Page 16 - QSC Benefit Guide 7-18 SLO

FLEXIBLE SPENDING ACCOUNT (FSA)

With the WageWorks Flexible Spending Account (FSA), you can set aside money before taxes are deducted to pay for certain
health expenses, lowering your taxable income and increasing your take home pay. Only expenses for services incurred during
the plan year are eligible for reimbursement from your account. You choose how you want to receive reimbursement for
your eligible expenses. You may use a debit card provided by WageWorks, sign up for direct deposit to your bank account,
or you may have a check sent to your home. Please remember that if you are using your debit card, you must save your
receipts, just in case WageWorks needs a copy for verification. Also, all receipts should be itemized to reflect what product
or service was purchased. Credit card receipts are not sufficient per IRS guidelines.

Flexible Spending Account - Health Care
This plan is used to pay for expenses not covered under your Medical, Dental, and Vision plans, such as deductibles,
coinsurance, copays and expenses that exceed plan limits. You may defer a minimum of $200 up to $2,650 pre-tax per year.
Flexible Spending Account - Limited Purpose Health Care
This plan is used to pay for expenses not covered under your Dental and Vision plans, such as deductibles, coinsurance,
copays and expenses that exceed plan limits. You may defer a minimum of $200 up to $2,650 pre-tax per year. Please
note, only HSA PPO medical plan participants may enroll in the Limited Purpose FSA plan.

As a HSA PPO medical plan participant, you now have a NEW reimbursement option available to you. QSC will allow you
to use your Limited Purpose FSA funds for qualified medical expenses incurred after the statutory annual deductible set
by the IRS has been satisfied.
Flexible Spending Account - Dependent Care
This plan is used to pay for eligible expenses you incur for child care, or for the care of a disabled dependent, while you
work. You may defer up to $5,000 pre-tax per year.

The FSA offers sizable tax advantages. The trade-off is that these accounts are subject to strict IRS regulations, including
the use-it-or-lose-it rule. According to this rule, up to $500 of any unspent funds remaining in your account at the end of
the plan year will carry-over to the next plan year, and unspent funds above $500 will be forfeited. We encourage you to
plan ahead to make the most of your FSA dollars. If you are unable to estimate your health care expenses accurately, it is
better to be conservative and underestimate rather than overestimate your expenses.

You must re-enroll in the FSA each year as your elections will not carry over from year to year.

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