage for Participant and/or Dependents. Each Participant may elect to be covered under the
Employer's cancer Insurance Contract. In addition, the Participant may elect either individual or family coverage.
(b)
Employer selects contracts. The Employer may select suitable cancer Insurance Contracts for use in
providing this cancer insurance benefit, which policies will provide uniform benefits for all Participants electing this Benefit.
(c)
Contract incorporated by reference. The rights and conditions with respect to the benefits payable from
such cancer Insurance Contract shall be determined therefrom, and such cancer Insurance Contract shall be incorporated herein
by reference.

4.7

VISION INSURANCE BENEFIT
(a)
Coverage for Participant and/or Dependents. Each Participant may elect to be covered under the
Employer's vision Insurance Contract. In addition, the Participant may elect either individual or family coverage.
(b)
Employer selects contracts. The Employer may select suitable vision Insurance Contracts for use in
providing this vision insurance benefit, which policies will provide uniform benefits for all Participants electing this Benefit.
(c)
Contract incorporated by reference. The rights and conditions with respect to the benefits payable from
such vision Insurance Contract shall be determined therefrom, and such vision Insurance Contract shall be incorporated herein by
reference.

4.8

ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE BENEFIT
(a)
Coverage for Participant and/or Dependents. Each Participant may elect to be covered under the
Employer's accidental death and dismemberment Insurance Contract.
(b)
Employer selects contracts. The Employer may select suitable accidental death and dismemberment policies
for use in providing this accidental death and dismemberment insurance benefit, which policies will provide uniform benefits for
all Participants electing this Benefit.
(c)
Contract incorporated by reference. The rights and conditions with respect to the benefits payable from
such accidental death and dismemberment Insurance Contract shall be determined therefrom, and such accidental death and
dismemberment Insurance Contract shall be incorporated herein by reference.

4.9

NONDISCRIMINATION REQUIREMENTS
(a)
Intent to be nondiscriminatory. It is the intent of this Plan to provide benefits to a classification of
employees which the Secretary of the Treasury finds not to be discriminatory in favor of the group in whose favor discrimination
may not occur under Code Section 125.
(b)
25% concentration test. It is the intent of this Plan not to provide qualified benefits as defined under Code
Section 125 to Key Employees in amounts that exceed 25% of the aggregate of such Benefits provided for all Eligible Employees
under the Plan. For purposes of the preceding sentence, qualified benefits shall not include benefits which (without regard to this
paragraph) are includible in gross income.
(c)
Adjustment to avoid test failure. If the Administrator deems it necessary to avoid discrimination or possible
taxation to Key Employees or a group of employees in whose favor discrimination may not occur in violation of Code Section
125, it may, but shall not be required to, reduce contributions or non-taxable Benefits in order to assure compliance with the Code
and regulations. Any act taken by the Administrator shall be carried out in a uniform and nondiscriminatory manner. With respect
to any affected Participant who has had Benefits reduced pursuant to this Section, the reduction shall be made proportionately
among Health Flexible Spending Account Benefits and Dependent Care Flexible Spending Account Benefits, and once all these
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Benefits are expended, proportionately among insured Benefits. Contributions which are not utilized to provide Benefits to any
Participant by virtue of any administrative act under this paragraph shall be forfeited and deposited into the benefit plan surplus.
ARTICLE V
PARTICIPANT ELECTIONS
5.1

INITIAL ELECTIONS

An Employee who meets the eligibility requirements of Section 2.1 on the first day of, or during, a Plan Year may elect to
participate in this Plan for all or the remainder of such Plan Year, provided he elects to do so on or before his effective date of participation
pursuant to Section 2.2.
Notwithstanding the foregoing, an Employee who is eligible to participate in this Plan and who is covered by the Employer's
insured benefits under this Plan shall automatically become a Participant to the extent of the Premiums for such insurance unless the
Employee elects, during the Election Period, not to participate in the Plan.
5.2

SUBSEQUENT ANNUAL ELECTIONS

During the Election Period prior to each subsequent Plan Year, each Participant shall be given the opportunity to elect, on an
election of benefits form to be provided by the Administrator, which spending account Benefit options he wishes to select. Any such
election shall be effective for any Benefit expenses incurred during the Plan Year which follows the end of the Election Period. With regard
to subsequent annual elections, the following options shall apply:
(a)
A Participant or Employee who failed to initially elect to participate may elect different or new Benefits
under the Plan during the Election Period;
(b)
A Participant may terminate his participation in the Plan by notifying the Administrator in writing during the
Election Period that he does not want to participate in the Plan for the next Plan Year;
(c)
An Employee who elects not to participate for the Plan Year following the Election Period will have to wait
until the next Election Period before again electing to participate in the Plan, except as provided for in Section 5.4.
5.3

FAILURE TO ELECT

With regard to Benefits available under the Plan for which no Premium Expenses apply, any Participant who fails to complete a
new benefit election form pursuant to Section 5.2 by the end of the applicable Election Period shall be deemed to have elected not to
participate in the Plan for the upcoming Plan Year. No further Salary Redirections shall therefore be authorized or made for the subsequent
Plan Year for such Benefits.
With regard to Benefits available under the Plan for which Premium Expenses apply, any Participant who fails to complete a new
benefit election form pursuant to Section 5.2 by the end of the applicable Election Period shall be deemed to have made the same Benefit
elections as are then in effect for the current Plan Year. The Participant shall also be deemed to have elected Salary Redirection in an
amount necessary to purchase such Benefit options.
5.4

CHANGE IN STATUS
(a)
Change in status defined. Any Participant may change a Benefit election after the Plan Year (to which such
election relates) has commenced and make new elections with respect to the remainder of such Plan Year if, under the facts and
circumstances, the changes are necessitated by and are consistent with a change in status which is acceptable under rules and
regulations adopted by the Department of the Treasury, the provisions of which are incorporated by reference. Notwithstanding
anything herein to the contrary, if the rules and regulations conflict, then such rules and regulations shall control.
In general, a change in election is not consistent if the change in status is the Participant's divorce, annulment or legal
separation from a Spouse, the death of a Spouse or Dependent, or a Dependent ceasing to satisfy the eligibility requirements for
coverage, and the Participant's election under the Plan is to cancel accident or health insurance coverage for any individual other than
the one involved in such event. In addition, if the Participant, Spouse or Dependent gains or loses eligibility for coverage, then a
Participant's election under the Plan to cease or decrease coverage for that individual under the Plan corresponds with that change in
status only if coverage for that individual becomes applicable or is increased under the family member plan.
Regardless of the consistency requirement, if the individual, the individual's Spouse, or Dependent becomes eligible for
continuation coverage under the Employer's group health plan as provided in Code Section 4980B or any similar state law, then the
individual may elect to increase payments under this Plan in order to pay for the continuation coverage. However, this does not apply
for COBRA eligibility due to divorce, annulment or legal separation.

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Any new election shall be effective at such time as the Administrator shall prescribe, but not earlier than the first pay
period beginning after the election form is completed and returned to the Administrator. For the purposes of this subsection, a change
in status shall only include the following events or other events permitted by Treasury regulations:
(1)
Legal Marital Status: events that change a Participant's legal marital status, including marriage, divorce, death
of a Spouse, legal separation or annulment;
(2)
Number of Dependents: Events that change a Participant's number of Dependents, including birth, adoption,
placement for adoption, or death of a Dependent;
(3)
Employment Status: Any of the following events that change the employment status of the Participant, Spouse,
or Dependent: termination or commencement of employment, a strike or lockout, commencement or return from an unpaid
leave of absence, or a change in worksite. In addition, if the eligibility conditions of this Plan or other employee benefit
plan of the Employer of the Participant, Spouse, or Dependent depend on the employment status of that individual and
there is a change in that individual's employment status with the consequence that the individual becomes (or ceases to be)
eligible under the plan, then that change constitutes a change in employment under this subsection;
(4)
Dependent satisfies or ceases to satisfy the eligibility requirements: An event that causes the Participant's
Dependent to satisfy or cease to satisfy the requirements for coverage due to attainment of age, student status, or any
similar circumstance; and
(5)
Residency: A change in the place of residence of the Participant, Spouse or Dependent, that would lead to a
change in status (such as a loss of HMO coverage).
For the Dependent Care Flexible Spending Account, a Dependent becoming or ceasing to be a "Qualifying Dependent" as
defined under Code Section 21(b) shall also qualify as a change in status.
Notwithstanding anything in this Section to the contrary, the gain of eligibility or change in eligibility of a child, as
allowed under Code Sections 105(b) and 106, and guidance thereunder, shall qualify as a change in status.
(b)
Special enrollment rights. Notwithstanding subsection (a), the Participants may change an election for
group health coverage during a Plan Year and make a new election that corresponds with the special enrollment rights provided
in Code Section 9801(f), including those authorized under the provisions of the Children's Health Insurance Program
Reauthorization Act of 2009 (SCHIP); provided that such Participant meets the sixty (60) day notice requirement imposed by
Code Section 9801(f) (or such longer period as may be permitted by the Plan and communicated to Participants). Such change
shall take place on a prospective basis, unless otherwise required by Code Section 9801(f) to be retroactive.
(c)
Qualified Medical Support Order. Notwithstanding subsection (a), in the event of a judgment, decree, or
order (including approval of a property settlement) ("order") resulting from a divorce, legal separation, annulment, or change in
legal custody which requires accident or health coverage for a Participant's child (including a foster child who is a Dependent of
the Participant):
(1)
The Plan may change an election to provide coverage for the child if the order requires coverage under the
Participant's plan; or
(2)
The Participant shall be permitted to change an election to cancel coverage for the child if the order requires
the former Spouse to provide coverage for such child, under that individual's plan and such coverage is actually
provided.
(d)
Medicare or Medicaid. Notwithstanding subsection (a), a Participant may change elections to cancel or reduce
accident or health coverage for the Participant or the Participant's Spouse or Dependent if the Participant or the Participant's Spouse
or Dependent is enrolled in the accident or health coverage of the Employer and becomes entitled to coverage (i.e., enrolled) under
Part A or Part B of the Title XVIII of the Social Security Act (Medicare) or Title XIX of the Social Security Act (Medicaid), other
than coverage consisting solely of benefits under Section 1928 of the Social Security Act (the program for distribution of pediatric
vaccines). If the Participant or the Participant's Spouse or Dependent who has been entitled to Medicaid or Medicare coverage loses
eligibility, that individual may prospectively elect coverage under the Plan if a benefit package option under the Plan provides similar
coverage.
(e)
Cost increase or decrease. If the cost of a Benefit provided under the Plan increases or decreases during a
Plan Year, then the Plan shall automatically increase or decrease, as the case may be, the Salary Redirections of all affected
Participants for such Benefit. Alternatively, if the cost of a benefit package option increases significantly, the Administrator shall
permit the affected Participants to either make corresponding changes in their payments or revoke their elections and, in lieu
thereof, receive on a prospective basis coverage under another benefit package option with similar coverage, or drop coverage
prospectively if there is no benefit package option with similar coverage.
A cost increase or decrease refers to an increase or decrease in the amount of elective contributions under the Plan,
whether resulting from an action taken by the Participants or an action taken by the Employer.
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(f)
Loss of coverage. If the coverage under a Benefit is significantly curtailed or ceases during a Plan Year,
affected Participants may revoke their elections of such Benefit and, in lieu thereof, elect to receive on a prospective basis
coverage under another plan with similar coverage, or drop coverage prospectively if no similar coverage is offered.
(g)
Addition of a new benefit. If, during the period of coverage, a new benefit package option or other coverage
option is added, an existing benefit package option is significantly improved, or an existing benefit package option or other
coverage option is eliminated, then the affected Participants may elect the newly-added option, or elect another option if an
option has been eliminated prospectively and make corresponding election changes with respect to other benefit package options
providing similar coverage. In addition, those Eligible Employees who are not participating in the Plan may opt to become
Participants and elect the new or newly improved benefit package option.
(h)
Loss of coverage under certain other plans. A Participant may make a prospective election change to add
group health coverage for the Participant, the Participant's Spouse or Dependent if such individual loses group health coverage
sponsored by a governmental or educational institution, including a state children's health insurance program under the Social
Security Act, the Indian Health Service or a health program offered by an Indian tribal government, a state health benefits risk
pool, or a foreign government group health plan.
(i)
Change of coverage due to change under certain other plans. A Participant may make a prospective
election change that is on account of and corresponds with a change made under the plan of a Spouse's, former Spouse's or
Dependent's employer if (1) the cafeteria plan or other benefits plan of the Spouse's, former Spouse's or Dependent's employer
permits its participants to make a change; or (2) the cafeteria plan permits participants to make an election for a period of
coverage that is different from the period of coverage under the cafeteria plan of a Spouse's, former Spouse's or Dependent's
employer.
(j)
Change in dependent care provider. A Participant may make a prospective election change that is on
account of and corresponds with a change by the Participant in the dependent care provider. The availability of dependent care
services from a new childcare provider is similar to a new benefit package option becoming available. A cost change is allowable
in the Dependent Care Flexible Spending Account only if the cost change is imposed by a dependent care provider who is not
related to the Participant, as defined in Code Section 152(a)(1) through (8).
(k)
Health FSA cannot change due to insurance change. A Participant shall not be permitted to change an
election to the Health Flexible Spending Account as a result of a cost or coverage change under any health insurance benefits.
(l)
Changes due to reduction in hours or enrollment in an Exchange Plan. A Participant may prospectively
revoke coverage under the group health plan (that is not a health Flexible Spending Account) which provides minimum essential
coverage (as defined in Code §5000A(f)(1)) provided the following conditions are met:
Conditions for revocation due to reduction in hours of service:
(1)
The Participant has been reasonably expected to average at least 30 hours of service per week and there is a
change in that Participant's status so that the Participant will reasonably be expected to average less than 30 hours of
service per week after the change, even if that reduction does not result in the Participant ceasing to be eligible under
the group health plan; and
(2)
The revocation of coverage under the group health plan corresponds to the intended enrollment of the
Participant, and any related individuals who cease coverage due to the revocation, in another plan that provides
minimum essential coverage with the new coverage effective no later than the first day of the second month following
the month that includes the date the original coverage is revoked.
The Administrator may rely on the reasonable representation of the Participant who is reasonably expected to have an average of
less than 30 hours of service per week for future periods that the Participant and related individuals have enrolled or intend to
enroll in another plan that provides minimum essential coverage for new coverage that is effective no later than the first day of
the second month following the month that includes the date the original coverage is revoked.
Conditions for revocation due to enrollment in a Qualified Health Plan:
(1)
The Participant is eligible for a Special Enrollment Period to enroll in a Qualified Health Plan through a
Marketplace (federal or state exchange) pursuant to guidance issued by the Department of Health and Human Services
and any other applicable guidance, or the Participant seeks to enroll in a Qualified Health Plan through a Marketplace
during the Marketplace's annual open enrollment period; or
(2)
One or more related individuals of the Participant is eligible for a Special Enrollment Period to enroll in a
Qualified Health Plan through a Marketplace (federal or state exchange) pursuant to guidance issued by the Department
of Health and Human Services and any other applicable guidance, or related individual(s) seeks to enroll in a Qualified
Health Plan through a Marketplace during the Marketplace's annual open enrollment period; and
(3)
The revocation of the election of coverage under the group health plan – either revocation in whole or
revocation of other-than-self coverage – corresponds to the intended enrollment of the Participant and/or any related
8

individuals who cease coverage due to the revocation in a Qualified Health Plan through a Marketplace for new
coverage that is effective beginning no later than the day immediately following the last day of the original coverage
that is revoked.
The Administrator may rely on the reasonable representation of a Participant (on behalf of themselves or related individuals) who
has an enrollment opportunity for a Qualified Health Plan through a Marketplace that the Participant or related individuals have
enrolled or intend to enroll in a Qualified Health Plan for new coverage that is effective beginning no later than the day
immediately following the last day of the original coverage that is revoked.
ARTICLE VI
HEALTH FLEXIBLE SPENDING ACCOUNT
6.1

ESTABLISHMENT OF PLAN

This Health Flexible Spending Account is intended to qualify as a medical reimbursement plan under Code Section 105 and shall
be interpreted in a manner consistent with such Code Section and the Treasury regulations thereunder. Participants who elect to participate
in this Health Flexible Spending Account may submit claims for the reimbursement of Medical Expenses. All amounts reimbursed shall be
periodically paid from amounts allocated to the Health Flexible Spending Account. Periodic payments reimbursing Participants from the
Health Flexible Spending Account shall in no event occur less frequently than monthly.
6.2

DEFINITIONS
For the purposes of this Article and the Cafeteria Plan, the terms below have the following meaning:
(a)
"Health Flexible Spending Account" means the account established for Participants pursuant to this Plan to
which part of their Cafeteria Plan Benefit Dollars may be allocated and from which all allowable Medical Expenses incurred by a
Participant, his or her Spouse and his or her Dependents may be reimbursed.
(b)
"Highly Compensated Participant" means, for the purposes of this Article and determining discrimination
under Code Section 105(h), a participant who is:
(1)

one of the 5 highest paid officers;

(2)
a shareholder who owns (or is considered to own applying the rules of Code Section 318) more than 10
percent in value of the stock of the Employer; or
(3)
among the highest paid 25 percent of all Employees (other than exclusions permitted by Code Section
105(h)(3)(B) for those individuals who are not Participants).
(c)
"Medical Expenses" means any expense for medical care within the meaning of the term "medical care" as
defined in Code Section 213(d) and the rulings and Treasury regulations thereunder, and not otherwise used by the Participant as
a deduction in determining his tax liability under the Code. "Medical Expenses" can be incurred by the Participant, his or her
Spouse and his or her Dependents. "Incurred" means, with regard to Medical Expenses, when the Participant is provided with the
medical care that gives rise to the Medical Expense and not when the Participant is formally billed or charged for, or pays for, the
medical care.
A Participant may not be reimbursed for the cost of other health coverage such as premiums paid under plans
maintained by the employer of the Participant's Spouse or individual policies maintained by the Participant or his Spouse or
Dependent.
A Participant may not be reimbursed for "qualified long-term care services" as defined in Code Section 7702B(c).
(d)
The definitions of Article I are hereby incorporated by reference to the extent necessary to interpret and apply
the provisions of this Health Flexible Spending Account.
6.3

FORFEITURES

The amount in the Health Flexible Spending Account as of the end of any Plan Year (and after the processing of all claims for
such Plan Year pursuant to Section 6.7 hereof, excluding any carryover) shall be forfeited and credited to the benefit plan surplus. In such
event, the Participant shall have no further claim to such amount for any reason, subject to Section 8.2.
6.4

LIMITATION ON ALLOCATIONS
(a)
Notwithstanding any provision contained in this Health Flexible Spending Account to the contrary, the
maximum amount of salary reductions that may be allocated to the Health Flexible Spending Account by a Participant in or on
account of any Plan Year is the statutory amount under Code Section 125(i), as adjusted for increases in the cost of living. The
cost of living adjustment in effect for a calendar year applies to any Plan Year beginning with or within such calendar year. The
9

dollar increase in effect on January 1 of any calendar year shall be effective for the Plan Year beginning with or within such
calendar year. For any short Plan Year, the limit shall be an amount equal to the limit for the calendar year in which the Plan
Year begins multiplied by the ratio obtained by dividing the number of full months in the short Plan Year by twelve (12).
(b)
Participation in Other Plans. All employers that are treated as a single employer under Code Sections
414(b), (c), or (m), relating to controlled groups and affiliated service groups, are treated as a single employer for purposes of the
statutory limit. If a Participant participates in multiple cafeteria plans offering health flexible spending accounts maintained by
members of a controlled group or affiliated service group, the Participant's total Health Flexible Spending Account contributions
under all of the cafeteria plans are limited to the statutory limit (as adjusted). However, a Participant employed by two or more
employers that are not members of the same controlled group may elect up to the statutory limit (as adjusted) under each
Employer's Health Flexible Spending Account.
(c)
Carryover. These amounts can be used during the following Plan Year for expenses incurred in that Plan
Year. Amounts carried over do not affect the maximum amount of salary redirection contributions for the Plan Year to which
they are carried over. Unused amounts are those remaining after expenses have been reimbursed during the runout period. These
amounts may not be cashed out or converted to any other taxable or nontaxable benefit. Amounts in excess will be forfeited. The
Plan is allowed, but not required, to treat claims as being paid first from the current year amounts, then from the carryover
amounts.
6.5

NONDISCRIMINATION REQUIREMENTS
(a)
Intent to be nondiscriminatory. It is the intent of this Health Flexible Spending Account not to discriminate
in violation of the Code and the Treasury regulations thereunder.
(b)
Adjustment to avoid test failure. If the Administrator deems it necessary to avoid discrimination under this
Health Flexible Spending Account, it may, but shall not be required to, reject any elections or reduce contributions or Benefits in
order to assure compliance with this Section. Any act taken by the Administrator under this Section shall be carried out in a
uniform and nondiscriminatory manner. If the Administrator decides to reject any elections or reduce contributions or Benefits, it
shall be done in the following manner. First, the Benefits designated for the Health Flexible Spending Account by the member of
the group in whose favor discrimination may not occur pursuant to Code Section 105 that elected to contribute the highest
amount to the fund for the Plan Year shall be reduced until the nondiscrimination tests set forth in this Section or the Code are
satisfied, or until the amount designated for the fund equals the amount designated for the fund by the next member of the group
in whose favor discrimination may not occur pursuant to Code Section 105 who has elected the second highest contribution to the
Health Flexible Spending Account for the Plan Year. This process shall continue until the nondiscrimination tests set forth in this
Section or the Code are satisfied. Contributions which are not utilized to provide Benefits to any Participant by virtue of any
administrative act under this paragraph shall be forfeited and credited to the benefit plan surplus.

6.6

COORDINATION WITH CAFETERIA PLAN

All Participants under the Cafeteria Plan are eligible to receive Benefits under this Health Flexible Spending Account. The
enrollment under the Cafeteria Plan shall constitute enrollment under this Health Flexible Spending Account. In addition, other matters
concerning contributions, elections and the like shall be governed by the general provisions of the Cafeteria Plan.
6.7

HEALTH FLEXIBLE SPENDING ACCOUNT CLAIMS
(a)
Expenses must be incurred during Plan Year. All Medical Expenses incurred by a Participant, his or her
Spouse and his or her Dependents during the Plan Year shall be reimbursed during the Plan Year subject to Section 2.5, even
though the submission of such a claim occurs after his participation hereunder ceases; but provided that the Medical Expenses
were incurred during the applicable Plan Year. Medical Expenses are treated as having been incurred when the Participant is
provided with the medical care that gives rise to the medical expenses, not when the Participant is formally billed or charged for,
or pays for the medical care.
(b)
Reimbursement available throughout Plan Year. The Administrator shall direct the reimbursement to each
eligible Participant for all allowable Medical Expenses, up to a maximum of the amount designated by the Participant for the
Health Flexible Spending Account for the Plan Year. Reimbursements shall be made available to the Participant throughout the
year without regard to the level of Cafeteria Plan Benefit Dollars which have been allocated to the fund at any given point in
time. Furthermore, a Participant shall be entitled to reimbursements only for amounts in excess of any payments or other
reimbursements under any health care plan covering the Participant and/or his Spouse or Dependents.
(c)
Payments. Reimbursement payments under this Plan shall be made directly to the Participant. However, in
the Administrator's discretion, payments may be made directly to the service provider. The application for payment or
reimbursement shall be made to the Administrator on an acceptable form within a reasonable time of incurring the debt or paying
for the service. The application shall include a written statement from an independent third party stating that the Medical Expense
has been incurred and the amount of such expense. Furthermore, the Participant shall provide a written statement that the Medical
Expense has not been reimbursed or is not reimbursable under any other health plan coverage and, if reimbursed from the Health
Flexible Spending Account, such amount will not be claimed as a tax deduction. The Administrator shall retain a file of all such
applications.
10

(d)
Claims for reimbursement. Claims for the reimbursement of Medical Expenses incurred in any Plan Year
shall be paid as soon after a claim has been filed as is administratively practicable; provided however, that if a Participant fails to
submit a claim within 90 days after the end of the Plan Year, those Medical Expense claims shall not be considered for
reimbursement by the Administrator. However, if a Participant terminates employment during the Plan Year, claims for the
reimbursement of Medical Expenses must be submitted within 90 days after termination of employment.
6.8

DEBIT AND CREDIT CARDS

Participants may, subject to a procedure established by the Administrator and applied in a uniform nondiscriminatory manner,
use debit and/or credit (stored value) cards ("cards") provided by the Administrator and the Plan for payment of Medical Expenses, subject
to the following terms:
(a)
Card only for medical expenses. Each Participant issued a card shall certify that such card shall only be
used for Medical Expenses. The Participant shall also certify that any Medical Expense paid with the card has not already been
reimbursed by any other plan covering health benefits and that the Participant will not seek reimbursement from any other plan
covering health benefits.
(b)
Card issuance. Such card shall be issued upon the Participant's Effective Date of Participation and reissued
for each Plan Year the Participant remains a Participant in the Health Flexible Spending Account. Such card shall be
automatically cancelled upon the Participant's death or termination of employment, or if such Participant has a change in status
that results in the Participant's withdrawal from the Health Flexible Spending Account.
(c)
Maximum dollar amount available. The dollar amount of coverage available on the card shall be the
amount elected by the Participant for the Plan Year. The maximum dollar amount of coverage available shall be the maximum
amount for the Plan Year as set forth in Section 6.4.
(d)
Only available for use with certain service providers. The cards shall only be accepted by such merchants
and service providers as have been approved by the Administrator following IRS guidelines.
(e)
Card use. The cards shall only be used for Medical Expense purchases at these providers, including, but not
limited to, the following:
(1)

Co-payments for doctor and other medical care;

(2)

Purchase of drugs as allowed under law or IRS regulations;

(3)

Purchase of medical items such as eyeglasses, syringes, crutches, etc.

(f)
Substantiation. Such purchases by the cards shall be subject to substantiation by the Administrator, usually
by submission of a receipt from a service provider describing the service, the date and the amount. The Administrator shall also
follow the requirements set forth in Revenue Ruling 2003-43 and Notice 2006-69. All charges shall be conditional pending
confirmation and substantiation.
(g)
Correction methods. If such purchase is later determined by the Administrator to not qualify as a Medical
Expense, the Administrator, in its discretion, shall use one of the following correction methods to make the Plan whole. Until the
amount is repaid, the Administrator shall take further action to ensure that further violations of the terms of the card do not occur,
up to and including denial of access to the card.
(1)

Repayment of the improper amount by the Participant;

(2)
Withholding the improper payment from the Participant's wages or other compensation to the extent
consistent with applicable federal or state law;
(3)

Claims substitution or offset of future claims until the amount is repaid; and

(4)
if subsections (1) through (3) fail to recover the amount, consistent with the Employer's business practices,
the Employer may treat the amount as any other business indebtedness.
6.9

QUALIFIED RESERVIST DISTRIBUTIONS
(a)
Qualified Reservist Distribution. A Participant may request a Qualified Reservist Distribution, provided the
following provisions are satisfied. "Qualified Reservist Distribution" means any distribution to a Participant of all or a portion of
the balance in the Participant's Health Flexible Spending Account if:
(1)
Such Participant was an individual who was (by reason of being a member of a reserve component (as
defined in Section 101 of Title 37, United States Code)) ordered or called to active duty for a period of 180 days or
more or for an indefinite period.
11

(2)
A Participant may have been called prior to June 18, 2008, provided the individual's active duty continues
after June 18, 2008 and the period of duty complies with subsection (a).
(3)
The distribution is made during the period beginning on the date of the order or call that applies to the
Participant and ending on the last day of the Plan Year which includes the date of such order or call.
(4)

The Qualified Reservist Distribution option is offered to all Participants who qualify under this Article.

(5)
Qualified Reservist Distributions may only be made if the Participant is ordered or called to active duty, not
the Participant's spouse or dependents.
(6)
Under Section 101 of the Title 37 of the United States Code, "reserve component" means: (1) the Army
National Guard, (2) the Army Reserve, (3) the Navy Reserve, (4) the Marine Corps Reserve, (5) the Air National
Guard, (6) the Air Force Reserve, (7) the Coast Guard Reserve, or (8) the Reserve Corps of the Public Health Service.
(b)

Conditions: The following conditions apply:

(1)
The Employer must receive a copy of the order or call to active duty and may rely on the order or call to
determine the period that the Participant has been ordered or called to duty.
(2)
Eligibility for a Qualified Reservist Distribution is not affected if the order or call is for 180 days or more or
is indefinite, but the actual period of active duty is less than 180 days or is changed otherwise from the order or call.
(3)
If the original order is less than 180 days, then no Qualified Reservist Distribution is allowed. However, if
subsequent calls or orders increase the total days of active duty to 180 or more, then a Qualified Reservist Distribution
will be allowed.
(c)
Amount: The amount a Participant may be reimbursed from the Health Flexible Spending Account is the
amount contributed by the Participant to the Health Flexible Spending Account as of the date of the distribution request, less any
reimbursements received as of the date of the distribution request.
(d)
Procedure. The Employer must specify a process for requesting the distribution. The Employer may limit the
number of distributions processed for a Participant to 1 per Plan Year. The distribution request must be made on or after the call
or order and before the last day of the Plan Year. The QRD shall be paid within a reasonable time but in no event more than 60
days after the date of the request.
(e)
Claims. Claims incurred prior to the date of the request of the distribution shall be paid as any other claim.
Claims incurred after the date of the distribution shall not be paid and the Participant's right to submit a claim shall be terminated
as of the date of the distribution request.
ARTICLE VII
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT
7.1

ESTABLISHMENT OF ACCOUNT

This Dependent Care Flexible Spending Account is intended to qualify as a program under Code Section 129 and shall be
interpreted in a manner consistent with such Code Section. Participants who elect to participate in this program may submit claims for the
reimbursement of Employment-Related Dependent Care Expenses. All amounts reimbursed shall be paid from amounts allocated to the
Participant's Dependent Care Flexible Spending Account.
7.2

DEFINITIONS
For the purposes of this Article and the Cafeteria Plan the terms below shall have the following meaning:
(a)
"Dependent Care Flexible Spending Account" means the account established for a Participant pursuant to
this Article to which part of his Cafeteria Plan Benefit Dollars may be allocated and from which Employment-Related Dependent
Care Expenses of the Participant may be reimbursed for the care of the Qualifying Dependents of Participants.
(b)
"Earned Income" means earned income as defined under Code Section 32(c)(2), but excluding such
amounts paid or incurred by the Employer for dependent care assistance to the Participant.

12

(c)
"Employment-Related Dependent Care Expenses" means the amounts paid for expenses of a Participant
for those services which if paid by the Participant would be considered employment related expenses under Code Section
21(b)(2). Generally, they shall include expenses for household services and for the care of a Qualifying Dependent, to the extent
that such expenses are incurred to enable the Participant to be gainfully employed for any period for which there are one or more
Qualifying Dependents with respect to such Participant. Employment-Related Dependent Care Expenses are treated as having
been incurred when the Participant's Qualifying Dependents are provided with the dependent care that gives rise to the
Employment-Related Dependent Care Expenses, not when the Participant is formally billed or charged for, or pays for the
dependent care. The determination of whether an amount qualifies as an Employment-Related Dependent Care Expense shall be
made subject to the following rules:
(1)
If such amounts are paid for expenses incurred outside the Participant's household, they shall constitute
Employment-Related Dependent Care Expenses only if incurred for a Qualifying Dependent as defined in Section
7.2(d)(1) (or deemed to be, as described in Section 7.2(d)(1) pursuant to Section 7.2(d)(3)), or for a Qualifying
Dependent as defined in Section 7.2(d)(2) (or deemed to be, as described in Section 7.2(d)(2) pursuant to Section
7.2(d)(3)) who regularly spends at least 8 hours per day in the Participant's household;
(2)
If the expense is incurred outside the Participant's home at a facility that provides care for a fee, payment, or
grant for more than 6 individuals who do not regularly reside at the facility, the facility must comply with all applicable
state and local laws and regulations, including licensing requirements, if any; and
(3)
Employment-Related Dependent Care Expenses of a Participant shall not include amounts paid or incurred to
a child of such Participant who is under the age of 19 or to an individual who is a Dependent of such Participant or such
Participant's Spouse.
(d)

"Qualifying Dependent" means, for Dependent Care Flexible Spending Account purposes,

(1)

a Participant's Dependent (as defined in Code Section 152(a)(1)) who has not attained age 13;

(2)
a Dependent or the Spouse of a Participant who is physically or mentally incapable of caring for himself or
herself and has the same principal place of abode as the Participant for more than one-half of such taxable year; or
(3)
a child that is deemed to be a Qualifying Dependent described in paragraph (1) or (2) above, whichever is
appropriate, pursuant to Code Section 21(e)(5).
(e)
The definitions of Article I are hereby incorporated by reference to the extent necessary to interpret and apply
the provisions of this Dependent Care Flexible Spending Account.
7.3

DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTS

The Administrator shall establish a Dependent Care Flexible Spending Account for each Participant who elects to apply Cafeteria
Plan Benefit Dollars to Dependent Care Flexible Spending Account benefits.
7.4

INCREASES IN DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTS

A Participant's Dependent Care Flexible Spending Account shall be increased each pay period by the portion of Cafeteria Plan
Benefit Dollars that he has elected to apply toward his Dependent Care Flexible Spending Account pursuant to elections made under
Article V hereof.
7.5

DECREASES IN DEPENDENT CARE FLEXIBLE SPENDING ACCOUNTS

A Participant's Dependent Care Flexible Spending Account shall be reduced by the amount of any Employment-Related
Dependent Care Expense reimbursements paid or incurred on behalf of a Participant pursuant to Section 7.12 hereof.
7.6

ALLOWABLE DEPENDENT CARE REIMBURSEMENT

Subject to limitations contained in Section 7.9 of this Program, and to the extent of the amount contained in the Participant's
Dependent Care Flexible Spending Account, a Participant who incurs Employment-Related Dependent Care Expenses shall be entitled to
receive from the Employer full reimbursement for the entire amount of such expenses incurred during the Plan Year or portion thereof
during which he is a Participant.
7.7

ANNUAL STATEMENT OF BENEFITS

On or before January 31st of each calendar year, the Employer shall furnish to each Employee who was a Participant and
received benefits under Section 7.6 during the prior calendar year, a statement of all such benefits paid to or on behalf of such Participant
during the prior calendar year. This statement is set forth on the Participant's Form W-2.

13

7.8

FORFEITURES

The amount in a Participant's Dependent Care Flexible Spending Account as of the end of any Plan Year (and after the
processing of all claims for such Plan Year pursuant to Section 7.12 hereof) shall be forfeited and credited to the benefit plan surplus. In
such event, the Participant shall have no further claim to such amount for any reason.
7.9

LIMITATION ON PAYMENTS
(a)
Plan limits. Notwithstanding any provision contained in this Dependent Care Flexible Spending Account to
the contrary, the following limits apply. The maximum amount that may be allocated to the Dependent Care Flexible Spending
Account by a Participant in or on account of any Plan Year is the Code Limit as defined in paragraph (b). The maximum amount
that may be allocated to the Dependent Care Flexible Spending Account by a Participant in or on account of any Plan Year is
$$7,500.
(b)
Code limits. Notwithstanding any provision contained in this Article to the contrary, amounts paid from a
Participant's Dependent Care Flexible Spending Account in or on account of any taxable year of the Participant shall not exceed
the lesser of the Earned Income limitation described in Code Section 129(b) or $7,500 ($3,750 if a separate tax return is filed by a
Participant who is married as determined under the rules of paragraphs (3) and (4) of Code Section 21(e)).

7.10

NONDISCRIMINATION REQUIREMENTS
(a)
Intent to be nondiscriminatory. It is the intent of this Dependent Care Flexible Spending Account that
contributions or benefits not discriminate in favor of the group of employees in whose favor discrimination may not occur under
Code Section 129(d).
(b)
25% test for shareholders. It is the intent of this Dependent Care Flexible Spending Account that not more
than 25 percent of the amounts paid by the Employer for dependent care assistance during the Plan Year will be provided for the
class of individuals who are shareholders or owners (or their Spouses or Dependents), each of whom (on any day of the Plan
Year) owns more than 5 percent of the stock or of the capital or profits interest in the Employer.
(c)
Adjustment to avoid test failure. If the Administrator deems it necessary to avoid discrimination or possible
taxation to a group of employees in whose favor discrimination may not occur in violation of Code Section 129 it may, but shall
not be required to, reject any elections or reduce contributions or non-taxable benefits in order to assure compliance with this
Section. Any act taken by the Administrator under this Section shall be carried out in a uniform and nondiscriminatory manner. If
the Administrator decides to reject any elections or reduce contributions or Benefits, it shall be done in the following manner.
First, the Benefits designated for the Dependent Care Flexible Spending Account by the affected Participant that elected to
contribute the highest amount to such account for the Plan Year shall be reduced until the nondiscrimination tests set forth in this
Section are satisfied, or until the amount designated for the account equals the amount designated for the account of the affected
Participant who has elected the second highest contribution to the Dependent Care Flexible Spending Account for the Plan Year.
This process shall continue until the nondiscrimination tests set forth in this Section are satisfied. Contributions which are not
utilized to provide Benefits to any Participant by virtue of any administrative act under this paragraph shall be forfeited.

7.11

COORDINATION WITH CAFETERIA PLAN

All Participants under the Cafeteria Plan are eligible to receive Benefits under this Dependent Care Flexible Spending Account.
The enrollment and termination of participation under the Cafeteria Plan shall constitute enrollment and termination of participation under
this Dependent Care Flexible Spending Account. In addition, other matters concerning contributions, elections and the like shall be
governed by the general provisions of the Cafeteria Plan.
7.12

DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT CLAIMS

The Administrator shall direct the payment of all such Dependent Care claims to the Participant upon the presentation to the
Administrator of documentation of such expenses in a form satisfactory to the Administrator. However, in the Administrator's discretion,
payments may be made directly to the service provider. In its discretion in administering the Plan, the Administrator may utilize forms and
require documentation of costs as may be necessary to verify the claims submitted. At a minimum, the form shall include a statement from
an independent third party as proof that the expense has been incurred during the Plan Year and the amount of such expense. In addition,
the Administrator may require that each Participant who desires to receive reimbursement under this Program for Employment-Related
Dependent Care Expenses submit a statement which may contain some or all of the following information:
(a)

The Dependent or Dependents for whom the services were performed;

(b)

The nature of the services performed for the Participant, the cost of which he wishes reimbursement;

(c)

The relationship, if any, of the person performing the services to the Participant;

(d)

If the services are being performed by a child of the Participant, the age of the child;

(e)

A statement as to where the services were performed;
14

(f)
If any of the services were performed outside the home, a statement as to whether the Dependent for whom
such services were performed spends at least 8 hours a day in the Participant's household;
(g)

If the services were being performed in a day care center, a statement:

(1)

that the day care center complies with all applicable laws and regulations of the state of residence,

(2)
that the day care center provides care for more than 6 individuals (other than individuals residing at the
center), and
(3)

of the amount of fee paid to the provider.

(h)

If the Participant is married, a statement containing the following:

(1)

the Spouse's salary or wages if he or she is employed, or

(2)

if the Participant's Spouse is not employed, that
(i)

he or she is incapacitated, or

(ii)
he or she is a full-time student attending an educational institution and the months during the year
which he or she attended such institution.
(i)
Claims for reimbursement. If a Participant fails to submit a claim within 90 days after the end of the Plan
Year, those claims shall not be considered for reimbursement by the Administrator. However, if a Participant terminates
employment during the Plan Year, claims for reimbursement must be submitted within 90 days after termination of employment.
7.13

DEBIT AND CREDIT CARDS

Participants may, subject to a procedure established by the Administrator and applied in a uniform nondiscriminatory manner,
use debit and/or credit (stored value) cards ("cards") provided by the Administrator and the Plan for payment of Employment-Related
Dependent Care Expenses, subject to the following terms:
(a)
Card only for dependent care expenses. Each Participant issued a card shall certify that such card shall
only be used for Employment-Related Dependent Care Expenses. The Participant shall also certify that any Employment-Related
Dependent Care Expense paid with the card has not already been reimbursed by any other plan covering dependent care benefits
and that the Participant will not seek reimbursement from any other plan covering dependent care benefits.
(b)
Card issuance. Such card shall be issued upon the Participant's Effective Date of Participation and reissued
for each Plan Year the Participant remains a Participant in the Dependent Care Flexible Spending Account. Such card shall be
automatically cancelled upon the Participant's death or termination of employment, or if such Participant has a change in status
that results in the Participant's withdrawal from the Dependent Care Flexible Spending Account.
(c)
Only available for use with certain service providers. The cards shall only be accepted by such service
providers as have been approved by the Administrator. The cards shall only be used for Employment-Related Dependent Care
Expenses from these providers.
(d)
Substantiation. Such purchases by the cards shall be subject to substantiation by the Administrator, usually
by submission of a receipt from a service provider describing the service, the date and the amount. The Administrator shall also
follow the requirements set forth in Revenue Ruling 2003-43 and Notice 2006-69. All charges shall be conditional pending
confirmation and substantiation.
(e)
Correction methods. If such purchase is later determined by the Administrator to not qualify as an
Employment-Related Dependent Care Expense, the Administrator, in its discretion, shall use one of the following correction
methods to make the Plan whole. Until the amount is repaid, the Administrator shall take further action to ensure that further
violations of the terms of the card do not occur, up to and including denial of access to the card.
(1)

Repayment of the improper amount by the Participant;

(2)
Withholding the improper payment from the Participant's wages or other compensation to the extent
consistent with applicable federal or state law;
(3)

Claims substitution or offset of future claims until the amount is repaid; and

(4)
if subsections (1) through (3) fail to recover the amount, consistent with the Employer's business practices,
the Employer may treat the amount as any other business indebtedness.
15

ARTICLE VIII
BENEFITS AND RIGHTS
8.1

CLAIM FOR BENEFITS
(a)
Insurance claims. Any claim for Benefits underwritten by Insurance Contract(s) shall be made to the
Insurer. If the Insurer denies any claim, the Participant or beneficiary shall follow the Insurer's claims review procedure.
(b)
Dependent Care Flexible Spending Account or Health Flexible Spending Account claims. Any claim for
Dependent Care Flexible Spending Account or Health Flexible Spending Account Benefits shall be made to the Administrator.
For the Health Flexible Spending Account, if a Participant fails to submit a claim within 90 days after the end of the Plan Year,
those claims shall not be considered for reimbursement by the Administrator. However, if a Participant terminates employment
during the Plan Year, claims for the reimbursement of Medical Expenses must be submitted within 90 days after termination of
employment. For the Dependent Care Flexible Spending Account, if a Participant fails to submit a claim within 90 days after the
end of the Plan Year, those claims shall not be considered for reimbursement by the Administrator. However, if a Participant
terminates employment during the Plan Year, claims for reimbursement must be submitted within 90 days after termination of
employment. If the Administrator denies a claim, the Administrator may provide notice to the Participant or beneficiary, in
writing, within 90 days after the claim is filed unless special circumstances require an extension of time for processing the claim.
The notice of a denial of a claim shall be written in a manner calculated to be understood by the claimant and shall set forth:
(1)

specific references to the pertinent Plan provisions on which the denial is based;

(2)
a description of any additional material or information necessary for the claimant to perfect the claim and an
explanation as to why such information is necessary; and
(3)

an explanation of the Plan's claim procedure.

(c)
Appeal. Within 60 days after receipt of the above material, the claimant shall have a reasonable opportunity
to appeal the claim denial to the Administrator for a full and fair review. The claimant or his duly authorized representative may:
(1)

request a review upon written notice to the Administrator;

(2)

review pertinent documents; and

(3)

submit issues and comments in writing.

(d)
Review of appeal. A decision on the review by the Administrator will be made not later than 60 days after
receipt of a request for review, unless special circumstances require an extension of time for processing (such as the need to hold
a hearing), in which event a decision should be rendered as soon as possible, but in no event later than 120 days after such
receipt. The decision of the Administrator shall be written and shall include specific reasons for the decision, written in a manner
calculated to be understood by the claimant, with specific references to the pertinent Plan provisions on which the decision is
based.
(e)
Forfeitures. Any balance remaining in the Participant's Health Flexible Spending Account (excluding any
carryover) or Dependent Care Flexible Spending Account as of the end of the time for claims reimbursement for each Plan Year
shall be forfeited and deposited in the benefit plan surplus of the Employer pursuant to Section 6.3 or Section 7.8, whichever is
applicable, unless the Participant had made a claim for such Plan Year, in writing, which has been denied or is pending; in which
event the amount of the claim shall be held in his account until the claim appeal procedures set forth above have been satisfied or
the claim is paid. If any such claim is denied on appeal, the amount held beyond the end of the Plan Year shall be forfeited and
credited to the benefit plan surplus.
8.2

APPLICATION OF BENEFIT PLAN SURPLUS

Any forfeited amounts credited to the benefit plan surplus by virtue of the failure of a Participant to incur a qualified expense or
seek reimbursement in a timely manner may, but need not be, separately accounted for after the close of the Plan Year (or after such further
time specified herein for the filing of claims) in which such forfeitures arose. In no event shall such amounts be carried over to reimburse a
Participant for expenses incurred during a subsequent Plan Year for the same or any other Benefit available under the Plan (excepting any
carryover); nor shall amounts forfeited by a particular Participant be made available to such Participant in any other form or manner, except
as permitted by Treasury regulations. Amounts in the benefit plan surplus shall be used to defray any administrative costs and experience
losses or used to provide additional benefits under the Plan.

16

ARTICLE IX
ADMINISTRATION
9.1

PLAN ADMINISTRATION

The Employer shall be the Administrator, unless the Employer elects otherwise. The Employer may appoint any person,
including, but not limited to, the Employees of the Employer, to perform the duties of the Administrator. Any person so appointed shall
signify acceptance by filing acceptance in writing (or such other form as acceptable to both parties) with the Employer. Upon the
resignation or removal of any individual performing the duties of the Administrator, the Employer may designate a successor.
If the Employer elects, the Employer shall appoint one or more Administrators. Any person, including, but not limited to, the
Employees of the Employer, shall be eligible to serve as an Administrator. Any person so appointed shall signify acceptance by filing
acceptance in writing (or such other form as acceptable to both parties) with the Employer. An Administrator may resign by delivering a
resignation in writing (or such other form as acceptable to both parties) to the Employer or be removed by the Employer by delivery of
notice of removal (in writing or such other form as acceptable to both parties), to take effect at a date specified therein, or upon delivery to
the Administrator if no date is specified. The Employer shall be empowered to appoint and remove the Administrator from time to time as
it deems necessary for the proper administration of the Plan to ensure that the Plan is being operated for the exclusive benefit of the
Employees entitled to participate in the Plan in accordance with the terms of the Plan and the Code.
The operation of the Plan shall be under the supervision of the Administrator. It shall be a principal duty of the Administrator to
see that the Plan is carried out in accordance with its terms, and for the exclusive benefit of Employees entitled to participate in the Plan.
The Administrator shall have full power and discretion to administer the Plan in all of its details and determine all questions arising in
connection with the administration, interpretation, and application of the Plan. The Administrator may establish procedures, correct any
defect, supply any information, or reconciles any inconsistency in such manner and to such extent as shall be deemed necessary or
advisable to carry out the purpose of the Plan. The Administrator shall have all powers necessary or appropriate to accomplish the
Administrator's duties under the Plan. The Administrator shall be charged with the duties of the general administration of the Plan as set
forth under the Plan, including, but not limited to, in addition to all other powers provided by this Plan:
(a)
To make and enforce such procedures, rules and regulations as the Administrator deems necessary or proper
for the efficient administration of the Plan;
(b)
To interpret the provisions of the Plan, the Administrator's interpretations thereof in good faith to be final and
conclusive on all persons claiming benefits by operation of the Plan;
(c)
To decide all questions concerning the Plan and the eligibility of any person to participate in the Plan and to
receive benefits provided by operation of the Plan;
(d)
To reject elections or to limit contributions or Benefits for certain highly compensated participants if it deems
such to be desirable in order to avoid discrimination under the Plan in violation of applicable provisions of the Code;
(e)
To provide Employees with a reasonable notification of their benefits available by operation of the Plan and
to assist any Participant regarding the Participant's rights, benefits or elections under the Plan;
(f)
To keep and maintain the Plan documents and all other records pertaining to and necessary for the
administration of the Plan;
(g)
To review and settle all claims against the Plan, to approve reimbursement requests, and to authorize the
payment of benefits if the Administrator determines such shall be paid if the Administrator decides in its discretion that the
applicant is entitled to them. This authority specifically permits the Administrator to settle disputed claims for benefits and any
other disputed claims made against the Plan;
(h)
To appoint such agents, counsel, accountants, consultants, and other persons or entities as may be required to
assist in administering the Plan.
Any procedure, discretionary act, interpretation or construction taken by the Administrator shall be done in a nondiscriminatory
manner based upon uniform principles consistently applied and shall be consistent with the intent that the Plan shall continue to comply
with the terms of Code Section 125 and the Treasury regulations thereunder.
9.2

EXAMINATION OF RECORDS

The Administrator shall make available to each Participant, Eligible Employee and any other Employee of the Employer such
records as pertain to their interest under the Plan for examination at reasonable times during normal business hours.

17

9.3

PAYMENT OF EXPENSES

Any reasonable administrative expenses shall be paid by the Employer unless the Employer determines that administrative costs
shall be borne by the Participants under the Plan or by any Trust Fund which may be established hereunder. The Administrator may impose
reasonable conditions for payments, provided that such conditions shall not discriminate in favor of highly compensated employees.
9.4

INSURANCE CONTROL CLAUSE

In the event of a conflict between the terms of this Plan and the terms of an Insurance Contract of an independent third party
Insurer whose product is then being used in conjunction with this Plan, the terms of the Insurance Contract shall control as to those
Participants receiving coverage under such Insurance Contract. For this purpose, the Insurance Contract shall control in defining the
persons eligible for insurance, the dates of their eligibility, the conditions which must be satisfied to become insured, if any, the benefits
Participants are entitled to and the circumstances under which insurance terminates.
9.5

INDEMNIFICATION OF ADMINISTRATOR

The Employer agrees to indemnify and to defend to the fullest extent permitted by law any Employee serving as the
Administrator or as a member of a committee designated as Administrator (including any Employee or former Employee who previously
served as Administrator or as a member of such committee) against all liabilities, damages, costs and expenses (including attorney's fees
and amounts paid in settlement of any claims approved by the Employer) occasioned by any act or omission to act in connection with the
Plan, if such act or omission is in good faith.
ARTICLE X
AMENDMENT OR TERMINATION OF PLAN
10.1

AMENDMENT

The Employer, at any time or from time to time, may amend any or all of the provisions of the Plan without the consent of any
Employee or Participant. No amendment shall have the effect of modifying any benefit election of any Participant in effect at the time of
such amendment, unless such amendment is made to comply with Federal, state or local laws, statutes or regulations.
10.2

TERMINATION

The Employer reserves the right to terminate this Plan, in whole or in part, at any time. In the event the Plan is terminated, no
further contributions shall be made. Benefits under any Insurance Contract shall be paid in accordance with the terms of the Insurance
Contract.
No further additions shall be made to the Health Flexible Spending Account or Dependent Care Flexible Spending Account, but
all payments from such fund shall continue to be made according to the elections in effect until 90 days after the termination date of the
Plan. Any amounts remaining in any such fund or account as of the end of such period shall be forfeited and deposited in the benefit plan
surplus after the expiration of the filing period.
ARTICLE XI
MISCELLANEOUS
11.1

PLAN INTERPRETATION

All provisions of this Plan shall be interpreted and applied in a uniform, nondiscriminatory manner. This Plan shall be read in its
entirety and not severed except as provided in Section 11.12.
11.2

GENDER, NUMBER AND TENSE

Wherever any words are used herein in one gender, they shall be construed as though they were also used in all genders in all
cases where they would so apply; whenever any words are used herein in the singular or plural form, they shall be construed as though they
were also used in the other form in all cases where they would so apply; and whenever any words are used herein in the past or present
tense, they shall be construed as though they were also used in the other form in all cases where they would so apply.
11.3

WRITTEN DOCUMENT

This Plan, in conjunction with any separate written document which may be required by law, is intended to satisfy the written
Plan requirement of Code Section 125 and any Treasury regulations thereunder relating to cafeteria plans.
11.4

EXCLUSIVE BENEFIT
This Plan shall be maintained for the exclusive benefit of the Employees who participate in the Plan.
18

11.5

PARTICIPANT'S RIGHTS

This Plan shall not be deemed to constitute an employment contract between the Employer and any Participant or to be a
consideration or an inducement for the employment of any Participant or Employee. Nothing contained in this Plan shall be deemed to give
any Participant or Employee the right to be retained in the service of the Employer or to interfere with the right of the Employer to
discharge any Participant or Employee at any time regardless of the effect which such discharge shall have upon him as a Participant of this
Plan.
11.6

ACTION BY THE EMPLOYER

Whenever the Employer under the terms of the Plan is permitted or required to do or perform any act or matter or thing, it shall
be done and performed by a person duly authorized by its legally constituted authority.
11.7

EMPLOYER'S PROTECTIVE CLAUSES
(a)
Insurance purchase. Upon the failure of either the Participant or the Employer to obtain the insurance
contemplated by this Plan (whether as a result of negligence, gross neglect or otherwise), the Participant's Benefits shall be
limited to the insurance premium(s), if any, that remained unpaid for the period in question and the actual insurance proceeds, if
any, received by the Employer or the Participant as a result of the Participant's claim.
(b)
Validity of insurance contract. The Employer shall not be responsible for the validity of any Insurance
Contract issued hereunder or for the failure on the part of the Insurer to make payments provided for under any Insurance
Contract. Once insurance is applied for or obtained, the Employer shall not be liable for any loss which may result from the
failure to pay Premiums to the extent Premium notices are not received by the Employer.

11.8

NO GUARANTEE OF TAX CONSEQUENCES

Neither the Administrator nor the Employer makes any commitment or guarantee that any amounts paid to or for the benefit of a
Participant under the Plan will be excludable from the Participant's gross income for federal or state income tax purposes, or that any other
federal or state tax treatment will apply to or be available to any Participant. It shall be the obligation of each Participant to determine
whether each payment under the Plan is excludable from the Participant's gross income for federal and state income tax purposes, and to
notify the Employer if the Participant has reason to believe that any such payment is not so excludable. Notwithstanding the foregoing, the
rights of Participants under this Plan shall be legally enforceable.
11.9

INDEMNIFICATION OF EMPLOYER BY PARTICIPANTS

If any Participant receives one or more payments or reimbursements under the Plan that are not for a permitted Benefit, such
Participant shall indemnify and reimburse the Employer for any liability it may incur for failure to withhold federal or state income tax or
Social Security tax from such payments or reimbursements. However, such indemnification and reimbursement shall not exceed the
amount of additional federal and state income tax (plus any penalties) that the Participant would have owed if the payments or
reimbursements had been made to the Participant as regular cash compensation, plus the Participant's share of any Social Security tax that
would have been paid on such compensation, less any such additional income and Social Security tax actually paid by the Participant.
11.10

FUNDING

Unless otherwise required by law, contributions to the Plan need not be placed in trust or dedicated to a specific Benefit, but may
instead be considered general assets of the Employer. Furthermore, and unless otherwise required by law, nothing herein shall be construed
to require the Employer or the Administrator to maintain any fund or segregate any amount for the benefit of any Participant, and no
Participant or other person shall have any claim against, right to, or security or other interest in, any fund, account or asset of the Employer
from which any payment under the Plan may be made.
11.11

GOVERNING LAW

This Plan is governed by the Code and the Treasury regulations issued thereunder (as they might be amended from time to time).
In no event shall the Employer guarantee the favorable tax treatment sought by this Plan. To the extent not preempted by Federal law, the
provisions of this Plan shall be construed, enforced and administered according to the laws of the State of Kansas.
11.12

SEVERABILITY

If any provision of the Plan is held invalid or unenforceable, its invalidity or unenforceability shall not affect any other provisions
of the Plan, and the Plan shall be construed and enforced as if such provision had not been included herein.
11.13

CAPTIONS

The captions contained herein are inserted only as a matter of convenience and for reference, and in no way define, limit, enlarge
or describe the scope or intent of the Plan, nor in any way shall affect the Plan or the construction of any provision thereof.

19

11.14

CONTINUATION OF COVERAGE (COBRA)

Notwithstanding anything in the Plan to the contrary, in the event any benefit under this Plan subject to the continuation coverage
requirement of Code Section 4980B becomes unavailable, each Participant will be entitled to continuation coverage as prescribed in Code
Section 4980B, and related regulations. This Section shall only apply if the Employer employs at least twenty (20) employees on more than
50% of its typical business days in the previous calendar year.
11.15

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

Notwithstanding anything in this Plan to the contrary, this Plan shall be operated in accordance with HIPAA and regulations
thereunder.
11.16

UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT (USERRA)

Notwithstanding any provision of this Plan to the contrary, contributions, benefits and service credit with respect to qualified military
service shall be provided in accordance with the Uniform Services Employment And Reemployment Rights Act (USERRA) and the
regulations thereunder.
11.17

COMPLIANCE WITH HIPAA PRIVACY STANDARDS
(a)
Application. If any benefits under this Cafeteria Plan are subject to the Standards for Privacy of Individually
Identifiable Health Information (45 CFR Part 164, the "Privacy Standards"), then this Section shall apply.
(b)
Disclosure of PHI. The Plan shall not disclose Protected Health Information to any member of the
Employer's workforce unless each of the conditions set out in this Section are met. "Protected Health Information" shall have the
same definition as set forth in the Privacy Standards but generally shall mean individually identifiable information about the past,
present or future physical or mental health or condition of an individual, including genetic information and information about
treatment or payment for treatment.
(c)
PHI disclosed for administrative purposes. Protected Health Information disclosed to members of the
Employer's workforce shall be used or disclosed by them only for purposes of Plan administrative functions. The Plan's
administrative functions shall include all Plan payment functions and health care operations. The terms "payment" and "health
care operations" shall have the same definitions as set out in the Privacy Standards, but the term "payment" generally shall mean
activities taken to determine or fulfill Plan responsibilities with respect to eligibility, coverage, provision of benefits, or
reimbursement for health care. Protected Health Information that consists of genetic information will not be used or disclosed for
underwriting purposes.
(d)
PHI disclosed to certain workforce members. The Plan shall disclose Protected Health Information only to
members of the Employer's workforce who are designated and authorized to receive such Protected Health Information, and only
to the extent and in the minimum amount necessary for that person to perform his or her duties with respect to the Plan.
"Members of the Employer's workforce" shall refer to all employees and other persons under the control of the Employer. The
Employer shall keep an updated list of those authorized to receive Protected Health Information.
(1)
An authorized member of the Employer's workforce who receives Protected Health Information shall use or
disclose the Protected Health Information only to the extent necessary to perform his or her duties with respect to the
Plan.
(2)
In the event that any member of the Employer's workforce uses or discloses Protected Health Information
other than as permitted by this Section and the Privacy Standards, the incident shall be reported to the Plan's privacy
official. The privacy official shall take appropriate action, including:
(i)
investigation of the incident to determine whether the breach occurred inadvertently, through
negligence or deliberately; whether there is a pattern of breaches; and the degree of harm caused by the
breach;
(ii)
appropriate sanctions against the persons causing the breach which, depending upon the nature of
the breach, may include oral or written reprimand, additional training, or termination of employment;

(e)

(iii)

mitigation of any harm caused by the breach, to the extent practicable; and

(iv)

documentation of the incident and all actions taken to resolve the issue and mitigate any damages.

Certification. The Employer must provide certification to the Plan that it agrees to:

(1)
Not use or further disclose the information other than as permitted or required by the Plan documents or as
required by law;

20

(2)
Ensure that any agent or subcontractor, to whom it provides Protected Health Information received from the
Plan, agrees to the same restrictions and conditions that apply to the Employer with respect to such information;
(3)
Not use or disclose Protected Health Information for employment-related actions and decisions or in
connection with any other benefit or employee benefit plan of the Employer;
(4)
Report to the Plan any use or disclosure of the Protected Health Information of which it becomes aware that
is inconsistent with the uses or disclosures permitted by this Section, or required by law;
(5)
Make available Protected Health Information to individual Plan members in accordance with Section 164.524
of the Privacy Standards;
(6)
Make available Protected Health Information for amendment by individual Plan members and incorporate
any amendments to Protected Health Information in accordance with Section 164.526 of the Privacy Standards;
(7)
Make available the Protected Health Information required to provide an accounting of disclosures to
individual Plan members in accordance with Section 164.528 of the Privacy Standards;
(8)
Make its internal practices, books and records relating to the use and disclosure of Protected Health
Information received from the Plan available to the Department of Health and Human Services for purposes of
determining compliance by the Plan with the Privacy Standards;
(9)
If feasible, return or destroy all Protected Health Information received from the Plan that the Employer still
maintains in any form, and retain no copies of such information when no longer needed for the purpose for which
disclosure was made, except that, if such return or destruction is not feasible, limit further uses and disclosures to those
purposes that make the return or destruction of the information infeasible; and
(10)
Ensure the adequate separation between the Plan and members of the Employer's workforce, as required by
Section 164.504(f)(2)(iii) of the Privacy Standards and set out in (d) above.
11.18

COMPLIANCE WITH HIPAA ELECTRONIC SECURITY STANDARDS

Under the Security Standards for the Protection of Electronic Protected Health Information (45 CFR Part 164.300 et. seq., the
"Security Standards"):
(a)
Implementation. The Employer agrees to implement reasonable and appropriate administrative, physical and
technical safeguards to protect the confidentiality, integrity and availability of Electronic Protected Health Information that the
Employer creates, maintains or transmits on behalf of the Plan. "Electronic Protected Health Information" shall have the same
definition as set out in the Security Standards, but generally shall mean Protected Health Information that is transmitted by or
maintained in electronic media.
(b)
Agents or subcontractors shall meet security standards. The Employer shall ensure that any agent or
subcontractor to whom it provides Electronic Protected Health Information shall agree, in writing, to implement reasonable and
appropriate security measures to protect the Electronic Protected Health Information.
(c)
Employer shall ensure security standards. The Employer shall ensure that reasonable and appropriate
security measures are implemented to comply with the conditions and requirements set forth in Section 11.17.
11.19

MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT
Notwithstanding anything in the Plan to the contrary, the Plan will comply with the Mental Health Parity and Addiction Equity Act.

11.20

GENETIC INFORMATION NONDISCRIMINATION ACT (GINA)
Notwithstanding anything in the Plan to the contrary, the Plan will comply with the Genetic Information Nondiscrimination Act.

11.21

WOMEN'S HEALTH AND CANCER RIGHTS ACT
Notwithstanding anything in the Plan to the contrary, the Plan will comply with the Women's Health and Cancer Rights Act of

1998.
11.22

NEWBORNS' AND MOTHERS' HEALTH PROTECTION ACT
Notwithstanding anything in the Plan to the contrary, the Plan will comply with the Newborns' and Mothers' Health Protection Act.

21

IN WITNESS WHEREOF, this Plan document is hereby executed this
City of Goddard
By
EMPLOYER

22

day of

.

ADOPTING RESOLUTION
The undersigned authorized representative of City of Goddard (the Employer) hereby certifies that the following resolutions were
duly adopted by the Employer on ______________________, and that such resolutions have not been modified or rescinded as of the date
hereof:
RESOLVED, that the form of amended Cafeteria Plan including a Health Flexible Spending Account and Dependent Care Flexible
Spending Account effective September 1, 2026, presented to this meeting is hereby approved and adopted and that an authorized
representative of the Employer is hereby authorized and directed to execute and deliver to the Administrator of the Plan one or more
counterparts of the Plan.
The undersigned further certifies that attached hereto as Exhibits A and B, respectively, are true copies of City of Goddard
Flexible Spending Account Plan as amended and restated, and the Summary Plan Description approved and adopted in the foregoing
resolutions.

Date:

Signed:

[print name/title]

CITY OF GODDARD
FLEXIBLE SPENDING ACCOUNT PLAN
SUMMARY PLAN DESCRIPTION

TABLE OF CONTENTS

I
ELIGIBILITY
1.

When can I become a participant in the Plan? ................................................................................................................................ 1

2.

What are the eligibility requirements for our Plan? ........................................................................................................................ 1

3.

When is my entry date?................................................................................................................................................................... 1

4.

What must I do to enroll in the Plan? .............................................................................................................................................. 1
II
OPERATION

1.

How does this Plan operate? ........................................................................................................................................................... 2
III
CONTRIBUTIONS

1.

How much of my pay may the Employer redirect? ......................................................................................................................... 2

2.

What happens to contributions made to the Plan?........................................................................................................................... 2

3.

When must I decide which accounts I want to use? ........................................................................................................................ 2

4.

When is the election period for our Plan? ....................................................................................................................................... 2

5.

May I change my elections during the Plan Year? .......................................................................................................................... 2

6.

May I make new elections in future Plan Years? ............................................................................................................................ 3
IV
BENEFITS

1.

Health Flexible Spending Account ................................................................................................................................................. 3

2.

Dependent Care Flexible Spending Account .................................................................................................................................. 4

3.

Premium Expense Account ............................................................................................................................................................. 4
V
BENEFIT PAYMENTS

1.

When will I receive payments from my accounts? ......................................................................................................................... 5

2.

What happens if I don't spend all Plan contributions during the Plan Year? ................................................................................... 5

3.

Uniformed Services Employment and Reemployment Rights Act (USERRA) .............................................................................. 5

4.

What happens if I terminate employment?...................................................................................................................................... 5

5.

Will my Social Security benefits be affected? ................................................................................................................................ 5

6.

Qualified Reservist Distributions .................................................................................................................................................... 5
VI
HIGHLY COMPENSATED AND KEY EMPLOYEES

1.

Do limitations apply to highly compensated employees? ............................................................................................................... 6
VII
PLAN ACCOUNTING

1.

Periodic Statements ......................................................................................................................................................................... 6
VIII
GENERAL INFORMATION ABOUT OUR PLAN

1.

General Plan Information ................................................................................................................................................................ 6

2.

Employer Information ..................................................................................................................................................................... 6

3.

Plan Administrator Information ...................................................................................................................................................... 6

4.

Service of Legal Process ................................................................................................................................................................. 7

5.

Type of Administration ................................................................................................................................................................... 7

6.

Claims Submission ......................................................................................................................................................................... 7
IX
ADDITIONAL PLAN INFORMATION

1.

Claims Process ................................................................................................................................................................................ 7
X
CONTINUATION COVERAGE RIGHTS UNDER COBRA

1.

What is COBRA continuation coverage? ........................................................................................................................................ 7

2.

Who can become a Qualified Beneficiary? ..................................................................................................................................... 8

3.

What is a Qualifying Event? ........................................................................................................................................................... 8

4.

What factors should be considered when determining to elect COBRA continuation coverage? ................................................... 9

5.

What is the procedure for obtaining COBRA continuation coverage?............................................................................................ 9

6.

What is the election period and how long must it last? ................................................................................................................... 9

7.

Is a covered Employee or Qualified Beneficiary responsible for informing the Plan Administrator of the
occurrence of a Qualifying Event? .................................................................................................................................................. 10

8.

Is a waiver before the end of the election period effective to end a Qualified Beneficiary's election rights? .................................. 10

9.

Is COBRA coverage available if a Qualified Beneficiary has other group health plan coverage or Medicare? .............................. 11

10.

When may a Qualified Beneficiary's COBRA continuation coverage be terminated? .................................................................... 11

11.

What are the maximum coverage periods for COBRA continuation coverage? ............................................................................. 11

12.

Under what circumstances can the maximum coverage period be expanded? ................................................................................ 11

13.

How does a Qualified Beneficiary become entitled to a disability extension? ................................................................................ 12

14.

Does the Plan require payment for COBRA continuation coverage? ............................................................................................. 12

15.

Must the Plan allow payment for COBRA continuation coverage to be made in monthly installments? ....................................... 12

16.

What is Timely Payment for COBRA continuation coverage? ....................................................................................................... 12

17.

Must a Qualified Beneficiary be given the right to enroll in a conversion health plan at the end of the maximum
coverage period for COBRA continuation coverage? ..................................................................................................................... 12

18.

How is my participation in the Health Flexible Spending Account affected? ................................................................................. 12
XI
SUMMARY

CITY OF GODDARD
FLEXIBLE SPENDING ACCOUNT PLAN
INTRODUCTION
We have amended the "Flexible Benefits Plan" that we previously established for you and other eligible employees. Under this Plan,
you will be able to choose among certain benefits that we make available. The benefits that you may choose are outlined in this Summary
Plan Description. We will also tell you about other important information concerning the amended Plan, such as the rules you must satisfy
before you can join and the laws that protect your rights.
One of the most important features of our Plan is that the benefits being offered are generally ones that you are already paying for, but
normally with money that has first been subject to income and Social Security taxes. Under our Plan, these same expenses will be paid for
with a portion of your pay before Federal income or Social Security taxes are withheld. This means that you will pay less tax and have
more money to spend and save.
Read this Summary Plan Description carefully so that you understand the provisions of our amended Plan and the benefits you will
receive. This SPD describes the Plan's benefits and obligations as contained in the legal Plan document, which governs the operation of the
Plan. The Plan document is written in much more technical and precise language. If the non-technical language in this SPD and the
technical, legal language of the Plan document conflict, the Plan document always governs. Also, if there is a conflict between an insurance
contract and either the Plan document or this Summary Plan Description, the insurance contract will control. If you wish to receive a copy
of the legal Plan document, please contact the Administrator.
This SPD describes the current provisions of the Plan which are designed to comply with applicable legal requirements. The Plan is
subject to federal laws, such as the Internal Revenue Code and other federal and state laws which may affect your rights. The provisions of
the Plan are subject to revision due to a change in laws or due to pronouncements by the Internal Revenue Service (IRS) or other federal
agencies. We may also amend or terminate this Plan. If the provisions of the Plan that are described in this SPD change, we will notify you.
We have attempted to answer most of the questions you may have regarding your benefits in the Plan. If this SPD does not answer all
of your questions, please contact the Administrator (or other plan representative). The name and address of the Administrator can be found
in the Article of this SPD entitled "General Information About the Plan."
I
ELIGIBILITY
1.

When can I become a participant in the Plan?

Before you become a Plan member (referred to in this Summary Plan Description as a "Participant"), there are certain rules which you
must satisfy. First, you must meet the eligibility requirements and be an active employee. After that, the next step is to actually join the
Plan on the "entry date" that we have established for all employees. The "entry date" is defined in Question 3 below. You will also be
required to complete certain application forms before you can enroll in the Health Flexible Spending Account or Dependent Care Flexible
Spending Account.
2.

What are the eligibility requirements for our Plan?

You will be eligible to join the Plan once you have satisfied the conditions for coverage under our group medical plan. Of course, if
you were already a participant before this amendment, you will remain a participant.
3.

When is my entry date?
You can join the Plan on the same day you can enter our group medical plan.

4.

What must I do to enroll in the Plan?

Before you can join the Plan, you must complete an application to participate in the Plan. The application includes your personal
choices for each of the benefits which are being offered under the Plan. You must also authorize us to set some of your earnings aside in
order to pay for the benefits you have elected.
However, if you are already covered under any of the insured benefits, you will automatically participate in this Plan to the extent of
your premiums unless you elect not to participate in this Plan.

1

II
OPERATION
1.

How does this Plan operate?

Before the start of each Plan Year, you will be able to elect to have some of your upcoming pay contributed to the Plan. These
amounts will be used to pay for the benefits you have chosen. The portion of your pay that is paid to the Plan is not subject to Federal
income or Social Security taxes. In other words, this allows you to use tax-free dollars to pay for certain kinds of benefits and expenses
which you normally pay for with out-of-pocket, taxable dollars. However, if you receive a reimbursement for an expense under the Plan,
you cannot claim a Federal income tax credit or deduction on your return. (See the Article entitled "General Information About Our Plan"
for the definition of "Plan Year.")
III
CONTRIBUTIONS
1.

How much of my pay may the Employer redirect?

Each year, we will automatically contribute on your behalf enough of your compensation to pay for the insurance coverage provided
unless you elect not to receive any or all of such coverage. You may also elect to have us contribute on your behalf enough of your
compensation to pay for any other benefits that you elect under the Plan. These amounts will be deducted from your pay over the course of
the year.
2.

What happens to contributions made to the Plan?

Before each Plan Year begins, you will select the benefits you want and how much of the contributions should go toward each benefit.
It is very important that you make these choices carefully based on what you expect to spend on each covered benefit or expense during the
Plan Year. Later, they will be used to pay for the expenses as they arise during the Plan Year.
3.

When must I decide which accounts I want to use?

You are required by Federal law to decide before the Plan Year begins, during the election period (defined below). You must decide
two things. First, which benefits you want and, second, how much should go toward each benefit.
If you are already covered by any of the insured benefits offered by this Plan, you will automatically become a Participant to the
extent of the premiums for such insurance unless you elect, during the election period (defined below), not to participate in the Plan.
4.

When is the election period for our Plan?

You will make your initial election on or before your entry date. (You should review Section I on Eligibility to better understand the
eligibility requirements and entry date.) Then, for each following Plan Year, the election period is established by the Administrator and
applied uniformly to all Participants. It will normally be a period of time prior to the beginning of each Plan Year. The Administrator will
inform you each year about the election period. (See the Article entitled "General Information About Our Plan" for the definition of Plan
Year.)
5.

May I change my elections during the Plan Year?

Generally, you cannot change the elections you have made after the beginning of the Plan Year. However, there are certain limited
situations when you can change your elections. You are permitted to change elections if you have a "change in status" and you make an
election change that is consistent with the change in status. Currently, Federal law considers the following events to be a change in status:
-- Marriage, divorce, death of a spouse, legal separation or annulment;
-- Change in the number of dependents, including birth, adoption, placement for adoption, or death of a dependent;
-- Any of the following events for you, your spouse or dependent: termination or commencement of employment, a strike or lockout,
commencement or return from an unpaid leave of absence, a change in worksite, or any other change in employment status that affects
eligibility for benefits;
-- One of your dependents satisfies or ceases to satisfy the requirements for coverage due to change in age, student status, or any
similar circumstance; and
-- A change in the place of residence of you, your spouse or dependent that would lead to a change in status, such as moving out of a
coverage area for insurance.
In addition, if you are participating in the Dependent Care Flexible Spending Account, then there is a change in status if your dependent
no longer meets the qualifications to be eligible for dependent care.
2

There are detailed rules on when a change in election is deemed to be consistent with a change in status. In addition, there are laws
that give you rights to change health coverage for you, your spouse, or your dependents. If you change coverage due to rights you have
under the law, then you can make a corresponding change in your elections under the Plan. If any of these conditions apply to you, you
should contact the Administrator.
If the cost of a benefit provided under the Plan increases or decreases during a Plan Year, then we will automatically increase or
decrease, as the case may be, your salary redirection election. If the cost increases significantly, you will be permitted to either make
corresponding changes in your payments or revoke your election and obtain coverage under another benefit package option with similar
coverage, or revoke your election entirely.
If the coverage under a Benefit is significantly curtailed or ceases during a Plan Year, then you may revoke your elections and elect to
receive on a prospective basis coverage under another plan with similar coverage. In addition, if we add a new coverage option or eliminate
an existing option, you may elect the newly-added option (or elect another option if an option has been eliminated) and make
corresponding election changes to other options providing similar coverage. If you are not a Participant, you may elect to join the Plan.
There are also certain situations when you may be able to change your elections on account of a change under the plan of your spouse's,
former spouse's or dependent's employer.
These rules on change due to cost or coverage do not apply to the Health Flexible Spending Account, and you may not change your
election to the Health Flexible Spending Account if you make a change due to cost or coverage for insurance.
You may not change your election under the Dependent Care Flexible Spending Account if the cost change is imposed by a dependent
care provider who is your relative.
You may revoke your coverage under the employer's group health plan outside of our open enrollment period, if your employment
status changes from working at least 30 hours per week to less than 30 hours. This is regardless of whether the reduction in hours has
resulted in loss of eligibility. You must show intent to enroll in another health plan.
You may also revoke or modify your coverage (including change to self only from family/other-than-self coverage in certain cases)
under our Employer sponsored group health plan if you (or individuals related to you in certain cases) are eligible to obtain coverage
through the health exchanges.
6.

May I make new elections in future Plan Years?

Yes, you may. For each new Plan Year, you may change the elections that you previously made. You may also choose not to
participate in the Plan for the upcoming Plan Year. If you do not make new elections during the election period before a new Plan Year
begins, we will assume you want your elections for insured benefits only to remain the same and you will not be considered a Participant
for the non-insured benefit options under the Plan for the upcoming Plan Year.
IV
BENEFITS
1.

Health Flexible Spending Account

The Health Flexible Spending Account enables you to pay for expenses allowed under Sections 105 and 213(d) of the Internal
Revenue Code which are not covered by our insured medical plan and save taxes at the same time. The Health Flexible Spending Account
allows you to be reimbursed by the Employer for expenses incurred by you and your dependents.
Drug costs, including insulin, may be reimbursed.
You may not be reimbursed for the cost of other health care coverage maintained outside of the Plan, or for long-term care expenses.
A list of covered expenses is available from the Administrator.
For 2026, the most you can contribute is $3,400. After 2026, the dollar limit may increase for cost of living adjustments. This means
that amounts you do not use during a Plan Year can be carried over to the next Plan Year and used for expenses incurred in the next Plan
Year.
In order to be reimbursed for a health care expense, you must submit to the Administrator an itemized bill from the service provider.
We will also provide you with a debit or credit card to use to pay for medical expenses. The Administrator will provide you with further
details. Amounts reimbursed from the Plan may not be claimed as a deduction on your personal income tax return. Reimbursement from
the fund shall be paid at least once a month. Expenses under this Plan are treated as being "incurred" when you are provided with the care
that gives rise to the expenses, not when you are formally billed or charged, or you pay for the medical care.
You may be reimbursed for expenses for any child until the end of the calendar year in which the child reaches age 26. A child is a
natural child, stepchild, foster child, adopted child, or a child placed with you for adoption. If a child gains or regains eligibility due to
these new rules, that qualifies as a change in status to change coverage.

3

Newborns' and Mothers' Health Protection Act: Group health plans generally may not, under Federal law, restrict benefits for any
hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or
less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother's or newborn's attending
provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In
any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the issuer for
prescribing a length of stay not in excess of 48 hours (or 96 hours).
Women's Health and Cancer Rights Act: This plan, as required by the Women's Health and Cancer Rights Act of 1998, will reimburse
up to plan limits for benefits for mastectomy-related services including reconstruction and surgery to achieve symmetry between the
breasts, prostheses, and complications resulting from a mastectomy (including lymphedema). Contact your Plan Administrator for more
information.
2.

Dependent Care Flexible Spending Account

The Dependent Care Flexible Spending Account enables you to pay for out-of-pocket, work-related dependent day-care cost with
pre-tax dollars. If you are married, you can use the account if you and your spouse both work or, in some situations, if your spouse goes to
school full-time. Single employees can also use the account.
An eligible dependent is someone for whom you can claim expenses on Federal Income Tax Form 2441 "Credit for Child and
Dependent Care Expenses." Children must be under age 13. Other dependents must be physically or mentally unable to care for
themselves. Dependent Care arrangements which qualify include:
(a) A Dependent (Day) Care Center, provided that if care is provided by the facility for more than six individuals, the facility
complies with applicable state and local laws;
(b) An Educational Institution for pre-school children. For older children, only expenses for non-school care are eligible; and
(c) An "Individual" who provides care inside or outside your home: The "Individual" may not be a child of yours under age 19 or
anyone you claim as a dependent for Federal tax purposes.
You should make sure that the dependent care expenses you are currently paying for qualify under our Plan. We will also provide you
with a debit or credit card to use to pay for dependent care expenses. The Administrator will provide you with further details.
Each Plan Year, you may contribute up to $$7,500.
Also, in order to have the reimbursements made to you from this account be excludable from your income, you must provide a
statement from the service provider including the name, address, and in most cases, the taxpayer identification number of the service
provider on your tax form for the year, as well as the amount of such expense as proof that the expense has been incurred. In addition,
Federal tax laws permit a tax credit for certain dependent care expenses you may be paying for even if you are not a Participant in this Plan.
You may save more money if you take advantage of this tax credit rather than using the Dependent Care Flexible Spending Account under
our Plan. Ask your tax adviser which is better for you.
3.

Premium Expense Account

A Premium Expense Account allows you to use tax-free dollars to pay for certain premium expenses under various insurance
programs that we offer you. These premium expenses include:
-- Health care premiums under our insured group medical plan.
-- Dental insurance premiums.
-- Cancer insurance premiums.
-- Vision insurance premiums.
-- Accidental death and dismemberment insurance premiums.
Under our Plan, we will establish sub-accounts for you for each different type of insurance coverage that is available. Also, certain
limits on the amount of coverage may apply.
The Administrator may terminate or modify Plan benefits at any time, subject to the provisions of any insurance contracts providing
benefits described above. We will not be liable to you if an insurance company fails to provide any of the benefits described above. Also,
your insurance will end when you leave employment, are no longer eligible under the terms of any insurance policies, or when insurance
terminates.
Any benefits to be provided by insurance will be provided only after (1) you have provided the Administrator the necessary
information to apply for insurance, and (2) the insurance is in effect for you.
4

If you cover your children up to age 26 under your insurance, you can pay for that coverage through the Plan.
V
BENEFIT PAYMENTS
1.

When will I receive payments from my accounts?

During the course of the Plan Year, you may submit requests for reimbursement of expenses you have incurred. Expenses are
considered "incurred" when the service is performed, not necessarily when it is paid for. The Administrator will provide you with
acceptable forms for submitting these requests for reimbursement. If the request qualifies as a benefit or expense that the Plan has agreed to
pay, you will receive a reimbursement payment soon thereafter. Remember, these reimbursements which are made from the Plan are
generally not subject to federal income tax or withholding. Nor are they subject to Social Security taxes. Requests for payment of insured
benefits should be made directly to the insurer. You will only be reimbursed from the Dependent Care Flexible Spending Account to the
extent that there are sufficient funds in the Account to cover your request.
2.

What happens if I don't spend all Plan contributions during the Plan Year?

Any monies left at the end of the Plan Year will be forfeited, except for amounts that can be carried over into the next Plan Year for
the Health Flexible Spending Account. Obviously, qualifying expenses that you incur late in the Plan Year for which you seek
reimbursement after the end of such Plan Year will be paid first before any amount is forfeited. For the Health Flexible Spending Account,
you must submit claims no later than 90 days after the end of the Plan Year. For the Dependent Care Flexible Spending Account, you must
submit claims no later than 90 days after the end of the Plan Year. Because it is possible that you might forfeit amounts in the Plan if you
do not fully use the contributions that have been made, it is important that you decide how much to place in each account carefully and
conservatively. Remember, you must decide which benefits you want to contribute to and how much to place in each account before the
Plan Year begins. You want to be as certain as you can that the amount you decide to place in each account will be used up entirely.
3.

Uniformed Services Employment and Reemployment Rights Act (USERRA)

If you are going into or returning from military service, you may have special rights to health care coverage under your Health Flexible
Spending Account under the Uniformed Services Employment and Reemployment Rights Act of 1994. These rights can include extended
health care coverage. If you may be affected by this law, ask your Administrator for further details.
4.

What happens if I terminate employment?
If you terminate employment during the Plan Year, your right to benefits will be determined in the following manner:
(a) You will remain covered by insurance, but only for the period for which premiums have been paid prior to your termination of
employment.
(b) You will still be able to request reimbursement for qualifying dependent care expenses incurred prior to your date of termination
from the balance remaining in your dependent care account at the time of termination of employment. However, no further salary
redirection contributions will be made on your behalf after you terminate. You must submit claims within 90 days after termination.
(c) For health benefit coverage and Health Flexible Spending Account coverage on termination of employment, please see the
Article entitled "Continuation Coverage Rights Under COBRA." Upon your termination of employment, your participation in the
Health Flexible Spending Account will cease, and no further salary redirection contributions will be contributed on your behalf.
However, you will be able to submit claims for health care expenses that were incurred before the end of the period for which
payments to the Health Flexible Spending Account have already been made. Your further participation will be governed by
"Continuation Coverage Rights Under COBRA."

5.

Will my Social Security benefits be affected?

Your Social Security benefits may be slightly reduced because when you receive tax-free benefits under our Plan, it reduces the
amount of contributions that you make to the Federal Social Security system as well as our contribution to Social Security on your behalf.
6.

Qualified Reservist Distributions

If you are a member of a reserve unit and if you are ordered or called to active duty, then you may request a Qualified Reservist
Distribution (QRD). A Qualified Reservist Distribution is a distribution of all or a portion of the amounts remaining in your Health Flexible
Spending Account. You can only request this distribution if you are called to active duty for a period of 180 days or more or for an
indefinite period. The distribution must be made during the period beginning on the date of the call and ending on the last date that
reimbursements could otherwise be made under the Plan for the Plan Year which includes the date of the call.
You can receive the amount you have actually contributed minus any reimbursements you have already received (or are in process).
The amount you request may be adjusted if needed to conform with your actual account balance. You must request the QRD before the last
5

day of the Plan Year. Any claims that you submit after the date you request the QRD will not be processed. You can only request 1 QRDs
for a Plan Year.
VI
HIGHLY COMPENSATED AND KEY EMPLOYEES
1.

Do limitations apply to highly compensated employees?

Under the Internal Revenue Code, highly compensated employees and key employees generally are Participants who are officers,
shareholders or highly paid. You will be notified by the Administrator each Plan Year whether you are a highly compensated employee or a
key employee.
If you are within these categories, the amount of contributions and benefits for you may be limited so that the Plan as a whole does not
unfairly favor those who are highly paid, their spouses or their dependents. Federal tax laws state that a plan will be considered to unfairly
favor the key employees if they as a group receive more than 25% of all of the nontaxable benefits provided for under our Plan.
Plan experience will dictate whether contribution limitations on highly compensated employees or key employees will apply. You will
be notified of these limitations if you are affected.
VII
PLAN ACCOUNTING
1.

Periodic Statements

The Administrator will provide you with a statement of your account periodically during the Plan Year that shows your account
balance. It is important to read these statements carefully so you understand the balance remaining to pay for a benefit. Remember, you
want to spend all the money you have designated for a particular benefit by the end of the Plan Year.
VIII
GENERAL INFORMATION ABOUT OUR PLAN
This Section contains certain general information which you may need to know about the Plan.
1.

General Plan Information
City of Goddard Flexible Spending Account Plan is the name of the Plan.
Your Employer has assigned Plan Number 501 to your Plan.
The provisions of your amended Plan become effective on September 1, 2026. Your Plan was originally effective on October 1, 2018.

Your Plan's records are maintained on a twelve-month period of time. This is known as the Plan Year. The Plan Year begins on
September 1 and ends on August 31.
2.

Employer Information
Your Employer's name, address, and identification number are:
City of Goddard
118 N. Main
Goddard, Kansas 67052
48-101337

3.

Plan Administrator Information
The name, address and business telephone number of your Plan's Administrator are:
City of Goddard
118 N. Main
Goddard, Kansas 67052
316-794-2441

The Administrator keeps the records for the Plan and is responsible for the administration of the Plan. The Administrator will also
answer any questions you may have about our Plan. You may contact the Administrator for any further information about the Plan.

6

4.

Service of Legal Process
The name and address of the Plan's agent for service of legal process are:
City of Goddard
118 N. Main
Goddard, Kansas 67052

5.

Type of Administration
The type of Administration is Employer Administration.

6.

Claims Submission
Claims for expenses should be submitted to:
Empower
7309 E. 21st Street North, Suite 110
Wichita, KS 67206
IX
ADDITIONAL PLAN INFORMATION

1.

Claims Process

You should submit all reimbursement claims during the Plan Year. For the Health Flexible Spending Account, you must submit
claims no later than 90 days after the end of the Plan Year. However, if you terminate employment during the Plan Year, you must submit
your Health Flexible Spending Account claims within 90 days after your termination of employment. For the Dependent Care Flexible
Spending Account, you must submit claims no later than 90 days after the end of the Plan Year. However, if you terminate employment
during the Plan Year, you must submit your Dependent Care Flexible Spending Account claims within 90 days after your termination of
employment. Any claims submitted after that time will not be considered.
Claims that are insured will be handled in accordance with procedures contained in the insurance policies. All other general requests
should be directed to the Administrator of our Plan. If a dependent care or medical expense claim under the Plan is denied in whole or in
part, you or your beneficiary will receive written notification. The notification will include the reasons for the denial, with reference to the
specific provisions of the Plan on which the denial was based, a description of any additional information needed to process the claim and
an explanation of the claims review procedure. Within 60 days after denial, you or your beneficiary may submit a written request for
reconsideration of the denial to the Administrator.
Any such request should be accompanied by documents or records in support of your appeal. You or your beneficiary may review
pertinent documents and submit issues and comments in writing. The Administrator will review the claim and provide, within 60 days, a
written response to the appeal. (This period may be extended an additional 60 days under certain circumstances.) In this response, the
Administrator will explain the reason for the decision, with specific reference to the provisions of the Plan on which the decision is based.
The Administrator has the exclusive right to interpret the appropriate plan provisions. Decisions of the Administrator are conclusive and
binding.
X
CONTINUATION COVERAGE RIGHTS UNDER COBRA
Under federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), certain employees and their families
covered under health benefits under this Plan will be entitled to the opportunity to elect a temporary extension of health coverage (called
"COBRA continuation coverage") where coverage under the Plan would otherwise end. This notice is intended to inform Plan Participants
and beneficiaries, in summary fashion, of their rights and obligations under the continuation coverage provisions of COBRA, as amended
and reflected in final and proposed regulations published by the Department of the Treasury. This notice is intended to reflect the law and
does not grant or take away any rights under the law.
The Plan Administrator or its designee is responsible for administering COBRA continuation coverage. Complete instructions on
COBRA, as well as election forms and other information, will be provided by the Plan Administrator or its designee to Plan Participants
who become Qualified Beneficiaries under COBRA. While the Plan itself is not a group health plan, it does provide health benefits.
Whenever "Plan" is used in this section, it means any of the health benefits under this Plan including the Health Flexible Spending
Account.
1.

What is COBRA continuation coverage?

COBRA continuation coverage is the temporary extension of group health plan coverage that must be offered to certain Plan
Participants and their eligible family members (called "Qualified Beneficiaries") at group rates. The right to COBRA continuation coverage
is triggered by the occurrence of a life event that results in the loss of coverage under the terms of the Plan (the "Qualifying Event"). The
7

coverage must be identical to the coverage that the Qualified Beneficiary had immediately before the Qualifying Event, or if the coverage
has been changed, the coverage must be identical to the coverage provided to similarly situated active employees who have not experienced
a Qualifying Event (in other words, similarly situated non-COBRA beneficiaries).
There may be other options available when you lose group health coverage. For example, you may be eligible to buy an individual
plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower costs on your
monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-day special enrollment period for another group
health plan for which you are eligible (such as a spouse's plan), even if that plan generally doesn't accept late enrollees.
2.

Who can become a Qualified Beneficiary?
In general, a Qualified Beneficiary can be:
(a) Any individual who, on the day before a Qualifying Event, is covered under a Plan by virtue of being on that day either a covered
Employee, the Spouse of a covered Employee, or a Dependent child of a covered Employee. If, however, an individual who otherwise
qualifies as a Qualified Beneficiary is denied or not offered coverage under the Plan under circumstances in which the denial or failure
to offer constitutes a violation of applicable law, then the individual will be considered to have had the coverage and will be
considered a Qualified Beneficiary if that individual experiences a Qualifying Event.
(b) Any child who is born to or placed for adoption with a covered Employee during a period of COBRA continuation coverage, and
any individual who is covered by the Plan as an alternate recipient under a qualified medical support order. If, however, an individual
who otherwise qualifies as a Qualified Beneficiary is denied or not offered coverage under the Plan under circumstances in which the
denial or failure to offer constitutes a violation of applicable law, then the individual will be considered to have had the coverage and
will be considered a Qualified Beneficiary if that individual experiences a Qualifying Event.

The term "covered Employee" includes any individual who is provided coverage under the Plan due to his or her performance of
services for the employer sponsoring the Plan. However, this provision does not establish eligibility of these individuals. Eligibility for Plan
coverage shall be determined in accordance with Plan Eligibility provisions.
An individual is not a Qualified Beneficiary if the individual's status as a covered Employee is attributable to a period in which the
individual was a nonresident alien who received from the individual's Employer no earned income that constituted income from sources
within the United States. If, on account of the preceding reason, an individual is not a Qualified Beneficiary, then a Spouse or Dependent
child of the individual will also not be considered a Qualified Beneficiary by virtue of the relationship to the individual. A domestic partner
is not a Qualified Beneficiary.
Each Qualified Beneficiary (including a child who is born to or placed for adoption with a covered Employee during a period of
COBRA continuation coverage) must be offered the opportunity to make an independent election to receive COBRA continuation
coverage.
3.

What is a Qualifying Event?

A Qualifying Event is any of the following if the Plan provided that the Plan participant would lose coverage (i.e., cease to be covered
under the same terms and conditions as in effect immediately before the Qualifying Event) in the absence of COBRA continuation
coverage:
(a) The death of a covered Employee.
(b) The termination (other than by reason of the Employee's gross misconduct), or reduction of hours, of a covered Employee's
employment.
(c) The divorce or legal separation of a covered Employee from the Employee's Spouse. If the Employee reduces or eliminates the
Employee's Spouse's Plan coverage in anticipation of a divorce or legal separation, and a divorce or legal separation later occurs, then
the divorce or legal separation may be considered a Qualifying Event even though the Spouse's coverage was reduced or eliminated
before the divorce or legal separation.
(d) A covered Employee's enrollment in any part of the Medicare program.
(e) A Dependent child's ceasing to satisfy the Plan's requirements for a Dependent child (for example, attainment of the maximum
age for dependency under the Plan).
If the Qualifying Event causes the covered Employee, or the covered Spouse or a Dependent child of the covered Employee, to cease
to be covered under the Plan under the same terms and conditions as in effect immediately before the Qualifying Event, the persons losing
such coverage become Qualified Beneficiaries under COBRA if all the other conditions of COBRA are also met. For example, any increase
in contribution that must be paid by a covered Employee, or the Spouse, or a Dependent child of the covered Employee, for coverage under
the Plan that results from the occurrence of one of the events listed above is a loss of coverage.

8

The taking of leave under the Family and Medical Leave Act of 1993, as amended ("FMLA") does not constitute a Qualifying Event.
A Qualifying Event will occur, however, if an Employee does not return to employment at the end of the FMLA leave and all other
COBRA continuation coverage conditions are present. If a Qualifying Event occurs, it occurs on the last day of FMLA leave and the
applicable maximum coverage period is measured from this date (unless coverage is lost at a later date and the Plan provides for the
extension of the required periods, in which case the maximum coverage date is measured from the date when the coverage is lost.) Note
that the covered Employee and family members will be entitled to COBRA continuation coverage even if they failed to pay the employee
portion of premiums for coverage under the Plan during the FMLA leave.
4.

What factors should be considered when determining to elect COBRA continuation coverage?
When considering options for health coverage, Qualified Beneficiaries should consider:


Premiums: This plan can charge up to 102% of total plan premiums for COBRA coverage. Other options, like coverage on a
spouse's plan or through the Marketplace, may be less expensive. Qualified Beneficiaries have special enrollment rights under
federal law (HIPAA). They have the right to request special enrollment in another group health plan for which they are otherwise
eligible (such as a plan sponsored by a spouse's employer) within 30 days after Plan coverage ends due to one of the Qualifying
Events listed above.



Provider Networks: If a Qualified Beneficiary is currently getting care or treatment for a condition, a change in health coverage
may affect access to a particular health care provider. You may want to check to see if your current health care providers
participate in a network in considering options for health coverage.



Drug Formularies: For Qualified Beneficiaries taking medication, a change in health coverage may affect costs for medication –
and in some cases, the medication may not be covered by another plan. Qualified beneficiaries should check to see if current
medications are listed in drug formularies for other health coverage.



Severance payments: If COBRA rights arise because the Employee has lost his job and there is a severance package available
from the employer, the former employer may have offered to pay some or all of the Employee's COBRA payments for a period
of time. This can affect the timing of coverage available in the Marketplace. In this scenario, the Employee may want to contact
the Department of Labor at 1-866-444-3272 to discuss options.



Medicare Eligibility: You should be aware of how COBRA coverage coordinates with Medicare eligibility. If you are eligible
for Medicare at the time of the Qualifying Event, or if you will become eligible soon after the Qualifying Event, you should know
that you have 8 months to enroll in Medicare after your employment –related health coverage ends. Electing COBRA coverage
does not extend this 8-month period. For more information, see medicare.gov/sign-up-change-plan.



Service Areas: If benefits under the Plan are limited to specific service or coverage areas, benefits may not be available to a
Qualified Beneficiary who moves out of the area.



Other Cost-Sharing: In addition to premiums or contributions for health coverage, the Plan requires participants to pay
copayments, deductibles, coinsurance, or other amounts as benefits are used. Qualified beneficiaries should check to see what the
cost-sharing requirements are for other health coverage options. For example, one option may have much lower monthly
premiums, but a much higher deductible and higher copayments.

Are there other coverage options besides COBRA Continuation Coverage? Yes. Instead of enrolling in COBRA continuation
coverage, there may be other coverage options for Qualified Beneficiaries through the Health Insurance Marketplace, Medicaid, or other
group health plan coverage options (such as a spouse's plan) through what is called a "special enrollment period." Some of these options
may cost less than COBRA continuation coverage. You can learn more about many of these options at www.healthcare.gov.
5.

What is the procedure for obtaining COBRA continuation coverage?

The Plan has conditioned the availability of COBRA continuation coverage upon the timely election of such coverage. An election is
timely if it is made during the election period.
6.

What is the election period and how long must it last?

The election period is the time period within which the Qualified Beneficiary must elect COBRA continuation coverage under the
Plan. The election period must begin no later than the date the Qualified Beneficiary would lose coverage on account of the Qualifying
Event and ends 60 days after the later of the date the Qualified Beneficiary would lose coverage on account of the Qualifying Event or the
date notice is provided to the Qualified Beneficiary of her or his right to elect COBRA continuation coverage. If coverage is not elected
within the 60 day period, all rights to elect COBRA continuation coverage are forfeited.
Note: If a covered Employee who has been terminated or experienced a reduction of hours qualifies for a trade readjustment allowance
or alternative trade adjustment assistance under a federal law called the Trade Act of 2002, as extended by the Trade Preferences Extension
Act of 2015, and the employee and his or her covered dependents have not elected COBRA coverage within the normal election period, a
second opportunity to elect COBRA coverage will be made available for themselves and certain family members, but only within a limited
period of 60 days or less and only during the six months immediately after their group health plan coverage ended. Any person who
9

qualifies or thinks that he or she and/or his or her family members may qualify for assistance under this special provision should contact the
Plan Administrator or its designee for further information about the special second election period. If continuation coverage is elected
under this extension, it will not become effective prior to the beginning of this special second election period.
7. Is a covered Employee or Qualified Beneficiary responsible for informing the Plan Administrator of the occurrence of a
Qualifying Event?
The Plan will offer COBRA continuation coverage to Qualified Beneficiaries only after the Plan Administrator or its designee has
been timely notified that a Qualifying Event has occurred. The Employer (if the Employer is not the Plan Administrator) will notify the
Plan Administrator or its designee of the Qualifying Event within 30 days following the date coverage ends when the Qualifying Event is:
(a) the end of employment or reduction of hours of employment,
(b) death of the employee,
(c) commencement of a proceeding in bankruptcy with respect to the Employer, or
(d) entitlement of the employee to any part of Medicare.
IMPORTANT:
For the other Qualifying Events (divorce or legal separation of the employee and spouse or a dependent child's losing
eligibility for coverage as a dependent child), you or someone on your behalf must notify the Plan Administrator or its designee in
writing within 60 days after the Qualifying Event occurs, using the procedures specified below. If these procedures are not followed
or if the notice is not provided in writing to the Plan Administrator or its designee during the 60-day notice period, any spouse or
dependent child who loses coverage will not be offered the option to elect continuation coverage. You must send this notice to the
Plan Administrator or its designee.
NOTICE PROCEDURES:
Any notice that you provide must be in writing. Oral notice, including notice by telephone, is not acceptable. You must mail, fax
or hand-deliver your notice to the person, department or firm listed below, at the following address:
City of Goddard
118 N. Main
Goddard, Kansas 67052
If mailed, your notice must be postmarked no later than the last day of the required notice period. Any notice you provide must state:





the name of the plan or plans under which you lost or are losing coverage,
the name and address of the employee covered under the plan,
the name(s) and address(es) of the Qualified Beneficiary(ies), and
the Qualifying Event and the date it happened.

If the Qualifying Event is a divorce or legal separation, your notice must include a copy of the divorce decree or the legal
separation agreement.
Be aware that there are other notice requirements in other contexts, for example, in order to qualify for a disability extension.
Once the Plan Administrator or its designee receives timely notice that a Qualifying Event has occurred, COBRA continuation
coverage will be offered to each of the qualified beneficiaries. Each Qualified Beneficiary will have an independent right to elect
COBRA continuation coverage. Covered employees may elect COBRA continuation coverage for their spouses, and parents may e lect
COBRA continuation coverage on behalf of their children. For each Qualified Beneficiary who elects COBRA continuation coverag e,
COBRA continuation coverage will begin on the date that plan coverage would otherwise have been lost. If you or your spouse or
dependent children do not elect continuation coverage within the 60-day election period described above, the right to elect continuation
coverage will be lost.
8.

Is a waiver before the end of the election period effective to end a Qualified Beneficiary's election rights?

If, during the election period, a Qualified Beneficiary waives COBRA continuation coverage, the waiver can be revoked at any time
before the end of the election period. Revocation of the waiver is an election of COBRA continuation coverage. However, if a waiver is
later revoked, coverage need not be provided retroactively (that is, from the date of the loss of coverage until the waiver is revoked).
Waivers and revocations of waivers are considered made on the date they are sent to the Plan Administrator or its designee, as applicable.

10

9.

Is COBRA coverage available if a Qualified Beneficiary has other group health plan coverage or Medicare?

Qualified Beneficiaries who are entitled to elect COBRA continuation coverage may do so even if they are covered under another
group health plan or are entitled to Medicare benefits on or before the date on which COBRA is elected. However, a Qualified
Beneficiary's COBRA coverage will terminate automatically if, after electing COBRA, he or she becomes entitled to Medicare or becomes
covered under other group health plan coverage.
10. When may a Qualified Beneficiary's COBRA continuation coverage be terminated?
During the election period, a Qualified Beneficiary may waive COBRA continuation coverage. Except for an interruption of coverage
in connection with a waiver, COBRA continuation coverage that has been elected for a Qualified Beneficiary must extend for at least the
period beginning on the date of the Qualifying Event and ending not before the earliest of the following dates:
(a) The last day of the applicable maximum coverage period.
(b) The first day for which Timely Payment is not made to the Plan with respect to the Qualified Beneficiary.
(c) The date upon which the Employer ceases to provide any group health plan (including a successor plan) to any employee.
(d) The date, after the date of the election, that the Qualified Beneficiary first becomes entitled to Medicare (either part A or part B,
whichever occurs earlier).
(e) In the case of a Qualified Beneficiary entitled to a disability extension, the later of:
(1) (i) 29 months after the date of the Qualifying Event, or (ii) the first day of the month that is more than 30 days after the date
of a final determination under Title II or XVI of the Social Security Act that the disabled Qualified Beneficiary whose disability
resulted in the Qualified Beneficiary's entitlement to the disability extension is no longer disabled, whichever is earlier; or
(2) the end of the maximum coverage period that applies to the Qualified Beneficiary without regard to the disability extension.
The Plan can terminate for cause the coverage of a Qualified Beneficiary on the same basis that the Plan terminates for cause the
coverage of similarly situated non-COBRA beneficiaries, for example, for the submission of a fraudulent claim.
In the case of an individual who is not a Qualified Beneficiary and who is receiving coverage under the Plan solely because of the
individual's relationship to a Qualified Beneficiary, if the Plan's obligation to make COBRA continuation coverage available to the
Qualified Beneficiary ceases, the Plan is not obligated to make coverage available to the individual who is not a Qualified Beneficiary.
11. What are the maximum coverage periods for COBRA continuation coverage?
The maximum coverage periods are based on the type of the Qualifying Event and the status of the Qualified Beneficiary, as shown
below.
(a) In the case of a Qualifying Event that is a termination of employment or reduction of hours of employment, the maximum
coverage period ends 18 months after the Qualifying Event if there is not a disability extension and 29 months after the Qualifying
Event if there is a disability extension.
(b) In the case of a covered Employee's enrollment in the Medicare program before experiencing a Qualifying Event that is a
termination of employment or reduction of hours of employment, the maximum coverage period for Qualified Beneficiaries ends on
the later of:
(1) 36 months after the date the covered Employee becomes enrolled in the Medicare program. This extension does not apply to
the covered Employee; or
(2) 18 months (or 29 months, if there is a disability extension) after the date of the covered Employee's termination of
employment or reduction of hours of employment.
(c) In the case of a Qualified Beneficiary who is a child born to or placed for adoption with a covered Employee during a period of
COBRA continuation coverage, the maximum coverage period is the maximum coverage period applicable to the Qualifying Event
giving rise to the period of COBRA continuation coverage during which the child was born or placed for adoption.
(d) In the case of any other Qualifying Event than that described above, the maximum coverage period ends 36 months after the
Qualifying Event.
12. Under what circumstances can the maximum coverage period be expanded?
If a Qualifying Event that gives rise to an 18-month or 29-month maximum coverage period is followed, within that 18- or 29-month
period, by a second Qualifying Event that gives rise to a 36-months maximum coverage period, the original period is expanded to 36
11

months, but only for individuals who are Qualified Beneficiaries at the time of and with respect to both Qualifying Events. In no
circumstance can the COBRA maximum coverage period be expanded to more than 36 months after the date of the first Qualifying Event.
The Plan Administrator must be notified of the second qualifying event within 60 days of the second qualifying event. This notice must be
sent to the Plan Administrator or its designee in accordance with the procedures above.
13. How does a Qualified Beneficiary become entitled to a disability extension?
A disability extension will be granted if an individual (whether or not the covered Employee) who is a Qualified Beneficiary in
connection with the Qualifying Event that is a termination or reduction of hours of a covered Employee's employment, is determined under
Title II or XVI of the Social Security Act to have been disabled at any time during the first 60 days of COBRA continuation coverage. To
qualify for the disability extension, the Qualified Beneficiary must also provide the Plan Administrator with notice of the disability
determination on a date that is both within 60 days after the date of the determination and before the end of the original 18-month
maximum coverage. This notice must be sent to the Plan Administrator or its designee in accordance with the procedures above.
14. Does the Plan require payment for COBRA continuation coverage?
For any period of COBRA continuation coverage under the Plan, Qualified Beneficiaries who elect COBRA continuation coverage
may be required to pay up to 102% of the applicable premium and up to 150% of the applicable premium for any expanded period of
COBRA continuation coverage covering a disabled Qualified Beneficiary due to a disability extension. Your Plan Administrator will
inform you of the cost. The Plan will terminate a Qualified Beneficiary's COBRA continuation coverage as of the first day of any period for
which timely payment is not made.
15. Must the Plan allow payment for COBRA continuation coverage to be made in monthly installments?
Yes. The Plan is also permitted to allow for payment at other intervals.
16. What is Timely Payment for COBRA continuation coverage?
Timely Payment means a payment made no later than 30 days after the first day of the coverage period. Payment that is made to the
Plan by a later date is also considered Timely Payment if either under the terms of the Plan, covered Employees or Qualified Beneficiaries
are allowed until that later date to pay for their coverage for the period or under the terms of an arrangement between the Employer and the
entity that provides Plan benefits on the Employer's behalf, the Employer is allowed until that later date to pay for coverage of similarly
situated non-COBRA beneficiaries for the period.
Notwithstanding the above paragraph, the Plan does not require payment for any period of COBRA continuation coverage for a
Qualified Beneficiary earlier than 45 days after the date on which the election of COBRA continuation coverage is made for that Qualified
Beneficiary. Payment is considered made on the date on which it is postmarked to the Plan.
If Timely Payment is made to the Plan in an amount that is not significantly less than the amount the Plan requires to be paid for a
period of coverage, then the amount paid will be deemed to satisfy the Plan's requirement for the amount to be paid, unless the Plan notifies
the Qualified Beneficiary of the amount of the deficiency and grants a reasonable period of time for payment of the deficiency to be made.
A "reasonable period of time" is 30 days after the notice is provided. A shortfall in a Timely Payment is not significant if it is no greater
than the lesser of $50 or 10% of the required amount.
17. Must a Qualified Beneficiary be given the right to enroll in a conversion health plan at the end of the maximum coverage
period for COBRA continuation coverage?
If a Qualified Beneficiary's COBRA continuation coverage under a group health plan ends as a result of the expiration of the applicable
maximum coverage period, the Plan will, during the 180-day period that ends on that expiration date, provide the Qualified Beneficiary
with the option of enrolling under a conversion health plan if such an option is otherwise generally available to similarly situated nonCOBRA beneficiaries under the Plan. If such a conversion option is not otherwise generally available, it need not be made available to
Qualified Beneficiaries.
18. How is my participation in the Health Flexible Spending Account affected?
You can elect to continue your participation in the Health Flexible Spending Account for the remainder of the Plan Year, subject to
the following conditions. You may only continue to participate in the Health Flexible Spending Account if you have elected to contribute
more money including any carryover amounts than you have taken out in claims. For example, if you elected to contribute an annual
amount of $500 and, at the time you terminate employment, you have contributed $300 but only claimed $150, you may elect to continue
coverage under the Health Flexible Spending Account. If you elect to continue coverage, then you would be able to continue to receive
your health reimbursements up to the $500. However, you must continue to pay for the coverage, just as the money has been taken out of
your paycheck, but on an after-tax basis. The Plan can also charge you an extra amount (as explained above for other health benefits) to
provide this benefit.

12

IF YOU HAVE QUESTIONS
If you have questions about your COBRA continuation coverage, you should contact the Plan Administrator or its designee. For more
information about your rights under ERISA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and
other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor's Employee
Benefits Security Administration (EBSA). Addresses and phone numbers of Regional and District EBSA Offices are available through
EBSA's website at www.dol.gov/ebsa.
KEEP YOUR PLAN ADMINISTRATOR INFORMED OF ADDRESS CHANGES
In order to protect your family's rights, you should keep the Plan Administrator informed of any changes in the addresses of family
members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator or its designee.
XI
SUMMARY
The money you earn is important to you and your family. You need it to pay your bills, enjoy recreational activities and save for the
future. Our flexible benefits plan will help you keep more of the money you earn by lowering the amount of taxes you pay. The Plan is the
result of our continuing efforts to find ways to help you get the most for your earnings.
If you have any questions, please contact the Administrator.

13

City of Goddard Financial Report
July 2026

Monthly Financial Update
Brooke Carroll, CFO

Overview
✓ Financial Summary as of July 31, 2026
✓ Includes Revenues, Expenditures, and Remaining
Budget Authority
✓ Covers General Fund, Other Budgeted Funds, and
Unbudgeted Funds
✓ Breakdown of General Fund Discretionary Line
✓ Breakdown of Capital Improvement Fund
✓ Investment Update

City of Goddard
Monthly Financial Update
7/31/2026- YTD
Fund Balance
Ending
7/31/2026

Jan-Jul
Revenues

2026 Budgeted
Expenditures

Jan-Jul
Expenditures

2026
Remaining
Budget
Authority

% of Budget
Remaining

General Fund:
Administration $
Court & Public Safety
Recreation & Culture
Community & Economic Development
Transfers
Total General Fund $

4,036,886

4,036,886

$
$
$
$
$
$

5,010,231
54,435
95,509
123,759
5,283,934

$
$
$
$
$
$

1,599,335
2,832,219
564,885
577,820
2,120,000
7,694,259

$
$
$
$
$
$

1,225,702
1,607,301
341,175
370,868
1,060,000
4,605,046

$
$
$
$
$
$

373,633
1,224,918
223,710
206,952
1,060,000
3,089,213

23.36%
43.25%
39.60%
35.82%
50.00%
40.15%

CID-Tanganyika $
Debt Service $
Library $
Special Highway-Street $
Special Parks & Rec $
Stormwater Utility $
Tourism Promotion $
Sewer Utility $
Water Utility $
Total Other Budgeted Funds $

2,081,909
1,067,276
242,029
225,670
151,440
1,652,052
1,457,432
6,877,807

$
$
$
$
$
$
$
$
$
$

76,336
1,514,991
263,026
1,159,814
44,176
80,228
50,613
1,128,658
1,085,738
5,403,579

$
$
$
$
$
$
$
$
$
$

100,000
2,357,415
284,987
2,139,192
93,200
136,900
1,914,541
1,578,977
8,605,212

$
$
$
$
$
$
$
$
$
$

76,336
540,712
263,026
761,978
17,335
61,303
1,075,221
916,123
3,712,033

$
$
$
$
$
$
$
$
$
$

23,664
1,816,703
21,961
1,377,215
75,865
75,597
839,320
662,854
4,893,179

23.66%
77.06%
7.71%
64.38%
0.00%
81.40%
55.22%
43.84%
41.98%

Unbudgeted Funds:
Capital Improvement $
Developer Projects $
Equipment Reserve $
Organizational Grant $
Sewer Reserve $
STAR Bond $
TDD - Goddard Galleria $
TDD - Tanganyika $
Water Reserve $
Total Unbudgeted Funds $

18,980,389
25,771,549
244,641
127
807,532
65,172
5,770
261,524
46,136,703

$
$
$
$
$
$
$
$
$
$

1,309,398
4,057,224
137,655
154,724
18,763
38,984
106,107
5,822,855

$
$
$
$
$
$
$
$
$
$

3,829,481
11,997,944
201,786
201,669
8,836
40,066
118,605
16,398,388

Total City Fund Balances $

57,051,397

Other Budgeted Funds:

Total Revenue Received (Jan-Jul)
Total Expenditures (Jan-Jul)
Change in Fund Balance

$ 16,510,368
$ 24,715,468
$ (8,205,100)

YTD – July 2026

General
Fund
Performance

✓ Fund Balance: $4,036,886
✓ Jan-Jul Revenues: $5,283,934
✓ 2026 Budgeted Expenditures: $7,694,259
✓ Jan-Jul Actual Expenditures: $4,605,046
✓ Remaining Budget Authority: $3,089,213 (40.15%)

General Fund - Departmental Breakdown

Total Discretionary Capital Expenditures: $529,049

Other
Budgeted
Funds
Performance

YTD – July 2026
✓ Total Ending Balance: $6,877,807
✓ Jan-Jul Revenues: $5,403,579
✓ 2026 Budgeted Expenditures: $8,605,212
✓ Jan-Jul Actual Expenditures: $3,712,033
✓ Remaining Budget Authority: $4,893,179 (56.86%)
Other Budgeted Funds Include: CID-Tanganyika, Debt Service,
Library, Special Highway, Special Parks & Rec, Storm Water
Utility, Tourism Promotion, Wastewater Utility, and Water
Utility

Other Budgeted Funds - Breakdown

YTD – July 2026

Unbudgeted
Funds
Performance

✓ Total Ending Balance: $46,136,703
✓ Jan-Jul Revenues: $5,822,855
✓ Jan-Jul Actual Expenditures: $16,398,388

Unbudgeted Funds Include: Capital Improvement, Developer
Projects, Equipment Reserves, Organizational Grant, Sewer
Reserves, STAR Bond, TDD-Goddard Galleria, TDD-Tanganyika,
and Water Reserves

Unbudgeted Funds - Breakdown

Total Capital Improvement Fund Expenditures: $3,829,481

Investment
Update
2026 YTD Interest Earnings: $1,226,766

City Fund Balances (YTD)
Total Ending Fund
Balances
$57,051,397

Total Revenue Received
$16,510,368
(Includes Interfund Transfers)

(All City Funds)

Total Expenditures
$24,715,468
(Includes Interfund Transfers)

Overall Change in Fund
Balance

$(8,205,100)

Agenda Item G.5

City of Goddard
City Council Meeting
August 17, 2026
TO:
SUBJECT:
PREPARED BY:
AGENDA:

Mayor and City Council
August 2026 Monthly Water Consumption Report
Brooke A. Carroll, Chief Financial Officer
Consent Agenda

Overview:
The following report provides a comparison of total water consumption and the number of active
water utility customers for calendar years 2023, 2024, 2025, and 2026. All water consumption figures
reflect the full amount of water consumed citywide, providing a complete picture of total system
demand.
Water Consumption – All Customer Classes (Gallons):
Month

2023

2024

2025

2026

% Change
(2025-2026)

% Change
(2023-2026)

January
February
March
April
May
June
July
August
September
October
November
December
Total

12,092,000
12,318,000
11,984,000
10,528,000
17,703,000
21,694,000
22,388,000
25,656,000
30,964,000
30,535,000
23,543,000
17,647,000
237,052,000

12,940,000
13,691,000
11,430,000
12,315,000
18,879,000
19,304,000
23,325,000
30,547,000
25,967,000
26,374,000
19,736,000
14,721,000
229,229,000

11,429,000
14,244,000
13,379,000
12,707,000
17,237,000
17,030,000
18,029,000
20,978,000
21,286,000
18,269,000
15,567,000
13,747,000
193,902,000

12,139,000
14,068,000
12,617,000
11,133,000
18,023,000
20,021,000
23,980,000
22,494,000

6.21%
-1.24%
-5.70%
-12.39%
4.56%
17.56%
33.01%
7.23%

0.39%
14.21%
5.28%
5.75%
1.81%
-7.71%
7.11%
-12.32%

134,475,000

Number of Active Water Utility Customers (Meters):
Month

2023

2024

2025

2026

% Change
(2025-2026)

% Change
(2023-2026)

January
February
March
April
May
June
July
August
September
October
November
December

2,127
2,129
2,154
2,146
2,155
2,180
2,199
2,200
2,211
2,217
2,214
2,224

2,220
2,221
2,244
2,254
2,288
2,305
2,336
2,366
2,389
2,446
2,454
2,468

2,477
2,462
2,468
2,485
2,510
2,531
2,547
2,551
2,562
2,570
2,602
2,578

2,597
2,609
2,621
2,627
2,643
2,671
2,659
2,669

4.84%
5.97%
6.20%
5.71%
5.30%
5.53%
4.40%
4.63%

22.10%
22.55%
21.68%
22.41%
22.65%
22.52%
20.92%
21.32%

Conclusion:
The number of active water utility customers continues to demonstrate strong and consistent
growth, with 2,669 active meters in August 2026, representing a 4.63% increase over August 2025
and a 21.32% increase compared to August 2023. This continued increase reflects the City's
sustained residential and commercial development and the ongoing expansion of the water utility
system.
Total water consumption during August 2026 reached 22.49 million gallons, an increase of 7.23%
compared with August 2025 but a decrease of 12.32% from August 2023. The year-over-year
increase likely reflects hotter and drier weather conditions, which contributed to greater outdoor
irrigation and landscape watering. Despite the increase from 2025, consumption remained below
the higher summer demand experienced in 2023.

Current system water loss is estimated at approximately 10%, which remains low and well within
acceptable operational ranges under Kansas Department of Health and Environment (KDHE)
guidelines. This compares favorably to many public water systems that experience significantly
higher levels of non-revenue water, reflecting the City's continued investment in system
maintenance, leak detection, and infrastructure improvements. As development continues, these
investments will help maintain the reliability and efficiency of the City's water distribution system
while supporting future growth.

Item I.1

City of Goddard
City Council Meeting
August 17, 2026
TO:
SUBJECT:
PREPARED BY:
AGENDA:

Mayor and City Council
Sedgwick County Electric CO-OP — Rachel Brooke Estates Addition (Phase 3)-Subdivision Electric Distribution Extension Agreement
Bond Counsel — Kevin M. Cowan
Consent

Background:
The City, through Ordinance No. 1047, has established that it will finance and pay the costs of Sedgwick
County Electric CO-OP electric utility system improvements to serve Rachel Brooke Estates Addition
(Phase 3), and that the owners of property benefitted by such improvements will pay special assessments
in respect of those improvements. The Subdivision Electric Distribution Extension Agreement (the
“Agreement”) presented is among TCRS, LLC, the “Developer” of Rachel Brooke Estates Addition,
Sedgwick County Electric CO-OP, and the City, and it provides the details under which the City will finance
and pay Sedgwick County Electric CO-OP for electric system improvements that will be made to the
Developer’s development, and the CO-OP will refund part of the costs of such improvements as homes are
built, occupied and connected to (i.e., become customers of) the CO-OP’s system.
Analysis:
By approving the Agreement, the City Council will authorize the Mayor and City staff to execute the
Agreement and deliver it to the Sedgwick County Electric CO-OP and the Developer. The City will then
be obligated to finance and pay for the electric system improvements, as described above, and be entitled
to a refund of costs upon completion and occupancy of homes in Rachel Brooke Estates Phase 3 over the
next five years. The refunded amounts will be applied by the City to reduce special assessments to be
imposed as described above. The total cost of the electric system improvements is estimated at
$380,000.00, broken down as follows, including anticipated refund amounts:
Item

Calculation

Average cost per lot

44 X $8,000.00/lot

$352,000.00 A portion is refundable, as
shown below

Concrete streetlight poles

14 X $1,800.00/Lt

$25,200.00 (NOT REFUNDABLE)

Street light wire

1,120 X $2.50

$2,800.00 (NOT REFUNDABLE)

GRAND TOTAL DUE
FOR IMPROVEMENTS

Amount Refund Status

$380,000.00

Non-refundable

44 X $5,500.00/lot

$242,000.00 (NOT REFUNDABLE)

Refundable

44 X $2,500.00/lot

$110,000.00 (REFUNDABLE)

The Developer or the City is separately responsible for trenching, boring, and plate compaction costs, which
are paid directly to the trenching company and are not included in the CO-OP construction costs shown
above. The Developer or City will use a trenching contractor recommended by the CO-OP.
Financial:
Costs outlined in the Agreement will be paid through the issuance of taxable general obligation temporary
notes or bonds of the City, as authorized by Ordinance No. 1047. As provided in Section 3(j) of the

Agreement, the City’s payment obligation is contingent upon the successful issuance of the notes or bonds.
The bonds of the City will be payable from special assessments imposed on property benefitted by the
electric system improvements.
Legal Considerations:
The Agreement is in a form reviewed and approved by bond counsel, including the provision that the
Agreement will not obligate the City to pay for any costs incurred if notes or bonds are not successfully
issued by the City.
Recommendations/Actions:
It is recommended the City Council accept the document as drafted in its substantially completed form,
allowing the Mayor to sign on behalf of the City, including any future minor modifications that may arise
prior to the execution of the Agreement.
(VOICE)
Attachments: Subdivision Electric Distribution Extension Agreement with Sedgwick County Electric
CO-OP and TCRS, LLC (3 Pages)

The Sedgwick County Electric
Cooperative Association, Inc.
1355 S. 383rd St. W. • P.O. Box 220 • Cheney, KS 67025-0220
Phone (local) 316-542-3131 • Toll Free 1-866-542-4732
www.sedgwickcountyelectric.coop
SUBDIVISION ELECTRIC DISTRIBUTION EXTENSION AGREEMENT
RACHEL BROOKE ESTATES ADDITION PH 3-4 CONTRACT
8-6-2026 PRICES ARE GOOD FOR 90 DAYS
This agreement made this 8th day of August 2026 between The Sedgwick County
Electric Cooperative (the “Company”), the City of Goddard, Kansas (the “City”) and TCRS,
LLC, (The Developer).
WITNESSETH: That the parties hereto, for in consideration of mutual agreements set forth,
contract as follows:
1. Developer owns the land described as Rachel Brooke Estates Addition Ph 3-4, located in
the Goddard City Limits, Sedgwick County, Kansas and has established a permanent
subdivision consisting of Lots 1-17, Block 1, Lots 29-43, Block 2, and Lots 1-12, Block 3,
totaling 44 lots. Developer and City desire that Company install an electric distribution
system which will make electric service available to each lot/unit prior to occupancy of a
home. The total cost of this portion of the subdivision is estimated to be $380,000.00.
NOTE 1: The Developer will be responsible for informing the lot owners that they must
build within 200 feet of the meter pedestal or the owner will incur additional charges for
the electric service.
2. Company agrees:
a.

To design, install, own, and maintain in said subdivision an electric distribution
system as necessary and appropriate to supply electric service to occupants of
homes located on Developer’s lots, and street light system as required. If an
underground system is installed, the Company will install and provide a meter
pedestal to the edge of each lot served by the aforesaid supply circuits for
secondary service connections.

b.

To deliver and sell electricity to the occupants of homes within said subdivision in
accordance with the Company’s applicable Rate Schedules items and conditions,
and Service Regulations.

c.

To complete installation of its supply circuits with all reasonable dispatch, taking
into consideration delays and necessity of coordinating such installation with the
installation of other facilities.

3. Developer and City agree:
a.

That the City will deposit with the Company $110,000.00 for construction of the
underground subdivision which is the amount equal to the cost of the extension.
The contribution shall be refunded to the City, proportionately ($2,500.00 per lot),
PAGE 1

as additional houses are built, occupied, and connected to the distribution system
during the succeeding five (5) years. It is further understood and agreed the amount
of contribution not refunded after five (5) years shall be forfeited to the Company.
Each lot will be served under the applicable rate schedule and other terms of
service, which said schedules and terms have been approved by the Company.
b.

To provide to Company, free of cost to it, the right-of-way on or over any part of
the subdivision as necessary for the construction, maintenance, and removal of said
electric distribution system, including adequate means of access to said electric
distribution system.

c.

That either the City or Developer will clear right-of-way of all obstructions, to
mark all lot corners with iron pins, to complete all earth work in the easements at
not more than four inches above or below final grade, prior to construction of the
electric distribution system.

d.

The Builder/Developer represents and warrants that street and curbing locations
and all grade levels and lot contours which may affect Company’s construction
have been determined and the Builder/Developer will reimburse the Company for
all cost to it for removal, replacement, damage to or destruction of its electric
supply lines, transformer pads, stub conduits and electric equipment resulting from
the relocation of streets, curbs, and installation of sewers, and change of grade
levels, or the change of lot contours or any other cost resulting from the street and
curbing locations and all grade levels and lot contours have not been determined
and permanently installed.

e.

Title to the distribution system referred to herein shall be vested and remain at all
times in the Company, which also shall own all facilities and equipment installed
by it for the delivery and measurement of electricity. The Company assumes no
responsibility for installation, repair or maintenance of any electric lines, property
or equipment owned or installed by anyone not authorized by the company.

f.

The provisions of this Agreement shall not be changed except by writing duly
signed by Company, the City and Developer.

g.

This Agreement shall inure to the benefit of and be binding upon the parties hereto,
their respective successors and assigns. Company shall have the same right to
invoke and enforce the above covenants, conditions, restrictions, and reservations
of this Agreement as to such future parties as if the original parties hereto.

h.

The Developer or the City will pay for all trenching, boring and plate compaction
costs associated with the installation of wire, conduit and equipment in the
subdivision directly to the trenching company. These costs are not included in the
Sedgwick County Electric Coop construction cost below.

i.

The Developer or City will use a company recommended by Sedgwick County
Electric Coop to do the trenching, boring, and plate compaction.

PAGE 2

Average cost per lot
Non-refundable
Refundable to Developer
Concrete Streetlight Poles
Street Light Wire

44 X $8,000.00/lot = $ 352,000.00
44 X $5,500.00/lot = $ 242,000.00
44 X $2,500.00/lot = $ 110,000.00
14 X $1,800.00/Lt = $ 25,200.00
1120 X $2.50 =
$ 2,800.00

GRAND TOTAL DUE UPON REQUEST
j.

(NOT REFUNDABLE)
(REFUNDABLE)
(NOT REFUNDABLE)
(NOT REFUNDABLE)

$380,000.00

The parties hereto acknowledge that the City’s only obligations hereunder are to (1)
pay for the costs of the electric distribution system improvements and deposit
described in Sections 1 and 3, with such payment of costs to be funded solely from
the proceeds of temporary notes or bonds issued by the City, and that such payment
is contingent upon the successful legal authorization and issuance of such notes or
bonds for the electric distribution system improvements; and (2) receive the per lot
refunds described in Section 3 and apply those refunds to reduce the amount of
special assessments that will be due and payable to the City for benefits accruing to
lots as result of the electric distribution system improvements described herein.

Rachel Brooke Estates Addition.

Sedgwick County Electric Cooperative

By: ______________________________
Rachel Lange-Mills (TCRS, LLC)

By: ______________________________
Tim Rosenhagen (Staking Engineer)

_________________________________
Date

_________________________________
Date

City of Goddard, Kansas
By: ______________________________
George Liebe, Mayor
___________________________
Date
Refund checks described in Section 3(a) will be sent to the City at the following address, and
applied by the City as provided in Section 3(j)
ADDRESS TO MAIL THE REFUND TO:
City of Goddard
118 N Main St
Goddard, Ks 67052
Attn: Community Development Director
PAGE 3

Item I.2

City of Goddard
City Council Meeting
August 17, 2026
TO:
SUBJECT:
PREPARED BY:
AGENDA:

Mayor and City Council
Change Order for 2026 Street Maintenance Contract – Public Works
Public Works Director
New Business

Background:
The City currently has an active roadway maintenance contract with APAC-Kansas, Inc., Shears Division
(“APAC”). As part of ongoing pavement management, we identified South 199th Street from US-54 to
Santa Fe Street as being in need of rehabilitation.
APAC submitted a proposal to mill South 199th Street, including full-depth asphalt patching, pavement
markings, and traffic control and partial closure of South 199th Street and Kellogg Drive during
construction. This also will include full depth concrete work on the intersection South of Kellogg Drive of
approximately 100’ terminating south of the Emprise Bank Drive. Staff will remove the MAC-52 surface
seal for a deduct of $94,659.63.
Analysis:
APAC-Kansas, Inc., Shears Division (Wichita Branch) submitted Proposal/Estimate No. 6965258ADD,
dated August 3, 2026, to furnish all labor, materials, and equipment required to mill and overlay South
199th Street from US-54 to Santa Fe Street. The scope of work includes mobilization, profile milling
(3,888 SY), excavation (340 SY), 8" concrete pavement with 6" rock base (340 SY), 2" asphalt overlay
(7,420 SY), traffic control, full depth asphalt patching (100 SY), and pavement markings, for a total bid
of $232,270.00.
Removal of the MAC-52 surface seal program ($94,659.63 credit) and adding the 199th Street
rehabilitation project ($232,270.00) would bring the revised contract value to $1,138,662.00. This falls
into our goal of holding the overall roadway program below the $1.25 million 2026 Roadway Budget,
leaving approximately $111,338.00 in remaining budget capacity.
Financial:
The total cost of the 199th Street Mill & Overlay project quoted by APAC-Kansas, Inc. is $232,270.00.
This cost is offset by a $94,659.63 credit from removing the MAC-52 surface seal program from the
current contract, resulting in a net revised roadway contract value of $1,138,662.00. Against the
$1,250,000.00 2026 Roadway Budget, this leaves approximately $111,338.00 remaining, assuming no
additional costs in engineering or unforeseen circumstances. Funding for this change order will come
from the 2026 Roadway Budget.
Legal Considerations:
Approved as to form.

Recommendation/Actions:
It is recommended that the City Council: approve a change order to the City's roadway maintenance
contract with APAC-Kansas, Inc., Shears Division, in the amount of $232,270.00 and authorize the City
Manager to execute the change order.
Attachments:
I.3a 199th Street Mill & Overlay Proposal

Agenda Item I.3
City of Goddard
City Council Meeting
August 17, 2026
TO:
SUBJECT:
PREPARED BY:
AGENDA:

Mayor and City Council
New Vehicle Purchase for Building Inspector
Community Development Director
New Business

Background: The city has a 2014 Chevy Impala that served as the code enforcement car for a
span of time before it was conveyed to the building inspector for building inspections. Over time
the car has had multiple issues come up with the more recent one being internal leaking of the
coolant.
In turning it in for repair it was quoted that the city could replace the head gaskets for $5,000 or
replace the engine for around $7,900.
Since the age of the car is twelve years old and the issues are becoming more frequent the city has
looked into purchasing a new vehicle. The city found a 2026 Nissan Sentra SV at Orr Nissan that
they felt would meet the requirements of the building inspector.
These cars tend to run around 30 MPG in the city and around 38 MPG highway and tend to have
an MSRP of around $26,000 to $27,000.
Analysis: The City Council is reviewing the possibility of replacing the 2014 Chevy Impala with
a new 2026 Nissan Sentra SV.
Financial: Costs associated with the purchase shall be charged to the Equipment Reserve Fund.
Legal Considerations: None
Recommendations/Actions: It is recommended the City Council:
1. Replace the engine of the Chevy Impala
2. Replace the head gaskets of the Chevy Impala
3. Approve the purchase of the 2026 Nissan Sentra SV not to exceed $28,000
4. Table it for further discussion
(VOICE)
Attachments:
Exhibit I.3a ORR Nissan
Exhibit I.3b Rausch Repair Quote (2 Pages)
Exhibit 1.3c Chevrolet-Trax-LT-

Rausch Repair

Sub Estimate for Order #

1173

1357 S 311th st W
Garden Plain, KS. 67050
Phone: (316)-519-9218 | Fax: ()-| [email protected]

Estimate Due: $5,014.02

SubEstimate
CITY OF GODDARD - ANDREW
MCNAUGHTEN
Goddard, KS 67052
Cellular: 316-309-8008
Type

2014 Chevrolet - Impala Limited - LS
3.6L, V6 (217CI) VIN(3)
VIN: 2G1WA5E36 E1158063
Odometer: In 0

License Plate: C1617 KS
Color: SILVER

Description

Estimate Date:

08/05/2026

Service Advisor:
Customer ID:

319

Qty

CYLINDER HEAD GASKET - Remove & Replace - Both Banks - [Includes: Lowering Subframe.
DOES NOT includ

Sale

Total

$4,992.33

Initials:

Labor

CYLINDER HEAD GASKET - Remove & Replace - Both Banks - [Includes: Lowering
Subframe.
DOES NOT include wheel alignment.] - [Includes: Remove carbon and check surfaces
for warpage. Includes adjust Valves (where applicable) and clean and adjust Spark
Plugs.]

Part

misc parts needed for head gasket

1.00

$714.29

$714.29

Part

Head Bolt Set

2.00

$87.72

$175.44

Part

Head Gasket Set

1.00

$836.96

$836.96

Part

OIL FILTER Size: 1

1.00

$6.49

$6.49

Part

5w30 oil Size: 1 QT

6.00

$5.22

$31.32

Part

Coolant Size: 1 GAL

3.00

$21.54

$64.62

Sublet

machine shop
machine shop

$960.00

$960.00

Parts: $1,829.12

Labor: $3,160.00

Tax: $3.21

Total: $4,992.33

I hereby authorize the above repair work to be done along with the necessary material and hereby grant you
and/or your employees permission to operate the vehicle described for testing and/or inspection. Express
mechanic's lien is hereby acknowledged on above vehicle to secure the amount of repairs thereto. SMOG: I
understand that I can have emission service and/or adjustments done elsewhere. I hereby waive this right.
TEARDOWN ESTIMATE: I understand that my vehicle will be reassembled within____days of the date shown
above if I choose not to authorize the service recommended. All Parts removed will be discarded unless
instructed otherwise: Save all Parts____. NOT RESPONSIBLE FOR LOSS OR DAMAGE TO CARS OR ARTICLES
LEFT IN CARS IN CASE OF FIRE, THEFT OR ANY OTHER CAUSE.
Copyright © Mitchell Repair Information Company LB1124E

$2,200.00

Labor
Parts
Sublet
Shop Supplies
Subtotal
Taxes

$2,200.00
$1,829.12
$960.00
$19.99
$5,009.11
$4.91

Estimate Total:

$5,014.02
1/1

Rausch Repair

Sub Estimate for Order #

1173

1357 S 311th st W
Garden Plain, KS. 67050
Phone: (316)-519-9218 | Fax: ()-| [email protected]

Estimate Due: $7,931.59

SubEstimate
CITY OF GODDARD - ANDREW
MCNAUGHTEN
Goddard, KS 67052
Cellular: 316-309-8008
Type

2014 Chevrolet - Impala Limited - LS
3.6L, V6 (217CI) VIN(3)
VIN: 2G1WA5E36 E1158063
Odometer: In 0

License Plate: C1617 KS
Color: SILVER

Description

Estimate Date:

08/05/2026

Service Advisor:
Customer ID:

319

Qty

Sale

LONG BLOCK - Remove & Replace - [DOES NOT include wheel alignment.] - [Consists of a Cylinder
Block
Labor

LONG BLOCK - Remove & Replace - [DOES NOT include wheel alignment.] - [Consists of
a Cylinder Block fitted with Pistons, Rings, Connecting Rods, Crankshaft and all
Bearings, Cylinder Head(s), Camshaft(s), Timing Chain or Belt and Sprockets or Gears.
Inclu

Part

OIL FILTER Size: 1

1.00

Part

5w30 oil Size: 1 QT

Part

Coolant Size: 1 GAL

Part

SMART CHOICE ENGINE 3Y/100K

Parts: $5,709.35

Labor: $2,200.00

Tax: $0.55

$7,909.90

Initials:

$2,200.00

$6.49

$6.49

6.00

$5.22

$31.32

1.00

$21.54

$21.54

1.00

$5,650.00

$5,650.00

Total: $7,909.90

I hereby authorize the above repair work to be done along with the necessary material and hereby grant you
and/or your employees permission to operate the vehicle described for testing and/or inspection. Express
mechanic's lien is hereby acknowledged on above vehicle to secure the amount of repairs thereto. SMOG: I
understand that I can have emission service and/or adjustments done elsewhere. I hereby waive this right.
TEARDOWN ESTIMATE: I understand that my vehicle will be reassembled within____days of the date shown
above if I choose not to authorize the service recommended. All Parts removed will be discarded unless
instructed otherwise: Save all Parts____. NOT RESPONSIBLE FOR LOSS OR DAMAGE TO CARS OR ARTICLES
LEFT IN CARS IN CASE OF FIRE, THEFT OR ANY OTHER CAUSE.
Copyright © Mitchell Repair Information Company LB1124E

Total

Labor
Parts
Shop Supplies
Subtotal
Taxes

$2,200.00
$5,709.35
$19.99
$7,929.34
$2.25

Estimate Total:

$7,931.59
1/1

Agenda Item I.4
City of Goddard
Special City Council Meeting
August 17, 2026
TO:
SUBJECT:
PREPARED BY:
AGENDA:

Mayor and City Council
Strategic Growth Zone Overlay District
Community Development Director, Micah Scoggan
New Business

Background: The proposed Strategic Growth Zone Overlay District was first presented to the
Planning Commission and City Council during their joint meeting on August 27, 2025. The
concept appeared to be generally viewed as a favorable long-term growth strategy by both bodies;
however, staff did not advance the proposal at that time.
On July 1, 2026, staff brought it back to the City Council to confirm they would like to move
forward with the proposed idea of adopting the Strategic Growth Zone Overlay District. The City
Council voted in favor of moving forward with the proposed amendment to the zoning
regulations.
It was published in the city newspaper and brought to the Planning Commission on August 10th
for the public hearing after which it was approved 5-0.
Analysis: The City Council is considering approving the adoption of the Strategic Overlay
District into the zoning and subdivision regulations and amending the Official Zoning Map.
The Strategic Growth Zone Overlay District is meant to be an area where developers can expect
a more favorable outcome from the Planning Commission and the City Council for rezoning with
the expectation that the restrictions passed on the two-family resolution related to ratios will not
apply in this area. The expectation would be that the design standards will still be in place.
The idea would be that if developers had to choose between Wichita and Goddard in this area
they would work with Goddard with the understanding that it would be less restrictive.
The overlay doesn’t give Goddard any additional authority in that area until land is acquired and
becomes annexed into the city limits.
Financial: Small publication cost for notice and if approved by the City Council the ordinance
publication.
Legal Considerations: Approved as to form.

Recommendations/Actions: It is recommended the City Council:
1. Waive the reading of the ordinance
(VOICE)
2. Approve the ordinance introducing the strategic overlay district into the zoning and
subdivision regulations and updating the official zoning map to reflect the new district
(VOICE+ROLL CALL)
Attachments:
Exhibit I.5a Strategic Growth Zone Map (1 page)
Exhibit I.5b Ordinance (3 Pages)
Exhibit I.5c Boundary Map (1 pages)

(Published in The Times-Sentinel on August 20, 2026)
ORDINANCE NO._____
AN ORDINANCE ADDING SECTION 115 TO ARTICLE 4 OF THE ZONING
REGULATIONS OF THE CITY OF GODDARD, ESTABLISHING THE
STRATEGIC GROWTH OVERLAY DISTRICT; AND, AMENDING THE
OFFICIAL ZONING MAP AFFECTING CERTAIN LANDS LOCATED IN THE
CITY OF GODDARD, KANSAS, AS SHOWN IN THE ATTACHED EXHIBIT,
UNDER THE AUTHORITY GRANTED BY THE ZONING REGULATIONS OF
THE CITY OF GODDARD, ARTICLE 13.
WHEREAS, the City of Goddard has adopted certain provisions regarding two-family
structures with resolution 26-36.
WHEREAS, the City of Goddard Planning Commission and the Governing Body
acknowledge that Wichita can continue to grow around the city and as such a development could
be located outside the corporate city limits but exist next to it at the same time.
WHEREAS, the City of Goddard Planning Commission and the Governing Body
desires those developments to be in the city limits and as such have generally agreed to create the
strategic growth zone as a way of indicating their willingness to view developments in that
area as more favorable and are more inclined to not apply some or all of the restrictions
as discussed in resolution 26-36.
WHEREAS, the City of Goddard Planning Commission and the Governing Body
acknowledges that in no way does this give the City of Goddard additional authority outside the
city limits and in no way does this ordinance and resulting strategic growth zone bypass or
invalidates the procedures set forth in K.S.A 12-757

NOW, THEREFORE, BE IT ORDAINED BY THE GOVERNING BODY OF THE
CITY OF GODDARD, KANSAS:

1

Section 1. Amendment of the City’s Zoning Regulations.
Article 4 of the Zoning Regulations of the City of Goddard is hereby amended to include
the following new section as follows:
115. Strategic Growth Zone (SGZ) District
The strategic growth zone is an area designed to facilitate a higher level of density and
development by indicating to the development community that the Planning Commission and the
City Council desire to see development happen in this area. This area will generally be viewed as
favorable for consideration of relaxed standards for the density requirements of resolution 26-36.

Section 2. Creation of Strategic Growth Zone District.
That having received a recommendation from the Planning Commission, and proper notice
having been given and hearing held as provided by law and under authority and subject to the
provisions of the Zoning Regulations of the City of Goddard, the zoning classification or districts
of the lands shown on the exhibit on file and provided for in the official zoning map are amended
to reflect said district.
Section 3. Amendment to the City’s Official Zoning Map.
That upon this Ordinance taking effect, the notation of such zone change shall be entered
in the official zoning map(s) on file with Zoning Administrator.
Section 4. Effective Date.
That this Ordinance shall take effect and be in force from and after its publication in the
official city newspaper.

17

th

PASSED AND ADOPTED by the Governing Body of the City of Goddard, Kansas this
day of August, 2026.

_____________________________________
2

SEAL

GEORGE W. LIEBE, MAYOR

ATTEST:
______________________________________
SARAH SIMON
CITY CLERK

3