Health Care Flexible Spending Account

Leidos offers the following Health Care Flexible Spending Accounts (FSAs):

Health Care FSA
Limited Purpose Health Care FSA

Employees enrolled in the Healthy Focus Essential or Advantage plan are eligible to participate in the Limited Purpose (HSA Compatible) FSA. The following chart compares the two types of Health Care FSAs:

HSA-Compatible (Limited Purpose Health Care FSA)	Standard Health Care FSA
Use it if enrolled in an HSA For eligible dental and vision expenses For medical and prescription drug expenses after deductible is met	Use it if not enrolled in Healthy Focus plan w/ HSA or any other High Deductible Medical plan with HSA For eligible medical, prescription drug, dental and vision expenses

In 2019, a participant can set aside between $100 and $2,650 — on a pre-tax basis — to pay for eligible medical, dental, vision, and hearing care expenses. Examples of expenses include:

Eligible services not covered by a medical, dental or vision plan (except for cosmetic procedures);
Annual deductibles;
Copayments; and
Out-of-pocket expenses

Once enrolled in the Health Care Flexible Spending Account, a participant may not change the amount he or she contributes to the account, unless the participant experiences a qualified status change. See Changing Coverage (Qualified Status Changes) in the Participating in the Plans section for more information about qualified status changes.

Participants will be able to carry over up to $500 of unused Limited Purpose FSA or Health Care FSA balance remaining at the end of the calendar year into the following calendar year. The carry-over feature helps participants avoid losing unused money at the end of the year!

Expenses

Generally, any health care expense that the IRS allows as a deduction on income tax returns is eligible for reimbursement, provided it is not reimbursed from any other source. This includes expenses incurred for anyone a participant is entitled to claim as a dependent on his or her tax return, regardless of whether that dependent is covered under Leidos's medical, dental or vision plans.

Neither participant insurance premiums nor expenses for registered domestic partners are eligible for reimbursement under the Health Care Flexible Spending Account.

Below are examples of eligible health care expenses. This list is meant to provide only a summary of eligible expenses. For a more comprehensive list, log into the administrator website to view a list of eligible and ineligible expenses:

Some expenses are not eligible for reimbursement from the Health Care Flexible Spending Account. Below are examples of ineligible health care expenses. This list is meant to provide only a summary of ineligible expenses:

Bottled water;
Care of a normal and healthy baby by a nurse;
Cosmetic dentistry, including teeth bleaching;
Cosmetic medical procedures, such as face lifts;
Dance lessons;
Diaper services;
Electric toothbrushes, even if recommended by a dentist;
Funeral and burial expenses;
Household help;
Insurance premiums;
Medical coverage premiums;
Marriage counseling fees;
Maternity clothes;
Special foods, even if required for allergies;
Swimming lessons;
Toothpaste and other sundries;
Trips or vacations for general health improvement;
Vitamins, supplements or tonics (unless specifically directed to use by a medical provider to treat a specific medical condition); and
Weight-loss programs for general well-being.

Reimbursement

Participants have three options in which to receive reimbursement from their HealthEquity health care flexible spending account.

Healthcare Debit Card — Participants can use their HealthEquity debit card at select pharmacies, healthcare providers and general merchandise stores that have an IRS-approved inventory and checkout system. In most instances, the card transaction will be automatically verified at checkout. With this verification, participant may have to submit a receipt to HealthEquity after the transaction. Participant is required to keep each receipt for tax purposes and in the event it is needed for verification.
Request Reimbursement Online — Participants will be able to claim funds from their health care flexible spending account online via the HealthEquity member portal. As part of the online process, they can upload the backup documentation and associate them directly to the claim. Most claims are processed within a few days after they are received and payments are sent shortly thereafter. Participant will receive a check in the mail if they do not set up their direct deposit information with HealthEquity. To set up direct deposit, complete the Direct Deposit form and submit to HealthEquity.
Pay Doctor/Provider Online — Participant can pay many of their eligible healthcare expenses directly from their health care flexible spending account without filling out paper claims forms. Just enter the provider's name and other requested information with the backup documentation and payment will be sent directly to the provider.

Participants in the Health Care Flexible Spending Account can be reimbursed for the full amount they contribute during the year at any time during the year, even if they do not currently have that much money in their account. If a participant leaves Leidos employment, he or she may submit claims for expenses incurred only through the employment end date; however, April 30 of the following year is the deadline for filing for reimbursement of those claims.

If participants have concerns about how a claim has been administered, or wish to appeal a claims decision, complete the Claims Appeal form and submit to HealthEquity. Additional information on relevant procedures is available in the Plan Information section.

Electing COBRA Coverage

When your participation in your Health Care Flexible Spending Account ends due to one of the qualifying events listed below, you may have limited rights under the Consolidated Omnibus Budget Reconciliation Act (COBRA) to continue your account until the end of the calendar year in which your participation ends.

You leave the Company (for reasons other than gross misconduct);
Your coverage stops because you no longer meet the eligibility requirements;
You die; OR
You fail to return to work at the end of your leave under FMLA

If you have funds remaining in your Health Care Flexible Spending Account, the COBRA administrator will provide you with a COBRA election form for continued coverage. To elect COBRA continuation coverage, you must complete and return the form to the COBRA administrator within 60 days after your coverage ends or within 60 days after you receive the form (whichever is later). If you elect COBRA coverage, the effective date of the coverage is the date of the qualifying event. You will have an additional 45 days following your election of COBRA coverage to pay any outstanding premiums.

You can continue the coverage until the end of the calendar year, as long as:

You continue to make contributions for coverage within 30 days of the due date, and
The Company is still offering the Plan to its employees.

You will have to pay 100% of the monthly contribution plus a 2% administrative charge for coverage under COBRA. Your contributions will be made on an after-tax basis.