Page 43 - Public Citizen 2021-2022

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TERMINATION OF PARTICIPATION
Participants are enrolled in the plan for the entire Plan Year or the portion of the Plan Year remaining after enrollment.
You will automatically cease to be a Participant on the earliest of the following dates:
a. Your death, resignation or termination of employment with the Employer;
b. The date the plan terminates;
c. The date on which you fail to pay any required premium (including payment by salary reduction) under the plan;
d. The date you no longer meet the requirements for eligibility in the plan; or,
e. The date you revoke your election under a qualifying change in status event.

Benefit Account Coverage. When participation has terminated, you are eligible to incur Qualified Expenses against your
positive account balance* through the date your eligibility ends for your benefit account, as indicated in the chart below.
*Positive account balance: Coverage is limited for a Healthcare FSA (or LPFSA) once your Paid Coverage Period ends (as
indicated below), to the greater of (a) the amount you paid for coverage (year-to-date contributions) less prior
reimbursements or (b) your total reimbursements. If Carryover is offered by your Employer, funds that carried forward
into your current Healthcare FSA (or LPFSA) will be included. The positive account balance for any other benefit in the
chart below is your total contributions less prior reimbursements.

Benefit Account Paid Coverage Period Ends Plan Eligibility Ends

Healthcare FSA Date of Termination End of Month Paid Coverage Ends

Dependent Care FSA Date of Termination End of Month Paid Coverage Ends
Requests for Reimbursement (RFR). When your participation has terminated, you may submit eligible requests for
reimbursement (RFR) through your runout period as noted in the Request for Reimbursement (RFR) Procedure section of
this document.
Grace Period or Carryover. As a terminated Participant, you are not eligible for the Grace Period or Carryover (when
offered by your Employer) unless you are an active Participant in the plan and your Paid Coverage Period continues
through the last day of the Plan Year.

REQUEST FOR REIMBURSEMENT (RFR) PROCEDURE
Unless otherwise noted in this section, if you have elected reimbursement coverage, you may submit eligible requests for
reimbursement (RFR) through the Plan Runout End Date which ends on: 4/30/2021
If your coverage has terminated and you have elected reimbursement coverage you may submit eligible requests for
reimbursement (RFR) through your runout period of 90 days after your plan eligibility ends as noted under the
Termination of Participation section above.

All other RFR procedures for the plan are provided in a separate administrative document upon the original enrollment in
the plan. An additional copy may be provided without charge upon request.

TASC I 2302 International Lane I Madison, WI 53704-3140 I 1.800-422-4661 I www.tasconline.com I FX-5297a-061819
The information contained in this communication is confidential and to be used by TASC employees and representatives for only its intended purpose.
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