Common use of Federal Mandates Clause in Contracts

Federal Mandates. FMLA/TEFRA/DEFRA/COBRA/OBRA (Family and Medical Leave Act/Tax Equity and Fiscal Responsibility Act of 1982/Consolidated Omnibus Budget Reconciliation Act of 1985/Omnibus Budget Reconciliation Act of 1989 & 1993) Did your company employ 50 or more full-time and/or part-time employees during each of 20 calendar weeks in the current or preceding calendar year (January - December), and is it subject to FMLA? (If Yes, you are required by federal law to comply with FMLA provisions.) ❑ Yes ❑ No Did your company employ 20 or more full-time and/or part-time employees during each of 20 calendar weeks in the current or preced- ing calendar year (January - December), and is it subject to federal TEFRA/DEFRA laws? All Trust Companies are subject to TEFRA/DEFRA laws. Did your company employ 20 or more full-time and/or part-time employees for at least 50% of the workdays of the preceding calendar year (January - December), and is it subject to federal COBRA laws? ❑ Yes ❑ No Did your company employ 100 or more full-time and/or part-time employees for at least 50% of the workdays of the preceding calendar year (January - December), and is it subject to federal OBRA 1989/OBRA 1993 laws? All Trust Companies are subject to OBRA laws. TEFRA/DEFRA and COBRA provisions may apply to your group even if you have fewer than 20 employees enrolled through this coverage. If you have questions regarding TEFRA/ DEFRA, COBRA, or other employer laws, contact your legal counsel. ERISA Plan Year begin date 10/01/2012.

Federal Mandates. FMLA/TEFRA/DEFRA/COBRA/OBRA (Family and Medical Leave Act/Tax Equity and Fiscal Responsibility Act of 1982/Consolidated Omnibus Budget Reconciliation Act of 1985/Omnibus Budget Reconciliation Act of 1989 & 1993) Did your company employ 50 or more full-time and/or part-time employees during each of 20 calendar weeks in the current or preceding calendar year (January - December), and is it subject to FMLA? (If Yes, you are required by federal law to comply with FMLA provisions.) ❑  Yes ❑  No Did your company employ 20 or more full-time and/or part-time employees during each of 20 calendar weeks in the current or preced- ing calendar year (January - December), and is it subject to federal TEFRA/DEFRA laws? All Trust Companies are subject to TEFRA/DEFRA laws. Did your company employ 20 or more full-time and/or part-time employees for at least 50% of the workdays of the preceding calendar year (January - December), and is it subject to federal COBRA laws? ❑  Yes ❑  No Did your company employ 100 or more full-time and/or part-time employees for at least 50% of the workdays of the preceding calendar year (January - December), and is it subject to federal OBRA 1989/OBRA 1993 laws? All Trust Companies are subject to OBRA laws. TEFRA/DEFRA and COBRA provisions may apply to your group even if you have fewer than 20 employees enrolled through this coverage. If you have questions regarding TEFRA/ DEFRA, COBRA, or other employer laws, contact your legal counsel. ERISA Plan Year begin date 10/01/2012.

Federal Mandates. FMLA/TEFRA/DEFRA/COBRA/OBRA (Family and Medical Leave Act/Tax Equity and Fiscal Responsibility Act of 1982/Consolidated Omnibus Budget Reconciliation Act of 1985/Omnibus Budget Reconciliation Act of 1989 & 1993) Did your company employ 50 or more full-time and/or part-time employees during each of 20 calendar weeks in the current or preceding calendar year (January - December), and is it subject to FMLA? (If Yes, you are required by federal law to comply with FMLA provisions.) ❑  Yes ❑  No Did your company employ 20 or more full-time and/or part-time employees during each of 20 calendar weeks in the current or preced- ing calendar year (January - December), and is it subject to federal TEFRA/DEFRA laws? All Trust Companies are subject to TEFRA/DEFRA laws. Did your company employ 20 or more full-time and/or part-time employees for at least 50% of the workdays of the preceding calendar year (January - December), and is it subject to federal COBRA laws? ❑ Yes ❑ No All Trust Companies are subject to COBRA laws. Did your company employ 100 or more full-time and/or part-time employees for at least 50% of the workdays of the preceding calendar year (January - December), and is it subject to federal OBRA 1989/OBRA 1993 laws? All Trust Companies are subject to OBRA laws. TEFRA/DEFRA and COBRA provisions may apply to your group even if you have fewer than 20 employees enrolled through this coverage. If you have questions regarding TEFRA/ DEFRA, COBRA, or other employer laws, contact your legal counsel. ERISA Plan Year begin date 10/01/201210/01/2014.  If your group is renewing coverage, please check here and skip to section Section 6. (For renewing groups, the carrier has your group’s prior coverage information on file.  If your group is enrolling in the MBA Trust for the first time, please check here and complete this section in its entirety.

Federal Mandates. FMLA/TEFRA/DEFRA/COBRA/OBRA (Family and Medical Leave Act/Tax Equity and Fiscal Responsibility Act of 1982/Consolidated Omnibus Budget Reconciliation Act of 1985/Omnibus Budget Reconciliation Act of 1989 & 1993) Did your company employ 50 or more full-time and/or part-time employees during each of 20 calendar weeks in the current or preceding calendar year (January - December), and is it subject to FMLA? (If Yes, you are required by federal law to comply with FMLA provisions.) ❑ Yes ❑ No Did your company employ 20 or more full-time and/or part-time employees during each of 20 calendar weeks in the current or preced- ing calendar year (January - December), and is it subject to federal TEFRA/DEFRA laws? All Trust Companies are subject to TEFRA/DEFRA laws. Did your company employ 20 or more full-time and/or part-time employees for at least 50% of the workdays of the preceding calendar year (January - December), and is it subject to federal COBRA laws? ❑ Yes ❑ No Did your company employ 100 or more full-time and/or part-time employees for at least 50% of the workdays of the preceding calendar year (January - December), and is it subject to federal OBRA 1989/OBRA 1993 laws? All Trust Companies are subject to OBRA laws. TEFRA/DEFRA and COBRA provisions may apply to your group even if you have fewer than 20 employees enrolled through this coverage. If you have questions regarding TEFRA/ DEFRA, COBRA, or other employer laws, contact your legal counsel. ERISA Plan Year begin date 10/01/201204/01/2012. 5. PRIOR COVERAGE INFORMATION FOR NEW GROUPS