Page 36 - Public Citizen 2021-2022
P. 36
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Summary Plan Description
Note to Employer: The United States Department of Labor (DOL) requires this summary or a copy of it to be distributed
to each eligible Employee.
Plan Sponsor (Employer), Plan Administrator, and Agent for Legal Service
Employer/Plan Sponsor Name: Public Citizen
Contact Name: Joseph Stoshak Phone Number: 202-588-7706
Employer Address: 1600 20th Street NW
Federal Tax ID: 23-7104508
Washington, DC 20009 ERISA Plan Number: 501
Plan Administrator accepts service of legal process.
Employer’s Plan Name: Public Citizen Flexible Compensation Plan
Group Name:
Plan Year: 1/1/2020 to 12/31/2020 Client TASC ID: 4303-4138-6885
Healthcare FSA Plan Runout
$500.00 4/30/2021
Carryover Maximum: End Date:
PURPOSE
Your Employer has adopted this Flexible Compensation Plan to allow you to pay for benefit options made
available under this Flexible Compensation Plan for yourself, your spouse, and your dependents via pre-taxed
salary reduction contributions. You may choose from these “tax free” benefits in lieu of receiving taxable
compensation. The plan is intended to qualify as a “Cafeteria Plan” within the meaning of Section 125(d) of the
Internal Revenue Code, and the benefits you elect will be excluded from your income under Section 125(a).
Maximum Minimum Healthcare FSA Carryover
BENEFITS OFFERED TO
Participant Salary Participant or -
EMPLOYEES
Reduction Salary Reduction Grace Period End Date
Healthcare FSA $2750.00 $0 Carryover
Dependent Care FSA $5000.00 $0 1/31/2021
Medical or Medical-Related Offered N/A N/A
Premiums
Disability Insurance Premiums Offered N/A N/A
Dental Premiums Offered N/A N/A
Voluntary/Group Term Life
Offered N/A N/A
Insurance Premiums
This Flexible Compensation Plan allows you to reduce your taxable income in direct proportion to (a) your contribution to
the cost of your elected benefits and (b) your contribution to any account-based tax advantaged plan or fringe benefit
plan offered by your Employer.
ELIGIBILITY REQUIREMENTS
TASC I 2302 International Lane I Madison, WI 53704-3140 I 1.800-422-4661 I www.tasconline.com I FX-5297a-061819
The information contained in this communication is confidential and to be used by TASC employees and representatives for only its intended purpose.
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