Benefit Guide - People

HEALTH SAVINGS ACCOUNT INFORMATION

HOW CAN YOU BENEFIT FROM TAX SAVINGS? An HSA provides triple tax savings. Here ’ s how: • Contributions to your HSA can be made with pre - tax dollars and any after - tax contributions that you make to your HSA are tax deductible • HSA funds earn interest and investment earnings are tax free • When used for IRS - qualified medical expenses, distributions are free from tax IRS - QUALIFIED MEDICAL EXPENSES You can use your HSA to pay for a wide range of IRS - qualified medical expenses for yourself, your spouse, or tax dependents. An IRS - qualified medical expense is defined as an expense that pays for healthcare services, equipment, or medications. Funds used to pay for IRS - qualified medical expenses are always tax - free. HSA funds can be used to reimburse yourself for past medical expenses if the expense was incurred after your HSA was established. While you d not need to submit any receipts to BRI, you must save your bills and receipts for tax purposes. Example of IRS - Qualified Medical Expenses

• Acupuncture • Alcoholism treatment • Ambulance

• Disabled dependent care expenses • Drug addiction treatment • Eye exam and glasses • Eye surgery • Fertility enhancement (in vitro fertilization or surgery) • Guide dog or other service animal • Gynecologist • Health institute fees (if treatment is prescribed by a physician) • Hearing aids and batteries • Certain health insurance premiums (not premiums for employer sponsored plans, but certain other medical premiums) • Intellectually or developmentally disabled care, treatment or special home • Laboratory fees • Lactation expenses • Lead - based paint removal (if a child in the home has lead poisoning) • Learning disability care or treatment • Legal fees associated with medical treatment

• Lifetime care, advance payments or "founder's fee ” • Lodging at a hospital or similar institution • Long - term care • Medical conference expenses, if it concerns a chronic illness of yourself, spouse or dependent

• Special education • Sterilization • Stop - smoking programs • Surgery • Special education tutoring • Special telephone for hearing or visual impaired individuals • Television for hearing or visual impaired individuals • Therapy received as medical treatment • Transplants • Transportation for medical care • Tuition for special education • Vaccines • Vasectomy • Vision correction surgery • Weight - loss program if it is a treatment for a specific disease • Wheelchair • Wig • X - ray

• Annual physical examination • Artificial limb or prosthesis • Artificial teeth • Bandages • Birth control pills (by prescription) • Body scan • Braille books and magazines • Breast pumps and supplies • Breast reconstruction surgery • Capital expenses (improvements or special equipment installed in a home for a disabled condition) • Car modifications or special equipment installed for a person with a disability • Chiropractic visits • Christian Science treatment • Contact lenses • Crutches • Dental treatment (not including teeth whitening) • Diagnostic devices

• Medical information plan • Medications, if prescribed • Nursing home fees • Nursing services

• Obstetrician • Operations

• Osteopathic care • Optometrist visits • Oxygen • Physical examination • Podiatrist • Pregnancy test kit • Prosthesis • Psychiatric care • Psychoanalysis • Psychologist visits

For additional plan information, please refer to your detailed plan design. In the event of a discrepancy, the carrier Plan Document shall prevail.

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