Flexible Benefits Plan

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Termination Overview
The information below pertains to important details regarding your termination with ABC.
Final Paycheck
Your final paycheck will include all wages owed through your termination date with standard deductions
applied along with any accrued, but unused vacation/PTO time. Please note, the full month’s benefits
premium will be deducted from your final paycheck since benefits are effective through the last day of
the month in which you separate from ABC (some benefit plans end on the last day of employment). A
non-exempt employee must turn in his/her timesheet on the morning of the date of termination.
Amounts Owed
If you owe any funds to ABC they must be paid upon your termination date. The check should be made
payable to “ABC" and submitted to Human Resources. If you have expenses to submit to ABC, they
must be submitted within 30 calendar days from your termination date or 30 calendar days from the
statement closing date for the expense if it falls after your termination date.
Equipment
All ABC property must be returned on or before your termination date. On your termination date, you
must delete all hard and soft copy information from handheld devices. Voice mail, e-mail, and server
access are cancelled on your termination date.
Employment Verifications
All requests for reference checks should be forwarded to Human Resources. ABC will confirm title and
dates of employment. Requests for verification of salary must be accompanied by your written
authorization.
Benefits and COBRA
Medical, dental and vision benefits end the last day of the month in which you separate from ABC. All
other benefits end on your termination date.
If you are currently participating in the medical, dental and/or vision benefits, you have an option to
continue your current coverage through the utilization of COBRA. You will receive additional
information on your COBRA options via mail approximately 14 days after your termination date.
Life Insurance and Accidental Death and Dismemberment (AD&D)
Your life insurance and AD&D benefits have a portability provision; therefore upon termination from
ABC, you may choose to establish one or both plans to an individual policy. If you choose this option, the
relationship is between you and Carrier Name. You have 31 days from your date of termination to
submit the completed Conversion Form to Carrier Name. Please contact Carrier Name at number for
rate information.
Flexible Benefits Plan
If you are currently participating in the Flexible Benefits Plan, you have 90 days from the end of the plan
year in which you separate from ABC to file a claim directly with Carrier Name. The plan year for ABC is
the same as the calendar year. All claims submitted must be for services and expenses incurred on or
before your termination date for the Health Care Reimbursement Account. For the Dependent Care
Melita
1/1/15
The above/attached information is not legal advice. It should not be considered a legal opinion as to which laws apply or as to how any law
applies to a particular situation. Companies or individuals should seek advice of counsel with regards to their particular situation.
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Reimbursement Account, you may submit expenses incurred through the end of the plan year in which
you separate from ABC. Any funds remaining in your account for which no eligible claims have been
submitted within 90 days from the end of the plan year are forfeited. You may continue coverage, on an
after-tax basis, for the Health Care Reimbursement Account through COBRA and submitting to Carrier
Name on a monthly basis the amount normally deducted from your paycheck. If you choose this option,
you may continue participation though the end of the plan year in which you terminate. All questions
regarding Flexible Benefits Plan should be directed to Carrier Name at number.
401(k) Plan
Refer to the 401(k) information in your packet for an explanation of your options. If you have an
outstanding loan in the plan, it is due and payable immediately upon your termination or it will be
deemed a distribution and tax penalties will be applied. You are responsible for obtaining independent
advice from your own personal tax advisor regarding distributions.
Stock
A Closing Statement regarding your stock options is enclosed. Vesting stops on your termination date.
You have 60 days to exercise options that were fully vested as of your termination date. If you earlyexercised stock, ABC has the option to buy back any unvested shares within 90 days of your termination,
and will notify you of its decision before the end of that 90 day period. To exercise your vested options,
please complete the applicable forms in your Termination Packet. For questions regarding stock options,
please contact Human Resources.
Notice to Terminating Employees
For employees in California, in compliance with the Health Insurance Premium Payment (HIPP) program,
a copy of the Notice to Terminating Employees is included in your Termination Packet.
EDD
For employees in California, a copy of the For Your Benefit (DE 2320) brochure from the Employment
Development Department is included in your Termination Packet.
W-2 and Address Changes
W-2s are mailed out by January 31st each year. It is important to keep Human Resources informed of any
address changes to ensure your W-2 information is sent to the correct address. Please note, you are
responsible after your termination date for notifying benefit carriers of any address changes.
Questions
Please contact Human Resources with any questions regarding your termination details or any of the
items addressed above.
Melita
1/1/15
The above/attached information is not legal advice. It should not be considered a legal opinion as to which laws apply or as to how any law
applies to a particular situation. Companies or individuals should seek advice of counsel with regards to their particular situation.
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