SECTION 125 CAFETERIA PLANS

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1 SECTION 125 CAFETERIA PLANS Medical Spending Account Dependent Care Spending Account Without Flex Plan With Flex Plan Gross Earnings $2,000 Gross Earnings $2,000 FICA, Federal, State Taxes - $500 Premiums / OOP Expenses - $400 Subtotal $1,500 Adjusted Gross Earnings $1,600 Premiums / OOP Expenses - $400 FICA, Federal, State Taxes - $400 NET EARNINGS $1,100 NET EARNINGS $1,200 Caprock HealthPlans/Verity P.O. Box San Antonio, TX Phone (210) or (800)

2 Section 125 Cafeteria Plans Cardholder Information Overview Initiated by the Internal Revenue Service (IRS) in the mid-80s, a cafeteria plan is simply a program that employers can offer to their employees to pay for certain health-related expenses and dependent care with pre-tax dollars. These plans are one of the most popular benefits around, for good reason. Buying benefits with pre-tax dollars gives you more take-home pay. You also get to pay for only those benefits they really want... like ordering lunch a la carte instead of being stuck with the blue plate special... hence the name cafeteria. Payroll Deductions Once you complete and sign an Enrollment Form indicating how much you d like to contribute to your Flexible Spending Account from each paycheck, company enters your election into the payroll system, along with your health insurance premium, and other benefit deductions on a pre-tax basis. The result is that income tax withholding and FICA withholding will be based on each of your reduced wages, ultimately giving you more take home pay and reducing your tax burden. Accessing Your Dollars We provide you with instant access to your account balance via internet access. This allows you to monitor your account balance and transaction history, or print a statement at any time, night or day using a secure web page: The account is restricted to, use for eligible services and/or purchases associated with your FSA, as governed by the Internal Revenue Service. When you have a service, purchase glasses/contacts, or purchase a prescription, you ll need to pay out-of-pocket and submit a completed claim form with your receipt(s) to Caprock HealthPlans/Verity for immediate reimbursement by check or direct deposit (if your employer has this feature set up). Eligible and Ineligible Expenses Please note that certain plan restrictions may apply and what might normally be considered an eligible expense may not be allowed by your employer s plan. You can refer to your company s Plan Document (also available at the website) or call Caprock HealthPlans/Verity for any questions regarding eligible expenses. Annual Elections The Annual Election is the total dollar amount you have elected to deduct from your payroll over the course of the Plan Year. These dollars are loaded in the FSA account at the beginning of the Plan Year and are available from the first day of the Plan Year. Be sure to choose your annual benefit election(s) carefully, as they cannot be changed during the Plan Year unless you have a qualified status change. Qualified status changes include:

3 Marriage or divorce Birth or adoption Death of employee or dependent Employment status change for employee or spouse Benefit eligibility change for employee, spouse or dependent In the case of both the Medical Spending Account and the Dependent Care Spending Account, all dollars must be used during the Plan Year. Your Plan may allow a 2 month and 15 day Grace Period for additional time to use expenses (a total of 14 ½ months) or a $500 rollover amount for the Medical Spending account (please consult the Plan Document for clarification(. In addition, there is a 60-day or 90-day (please consult the Plan Document for clarification) run out following the conclusion of the Plan Year during which an employee can submit, but not incur, expenses from the previous Plan Year. Dollars that have not been used at the end of the filing deadline are lost or forfeited. Dependent Care Spending Account If your employer has this additional account set up. The Dependent Care Spending Account is a dependent care assistance program that is also part of the FSA program. An employee can use the Dependent Care Spending Account to be reimbursed for expenses that allow the employee and his or her spouse to be gainfully employed. Typically those are expenses that are incurred to have a baby-sitter or day-care provider take care of an employee s child (under the age of 13) while Mom and Dad are working, or to take care of a spouse, or parent, or other tax dependent that lives with you and is incapable of self-care. Dependent care coverage is limited by the IRS to an annual contribution of up to $5,000 per family. Employees pay for the dependent care coverage with pre-tax salary reduction dollars, however, unlike the Medical FSA, which allows the annual election amount to be loaded on the card from the first day of the Plan Year, the dependent care dollars are only available as the payroll contributions are received by the Plan Administrator. You may send Caprock HealthPlans/Verity a single monthly invoice from the day care provider and Caprock HealthPlans/Verity will automatically reimburses you when the payroll dollars are deposited. These reimbursements can also be automatically deposited into your bank account.

4 Frequently Asked Questions About Flexible Spending Accounts (FSAs) What is a Flexible Spending Account (FSA) and how does it work? A Flexible Spending Account allows you to set aside pre-tax dollars from your paycheck to cover eligible healthcare expenses. Your employer may call an FSA by any number of other names, such as a reimbursement account, Section 125 or Cafeteria Plan. What is a pre-tax contribution? Contributions also referred to as elections to an FSA are made on a pre-tax basis. This means your contributions are taken from your paycheck before Federal, Social Security (FICA) and most state and local taxes are withheld. Each pretax dollar you contribute to an FSA lowers your current taxable income, so you end up reducing the current Federal income tax that you pay. In most cases, you'll also pay lower state and local taxes. Do I need to enroll to participate in an FSA? Yes, you must enroll if you want to participate in an FSA. To continue participating after your initial enrollment, you must re-enroll each year during Open Enrollment. Your contributions (the dollar amount you deduct from your paycheck to put in your FSA) do not automatically continue from one year to the next. How do I contribute to an FSA? You fund your FSA with pre-tax dollars deducted from your paycheck in equal installments throughout the year. Your plan document will define both minimum (if applicable) and maximum contribution amounts as set by IRS guidelines. When may I change my FSA? You may change your FSA contributions each year during Open Enrollment. Your plan may also allow you to change your contribution amount during the year if your situation changes due to a "qualifying life event" such as marriage, death, birth, adoption and divorce. What happens to contributions left in my FSA at the end of the plan year because I didn't file claims against them? Because of the favorable tax treatment provided by the FSA, government regulations require that the money you contribute to your FSA only be used for eligible expenses incurred during that Plan Year and during the 2 month & 15 day grace period, if your employer allows. You may, however, submit claims incurred during the prior Plan Year up to 60 days (or 90 days, if your Plan allows) following the end of the Plan Year. Any money left in your account after the claims filing deadline is forfeited. You cannot use one Plan Year's contributions for the next Plan Year's expenses. My Employer offers both a Medical FSA and a Dependent Care FSA and I participate in both. Can I shift my money between my FSA accounts? Yes; you may participate in both accounts, however, IRS regulations require the accounts to operate separately. You cannot use funds from one for expenses from the other. How do I estimate my contributions? Use the worksheets attached along with a list of eligible expenses to estimate the right contribution amount for your family. To estimate future expenses, first review similar expenses you've had over the last couple of years. Also consider any changes to your healthcare needs that you expect may occur during the year. It's important to carefully estimate your expenses before you decide how much you want to contribute to the FSA each year. The first time you participate in an FSA, try to be conservative in your estimate since your forfeit (lose) any balance that isn't used by the claims filing deadline. On the other hand, if your expenses dramatically exceed the amount you contribute to the FSA, you miss out on some tax savings.

5 MEDICAL REIMBURSEMENT ACCOUNT QUALIFYING EXPENSE WORKSHEET To gain maximum benefit from your flexible spending account(s), you should accurately budget your unreimbursed medical expenses. Only expenses that you know you will incur during the Plan Year should be included in this program. This worksheet is a guide to assist you with common items, but does not include all types of expenses that may be eligible. IRS sets a maximum allowable amount of $2,500 per calendar year. QUALIFYING EXPENSE ESTIMATED ANNUAL EXPENSE YOU SPOUSE DEPENDENT(S) Medical Expenses: Medical Doctor s Fees/Co-Payments $ $ $ Annual Physical Examinations $ $ $ Prescription Drugs $ $ $ X-rays and Lab Fees $ $ $ Hospital Services $ $ $ Chiropractors and Acupuncturists $ $ $ Surgery $ $ $ Ambulance Service $ $ $ Psychiatrists or Psychologists $ $ $ Visions Expenses: Eye Exams $ $ $ Glasses, Contact Lenses, Solutions $ $ $ Lasik Eye Surgery $ $ $ Dental Expenses: Deductible/Co-pay $ $ $ Teeth Cleaning, X-rays, Fillings $ $ $ Crowns, Root Canals $ $ $ Braces $ $ $ Dentures, Bridges $ $ $ Hearing Expenses: Exams, Hearing Aids $ $ $ Other Eligible Expenses: $ $ $ TOTAL ANNUAL MEDICALLY RELATED EXPENSES PAY PERIOD ELECTION (Divide total annual expenses by number of pay periods per year) $ $

6 DEPENDENT CARE REIMBURSEMENT ACCOUNT QUALIFYING EXPENSE WORKSHEET To gain maximum benefit from your flexible spending account(s), you should accurately budget your dependent care expenses. Only expenses that you know you will incur during the Plan Year should be included in this program. IRS sets a maximum allowable amount of $5,000 per household per calendar year. QUALIFYING EXPENSE Amounts paid to a dependent care center (i.e. child day care) Amounts paid for a dependent care center services outside your home Amounts paid for dependent care services inside your home TOTAL ANNUAL DEPENDENT CARE EXPENSES: (Divide annual expense total by number of pay periods per year) ESTIMATED ANNUAL EXPENSE $ $ $ $ The total reimbursement you receive from your account in any calendar year may NOT exceed the LEAST of the following limits: 1. $5, (if you are the Head of Household or married and file a joint return), or $2, (if you are married and file separate returns.) 2. Your taxable compensation (after all compensation reduction arrangements). 3. If you are married, your spouse s actual or deemed EARNED income. Please Note: Your spouse will be deemed to have earned income of $ ($ if you have two or more dependents), for each month in which your spouse is physically or mentally incapable of caring for him/herself, or a full-time student at an educational institution. A Federal Tax ID Number is required for Dependent Care providers.

7 Logging-On to Your Star Card Account To begin, please visit: Click on Participant Login If this is your first time visiting the Participant Portal you will need to create your account. In the box to Login to your secure account on the bottom right corner please click on Create Account The next screen will pop up for you to create a new user account. Enter your First Name, Last Name & your Employee ID (this will be your Social Security #). Next box you will need to enter either your employer ID or if you have a Star Card the number on your card for the field labeled Card Number no spaces/no dashes. Create your New User ID using the following criteria: Between 7-10 characters Create your Password Between 8-10 characters, letter and numbers only Contain one instance of at least three of four types of characters: upper case, lower case, special character, and number Cannot contain same character repeating 3 or more times, ex. AAA Cannot contain the word password Cannot be the same as username Cannot contain spaces If you require assistance please call our dedicated Customer Service at