ADOPTION AGREEMENT FOR HEALTH REIMBURSEMENT ARRANGEMENTHealth Reimbursement Arrangement • March 3rd, 2014
Contract Type FiledMarch 3rd, 2014The undersigned self-employer Employer of only one employee, by executing this Adoption Agreement, elects to adopt the accompanying Health Reimbursement Arrangement (the "Plan") by adopting said plan document in full. The Employer makes the following elections granted under the provisions of the Plan.