Laserfiche WebLink
<br />dependent or $400 for two or more dependents). Also, in order to have the reimbursements made <br />to you from this account be excludable from your income, you must provide a statement from the <br />service provider including the name, address, and in most cases, the taxpayer identification <br />number of the service provider on your tax form for the year, as well as the amount of such <br />expense as proof that the expense has been incurred. In addition, Federal tax laws permit a tax <br />credit for certain dependent care expenses you may be paying for even if you are not a <br />Participant in this Plan. You may save more money if you take advantage of this tax credit rather <br />than using the Dependent Care Assistance Account under our Plan. Ask your tax adviser which is <br />better for you. <br /> <br />Premium Expense Account: <br /> <br />A Premium Expense Account allows you to use tax-free dollars to pay for certain <br />premium expenses under various insurance programs that we offer you. These premium expenses <br />include: <br /> <br />-- Health care premiums for your spouse and dependents under our self-funded medical <br />plan. <br /> <br />-- Dental insurance premiums for your spouse and dependents under our self-funded <br />dental plan. <br /> <br />Under our Plan, we will establish sub-accounts for you for each different type of coverage <br />that is available. Also, certain limits on the amount of coverage may apply. <br /> <br />The Administrator may terminate or modify Plan benefits at any time, subject to the <br />provisions of any contracts providing benefits described above. Also, your coverage will end <br />when you leave employment, are no longer eligible under the terms of any coverage, or when <br />coverage terminates. <br /> <br />Any benefits to be provided by insurance will be provided only after (1) you have <br />provided the Administrator the necessary information to apply for insurance, and (2) the <br />insurance is in effect for you. <br /> <br />V <br />BENEFIT PAYMENTS <br /> <br />1. When Will I Receive Payments From My Accounts? <br /> <br />During the course of the Plan Year, you may submit requests for reimbursement of <br />expenses you have incurred. Expenses are considered "incurred" when the service is performed, <br />not necessarily when it is paid for. The Administrator will provide you with acceptable forms for <br />submitting these requests for reimbursement. If the request qualifies as a benefit or expense that <br />the Plan has agreed to pay, you will receive a reimbursement payment soon thereafter. <br /> <br />6 <br />