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2 <br /> <br />B. Company Elections and Plan Provisions <br /> <br /> <br />I. Extended Grace Period: The Plan adopts the Extended Grace Period for the Plan Years <br />with the conditions indicated below: (Note: Allowing an Extended Grace Period under a <br />general purpose Medical FSA will adversely impact HSA eligibility): <br /> <br />1. [ X ] For the Medical FSA for: <br />a. [ X ] 2020 Plan Year extending into 2021 <br />i. [ X ] Extending 12 months <br />ii. [ ] Extending other: (Specify: e.g. 2 ½ months, custom not to <br />exceed 12 months ) ____________ <br />b. [ X ] 2021 Plan Year extending into 2022 <br />i. [ X ] Extending 12 months, <br />ii. [ ] Extending other: (Specify: e.g. 2 ½ months, custom not to <br />exceed 12 months ) ____________ <br />2. [ X ] For the Dependent Care FSA for: <br />a. [ X ] 2020 Plan Year extending into 2021 <br />i. [ X ] Extending 12 months <br />ii. [ ] Extending other: (Specify: e.g. 2 ½ months, custom not to <br />exceed 12 months ) ____________ <br />b. [ X ] 2021 Plan Year extending into 2022 <br />i. [ X ] Extending 12 months <br />ii. [ ] Extending other: (Specify: e.g. 2 ½ months, custom not to <br />exceed 12 months ) <br /> <br />Plan Provision: Extended Grace Period (CAA Section 214(c)(1)): The Company <br />elects to apply an Extended Grace Period for the Medical FSA and/or the Dependent <br />Care FSA for Plan Years ending within 2020 and/or 2021, as applicable. Except as <br />otherwise limited or provided in Election 2, the Extended Grace Period will permit a <br />Participant to apply any unused amounts remaining in a Medical FSA or Dependent <br />Care FSA at the end of the applicable Plan Year to reimburse expenses incurred for the <br />same qualified benefit (medical care or dependent care) up to 12 months after the end <br />of the Plan Year. Unless such Medical FSA is an HSA-Compatible Medical FSA, a <br />Participant will not be permitted to contribute to an HSA during the Extended Grace <br />Period. <br /> <br /> <br />II. Extension of the Claims Submission Period for the Medical FSA <br />For the 2019 and 2020 Plan Years the Claims Submission Period (also known as the <br />runout period) for the Medical FSA shall each be extended one year. If as of the end of <br />the 2021 Plan Year the “Outbreak Period” as defined in the Joint Notice has not ended, <br />the Claims Submission Period for the 2021 Plan Year shall also be extended one year. <br /> <br /> <br />23