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Home My WebLink About92-1154 AS OF 8 - d. '1- ~ODlt; CASE# 1'1'1), - II s~ HAS BEEN SCANNED. ALL EARLIER FILINGS TO THIS CASE HAVE BEEN MICROFILMED. RECEIVED .}; AUG 1 7 2006 BY: Douldas R. Smith Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA VS. CML ACTION - LAW Karen S. Smith Defendant NO. 1154 Civil 1992 DOMESTIC RELATIONS ORDER This Domestic Relations Order ("Order") is intended to meet the requirements of a qualified domestic relations order ("QDRO"), as that term is defined in Section 206(d)(3) of the Employee Retirement Income Security Act of 197'il ("ERISA") and Section 414(p) of the Internal Revenue Code of 1986 ("Code"), and shall be modified as necessary to continue to meet the requirements of ERISA and the Code. The result of such qualification is that this Order will then become a QDRO. This Order is granted in accordance with 23 Pa. C.S.A. ~3502, which relates to marital property rights, child support, and/or spousal support between spouses and former spouses in matrimonial actions. THE COURT FINDS AND IT IS HEREBY ORDERED AS FOLLOWS: Section 1. Identification of Plan. This Order applies to benefits under the Highmark Retirement Plan (the "Plan"). It shall also apply to and bind any successor plan to the Plan. The name and address of the Plan Administrator is: Personnel and Compensation Committee, Highmark Inc., 1800 Center Street, Camp Hill, PA 17089-0089. Section 2. Identification of ParticiDant and Alternate Pavee. (a) Douglas R. Smith is hereafter referred to as the "Participant." The Participant's current and last known address is 1649 North Shore Drive, Painesville, OH 44077. This address may be changed, from time to time, by written notice to the Plan Administrator. It is the responsibility of the party whose address has changed to provide such notice. The Participant's Social Security Number is 288-40-6435. The Participant is not currently receiving benefits under this Plan. (b) Karen S. Smith is hereafter referred to as the "Alternate Payee." The Alternate Payee's current and last known address is 530 Joyce Road, Camp Hill, PA 17011. This address may be changed, from time to time, by written notice to the Plan Administrator. It is the responsibility of the party whose address has changed to provide such notice. The AlternatePayee's Social Security Number is 203-42-4555. The Alternate Payee is the Former Spouse of the Participant. I . (c) On November 14, 1991, the parties entered into a Matrimonial Settlement Agreement, which Agreement relates to the provision of marital property rights to the Alternate Payee, as the Former Spouse of the Participant. (d) The Participant and the Alternate Payee were married on May 8, 1976, and said marriage is registered in Beaver County, Pennsylvania. (e) Both the Participant and the Alternate Payee shall have the duty to notify the Personnel and Compensation Committee in writing of any changes in his or her respective mailing addresses subsequent to the entry of this Order. Section 3. Startimz Date for Benefit Payments. Distribution of the benefit assigned to the Alternate Payee shall be made or co=ence upon the Alternate Payee's request as soon as permitted by the Plan on or after the Participant's attainment of his or her "earliest retirement age," as defined in Code Section 414(p)(4)(B). However, if the "Actuarial Equivalent" (as that term is defined in Section 1.02 ofthe Plan) present value of the Alternate Payee's benefit is $5,000 or less, and payment of such benefit has not co=enced, the form of distribution of the benefit shall be in a single cash lump sum payment. Section 4. Form of Benefit. The Alternate Payee shall have the right to elect to receive a distribution of the assigned benefits in any form permitted under the Plan with respect to the Participant (other than in the form of either: (1) a joint and survivor annuity payable for the benefit of the Alternate Payee and the Alternate Payee's contingent beneficiary under Section 8.05(a)(1) of the Plan, or (2) an increased benefit paid prior to the co=encement of the Participant's eligibility for primary Social Security benefits and a reduced benefit thereafter under Section 8.05(a)(4) ofthe Plan), unless the Actuarial Equivalent present value of the Alternative Payee's benefit is $5,000 or less and payment of such benefits has not commenced, in which event the form of distribution shall be a . single cash lump sum payment. The payments expected to be made to the Alternate Payee over the life expectancy of the Alternate Payee shall be the Actuarial Equivalent of the benefit amount set forth in Section 5 below. Section 5. Amount of Benefit to be Paid to Alternate Pavee. Starting at the time specified in Section 3, under the terms of the Judgment, the Alternate Payee is to receive retirement benefits from the Plan from and out of the benefits otherwise payable to the Participant: a) In the amount of 50% of the vested accrued benefit of the Participant determined as of November 14, 1991, and the Participant's benefit is reduced accordingly. b) If the Alternate Payee elects to co=ence receiving benefits prior to the Participant's normal retirement age, the Alternate Payee's separate benefit will be reduced for such early co=encement using Plan factors in effect at such commencement. 2 ... . Once determined, the Alternate Payee's portion of the Plan benefit shall be actuarially adjusted using Plan factors in effect at the time benefit payments commence to the Alternate Payee. Such actuarial adjustment will take into account the age difference between the Participant and the Alternllte Payee. The Alternate Payee's benefits are to be actuarially adjusted to the Alternate Payee's own life expectancy. Section 6. Death Benefits. If the Alternate Payee dies before his or her "Annuity Starting Date" (as that term is defined in Section 1.04 of the Plan), the Alternate Payee's interest assigned hereunder shall be restored to the Participant's benefit, but no retroactive payment shall be made to or on behalf of the Participant as a result of the Alternate Payee's death after the Participant's Annuity Starting. Date. Except as stated above, the benefit assigned hereunder to the Alternate Payee shall not be reduced, abated or terminated as a result of the death of the Participant. The Alternate Payee will not be entitled to any survivor benefits with respect to the portion of the Participant's accrued benefit under the Plan not otherwise assigned to the Alternate Payee under this Order. Section 7. ComDliance with ADDlicable Laws. Nothing in this Order shall require the Plan to: (1) pay any benefits not permitted under ERISA or the Code; (2) provide any type or form of benefit, or option, not otherwise provided in the Plan; (3) provide increased benefits (determined on the basis of actuarial value); or (4) pay benefits of the Participant to the Alternate Payee that are required to be paid to another alternate payee under another order previously determined to be a QDRO. 3 .... Section 8. Reservation of Jurisdiction. The Court retains jurisdiction to establish or maintain this Order as a QDRO; provided, however, no amendment of this Order shall contain a requirement with respect to the Plan of a type described in Section 8 above. DATED this 1. q,'t. day of I\\)~V ~t , 20~. CONSENT TO ORDER: ~~i.~ ?ft,)d(, . ISate ,~ 01&.111 De endantJAlternate Payee 1174 Date /~~ ~1;jd6 Attorney for Plaintiff! Date Participant ?/, 9 0-' Date /ffiI.y ~\ O~e. 0\9 ~. ~~ o 4 ". l1iNVfilAS\!N3d 1 "jn~'-' .-"-"'n.... ^-i.!', l..,,"-) '-::J'~ u fJO :S ~ld 62 ~nY 900l Al:Nl0NOHlOi:!d 3H1 .:10 3::J13:1O-o3lI:l