BeneFLEX HR Resources & Benny Say:

1. BeneFLEX HR Resources & Benny Say: FSA Flexible Spending Account The more you know about Flexible Spending Accounts The more you save!

2. Section 125 Plan • Benefit paid for by the Company • HIPAA – Confidential/Private • Help you save money • We are here to help you get the most out of this benefit • Completely voluntary benefit for you and your whole family • You do not have to enroll in the company insurance to participate • Your election can be used for expenses incurred by you, your spouse, and dependents. They also do not need to be on your insurance plan to participate.

3. What is a Flexible Spending Account? An FSA is a benefit program that enables pre-tax dollars to be used to pay for eligible out-of-pocket health care expenses like: • Prescription co-payments and nondrug over-the-counter (OTC) items • Mail order prescription invoices and online pharmacy • “Amount Due” on medical and dental statements incurred in the plan year • Doctor and emergency room co-payments • Health plan deductibles and coinsurance • Dental expenses • Orthodontics • Vision services and eyeglasses • LASIK surgery

4. An Example: In this example, the employee participating in the FSA plan saves $100 a month - $1,200 a year pre-tax.

5. Use It or Lose It – THE FEAR IS GONE • Good Elections • Nondrug Over-the-Counter Items • 24/7 Account balance availability • Online at www.beneflexhr.com • IVR at (913) 789-4600

6. Worksheet Talk with your medical providers to help forecast your upcoming expenses.

7. Dependent Care FSA • The maximum election is $5,000 per year per household • Covers expenses for the following: • Daycare • Latchkey • Summer/Sports Camp (No overnight) • Adult Daycare

8. Medical FSA • The maximum election is determined by your company • Covers expenses for the following: • Dr. visit and prescription copayments • Vision Expenses • Dental Expenses • Nondrug Over-the-Counter Items Contact your HR department to determine the medical election amount available to you.

9. FSA Medical Expenses

10. Over-the-Counter Eligible Expenses • The recently enacted Patient Protection and Affordable Care Act of 2010 has changed the rules for the purchase of over-the-counter (OTC) products using your Flexible Spending Account (FSA) pre-tax funds. • The IRS currently allows OTC drugs and nondrug items to be reimbursed using your FSA dollars.

11. Over-the-Counter Eligible Expenses • As of January 1, 2011 • FSA funds can no longer be used to purchase OTC medicine and drugs unless a medicine or drug is prescribed. A “prescription” means a written or electronic order for a medicine or drug that meets the legal requirements of a prescription in the state in which the medical expense is incurred and that is issued by an individual who is legally authorized to issue a prescription in that state.

12. Over-the-Counter Eligible Expenses • The OTC items affected include items in the following categories

13. Over-the-Counter Eligible Items • If you have a prescription for an OTC medicine or drug, you must pay out-of-pocket at point-of-sale and then submit a manual claim requesting reimbursement. • You can continue to use your FSA funds to purchase OTC items that are not considered a medicine or drug (e.g. bandages, splints, contact lens solution, etc.) Please note that insulin remains an eligible expense with or without a prescription. • Remember to consider these new OTC rules when estimating the dollar amount to put in your FSA for the next plan year.

14. Dual Use In addition to OTC drug or medication requiring a doctor’s prescription. Items under the “dual use” require a doctor’s letter. Once BeneFLEX receives the letter, it is placed on file for the remainder of the year.

15. FSA Reimbursement Method • Manual • Deadline Tuesday 3:00 p.m. CST • Complete Claim Form – fax or mail along with a copy of receipts to BeneFLEX • Checks issued on Thursday • Direct Deposit

16. To download a direct deposit form, go to www.beneflexhr.com, hover over Section 125, HRA & HSA, Click Printable Forms

17. To download a claim form, go to www.beneflexhr.com, click on Section 125 & HRA, Click Printable Forms

18. Claim Form – Employee Information • Complete all employee information • Check the box if you have a new address

19. Claim Form – Dependent Care • Complete all requested information • The claim form can be used as the receipt if the provider signs the form and provides his or her Social Security Number or Tax ID

20. Claim Submission Guidelines Dependent Care Dependent Care Reimbursement • Canceled checks are ok. If you include a copy of the front & back, the dates of service & either the facility federal ID number or the social security number of the individual providing service. • All receipts must show the following information: • Who rendered the services (name and address) • What type of service was rendered • Date of original service, not a billing date • Amount of charge • Federal ID number (facility) or social security number (individual)

21. Claim Form – Flexible Medical Account • Claim must include a requested amount. • Claim must be itemized or group by item. • If claiming an OTC medicine, doctor’s prescription must be attached along with the receipts. • If claiming a “dual use” item, doctor’s letter must be attached along with receipts.

22. Claim Submission Guidelines Acceptable Receipts GUIDELINES FOR SUBMISSION OF CLAIMS:The Internal Revenue Code provides the following guidelines: Medical Reimbursement • The best receipt is an Explanation of Benefits from your insurance company. • If other receipts are submitted, they must show the following information: • Who rendered the service (name and address) • What type of service was rendered • Date service was provided, not a billing or due date • Amount of charge • Any insurance payment, if applicable • Canceled checks and credit card slips are not allowable receipts.

23. Claim Submission Guidelines Over-the-Counter Non Drugs • Over-the-Counter (OTC) non drugs – Partial listing online at www.beneflexhr.com • When and who sold the product (date, name & address) • Type of OTC was purchased - *Must show product or brand name • Amount of charge • *If the receipt does not show the name of the product you can write the product name on the receipt.

24. Claim Submission Guidelines Over-the-Counter Drugs • Over-the-Counter (OTC) drugs – Doctor’s prescription required • When and who sold the product (date, name & address) • Type of OTC was purchased - *Must show product or brand name • Amount of charge • *If the receipt does not show the name of the product you can write the product name on the receipt.

25. Claim Form – Signature • According to the IRS guidelines, requested reimbursements cannot be claimed through any other plan, the claim form must be signed acknowledging the participant is aware and abiding by this IRS rule.

26. Know your Account Balance • Web Site – www.beneflexhr.com • Interactive Voice Response (IVR) (913-789-4600) • Office Hours (7:00 a.m. to 6:00 p.m. CST) (314-909-6979) or  (800-631-3539) • 3rd Quarter Statement • Reimbursement Checks

27. To access your account information, hover over “Section 125, HRA & HSA” on the menu bar. Then click on “FSA & HRA Employee Account Information”.

28. If you are a new user, click “New User” on the right and follow the steps to setup your account.

29. Questions Please call BeneFLEX at (800) 631-3539 or (314) 909-6979