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<br />medical, dental and/or vision expenses incurred by you and your dependents. In addition, you <br />may claim reimbursement for your drug costs, including "over-the-counter" drugs. You may not, <br />however, be reimbursed for the cost of other health care coverage maintained outside of the <br />Plan, or for long-term care expenses. A list of covered expenses is available from the <br />Administrator. <br /> <br />The most that you can contribute to your Health Flexible Spending Account each Plan <br />Year is $2,000. In order to be reimbursed for a health care expense, you must submit to the <br />Administrator an itemized bill from the service provider. We will also provide you with a debit or <br />credit card to use to pay for medical expenses, such as co-pays, deductibles, medical <br />equipment and drug costs. The Administrator will provide you with further details. Amounts <br />reimbursed from the Plan may not be claimed as a deduction on your personal income tax <br />return. Reimbursement from the fund shall be paid at least once a month. <br /> <br />Newborns' and Mothers' Health Protection Act: Group health plans generally may not, <br />under Federal law, restrict benefits for any hospital length of stay in connection with childbirth <br />for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than <br />96 hours following a cesarean section. However, Federal law generally does not prohibit the <br />mother's or newborn's attending provider, after consulting with the mother, from discharging the <br />mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and <br />issuers may not, under Federal law, require that a provider obtain authorization from the plan or <br />the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). <br /> <br />Dependent Care Flexible Spending Account: <br /> <br />The Dependent Care Flexible Spending Account enables you to pay for out-of-pocket, <br />work-related dependent day-care cost with pre-tax dollars. If you are married, you can use the <br />account if you and your spouse both work or, in some situations, if your spouse goes to school <br />full-time. Single employees can also use the account. <br /> <br />An eligible dependent is someone for whom you can claim expenses on Federal Income <br />Tax Form 2441 "Credit for Child and Dependent Care Expenses." Children must be under age <br />13. Other dependents must be physically or mentally unable to care for themselves. Dependent <br />Care arrangements which qualify include: <br /> <br />(a) A Dependent (Day) Care Center, provided that if care is provided by the facility <br />for more than six individuals, the facility complies with applicable state and local laws: <br /> <br />(b) An Educational Institution for pre-school children. For older children, only <br />expenses for non-school care are eligible; and <br /> <br />(c) An "Individual" who provides care inside or outside your home: The "Individual" <br />may not be a child of yours under age 19 or anyone you claim as a dependent for <br />Federal tax purposes. <br /> <br />You should make sure that the dependent care expenses you are currently paying for <br />qualify under our Plan. The law places limits on the amount of money that can be paid to you in <br />a calendar year from your Dependent Care Flexible Spending Account. Generally, your <br />reimbursements may not exceed the lesser of: (a) $5,000 (if you are married filing a joint return <br />or you are head of a household) or $2,500 (if you are married filing separate returns); (b) your <br />taxable compensation; (c) your spouse's actual or deemed earned income (a spouse who is a <br />full time student or incapable of caring for himself/herself has a monthly earned income of $250 <br />for one dependent or $500 for two or more dependents). Also, in order to have the <br />reimbursements made to you from this account be excludable from your income, you must <br /> <br />5 <br />