Page 12 - Hitachi Benefit Guide 1.31.2019

Flexible Spending Accounts (FSA)

You can set aside money in Flexible Spending Accounts (FSAs) before taxes are deducted to pay for certain health and dependent
care 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 accounts. You choose how you would like to pay for your eligible FSA
expenses. You may use a debit card provided by Igoe or pay in full and file a claim for reimbursement.

Please remember these plans are regulated by the Internal Revenue Service (IRS) and it is good practice to save your receipts. At
times, Igoe may require substantiation of your claims. Igoe has a secured member site that allows you to save all your receipts in
their receipt storage.

CLICK HERE for a complete list of eligible health care expenses.

Igoe | Health Care Flexible Spending Account (HCFSA)
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 up to $2,700 pre‐tax per year.

FSAs offer 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 (minimum $50) of any unspent funds remaining in your health care account at the
end of the plan year will carry-over to the next plan year, and unspent funds above $500 will be forfeited. This $500 rollover
benefit applies to the Healthcare spending account only.

Note: In order to have access to the $500 rollover from the previous year, you must re-enroll in the FSA plan for the following
year.

Igoe | Dependent Care Flexible Spending Account (DCFSA)
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 (or $2,500 if you are married but file taxes separately). FSAs offer sizable tax advantages.
The trade‐off is that these accounts are subject to strict IRS regulations, including the use‐it‐or‐lose‐it rule. If you do not use your
funds within the plan year, they 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 and
dependent care expenses accurately, it is better to be conservative and underestimate rather than overestimate your expenses.

Accessing Your FSA Account
Create an online account at www.goigoe.com. You can view transaction status’, upload receipts, and much more. The site
is secure and fully encrypted for your protection.

Note: Your FSA elections will expire each year on December 31st. If you plan to participate in the FSA for the upcoming plan year,
you are required to re-enroll. There are very strict guidelines as dictated by the plan documents and the IRS. As a participant, you
are responsible for reviewing your balances and submitting your receipts in a timely fashion. Please be sure to request
reimbursement or use all your money by the deadlines, otherwise your money will be forfeited.

12 Hitachi Solutions America Employee Benefits Guide | 2019