Local 29 HRA Plan In conjunction with Trust Plan 6B

1. Local 29 HRA PlanIn conjunction with Trust Plan 6B

2. What is a Health Reimbursement Arrangement (HRA)? • An employer funded account created with tax free dollars, to pay for out-of-pocket health care expenses (defined by IRS code 213(d)) • You receive tax free reimbursement for qualified expenses • THIS IS YOUR MONEY THAT YOU CONTROL AND MANAGE! • You are able to use this money now, or save it for retirement

3. How do I participate? • Plan is in conjunction with enrollment in Trust Plan 6B. The City will make all contributions to the HRA • Once you satisfy the eligibility requirements set forth by the City, your account will be established with the first contribution we receive • When an eligible expense is incurred, you can either use your debit card, submit a paper claim for tax free reimbursement or pay for the expense out of pocket to preserve your HRA funds • Expenses incurred prior to Jan. 1, 2010 will not be covered

4. Enrollment into the HRA Account • You must be a participant of Trust Plan 6B • The account is employer funded only • You have complete control over the funds • You can use the funds now to pay for out of pocket medical expense or save it for retirement • Employees are automatically enrolled once we receive the first contribution

5. Contributions into YOUR HRA • $1,875 per individual • $3,775 per family • If you are not employed January 1, you will be given a pro-rated amount

6. How the HRA Account works City of Spokane Credits you HRA Account January 1 Incur Expenses January 1 through December 31 Grace Period to submit claim forms 90 days after end of Plan Year May 31 HRA Account Balance Rolled over to your VEBA Account

7. Order of Payment • Medical Plan • Flexible Spending Account (FSA)* • Health Reimbursement Arrangement (HRA) • VEBA *If applicable

8. How do I get a debit card? • Must get a new card annually after January 1 of the new plan year • Go to www.myflexonline.com • New user (set up account with username and password) • Returning users must sign in • Debit Card tab • Automatically routed here if new user • Follow steps to order card • max 2 cards first day • After only 1 card per day after • For dependant kids in college etc. • Card will arrive in about 10 days

9. How am I reimbursed? • Use Debit Card • No initial out-of-pocket expense • Roughly 80% of all claims require no further substantiation • Keep all receipts in case paper substantiation is required • DO NOT PAY FOR THE ENTIRE EXPENSE!!! Submit through Medical Trust first!! -OR- • Submit paper claim to Rehn&Associates • Must total and sign claim form • Must provide proper substantiation for approval of claim • Reimbursement made daily • Direct Deposit • Check

10. Proper Substantiation to submit with a claim form • Submit any one of the following • Explanation of Benefits (EOB) • Provider bill • Cash register receipt • Pharmacy tag • Itemized bill or receipt

11. Not Accepted for Substantiation • Cancelled check or a copy of a check • Credit/debit card statement • Balance forward statement from provider

12. Rollover into current VEBA Account • Remaining HRA balance at the end of each plan year are automatically rolled over into your VEBA Account (after all claims have been paid) • Your VEBA Account will be credited with the remaining HRA balance around May 15th of the following year • VEBA Account available for use whenever you desire (intended for use in retirement)

13. Separation from employment • Applies only to rollover of account balance • Must be employed at the City of Spokane at the end of the Plan Year (December 31) to have balance rolled over into VEBA Account • If you leave at any time during the year, you forfeit the remaining balance in your HRA Account • You still have access to funds currently in VEBA

14. Eligible Expenses (List not all inclusive) • Deductibles • Co-pays • Co-Insurance • Office visits (after 1st four have been used) • Prescriptions • Over the Counter items • Cough drops, Nicotine gum or patches to stop smoking, motion sickness pills, Bandaids, reading glasses, first aid kit and many more • Glasses, contact lenses and solutions • Laser Eye Surgery • Major dental including Crowns and Bridges • Orthodontia • All other section 213(d) expense

15. Ineligible Expenses(List not all inclusive) • Non-medical expenses or expenses that are not medically necessary • Cosmetic treatments • Vitamins, Minerals, Supplements • Items already reimbursed by a Flexible Spending Account (FSA)

16. Is my Spouse or Dependent(s) covered? • Yes! • Your Dependent(s) must qualify as a dependent as defined by the IRS • Must be able to claim as a dependent on your tax return • The expenses must qualify under the guidelines of IRS Section 213(d)

17. How do I submit a paper claim? • Send signed and totaled claim form to Rehn&Associates: • By E-Mail: flex@rehnonline.com • Must be able to scan signed claim form and substantiating material(s) • By Fax: (509) 535-7883 • By Mail: PO BOX 5433, Spokane, WA 99205 • Drop off in person: 1322 N. Post, Spokane, WA 99201

18. Web Site Information • www.ezflexplan.com/rehn • Sign up for debit card • Substantiate claim information • Download Claim forms • Claims history • Check account balance • Check recent transactions • Useful information

19. How often will I receive a statement of account activity? • Check account activity online ANYTIME • www.ezflexplan.com/rehn • Statements mailed 60 days prior to end of plan year • Can call and request statements at any time throughout the year • If you receive a reimbursement check in the mail, there is a “mini-statement” on the check stub

20. Main Points… Use the MEDICAL TRUST FIRST! Keep all EOBs and receipts This is your money! Unused balance will be rolled into current VEBA Account Recommended to only use your debit card for co-pays on the spot