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The $5,000 maximum limit is a household limit if you are married filing a joint federal income tax
return. Therefore, if both you and your spouse participate in a dependent care assistance plan
(through the Company or through another employer), your combined maximum tax-free benefit is
$5,000 in a calendar year.
By making an election to contribute to a Dependent Care Assistance Account, you are representing
to the Company that your contributions to the account are not expected to exceed the applicable
tax-free reimbursement limit.
To qualify for tax-free treatment, you are required to list on your federal income tax return the
names and taxpayer identification numbers of any person who provided you with dependent care
services during the calendar year for which you have claimed a tax-free reimbursement. The
identification number of a care provider who is an individual and not a care center is that
individual’s social security number. Your care provider should be made aware of this reporting
requirement. You generally must file a Form 2441 with your federal income tax return (Form
1040) to determine whether any part of your Dependent Care Assistance Account is taxable. Please
note that participation in the Plan may prevent you from taking a tax credit for the same expenses.
In addition, you should know that if you use a dependent care provider inside your home you may
be considered the employer of that individual and may be responsible for withholding and paying
employment taxes. For more information, refer to IRS Publication 926, “Employment Taxes for
Household Employees.” You should consult with your professional tax/financial advisor to
determine the consequences of your participation in this Plan.
Coordination with Other Plans
All claims for benefits that are covered by an insurance policy must be made to the insurance
company issuing such insurance policy.
Limits on Certain Employees
If you are a highly paid employee or an owner of the Company, federal law may impose limits on
your eligibility to participate in the Plan and/or the benefits you may receive from the Plan.
FORFEITURES
Except as provided below, any amounts remaining in your account at the end of the Plan Year will
be forfeited after all claims are paid.
Health Care Reimbursement Account Carryover
Except as provided below, any balance remaining in your Health Care Reimbursement Account at
the end of any Plan Year (beginning with the 2020 Plan Year) up to $550 will be carried forward
and used to fund such benefits in any subsequent Plan Year. This carryover amount will not affect
your ability to contribute the maximum amount ($2,750 for 2020 and 2021) in the subsequent Plan
Year.
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