Noblesville Schools Medical Plan 1 Summary Plan Description Summary Plan Description United Healthcare Services, Inc. What Is the Summary Plan Description? This Summary Plan Description (SPD) is a summary of the Covered Health Care Services available to you under the Noblesville Schools ("Plan Sponsor") Self-Funded health benefit plan. This SPD is a legal document that describes Benefits for the portion of the Plan for which United Healthcare Services, Inc. ("Claims Administrator") administers claims payment, either directly or in conjunction with one of the Claims Administrator's affiliates. For the purposes of this provision "Self-Funded" means that the Plan Sponsor, on behalf of the Plan, has the sole responsibility to pay, and provide funds, to pay for all Plan benefits. The Claims Administrator has no liability or responsibility to provide these funds. The Claims Administrator is a private healthcare claims administrator. The Claims Administrator is not the Plan Administrator for the Plan. Although the Claims Administrator will assist you in many ways, it does not guarantee any Benefits. The Plan Sponsor is solely responsible for the benefit plan design and funding payment of Benefits. In addition to this SPD, the Plan includes: • The Schedule of Benefits. • Amendments. • Addendums. • Summary Material Modifications (SMM). If there should be an inconsistency between the contents of this summary and the Plan, your rights shall be determined under the Plan and not under this summary. A copy of the plan document is available for your inspection during regular business hours in the office of the Plan Administrator. You (or your personal representative) may obtain a copy of the official plan document by written request to the Plan Administrator, for a nominal charge. Can This SPD Change? The Plan Sponsor may, from time to time, change this SPD by attaching legal documents called SMMs and/or Amendments that may change certain provisions of this SPD. When this happens the Plan Sponsor will send you a new SPD, Amendment, Addendums or SMMs. Other Information You Should Have The Plan Sponsor intends to continue this Plan, but reserves the right, in its sole discretion, to change, interpret, withdraw or add Benefits, or to end the Plan, as permitted by law, without your approval subject to any collective bargaining agreements, if applicable. On its effective date, this SPD replaces and overrules any SPD that the Plan Sponsor may have previously issued to you. This SPD will in turn be overruled by any SPD issued to you in the future. The Plan is not subject to ERISA. To the extent other federal law (e.g. PHSA, IRC) does not apply, IN- Indiana law governs the Plan.