2015-363-E HR - Flores & Associates, LLC - Medical Reimbursement and Dependent Care Assistance Claim Administration Agreement

Browse Search

DocuSign Envelope ID: EA6C45CD-7691-43D8-B939-A4300A7DD233 SerVtes IIIIG° l Section 125 Flexible Spending Account Administration The Flores &Associates Section 125 Flexible Spending Account Administration service offers you and your employees a way to save money on out-of-pocket medical expenses and dependent care expenses. Flores will provide a turnkey installation of this service, handling all employee introductions, enrollment and tracking of accounts. This monthly service is offered to ORANGE COUNTY on a highly cost effective basis. Employee Introduction Flores will provide your employees an online webinar if requested on the Section 125 Flexible Spending Account Plan to include all applicable components. Your employees will receive detailed information about how each account works and we will walk them through the enrollment information step by step. They will be encouraged to ask specific questions to ensure all participants understand how the plan can benefit them. Account Set-up/Discrimination Testing Flores will gather the necessary data from your company and completely set up your account. We will also perform all discrimination testing to ensure your plan is in compliance with IRS regulations and regular testing after additions/deletions have been made to the plan. Monthly Account Administration and Compliance Reporting Flores will provide the employer with all necessary forms including payroll notification forms, reimbursement forms, and status change forms. The employer will be responsible for making these forms available to their employees and notifying their payroll department or their outside payroll service of the necessary deductions. The company will send Flores an electronic direct debit for the aggregate medical spending and dependent care withholdings each pay period along with a complete payroll deduction file on a pre- determined basis (see Implementation Procedures & Pay Period Updates section). Flores will deposit these funds into a flex reimbursement account (First Citizens Bank &Trust, Charlotte, Account#0131375875) and then reimburse any employee claims on a pre-determined schedule (on-demand basis for Dependent Care and daily, weekly or biweekly for Medical Spending). All employee reimbursement checks will be mailed to the employee's home or will be deposited via direct deposit into the employee's checking or savings account and will be accompanied by an updated balance of their account. ORANGE COUNTY 4 Flores