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FLEXIBLE BENEFIT PLAN
EMPLOYEE GUIDE
NEW HORIZONS
REGIONAL EDUCATION CENTERS
Copyright 2013 - Flexible Benefit Administrators, Inc. TABLE OF CONTENTS

FLEXIBLE BENEFIT PLAN:
THE BETTER YOU PLAN, THE MORE YOU SAVE!
It's more than a slogan. The Flexible Benefit Plan is a real solution to issues facing all
of us. Simply stated, by taking advantage of tax laws, the Flexible Benefit Plan works
with your benefits to save you money.
Your insurance programs are designed to help you and your family become financially
secure as well as to protect you against the high cost of medical care including
catastrophic events. However, almost everyone has a number of necessary,
predictable expenses that are not covered by your insurance programs. The Flexible
Benefit Plan will help you pay for these predictable expenses.
The Flexible Benefit Plan offers a unique way to help pay for some of your health care
expenses and dependent care expenses.
The key to the Flexible Benefit Plan is that your eligible expenses are paid for with Tax
Free Dollars. You will not pay any federal, state or social security taxes on funds
placed in the Plan. You will save between, approximately, $27.65 and $37.65 on every
$100 you place in the Plan. The amount of your savings will depend on your federal tax
bracket.
Using the Flexible Benefit Plan can save you a significant amount of money each year,
however, it is important that you understand how the Plan works and how you can make
the most of the advantages the Flexible Benefit Plan offers.
This handbook will help you understand the Flexible Benefit Plan. The handbook
covers how the Plan works, describes the categories of the Plan, explains the rules
governing the Plan, the reimbursement process and how you can elect to participate in
the Flexible Benefit Plan. Prior to electing to participate in the Flexible Benefit Plan, it is
important that you read and understand the Rules and Regulations section of this
handbook.
After you read this material, if you have any questions please feel free to contact
Flexible Benefit Administrators, Inc. at (757) 340-4567 or (800) 437-FLEX.



FLEX NOTE:

FLEX is authorized by Section 125 of the Internal Revenue Code.
IMPORTANT INFORMATION

PLAN YEAR:
OCTOBER 1, 2014 – SEPTEMBER 30, 2015
ENROLLMENT PROCESS
You must complete an enrollment form to participate in the Spending Accounts each year
during the enrollment period. If an enrollment form is not completed during open enrollment, your
enrollment will be canceled and you will not be able to join until the next anniversary date of the Plan.

ELIGIBILITY REQUIREMENTS
Full-time and part-time employees are eligible to participate in the Plan on the first day of the month
following 30 days of employment.
HSA ELIGIBILITY
If you are participating in the HSA, please note that much of the information in the HealthCare
Reimbursement Account section does not apply to you! If you have enrolled in New Horizons
Regional Education Center's qualifying high deductible health care coverage, such that you are
eligible to make contributions to a Health Savings Account ("HSA"), your participation in the
HealthCare Reimbursement Program creates some issues for you. Coverage under the HealthCare
Reimbursement Program, which provides reimbursement for "medical care" as defined in the Tax
Code, generally disqualifies you from eligibility to make HSA contributions (and disqualifies your
employer from making any discretionary HSA contributions on your behalf). Similarly, because as a
general rule your spouse is also covered under the HealthCare Reimbursement Program if you are
enrolled, that coverage would also disqualify your spouse from making HSA contributions to his or
her own HSA.
New Horizons Regional Education Center has created a modified FSA under the HealthCare
Reimbursement Program, designed to avoid disqualifying you from making HSA contributions (or
having your employer make them on your behalf). Although you are not required to participate in the
modified FSA, you should do so if you want to enroll in the HealthCare Reimbursement Program and
make HSA contributions (or want to remain eligible for any discretionary employer contributions to
your HSA). Under the modified FSA, the HealthCare Reimbursement Program will only reimburse
you for "medical care" (as defined in the Tax Code) that is dental, vision, or "preventive care" (the
IRS has defined "preventive care" for this purpose; contact your employer, the HealthCare
Reimbursement Program administrator, or your tax advisor for more information about "preventive
care").
HEALTH CARE REIMBURSEMENT ACCOUNT

The Health Care Reimbursement Account allows you to pay for your uninsured medical expenses
with pre-tax dollars. With this account, you can pay for your out of pocket medical expenses for
yourself, your spouse and all of your dependents for medical services that are incurred during your
Plan Year. The maximum you may place in this account for the Plan Year is $2,500.
EXAMPLES OF ELIGIBLE HEALTH CARE EXPENSES
FEES/CO-PAYS/DEDUCTIBLES:
Acupuncture
Prescription Eye glasses/Contact lenses Laser Eye Surgery OTHER ELIGIBLE EXPENSES: • Prescription drugs • Diabetic supplies • Artificial limbs & breasts (only if reconstructive) • Routine Physicals • Birth control pills, patches (e.g. Norplant) • Orthopedic shoes/inserts • Carpal tunnel wrist supports • Incontinence supplies • Physical Therapy • Vaccinations & Immunizations • Fertility Treatments • Elastic hose (medically prescribed) • Hearing aids and batteries • Contact lens supplies • Reading glasses • Therapeutic care for drug and alcohol addiction • Medical equipment • Take-home screening kits (HIV, colon cancer) • Pedialyte for dehydration • At home pregnancy test kits • Mileage, parking and tolls ( you may be reimbursed $.235* a mile plus parking and tolls when
medical reasons make it necessary to travel) • Tuition fees for medical care (if the college furnishes a breakdown of medical charges) • Orthodontic expenses (not for cosmetic purposes) NOTE: ORTHODONTIC TREATMENT IS REIMBURSED ACCORDING TO YOUR PAYMENT PLAN WITH
THE ORTHODONTIST. FOR EXAMPLE: If your payment plan is set up to pay $100 a month for the
orthodontic treatment, you can be reimbursed $100 a month for the payments that become due during the Plan
Year.
This above list is compiled from IRS publication 502. If you are unsure that your expected medical expense
will be eligible under tax code regulations, please call Flexible Benefit Administrators at (757) 340-4567 or
(800) 437-FLEX before making your election for the Plan Year. IRS publication 502 can be ordered by calling
the IRS at (800) 829-3676.

* Mileage reimbursement rate is based on IRS regulation and subject to change.

FLEX NOTE:

You can save between 28% and 38% in taxes on every $100 you place in the Plan.
Health Care Reimbursement Account (continued)

OVER-THE-COUNTER DRUGS
Please be advised that recent Senate legislation has stated that effective January 1, 2011,
participants are required to have a prescription for Over-the-Counter ("OTC") products to be eligible
under their FSA plan. Therefore a prescription or letter of medical necessity would be required after
January 1, 2011 for OTC items.
OVER-THE-COUNTER EXPENSES
and drugs that may be purchased in reasonable quantities with a
prescription or letter of medical necessity:

Allergy & sinus medication Pain relievers/aspirin Cough & cold medications Ointments & creams for joint pain Laxatives Anti-diarrhea medicine Bug-bite medication First aid creams (Bactine, diaper rash) OVER-THE-COUNTER EXPENSES THAT ARE NOT ELIGIBLE • The following examples are OTC items that are not eligible and will not be reimbursed under
any circumstances because the items are considered dietary supplements, toiletries, cosmetic or personal use items: Multi/Daily Vitamins Herbal/natural supplements Face cream/moisteners Medicated shampoo/soaps Mouthwash/toothpaste (even if dentist recommends a special one) makeup/preparations DUAL PURPOSE DRUGS & ITEMS
EXPENSES THAT NEED DOCUMENTATION FROM YOUR PHYSICIAN TO BE ELIGIBLE
THROUGH THE HEALTH CARE ACCOUNT
• The following items are examples of products that are considered as having both a medical purpose and a general health, personal/cosmetic purpose and require a medical practitioner's note stating the name of the patient, the specific medical condition for which the OTC is recommended, the time frame of the treatment and that the treatment is not cosmetic: Weight-loss drugs (to treat obesity) Pills for lactose intolerance (to treat a medical condition for a limited time) OTC Hormone therapy (to treat menopausal symptoms) Nasal sprays for snoring St. John's Wort (for depression) Health Care Reimbursement Account (continued)
• EXPENSES FOR IMPROVEMENT OF GENERAL HEALTH are not eligible for reimbursement
even if a doctor prescribes the program. However, if the program is prescribed for a specific medical condition (e.g. Obesity, Emphysema), then the expense would be eligible. We must have a letter from your doctor on file for each Plan Year stating specifically what illness or disease is being treated or prevented and the length of time you will be required to use this treatment in order to reimburse for any of these types of expenses. Health Club Dues Exercise classes NOTE: For Weight Loss Programs, only the cost of the program is an eligible expense. Any
cost for food or food supplements is not an eligible expense.

COSMETIC expenses, prescriptions and treatments are not eligible. This applies to any procedure
that is directed at improving the patient's appearance and does not meaningfully promote the proper
function of the body or prevent or treat an illness or disease. If cosmetic treatment is necessary to
correct a deformity or abnormality, a personal injury or a disfiguring disease, it must meet IRS
eligibility guidelines outlined in IRS publication 502 and will require a physician's letter of medical
necessity.

OTHER EXPENSES THAT ARE NOT ELIGIBLE FOR REIMBURSEMENT THROUGH THE
HEALTH CARE ACCOUNT
/ ESTIMATES for medical expenses that have not been rendered cannot be reimbursed. Medical
services do not have to be paid for, however, the services must have been rendered during the Plan Year, to be eligible for reimbursement. / PREMIUM EXPENSES for any insurance policies are not eligible for reimbursement through
the Health Care Account. This includes contact lens insurance. / EXPENSES PAID BY AN INSURANCE COMPANY are not eligible for reimbursement through
the Health Care Account. Only the portion you have to pay out of your pocket for your medical expenses is eligible for reimbursement. FLEX NOTE:
The maximum you can place in your Health Care Account is $2,500.
Health Care Reimbursement Account (continued)

CLAIMS SUBMISSION
OBTAINING A REIMBURSEMENT FROM YOUR HEALTH CARE ACCOUNT

To obtain a reimbursement from your Health Care Account, you must complete a Claim Form. This
form is available from your employer (See sample Claim Form in back of handbook). You must
attach a receipt or bill from the service provider which includes all the pertinent information
regarding the expense:
• Date of service • Provider's name • Patient's name • Nature of the expense • Amount charged • Amount covered by insurance (if applicable)
Cash register receipts, credit card receipts and canceled checks alone are not eligible forms of
documentation for medical expenses. These items are not considered third party receipts because
they only reflect that payment has been made and do not provide the required information listed
above. Prescription documentation must include the name of the prescribed medication.
OBTAINING A REIMBURSEMENT FOR OVER-THE-COUNTER ITEMS
For the purchase of over-the-counter medications, with a prescription or a letter of medical
necessity, cash register receipts will be accepted as documentation if the receipt is detailed and
indicates the name of the service provider, the date of the purchase, the amount of the
purchase and the name of the product purchased. You must also send in a copy of the
prescription or letter of medical necessity signed by a physician, along with your claim form.
If the receipt does not specifically reflect the name of the product we cannot accept the claim for
reimbursement of that item. The name of the patient does not have to be on the receipt, however, the
name of the patient must be listed on the claim form.
NOTE: In order to be eligible for reimbursement through the Health Care Account, the medical
expense must be incurred during the Plan Year. IRS defines "incurred" as when the medical care is
provided (or date of service), not when you are formally billed, charged for, or pay for the care. FOR
EXAMPLE: If you go to the doctor on December 26th and your Plan Year begins on January 1st, this
expense is not eligible in the new Plan Year. Even if you pay for this expense after January 1st, the
"date of service" was before the Plan Year began and therefore is not eligible.

THE HEALTH CARE ACCOUNT IS A PRE-FUNDED ACCOUNT
This means that you can submit a claim for medical expenses in excess of your account balance.
You will be reimbursed your total eligible expense up to your annual election. The funds that you are
pre-funded will be recovered as deductions continue to be deposited into your account throughout the
Plan Year.

DEPENDENT CARE REIMBURSEMENT ACCOUNT
The Dependent Care Reimbursement Account allows you to pay for day care expenses for your
dependents with tax-free dollars.
ELIGIBLE DEPENDENT
• A child under 13 who qualifies as a dependent on your Federal Income Taxes • Any other dependents, including a disabled spouse, disabled children over age 13 and
elderly parents, who depend on you for financial support, qualify as dependents for tax
purposes, and are incapable of self care
• Please refer to "Rules & Regulations: Eligible Dependents" for the latest definition of a
dependent, as revised under Section 152 of the Code by the Working Families Tax Relief Act of 2005 (WFTRA)
ELIGIBLE DEPENDENT CARE EXPENSES
For dependent care expenses to be eligible for reimbursement, you must be working during the time
your eligible dependents are receiving care. If you are married, your spouse must be:
• Working at the time the day care services are provided; • A full-time student for at least five months during the year; or • Mentally or physically disabled and unable to provide care for him or herself
EXPENSES FOR KINDERGARTEN are not eligible for reimbursement since they are generally for
education, and not for custodial care. In order for an expense to be eligible for reimbursement from the Dependent Care Reimbursement Account, the primary purpose for the care of the qualifying individual must be to assure the individual's well-being and protection. Dependent care must still be primarily for custodial care, not education, in order to qualify as an eligible employment-related expense from the Dependent Care Reimbursement Account.
EXAMPLES OF DEPENDENT CARE EXPENSES
• Babysitters or Nannies that claim the child care as income on their taxes • Licensed day care centers • Before and after school care • Day care for an elderly or disabled dependent
EXPENSES THAT WOULD NOT BE ELIGIBLE THROUGH THE DEPENDENT CARE ACCOUNT
/ Kindergarten (kindergarten & above is considered an educational expense)
/ Days you or your spouse are not working, including sick leave, vacation days, maternity leave
/ Transportation, books, clothing, or entertainment (Note: These expenses will be covered if
provided by the nursery school or day care center as part of its preschool care services. If
these types of expenses are billed separately, they are not an eligible expense.)
/ Care provider may not be a child of yours under the age of 19 or anyone you claim as a dependent for federal income tax purposes / Babysitting for social events
/ OVERNIGHT CAMP: Overnight camp is not an eligible expense, only DAY CAMPS are
eligible. Remember that this account is set-up so that you and your spouse are able to go to
work and Overnight camp is 24-hour care.
Dependent Care Reimbursement Account (continued)

ANNUAL MAXIMUM FOR THE DEPENDENT CARE REIMBURSEMENT ACCOUNT
Must Not Exceed The Lesser Of:
• $5,000 for one or more children ($2,500 if you are a married individual filing a separate tax • Your wages or salary for the Plan Year; or • The wages or salary of your spouse If your spouse is either a full time student or is incapable of taking care of himself or herself then he or she is deemed to have monthly earnings of $250 if there is one (1) child or dependent, and $500 if there are two (2) or more children or dependents. USING THE DEPENDENT CARE REIMBURSEMENT ACCOUNT
FILING FOR A TAX CREDIT ON YOUR TAXES

Under current IRS regulations, you may be eligible to receive a tax credit for dependent care costs.
You may claim a credit for dependent care, up to $3,000 for one child and $6,000 for two or more
children, on your income taxes through the child care tax credit. However, through the Dependent
Care Reimbursement Account you may set aside up to $5,000 per year, for one or more children, if
you are married and filing a joint tax return or if you are a single parent. If you are married and filing
separate tax returns, you may set aside only $2,500.
Typically, more money is saved by paying for dependent care through the FSA Dependent Care
Reimbursement Account than by taking the dependent care credit on your tax return. This is because
the total for federal, state, and FICA savings usually exceeds the dependent care credit. At taxable
incomes greater than $14,000, participants will probably benefit more from taking reimbursement
from the Flexible Benefit Plan. These assumptions are based on the inclusion of your state income
tax.
You can also file for the tax credit while participating in the Dependent Reimbursement Care
Account. If the amount you have placed through the reimbursement account does not meet the
maximum allowed by the IRS, you can claim the difference between your Dependent Care deductions
and the IRS maximum allowable expenses for the tax credit. You can claim a tax credit for any
additional dependent care expenses incurred over the $5,000 maximum FSA limit up to the $6,000
child care tax credit limit on your taxes. You cannot claim the tax credit for any dependent care
expenses paid from the Dependent Care Reimbursement Account. It is your responsibility to report
the Dependent Care amount on your tax form 2441. The amount is listed on your W-2 under
Dependent Care Benefit for the tax year. If you are not sure about the eligibility of an expense, phone
Flexible Benefits Administrators at (757) 340-4567 or (800) 437-FLEX or refer to IRS Publication 503:
"Dependent Care Expenses". This publication can be ordered by calling the IRS at (800) 829-3676.



FLEX NOTE:

FLEX can help you cope with the high cost of quality day care.
Dependent Care Reimbursement Account (continued)

OBTAINING A REIMBURSEMENT FROM YOUR DEPENDENT CARE REIMBURSEMENT
ACCOUNT
To obtain a reimbursement from your Dependent Care Reimbursement Account you must complete a
Claim Form. This claim form is available from your employer (See sample Claim Form in back of
handbook). You must attach a receipt from the service provider which includes all of the following:
• Name of dependent receiving care • Date(s) care was provided (must match Claim Form) • Name of service provider • Social Security or Tax I.D. number of the provider • Amount of the charge
NOTE: Dependent care expenses can only be reimbursed after the care is provided. This means
that advance payments of dependent care expenses cannot be made. FOR EXAMPLE: If you
pay for a summer day camp for your child in May but the camp is the first week in July, we cannot
reimburse you for this expense until July when the service is provided.

THE DEPENDENT CARE REIMBURSEMENT ACCOUNT IS NOT A PRE-FUNDED ACCOUNT
This means that you will only be reimbursed up to your account balance at the time you submit your
claim. If your claim is for more than your account balance, the unreimbursed portion of your claim will
be tracked by Flexible Benefit Administrators. You will be automatically reimbursed as additional
deductions are taken and deposited into your account, until your entire claim is paid out.

BENEFITS CARD
The Benefits Card system allows you to pay for eligible pre-tax account expenses electronically at approved service providers and merchants. The Benefits Card provides you with instant access to your pre-funded Health Care Reimbursement Account for many common regular eligible expenses. You may also enjoy the convenience of paying for your childcare expenses (up to your account balance at the time of the "swipe") with the Benefits Card. In order for you to get the most benefit from your Plan, we want to remind you of a few things concerning the Benefits Card. • The Benefits Card works just like a debit card, only your "bank account" consists of the funds you elected to set aside in your pre-tax account(s). The card is not eligible for use at ATMs or other unqualified merchant locations. The card will be denied at the point of sale when a transaction at an ineligible location is attempted. If an eligible provider does not accept MasterCard®, you must file a paper claim. When using the card at a self-service merchant terminal, you may select the credit or debit option (with your PIN). • How To Receive Your PIN: The most cost effective way to provide a cardholder their PIN is to use the e-PIN delivery functionality. e-PIN delivery provides a simple and secure way for participants to view their PIN on the FBA WealthCare Portal. The FBA WealthCare Portal "My Cards" page provides a "View PIN" button next to each card number. Upon clicking "View PIN", FBA WealthCare Portal pops-up a new window containing the card's four digit PIN. Detailed information is also available on our website at . • Your card will be mailed to your home address via first class mail. Please allow up to two weeks for delivery of your card. If you do not receive your card two weeks after the start of your Plan Year, contact Flexible Benefit Administrators, Inc. so that a replacement card may be ordered. Any eligible expense incurred during that time may be reimbursed by mailing, faxing or emailing a claim form and proper documentation to Flexible Benefit Administrators, Inc., follo i w ng the customary claims filing procedure and cutoff times. • When you receive your card, sign the back of the card prior to using it. Your card is activated upon the first swipe of • Continue to save all receipts. Flexible Benefit Administrators, Inc. may request them to verify expense eligibility. • Flexible Benefit Administrators, Inc. will notify you by mail or e-mail if you incur an expense with the card that is or appears to be ineligible. Upon this notice you must send Flexible Benefit Administrators, Inc. a Transaction Substantiation Form with the corresponding itemized documentation within 40 days of the transaction; you may download and print a Transaction Substa ntiation Form from our w site. If you do not send in those required items, your card will be deactivated until the documentation is received. • Your transaction will be denied for any amount greater than your health care reimbursement account annual election or your dependent care reimbursement account posted balance at the time of the "swipe". • You should notify Flexible Benefit Administrators, Inc. immediately if your card is lost or stolen to deactivate the card. If your employment is terminated, your card will be permanently deactivated. • You may monitor your account balance, transaction history or print a statement at any time, night or day on the Benefits • Additional information regarding the Benefits Card is available on our website: www.mywealthcareonline.com/fba. You may also download the Transaction Substantiation Form from our website under Participants; FBA Benefit Cards; Forms. THE BENEFITS CARD

Attention: Benefits Card Participant
Subject: Benefits Card Use
In light of IRS Rulings on Benefits Card use, it is important that you make yourself familiar with the cardholder
agreement that accompanies your Benefits Card. Flexible Benefit Administrators, Inc. strongly suggests
reviewing this document and making yourself and any dependent cardholders in your household aware of the
terms.
Please be aware that upon receipt and signing of your Benefits Card, you as the cardholder and employee
participant of the Plan are ultimately responsible for using the card for eligible expenses. This also applies to
any dependent that has use of the Benefits Card. By signing the back of the card, the employee/dependent is
agreeing to the terms and conditions of this agreement.
As in the past, your responsibility as a participant in a tax-free plan is to use the card for eligible expenses
ONLY (such as prescriptions, eyeglasses and medical co-pays, etc.) As with paper claim submission,
cosmetic prescriptions and procedures as well as over the counter medications and products are not eligible
for reimbursement. Please remember that each time you use your card you are certifying that the expense is
eligible. If you have any doubt as to whether an expense is eligible, you should refer to your employee
handbook, IRS Publication 502 or call our office to speak with one of our administrators. It is also your
responsibility to acquire all documentation such as receipts, EOBs, etc. for the Plan Year's expenses and to
retain the documentation for the entire Plan Year. If you are aware that you have paid for an expense with the
card that is ineligible it is your responsibility to notify Flexible Benefit Administrators, Inc. immediately. You will
need to submit a paper claim form with substantiating documentation along with repayment for the amount of
the ineligible expense.
Flexible Benefit Administrators, Inc. may request documentation to substantiate your Benefits Card
transactions to determine eligibility of the expense. In the event that your documentation shows ineligible
expenses were paid with your Benefits Card, Flexible Benefit Administrators, Inc. will request that you re-pay
the amount of the ineligible expense. If the payment is not received in the allotted time frame your card will be
deactivated. Also, Flexible Benefit Administrators, Inc. may offset future claims and notify your employer. IRS
rulings allow your employer to withhold this amount from your wages if necessary.
The Benefits Card is NOT PAPERLESS, just less paper and is a great convenience for the participants in the
Plan, if used properly.
PLEASE NOTE: Eligible items purchased at participating Inventory Information Approval System (IIAS)
merchants will be automatically approved! When purchasing prescriptions and/or over-the-counter
FSA-eligible items, the merchant's IIAS will verify the items and automatically approve the transaction
with no follow-up request. The Benefits Card is not accepted at merchants who have not implemented
IIAS. Please visit www.sig-is.org and select "IIAS Merchants List" for the most recent list of IIAS
merchants.

RULES AND REGULATIONS
CLAIM FILING DATES
All claims received in the office of Flexible Benefit Administrators, Inc. will be processed within one week
via check or direct deposit.
COMMON ERRORS TO AVOID WHEN FILING CLAIMS
• The claim form is not signed • Canceled checks, cash register receipts or credit card receipts are sent in place of receipts or bills from the provider of service • Cash register receipts for OTC item(s) do not indicate the specific name of the product(s) • Claim form has not been completed • Insufficient postage on envelope • "Previous balance" statements or "payment on account" receipts submitted in place of actual date of service itemized bills or receipts
Your claim form may be returned to you or delayed in processing for improper or insufficient
documentation. If you have questions about your claims, you may contact Flexible Benefit Administrators,
Inc. at (757) 340-4567 or (800) 437-FLEX, from 8:30a.m. to 5:00p.m., Monday through Friday.

REIMBURSING THE PROVIDER OF SERVICE
All reimbursements will be sent to you directly. After receiving payment from your account, you are
responsible for paying your providers.
ELIGIBLE DEPENDENTS
An individual is considered to be a dependent if he or she is a qualifying child or qualifying relative of the
taxpayer. The following qualifying criteria now apply. To be a "dependent child": the individual is a child
to the participant, and the individual doesn't turn 27, regardless of any other status by the end of the
taxable year.
In addition, the following qualifying criteria apply to be a "dependent relative": the individual has a
specific family type relationship to the taxpayer, the individual is not a qualifying child of any other
taxpayer, the individual receives more than half of his or her support from the taxpayer, and the
individual's annual gross income is less than the Section 151 limit ($3,950 for 2014; this criteria does not
apply to health plans).
Rules and Regulations (continued)

GRACE PERIOD FOR FILING CLAIMS
You have the entire Plan Year plus 90 days to file all claims that were incurred during the Plan Year. All
claims must be received in the office of Flexible Benefit Administrators, Inc. by 5:00 p.m. on the 90th day,
following the end of your Plan Year. If claims are not received during this time frame for expenses
incurred during the Plan Year, your remaining funds will be forfeited. (Remember "90 days" does not
mean 3 months and "received in the office" does not mean the day it was postmarked). Please, do not
delay, complete your claims early.

FORFEITING FUNDS
Any money you do not use from a reimbursement account for expenses incurred during a Plan Year will
be forfeited. The forfeited funds will be returned to your employer to offset the cost of the program. If you
plan carefully, you can avoid being ffected by
this IRS restriction.
CHANGES IN YOUR ELECTION
No, generally you cannot change the elections you have made after the beginning of the PLAN YEAR.
However, there are certain limited situations when you can change your elections. You are per
change elections if you have a "change in status" and you make an election ge that is consistent with the "change in status." Currently, Federal law considers the following events to be "changes in status": • Marriage, divorce, death of a spouse, legal separation or annulment; • Change in the number of dependents, including birth, adoption, placement for adoption, or death of • Any of the following events for you, your spouse or dependent: Termination or commencement of employment, a strike or lockout, commencement or return from an unpaid leave of absence, a change in worksite, or any other change in employme tatus that affects eligibility for benef • One of your dependents satisfies or ceases to satisfy the requirements for coverage due to change in age, student status, or any similar circumstance; and • A change in place of of you, your spouse, or your dependent. This applies ONLY to Dependent Care and ONLY if that change in residence results in a change of dependent care service provider and its cost. In addition, if you are participating in the Dependent Care Reimbursement Account, then there is a "change in status" if your dependent no longer meets the qualifications to be eligible for dependent care. ou may not change your election under the Dependent Care Reimbursement Account if the cost change is imposed by a dependent care provider who is your relative. To make a change in your elections, a STATUS CH E FORM must be co mpleted within 30 days of the event. Flexible Benefit Administrators, Inc. or your benefits contact person will determine if your requests for an election change meets IRS Regulations. Rules and Regulations (continued)

TRANSFERRING FUNDS BETWEEN ACCOUNTS
IRS regulations do not allow money to be transferr
ed between reimbursement accounts. If you nds to be placed in your Healt h Care Account, you must submit eligible medical expenses to be imbursed from these funds. Th is IRS regulation also applies to the Dependent Care Account.
TERMINATION OF EMPLOYMENT
If you have funds in your Health Care Account and you submit receipts for expenses incurred prior to
your termination, you can be reimbursed for funds remaining in your account up to your annual
election. However, if you have money left in your Health Care Account and do not have receipts for
expenses incurred prior to your termination, you cannot be reimbursed for the money remaining in
your account unless you elect to participate in the federal program, COBRA. If you elect to
participate in COBRA, you
ontinue to set aside dollars on an after tax basis to be eposited into your Health Care account. You can receive information concerning this program from the contact person in your company. Your Dependent Care Account functions differently. If you have funds remaining in these accounts, this money will be reimbursed to you if appropriate receipts are submitted. You can receive imbursement for expenses incurr ed during the Plan Year if receipts are submitted within the Plan ear and before the end of the 90 day gr ace period following the Plan Year end.
EFFECT ON SOCIAL SECURITY BENEFITS
As you are not paying social security tax on the portion of your income th
been placed in the our social security benefits may be slightly reduced. We suggest putting part of your tax o your Employer's Retirement Program or some other savings vehicle.

ACCOUNT BALANCES
You may call Flexible Benefit Administrators, Inc. at (757) 340-4567 or (800) 437-FLEX from 8:30am
to 5:00pm, Monday through Friday, to check your account balances. You may also access your
personal account information at your convenience via our secure website:
. Each reimbursement check stub will show your contributions,
request for reimbursements, and disbursements for each account. It will also show your annual
lection and the balance to reques t by the end of the Plan Year for each account. A reminder letter will be sent two months prior to the end of the Plan Year if you have funds left in your accounts.
FLEX NOTE:
You must enroll in the reimbursement accounts each year before the
Plan effective date to participate during the Plan Year.
FLEXIBLE BENEFIT ADMINISTRATORS, INC.
509 VIKING DRIVE, SUITE F
P.O. BOX 8188
VIRGINIA BEACH, VA 23450
(757) 340-4567 or (800) 437-FLEX
FAX: (757) 431-1155

Source: http://nhgs.tec.va.us/~ciwaka.johnson/NHR_Employee%20Guide_14.pdf