Summary of Material Modification

to

[Insert name of Plan]

Summary Plan Description

To:Participants employed by[insert company name]and participating in the [insert name of plan]

From:[Insert Plan Administrators name and address]

Subject:Summary Plan Description Update – New YorkState Law – Marriage Equality Act

Date:

[Insert Plan Sponsor’s name], Plan Sponsor for the [insert plan name] is providing notice to plan participants of changes to the existing employee benefit programs represented in the [insert name of plan]Summary Plan Description.

State Benefit Mandates

Legislative changes have occurred since your Summary Plan Description was distributed to you. The following mandate may affect participation in your fully-insured employee benefit programs offered by [insert company name]. New YorkState’s Marriage Equality Act became effective on July 24, 2011. This Act amends New York’s Domestic Relations Law to provide that same-sex couples may obtain a marriage license in New York. It also requires that same-sex marriage be treated the same as an opposite-sex marriage in all respects under New York law.

New Definition of Spouse

The following definition has been added to the Definitions Section your Summary Plan Description:

Spouse – State Law - means same-sex couples who obtain a marriage license and enter into a civil union in the State of New York.”

Impact on federal laws

While plan coverage can be added for same-sex partners, doing so does not grant them federal protections under COBRA and Section 125 Cafeteria Plan rules. This means that employees cannot pay the portion of their health coverage attributable to same-sex partners with pre-tax dollars. This would apply since the definition of Spouse under New YorkState law is not recognized as a Spouse under federal law. Same-sex partners residing in the State of New York are eligible for New YorkState’s “mini” COBRA continuation laws. Same-sex partner’s excluded from cafeteria plan participation are also not eligible to have their medical bills paid out of a Flexible Spending Account (“FSA”)

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Summary of Material Modification

Please attach this Summary of Material Modification to your Summary Plan Description for future reference.

You may contact the Plan Administrator at [insert company name]if you have questions regarding the information in this Summary of Material Modification, or if you need another copy of the Summary Plan Description.

The Plan Administrator can be reached at [insert Plan Administrators phone number], or you can write to [insert name and address of company].

ERISA Information:

Plan Sponsor: Sponsor’s EIN:

Plan Name:

Plan Number:

SIGNATURE:

We have executed this Summary of Material Modification the date and year written below.

Employer: ______

[Insert Company Name]

Plan Administrator

Date: ______