APPENDIX A Qualifying Health Care Expenses Under the Plan, you will be reimbursed only for those types of medical expenses normally deductible on your federal income tax return (without regard to the 7.5% of adjusted gross income limitation). They include, for example, expenses you have incurred for: (i) Medicine, drugs, birth control pills, vaccines, and vitamins you are prescribed by your physician. (ii) Over the counter drugs deemed qualifying by the Internal Revenue Service under Code §213 (e.g., antacids, cold medicine, pain relievers and allergy medicine). (iii) Personal protective equipment ("PPE"), such as masks, hand sanitizer and sanitizing wipes, for the primary purpose of preventing the spread of the Coronavirus Disease 2019 (COVID-19 PPE). (iv) Menstrual care products. (v) Medical doctors, dentists, eye doctors, chiropractors, osteopaths, podiatrists, psychiatrists, psychologists, physical therapists, acupuncturists and psychoanalysts (medical care only). (vi) Medical examination, X-ray and laboratory service, insulin treatment, and whirlpool baths the doctor ordered. (vii) Nursing help. If you pay someone to do both nursing and housework, you can be reimbursed only for the cost of the nursing help. (viii) Hospital care (including meals and lodging), clinic costs, lab fees. (ix) Medical treatment at a center for drug addicts or alcoholics. (x) Medical aids such as hearing aids (and batteries), false teeth, eyeglasses, contact lenses, braces, orthopedic shoes, crutches, wheelchairs, guide dogs and the cost of maintaining them. (xi) Ambulance service and other travel costs to get medical care. If you use your own car, you can claim what you spend for gas and oil to go to and from the place you received the care; or you can claim the per-mile reimbursement rate established by the Internal Revenue Service as in effect at the time the travel costs are incurred. Add parking and tolls to the amount you claim under either method. You cannot obtain reimbursement for: (i) Expenses for which reimbursements are already available under another group health plan. (ii) Premiums paid for health coverage under any plan maintained by your Employer or any other employer. (iii) The basic cost of Medicare insurance (Medicare A). (iv) Life insurance or income protection policies. (v) The hospital insurance benefits tax withheld from your pay as part of the social security tax or paid as part of social security self-employment tax. (vi) Maternity clothes. (vii) Diaper service. (viii) Nursing care for a healthy baby. (ix) Illegal operations or drugs. (x) Travel your doctor told you to take for rest or change. (xi) Funeral expenses. Qualifying medical expenses include only those expenses incurred for: (i) Yourself. Page 22