3.7 May I Make New Elections In Future Plan Years? Yes, you may. If you want to participate in the Health Care Flexible Spending Account Program and/or the Dependent Care Assistance Account Program for an upcoming Plan Year, you must complete a new enrollment form/salary reduction agreement in order to participate for that Plan Year, regardless of whether or not you are making changes in your elections. Further, each year you will have the opportunity to renew your elections to participate in the Plan with respect to the pre-tax premiums for the underlying health and welfare benefits in the Plan that you choose for the next Plan Year. IV. BENEFITS 4.1 What Benefits Are Available Under The Plan? Under the Plan, you may choose to receive your entire compensation in cash or use a portion to pay for any of the nontaxable benefits available under the Plan. The nontaxable benefits under the Plan include: (i) Pre-tax premium contributions provided under the Plan Sponsor's health and welfare plans available under this Plan, as designated and announced by the Plan Sponsor from time to time; (ii) The Plan Sponsor's Health Care Flexible Spending Account program, the details of which are described below; (iii) The Plan Sponsor's Dependent Care Assistance Account program, the details of which are described below; In the case of insured benefits, certain limits may apply on the amount of coverage that we obtain on your behalf. For example, it is possible, though unlikely, that even if you are a participant in the Plan, you might fail to qualify for coverage under the insured benefits offered under the Plan. Here, it is the insurance contracts, and not the terms of the Plan, which will dictate. The Plan Sponsor may terminate or modify Plan benefits at any time, subject to the provisions of any insurance contracts. We will not be liable to you if an insurance company fails to provide any of the benefits described above, even if the failure to provide benefits is due to our gross negligence (for example, if we fail to enroll you or pay premiums). In the case of health benefits, you may have a right by law to continue your benefits that would otherwise terminate when (i) you leave employment, (ii) you are no longer eligible under the terms of any group health plan or insurance policy, or (iii) when insurance coverage terminates. Any benefits to be provided by insurance will be provided only after you have furnished the Plan Administrator with the necessary enrollment forms. V. HEALTH CARE FLEXIBLE SPENDING ACCOUNT PROGRAM 5.1 What Is A Health Care Flexible Spending Account? The Health Care Flexible Spending Account (HFSA), is intended to pay for health care expenses not covered by your group health plans and/or deductibles and other out-of-pocket expenses associated with your group health plans. The HFSA is a tax savings vehicle which enables you to take money pre-tax from your salary to pay for certain unreimbursed medical expenses. Then, as you incur eligible expenses, you are reimbursed from your account. The maximum amount you can elect to contribute to your HFSA is limited to the statutory amount under Section 125(i)(2) of the Code in effect on January 1st of the same calendar year in which the Plan Year begins, as indexed for cost of living increases for any Plan Year beginning with or within such calendar year, which has been communicated to you by the Plan Sponsor separately. The maximum amount is available to you as of the first day of the Plan Year. These limits will be reviewed annually and adjusted as experience indicates. The minimum amount you can elect to contribute your Health Care FSA is for the Plan Year is $120. 5.2 What Health Care Expenses Can Be Reimbursed? Only "qualifying health care expenses" can be reimbursed. To be eligible an expense must: Page 8
Summary Plan Description for Achieva Section 125 and FSA Plan Page 7 Page 9