2020-2021 Benefits Guide rev 6.22.2021

You CANNOT cash the HRA annual contribution out and the funds must be spent on eligible expenses. Any money that is not used during the plan year will be rolled over for use in future years for medical expenses up to a maximum of $2,500. At the end of the plan year and allotted run-off period, any funds over $2,500 are rolled over to a Retirement Health Savings Account (RHS) in April of each year. For more information regarding an RHS, please see the RHS section of this booklet. Eligible Expenses HRA eligible expenses are the same as FSA eligible expenses. A list of HRA eligible expenses can be found here. HRA Run Off Period December 31st is the last day to incur claims for the 2020 plan year, and you must submit all claims by March 31, 2021. FLEX SPENDING ACCOUNTS (FSA) A Flexible Spending Account (FSA) is a tax advantaged benefit plan administered by Proficient Benefit Solutions that allows employees to set aside portions of their salary to pay for their family’s health and/or daycare expenses. The amount set aside is not subject to payroll taxes. Flexible spending accounts contributions are based on the plan year (October 1, 2020 to September 30, 2021) election. Medical FSA You can receive reimbursement from your Health Care FSA for eligible medical and dental expenses incurred by you or an eligible dependent using your pre-tax dollars. Claims will be processed through Proficient Benefits Solution. The maximum amount you may contribute to your Health Care FSA for plan year 2020-2021 is $2,750. Employees who enroll in the HDHP medical plan will receive FSA funds from the EAA and the amount is The entire annual amount is prefunded at the beginning of the plan year for immediate use on eligible expenses for current employees. You must enroll as a new hire for the FSA or enroll for the FSA every year during open enrollment or after a qualifying life event. If you are a new hire and enrolling mid-year, you may want to choose a lower annual amount now and then increase it during open enrollment for the next year. For example, if you are hired in June and you choose a $4,000 annual contribution amount, that amount is divided by the number of payrolls left in the plan year (October – September) and that amount will be deducted from each paycheck (i.e. you elect $5,000, there are 7 pay periods remaining in the plan year, $714.28 will be deducted from each paycheck). The IRS publishes information on FSAs and eligible expenses on their website. If you have questions about an expense, please contact Proficient at (210) 659-8100, option 1. You may also view a list of eligible expenses on the Proficient Benefits Solution website. Dependent Care FSA A Dependent Care FSA offers an opportunity to save money on daycare expenses for eligible dependents. The maximum amount you may contribute to your Dependent Care FSA is $5,000 for individuals or married couples filing jointly or $2,500 for a married person filing separately. Also, the person whose daycare expenses you are claiming must satisfy the definition of a Tax Dependent, per IRA regulations. EAA FSA CONTRIBUTION NPOS HDHP October 1 $0.00 $500.00 pro-rated if you are a new hire. Please refer to the table on the right for the plan year amount. If you have funds remaining at the end of the plan year, a maximum of $550 will carry over to the next plan year while any funds in excess of $550 will be forfeited.

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