Item C06
Revised 2/95
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: Auoust 16-17.2000
Bulk Item: Yes ~ No D
Division: Countv Administrator
Department: County Administrator
AGENDA ITEM WORDING: Aooroval of resolution allowinQ Metrooolitan Life Insurance
Comoany (Metlife). an alternative orovider of a Qualified deferred comoensation olan, to
offer their olan to countv emolovees and aooroval of the necessarv documents to
accomolish same. Forms attached: Form 2678 Emoloyer Aooointment of Aoent: IRC
457(b) Plan Fundino, Certification and Particioation Aoreement and 457 Plan Waoe
Withholdino, Form W2 Reoortino Service Aoreement , and IRC 457 (b) Plan Desionation
of Authorized Emolover or Plan Trustee Reoresentatives. and Contract (form G3068)
ITEM BACKGROUND: The Emolovee Relations Committee has reQuested additional
investment ootions to PEBSCO for several vears. We contacted 62 oroviders of
Deferred Comoensation Plans and had resoonses from six oroviders.
PREVIOUS RELEVANT BOCC ACTION: Aooroval of Ordinance 037-1998 on the 12th
dav of November 1998, allowino the Countv Administrator to neootiate with oroviders of
deferred comoensation olans.
STAFF RECOMMENDATION: Aooroval
TOTAL COST: None
BUDGETED: Yes D No D
COST TO COUNTY: Minimal administrative assistance for scheduling locations for
Metlife to meeting with employees and accounting for participant contribution.
REVENUE PRODUCING: No XX AMOUNT PER MONTH
YEAR I
APPROVED BY: COUNTY ATTY D OMBlPURCHAS~ RISK MANAGEMENT ISZf w.\l.- .
DIVISION DIRECTOR APPROVAL: ~ --<~
-
James L. Roberts
DOCUMENTATION: INCLUDED: x TO FOLLOW: D NOT REQUIRED: D
DISPOSITION:
AGENDA ITEM #:
\.(JD
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with:Metropolitan Life Insurance Effective Date: When executed
Company (Metlife)
Expiration Date:None
Contract Purpose/Description:To provide deferred compensation to county employees in compliance
with section 457b of the Internal Revenue Code of 1986. as amended.
Attached:
~ lrJp#- I
-....-
Contract Manager: Sheila A. Barker
(Name)
4462
(Ext. )
HR
(Department)
for BOCC meeting on August 16-17, 2000 Agenda Deadline: August 2, 2000
CONTRACT COSTS
Total Dollar Value of Contract: $Nothing to Current Year Portion: $
County
Budgeted? YesO No 1:8]
Grant: $
County Match: $
Account Codes:
- - -
----
- - -
----
- - -
----
- - -
----
ADDITIONAL COSTS
Estimated Ongoing Costs: $Minimallyr For: Administrative services for scheduling
location for Metlife to meet witIlemployees and
accounting for participant contribution.
(Not included in dollar value above) (e~. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Date In Need~ ~vi~r!l
Division Director 41''' YesD No~ -- _ ;~ d'/~
Risk Management 'i<)i \00 YeSDNO~ ~ Wr~----,- ~O"- s-III.o
~1P.;.;t1ng 8M u= YesD NOci" ~ a ~ ,f-,~ -oJ
County Attorney -:t;,jal/OtJ YesD No~ ~
Date Out
? - J \- ~
Comments:
OMB Form Revised 9/11/95 MCP #2
Board of County Commissioners
RESOLUTION NO.
-2000
A RESOLUTION APPROVING METROPOLITAN LIFE INSURANCE COMPANY (METLIFE), AN
ALTERNATIVE PROVIDER OF A QUALIFIED DEFERRED COMPENSATION PLAN, TO OFFER
THEIR PLAN TO COUNTY EMPLOYEES.
WHEREAS, the Monroe County Board of County Commissioners granted the County Administrator the
right to negotiate with providers of deferred compensation plans by passage of Ordinance No. 037-1998,
WHEREAS, the County Administrator has selected a provider whose plan is qualified under section
457(b) of the Internal Revenue Code of 1986, as amended. .Said section provides for the deferral of income for
income tax purposes until the income is actually received by the participant, but is not deferred for social security
coverage.
WHEREAS, the Monroe County Board of County Commissioners grant approval to sign the necessary
documents to allow Metlife to become a deferred compensation provider to Monroe County Employees. This
resolution shall become effective when said documents are fully executed.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County, Florida, at a
regular meeting of said Board held on the 16th of August, 2000.
Mayor Shirley Freeman
Commissioner Wilhelmina Harvey
Commissioner George Neugent
Commissioner Mary Kay Reich
Commissioner Nora Williams
(SEAL)
ATTEST: Danny L. Kolhage, Clerk
COMMISSIONERS
BOARD OF COUNTY
OF MONROE COUNTY, FLORIDA
By:
(Deputy Clerk)
(Mayor)
Note: For purposes of reviewing this set offorms. here is a copy of the text on IRS Form 2678. The employer needs to
complete and return an actual IRS Form 2678 to MetLife alone: with the Service Ae:reement for us to be able to do W-2
reporting:. A copy ofIRS Form 2678 can be printed from the IRS Web site at: htto://ftp.fedworld.e:ov/oub/irs-pdflf2678.pdf .
IRS Form 2678 (Rev. June 1997)
Department of the Treasury - Intemal Revenue Service
Employer Appointment of Agent
Under Section 3504 of the Internal Revenue Code (for use by employers or payers)
OMB Number 1545-0748
Instructions
Employer or Payer: Please complete this form and give it to the agent.
Agent: Please attach a letter requesting authority to do either all that is required of the employer for wages you pay on the employer's behalf
or all that is required of the payer for requirements of backup withholding. (See applicable Revenue Procedures 70-6 or 84-33.) Forward
both the letter of request and Form 2678 to the Director of the Intemal Revenue Service Center where you file your retums. (See reverse
side for addresses.)
Note: Rev. Proc. 70-6 is available in Publication 1271 and Rev. Proc. 84-33 is available in Publication 1272.
1. To Oirector, Service C~QtW'
2. Employer'S or Payer's name /l1 0/1/ e () E C 0 U ItJ T 'I
3. Employer's or Payer's address (Number and street, city, town orfXJSIoffice, State and ZIP code) 5/01/) C:OL-c....!E erE 12 j,)
4. Employer identification number 5""'1"- C7 0 00 7 <{ 1 /(' e '1 w~ oS, jC L .5 s CJ v [)
5. Agent's name /J1 E r L I ,t: IE
6. Agent's address (Number and street, city, town or post office, State and ZIP code)
7. Agent's employer identification number
8. Effective for (Check the box or boxes that apply)
~mployment taxes (Rev. Proc. 70-6) 0 Backup withholding (Rev. Proc. 84-33)
9. If filing under Rev. Proc. 70-6, does this apply to all employees? cSl. Yes 0 No
10. Effective date of appointment by employer or payer
Under Section 3504 ofthe Internal Revenue Code, please authorize this agent to do all that is required under (Check the one(s) that apply)
o Chapter 21 (FICA)
o Chapter 22 (Railroad Retirement)
c:il. Chapter 24 -
g. Withholding and/or
o Backup withholding
o Chapter 25 (General Provisions) of Subtitle C
The agent named above has been appointed either to pay wages for employers and/or report and deposit backup withholding amounts for
payers. This appointment is effective on the date shown in Item 10.
It is understood that the agent and the employer or payer are subject to all provisions of law and regulations (including penalties) which apply
to employers or payers.
;( Signature of employer or payer
Oate
Title of signing official (Indicate whether the person signing is an owner, partner, member of firm, fiduciary, or a corporate officer.)
For Internal Revenue Service Use Only
Effective date granted by IRS ?
For the Paperwork Reduction Act Notice, please see the back of this form.
Catalog Number 187700
Form 2678 (Rev. 6-97)
Text from the back of this form:
Paperwork Reduction Act Notice
We ask for this information to carry out the Intemal Revenue laws of the United States. We need it to ensure that taxpayers are complying
with these laws and to allow us to figure and collect the right amount of tax. You are required to give us this information. The time needed to
complete this form will vary depending on individual circumstances. The estimated average time is: 30 minutes. If you have comments
concerning the accuracy of this time estimate or suggestions for making this form more simple, we would be happy to hear from you. You
can write to the Tax Form Committee, Westem Area Oistribution Center, Rancho Cordova, CA 95743-0001. DO NOT send this form to this
address. Instead, send it to the Director of the Intemal Revenue Service Center where you file your retums.
File with the Internal Revenue Service Center at: Holtsville, NY 005011 Andover, MA 05501/ Philadelphia, PA 19255/ Atlanta, GA 39901
I Cincinnati, OH 45999 / Austin, TX 73301 / Ogden, UT 84201 I Kansas City, MO 64999 / Fresno, CA 93888 / Memphis, TN 37501
457 Plan Wage Withholding and
Form W-2 Reporting Service Agreement
MetLife Logo
WHEREAS
(the "Employer") has requested that Metropolitan Life Insurance Company ("MetLife") issue a group deferred annuity
contract (the "Contract") to the Employer to be used as a funding vehicle under your IRC ~457(b) Plan (the "Plan"); and
WHEREAS MetLife is willing to provide certain services to the Employer in accordance with the terms of this Agreement;
NOW THEREFORE IT IS AGREED:
1. The Employer has executed and enclosed IRS Form 2678, Employer Appointment of Agent, appointing MetLife as
Agent for the Employer.
2. Upon receipt ofa request for a partial or full distribution to a participant, MetLife will send to the participant's address
of record a check for the distribution made payable to the participant. MetLife will withhold the appropriate flat state
tax and a flat Federal tax of28% (IRS Form W-4 will not be required). MetLife will not withhold Social Security or
Medicare tax from distributions nor will it pay FUT A tax.
3. On a daily basis, MetLife will send to the IRS all Federal taxes withheld. MetLife will send state taxes withheld to the
states within the period required by each state. On a quarterly bastS" MetLife will report to the IRS on IRS Form 941 all
taxes withheld. MetLife will also file any required state reports on a quarterly basis.
4. On a quarterly basis, MetLife will send the Employer a report showing the amounts withheld and reported to the IRS on
Form 941.
5. On an annual basis, MetLife will send a Form W-2 (wage statement) to the address of record of each participant for
whom MetLife withheld and reported taxes.
6. This Agreement only applies to wage withholding and Form W-2 reporting on full or partial distributions to participants
from the Contract. A separate agreement for wage withholding and Form W-2 reporting on MetLife income annuities
or life insurance may be arranged by contacting MetLife, Tulsa Customer Service, 12902 East 51st Street, Tulsa, OK
74102 or by calling 800-638-4986 (income annuities) or 800-638-5000 (life insurance).
7. MetLife will pay to the Employer all full or partial distributions requested as a result of the death of a participant.
8. The processing of distributions in accordance with this Agreement is a ministerial duty that does not involve the
exercise of any powers that would cause MetLife to be a fiduciary, Trustee or Plan Administrator. This Agreement is
not intended to create any potential or current liability on the part ofMetLife. It is acknowledged that MetLife is
merely accommodating the Employer by processing requests in accordance with the above.
9. The beginning date of this agreement will be the effective date granted by the IRS on Form 2678.
In witness whereof, MetLife and the Employer have executed and delivered this Agreement as of the day of
(Name of Employer)
By
Witness:
Title
Date:
METROPOLITAN LIFE INSURANCE COMPANY
By
Witness:
Title
Date:
IRe i457(b) Plan Designation of
Authorized Employer or Plan Trustee Representatives
Employer Identification:
EGN:
(10 be completed by MotLife)
Name of Plan
Employer Name
Address
Complete thelol/owing two items if this is a governmental plan and the MetLife group contract is held by a trust:
Trustee Name
Trustee Address
Use this form to identify individuals authorized to act on behalf of the Employer and/or the Plan Trustee. Please list each
individual's name and title and indicate whether the individual will represent the Employer or the Plan Trustee. Each
designated person must sign to indicate acceptance of the designation. Please use black ink only for the signatures.
Name (please print)
ntle
Signature (in black Ink only)
Represents
By signing this form, I hereby certify that the above-named individuals have been authorized as representatives of the
Employer or the Plan Trustee. I further certify the signatures of the representatives added above represent the genuine
signatures of the representatives. Furthermore, I authorize MetLife to act on any and all requests signed by these
representatives and hold MetLife harmless for the results of such transactions. MetLife will be fully protected in assuming
that these individuals continue to function as Employer or Plan Trustee representatives until it accepts a copy of this form
indicating that any of these individuals have been terminated as such.
Employer Signature
Title
Name
Date
Trustee Signature
Title
Name
Date
For MetLife Designated Office Use Only:
Signature
Date Accepted by MetLife
Remittance Information:
Payroll Contact Person/Title:
Payroll Contact Address:
If an outside organization will send the remittances to MetLife, please complete the following three lines:
Remitter Name:
Phone:
Address:
Contact Person and Title:
Phone:
Employer/Remitter will remit funds via: 0 Check
Employer/Remitter will remit backup info via: 0 E-Mail
Ifusing e-mail or diskettes, expected name of remittance files:
o Wire Transfer
o 3 yz" Diskette
o Paper Report.
Expected date(s) offrrst remittance..:
Frequency of remittances:
Employee
Employee
Employer
Employer
Please see next page for mailing instructions; file format, name, and layout requirements; test file procedures; and wiring instructions.
For best results with our scanning equipment, please avoid using computer grcenbar paper for paper remittance reports.
.. Please allow at least 5 business days for MetLife to establish new accounts before beginning to send remittances.
Participation Request:
I request that MetLife allow all eligible participants under the Plan referenced above to become participants under MetLife's
Variable Annuity Contract, as indicated above. I certifY that (1) I am an "Employer" as defmed in the Contract which
describes the rights of persons participating in the Contract; (2) should I cease to be such an Employer I will so notifY
MetLife; (3) all eligible participants under the Plan are eligible to become participants under the Contract; (4) for
governmental plans, the contract will be held for the exclusive benefit of plan participants and their beneficiaries; (5) I have
received a copy of the Variable Annuity prospectus from MetLife.
I understand MetLife assumes no responsibility for the Employer's Plan and is not a fiduciary of the Plan, nor is MetLife
authorized to act as its legal counselor representative. I understand MetLife will provide no administrative services to the
Plan except as may be agreed to in writing. I understand MetLife will not be obligated to inquire as to the terms of the Plan or
as to any action taken by the Employer or participants, but will execute all transactions at the request of the employer or
participants, as indicated above. MetLife's execution of certain transactions at the request of participants is merely to
accommodate the Employer and does not transfer any fiduciary responsibility to MetLife. I understand this is not intended to
create any liability on the part of MetLife for executing transactions at the request of the participants or the Employer.
For governmental plans, the Trustee or the Employer will hold the Contract for the exclusive benefit of plan participants and
their beneficiaries. For non-governmental plans, MetLife is not responsible for the Plan's compliance with the requirements
of ERISA.
I understand that no sales representative or other person, except an authorized officer of MetLife, has the authority to make or
change any contract, to waive or alter any rights ofMetLife, or to make any binding promises about any contract.
Employer or Trustee Signature
Title
City and State of Signing
Date
MetLife Marketing Director, Financial Services Representative or Broker Information:
MetLife Marketing Director Signature
Date
Producer Identity (District, Agency, Agency Index)
Agency Telephone Number
Name of Financial Services Representative or Broker
Date
Signature of Financial Services Representative or Broker
IRC S457(b) Plan Funding, Certification & Participation Agreement
Public Employee Deferred Compensation (PEDC)
MetLife Logo
Employer Identification:
IEGN<
. ..~_.......,
Name of Eligible 457(b) Plan
Employer Name
Address
Employer Telephone # Employer Federal Tax ID #
Tax Status: 0 Governmental Organization
o Tax-Exempt Organization (other than a church or a qualified church-controlled organization under IRe ~3121(w)(3)(A))
# ofEmployees/Independent Contractors # of Eligible Employees/Independent Contractors
TPA Name
TP A Address
TP A Contact Nameffitle
Complete the following items for governmental plans only:
Trustee Name
Trustee Address
Trustee Telephone #
TPA Contact Telephone #
Trustee Federal Tax ID Number
Funding Authorization:
I hereby certify that the MetLife Variable Annuity product selected below is permitted as funding vehicle(s) under the
terms of this Plan. (please check the appropriate box.)
o Preference Plusc Account D Enhanced Preference piusc Account
o Other:
Governmental Plan Certification:
Determination of status as a governmental plan under ~3(32) of the Employee Retirement Income Security Act ("ERISA"):
a. If an organization is a government oftbe United States or,
b. If an organization is a government of an U.S. State or a political subdivision of a U.S. State or,
c. Ifan organization is an agency or insttumentality of any of the foregoing, and
d. Ifa plan is established and/or maintained for employees of the foregoing,
then such plan as described above will be considered a governmental plan for purposes of ERISA ~3(32) and therefore
exempt from ERISA.
By executing this Agreement, the undersigned organization bereby certifies that this plan is a governmental plan and
therefore a non-ERISA plan. It is also understood that MetLife is not making any determination concerning the foregoing
qualification. Your organization has the sole responsibility for determining the qualification of the plan as a governmental
plan under any applicable legal or tax provision and ~3(32) of ERISA.
Recordkeeplng Requirements: (please check one box per line below.)
Employer must sign all MetLife 457(b) annuity applications? 0 No
DYes
Who will direct investment of Employer contributions? 0 Participants 0 Employer 0 Trustee 0 Nt A
Who will direct investment of Employee contributions? 0 Participants D Employer D Trustee 0 Nt A
Send statements and confirmations to: 0 Participants 0 Employer 0 Trustee 0 TPA
Send checks for non-death claim distributions to: 0 Participants. 0 Employer D Trustee 0 TP A
· This option is effective upon completion and processing of IRS Form 2678 and the MetLife 457 PIan Wage Withholding and Form W-2 Reporting
Service Agreement. Any distributions requested before processing is complete will be paid to the employer or trustee to ensure proper tax reporting.