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5.i) City of Scandia HSA Agreement 20140101[I,,:, ervice C�aperacives ADOPTION AGREEMENT For the HEALTH SAVINGS ACCOUNT MASTER SERVICE AGREEMENT City of Scandia ("Employer") hereby adopts the Health Savings Account Master Services Agreement attached hereto effective on January 1, 2014 and end on December 31, 2014. Each service year thereafter will begin January 1 and end on December 31. The Plan restates and amends the Health Savings Account maintained by the Employer and in effect prior to the Effective Date. Employer also agrees to the terms of the HSA Master Services Agreement ("the Agreement") attached hereto for the provision of administrative services by MII Life, Incorporated dba SelectAccount. SIGNATURES Date: Date: City of Scandia Signed: Name: Title: SelectAccount Accepted: Reed Erickson Title: Vice President, Compliance and Risk Manaizement