Page 18 - 2015 Enrollment Guide

2015 Employee

Beneits Program

Ineligible Healthcare Expenses
X Over-the-counter medications not medically necessary

X Cosmetic expenses

X Massage therapy

X Health club dues and weight loss programs
X Insurance premium

Dependent Care Flexible Spending Account

You may set aside an annual maximum of $5,000 (IRS allows a
maximum of $5,000 per household) in the Dependent Care Account
to pay for certain child/day care, or elder care expenses incurred during
the plan year. Your dependent care expenses must be necessary in order
for you and your spouse to work or actively look for work, or attend
school as full-time student.

Eligible Dependent Care Expenses

X Child care provided at a day care center or through a private
provider

X Nanny services in the home associated with the care of a
dependent
X Day camps associated with the care of a dependent

X Pre-school tuition that is day care related (price of tuition alone is
not eligible)

X Annual registration fees for day care providers
X After-hours care that results from working odd hours or overtime

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