29 Program
Administrator
The Program Administrator has sole discretionary authority to:
♦ oversee the administration and management of the program;
♦ make rules governing the operation and administration of the program, including but not limited to rules concerning participant investment elections and directions;
♦ interpret the program;
♦ determine eligibility for, and amount of, benefits.
The Administrator’s decisions are final and binding.
Administrative Expenses
The cost of administering the program may be paid by the program trust, which holds the participant accounts, or by the employer.
Agent for
Service of Legal Process
Legal process may be served on the Program Administrator and/or the Program Trustee at the addresses shown below.
Assignment of Benefits
For the protection of your interests and those of your dependents, your benefits under the program cannot be assigned and are not subject to garnishment or attachment, except under limited circumstances. For example, some or all of your benefits may be assigned to a former spouse under a Qualified Domestic Relations Order (QDRO).
A QDRO is an order issued by a court, usually in connection with divorce or legal separation. You should contact Fidelity or the Program Administrator if you would like to receive a copy, at no charge, of the program’s QDRO procedures or you have a question concerning the procedures.
Employer As used in this Summary Program Description, the term “employer”
means Blue Cross Blue Shield of Arizona, and any of its subsidiaries or affiliates that have adopted this program for their employees.
Continuance of the Program
The employer reserves the right to change, amend or terminate the program at any time. The Administrator may also amend the program at any time to comply with changes in the law affecting the program.
In the event that the employer fully or partially terminates the program, you will become 100% vested in the value of all of your program accounts if you are affected by the termination.
This program is not the type of program that is insured by the Pension Benefit Guaranty Corporation (PBGC), and is therefore not covered by its program termination insurance provisions.
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30 Employment
not Guaranteed
Your participation in this program or any other employer-sponsored benefit program does not mean that your employment with the employer is guaranteed for any length of time.
Employer
Federal regulations require that employer-sponsored savings
programs meet certain non-discrimination tests and other qualification rules to ensure that highly compensated employees do not receive a disproportionate share of benefits.
You can also contact the Program Administrator for more information concerning the maximum benefit limitations for the program.
Participating Companies
A complete list of companies that have adopted the program is available and may be obtained by making a written request to the Program Administrator.
Program Administrator
National Employee Benefits Committee Blue Cross and Blue Shield Association 225 North Michigan Avenue
Chicago, Illinois 60601 (312) 297-5722
Program Sponsor
Blue Cross Blue Shield of Arizona 2444 West Las Palmaritas Drive Phoenix, Arizona 85201
(602) 864-4100
Program Documents
This Summary Program Description (SPD) is only a summary of the official program documents. You should refer to the official program documents maintained by the Program Administrator for more
information about the program. In the event of any conflict between the information summarized in an online SPD or written SPD and the official program documents, the program documents will always govern.
Program Financing
Your contributions and the employer’s contributions to the program are deposited and held in an independent trust fund.
The program’s trust fund is administered by a Program Trustee in accordance with formal trust agreements among the Administrator, employer and the Trustee. The trust fund is maintained for the exclusive benefit of program participants and their beneficiaries. The employer is prevented by law from using this money for any other
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31 reason, except to pay the reasonable costs of administering the
program.
Program Name The official name of the program is: Blue Cross Blue Shield Arizona 401(k) Savings Plan (referred to in this Summary Program
Description as the “program”).
Program Trustee
The Trustee for the program is:
Fidelity Management Trust Company 82 Devonshire Street
Boston, Massachusetts 02109
Program Year The Program Year begins on January 1 and ends on December 31.
Special Rules for “Top Heavy”
Programs
The Internal Revenue Service has issued special rules establishing minimum vesting and benefit formulas for programs that become “top heavy.” In general, the program would become top heavy if the value of the benefits earned by certain highly compensated employees under the program (or any other pension, profit sharing or stock bonus
program in combination with this program) is more than 60% of the value of benefits earned by all covered employees.
It is unlikely that the program will ever become top heavy. If this should occur, however, you will receive complete information on any required vesting and benefit formula adjustments.
Type of
Administration
Contract administration
Type of Program
This program is considered by law to be a profit sharing program with cash or deferred features. Other terms to describe this program include defined contribution program and 401(k) program.
Participant Control of Investments (ERISA §404(c) Program)
As a participant or beneficiary in the program, you have the right to direct the investment of your account under the program. The program is a “participant-directed” program described in Section 404(c) of the Employee Retirement Income Security Act of 1974 ("ERISA"). Under an ERISA Section 404(c) program, the fiduciaries of the program may be relieved of liability for the losses that are the direct and necessary result of your investment instructions. As a participant, you control the investment of your program account, and are responsible for the investment results and investment performance of your program account.
You may direct the investment of your account in any investment option available under the program. The section entitled “Investing Your Account” describes the investment alternatives available under the program. Specific fund information is available by contacting Fidelity Investments. You are encouraged to review all of the
investment materials provided by the trustee so that you can make an
OTHER IMPORTANT INFORMATION
32 informed decision about the investment of your account. Fidelity
Management & Research Company is the program’s investment manager for the Fidelity funds and the non-Fidelity funds are managed by other fund companies.
Upon enrollment in the program, you need to select the investment alternatives in which you want your account invested. Your account will remain invested in the alternatives you select upon enrollment in the program until you provide instructions to change those
investments. If you fail to provide investment instructions, your account will be invested in one of the Fidelity Freedom K® Funds, based on your age. The section entitled “Investing Your Account”
describes the procedures for changing this default investment or your investment instructions.
Any transaction fees, investment management fees or other costs incurred in connection with the purchase or sale of an investment fund will be assessed as described in the prospectus for each investment alternative.
If you invest in any securities that are subject to the Securities Act of 1933, any prospectus that is received on behalf of your account will be forwarded to you immediately prior to or following your initial
investment. Subsequent to your initial investment in an investment alternative, you will be furnished with any program provisions or materials provided to the program relating to the exercise of voting, tender or similar rights to the extent such rights are passed through to participants.
In addition, the following information will be provided to you upon request:
♦ copies of any prospectuses, financial statements and reports and other materials relating to investment alternatives available under the program that are furnished to the program;
♦ a description of the annual operating expenses (for example, investment management fees) of each designated investment alternative, and the aggregate amount of such expenses expressed as a percentage of average net assets of that investment alternative;
♦ a list of assets held by an investment alternative and the value of each asset individually;
♦ with respect to each individual asset which is a fixed rate investment contract, the name of the issuer of the contract, the term of the contract, and the rate of return on the contract;
♦ information concerning the value of shares or units in investment alternatives, and the past and current investment performance of the alternatives determined net of expenses on a reasonable and consistent basis; and
♦ information concerning the value of shares or units in investment
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33 alternatives held in your account.
The Program Administrator has designated Fidelity Investments to provide this information. They will respond to your requests based on the latest information available to the program. To obtain any of the information described above, please call Fidelity at 1-877-980- BLUE (2583) or by mail at:
For regular mail: For express mail:
Fidelity Investments Attn: FITSCo P. O. Box 770002
Cincinnati, OH 45277-0090
Fidelity Investments Institutional Operations Company, Inc.
Attn: FITSCo
100 Crosby Parkway, KC1E Covington, KY 41015
Please remember that directing the investment of your account is both your right and your responsibility. Neither the Program Administrator nor the Trustee can provide you with individual investment advice, nor is the performance of any of the investment funds guaranteed. The past performance of any investment fund does not guarantee future results. Before selecting your investments, please consult with your personal financial advisor to determine which investment funds best suit your particular financial needs.