Your Flexible Spending Account

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Welcome to WageWorks. Start Saving. Here’s How.

Congratulations on enrolling in a health care Flexible Spending Account (FSA) sponsored by GE and brought to you by WageWorks.

Your FSA is a great way to save on hundreds of eligible expenses like prescriptions and eligible medical expenses.

Ready to get started? This guide will show you how. Your FSA: The Essentials

Your FSA is governed by IRS regulations that detail who is eligible to use the account and where and how the money in it is to be used. Your FSA was designed to be simple. To keep it that way, it’s important to comply with the IRS regulations that govern the program. The following guidelines will help you avoid any inconvenience.

• Know what expenses are eligible. Log into your account for a list of GE’s eligible health care expenses. Generally, eligible health care expenses include services and products that are medically necessary to treat a specific condition.

• Keep your receipts. Save receipts that describe exactly what you paid for. Make sure the amount and service date – not the payment date – are included.

• Get a prescription from your doctor. To use your account for over-the- counter (OTC) drugs, you’ll need to get a prescription from your doctor. You can use your WageWorks® Health Care Card (Card) for prescribed OTC drugs when filled and purchased as a prescription at the pharmacy counter. Alternatively, you can pay for the item out-of-pocket and use Pay Me Back to submit your claim and prescription to WageWorks for reimbursement. Pay Me Back claims can be submitted online, with your smartphone or mobile device or by mail or fax.

• Watch where you shop. If using the Card, shop only at general merchandise Includes:

Your FSA: The Essentials Managing Your Account Using Your FSA Dollars

• Eligible Expenses • 5 Ways to Use the Fund • Documentation Register for an online account now!

If you haven’t registered online yet, please do so – to register, just visit: www.wageworks.com/ge. You can also access your online portal using SSO by going to OneHR.ge.com and clicking on the Savings Accounts tab. An online account not only gives you 24/7 access to your account, but allows you to use the mobile app.

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• Verify all of your Card transactions. If a transaction is not automatically verified at checkout or by a third-party system, you will be notified by email or upon login to your account.

• Register for mobile access. When you register with WageWorks online, you ensure that you will have access to use the mobile app and take advantage of features like Upload Receipts for online claims and Card usage requests.

• Keep track of your FSA balance. Plan ahead. Eligible expenses should be incurred by December 31, but for the 2014 plan year and beyond, you can carry over up to $500 of unused FSA funds into the following plan year. Any amount above $500 remaining in your account on December 31, will be forfeited. Make sure you keep this in mind when determining how much to contribute to your account.

Managing Your Account

You can manage and check up on your WageWorks account through online or over the phone. The “Claims and Activity” page online details all your account activity and will even alert you if any Card transactions are in need of verification.

For the latest information, visit www.wageworks.com/ge or OneHR.ge.com and click on the Savings Accounts tab and log into your account 24/7. In addition to reviewing your most recent account activity, you can: • Update your account preferences and personal information.

• View your transaction and account history for current and past plan years. • Schedule payments to health care providers.

• Check the complete list of eligible expenses for your FSA program. • Order additional WageWorks® Health Care Cards for your family. • Manage your account while on the go via the WageWorks mobile website.

• Download the EZ Receipts® app so that you are able to file claims and take care of Card use paperwork from your smartphone or mobile device.

Using Your FSA Dollars

Eligible expenses

You can use your FSA for hundreds of eligible expenses. Log into your account to view GE’s list of eligible expenses. Typically, they include:

• Prescriptions for almost any medical condition

• Prescribed over-the-counter health care products like allergy medicine, antacid, antibiotics, aspirin • Coinsurance and deductibles

• Speech therapy

• Dental care, both preventive and restorative • Orthodontia

• Vision care, including eyeglasses, contact lenses and saline solution • Eye surgery, including laser vision correction

• Physical therapy, counseling and psychology • Chiropractic care

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Five ways to use your FSA money

When you pay for an eligible health care expense, you want to put your FSA to work right away. WageWorks gives you several options to use your money the way you choose:

I. WageWorks Health Care Card II. Pay My Provider

III. Pay Me Back IV. Pick & Process V. EZ Receipts®

I. WageWorks Health Care Card

Use your WageWorks Health Care Card (Card) instead of cash or credit at health care providers and pharmacies for eligible services, goods and prescriptions.

You can also use the Card at general merchants and drug stores that have an industry standard (IIAS) checkout system that can automatically verify if the item is eligible for purchase with your account. • Go to www.sigis.com to review a list of qualified merchants, like drug stores, supermarkets and

warehouse stores that accept the Card.

• When you swipe your Card at the checkout, choose “credit” (even though it isn’t a credit card) or “debit”. A debit PIN can be assigned to you when activating your card or by contacting WageWorks.

• Pay for services or purchases on the same day you receive them. If your health plan covers a portion of the cost, make sure you know what amount you need to pay before using the Card, by presenting your health plan member ID card first, so the merchant can identify your coinsurance amount and ensure the service is claimed to your health care, dental or vision insurance plan.

• Save your receipts or digital copies. You will need them for tax purposes. Plus, even when your Card is approved, a detailed receipt may still be requested.

• If you use your Card at an eye doctor’s or dentist’s office, we will most likely ask you to submit an Explanation of Benefits (EOB) or other documentation for verification.

• If you lose your Card, please call WageWorks immediately at (888) 303-3006 and order a new one. Activating your Card

Your WageWorks Health Care Card is mailed in a plain white envelope via US postal mail. You will receive one card, Card overview, instructions for activation and a Cardholder Agreement. Cards are valid for three years, so be sure to keep the Card even if you do not re-elect your benefit.

1) Activate your Card by calling toll-free (866) 692-4871. A debit PIN will be assigned to you during activation. Be sure to sign the back of your Card.

2) Use your Card to purchase eligible health care products and services only. 3) Choose “credit” or “debit” at the point of purchase.

4) Save all detailed receipts for your Card purchases.

When activating your Card, you will be asked to enter the Card number and the last 4 digits of your ID code. Your ID code is the last 4 digits of your social security number.

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II. Pay My Provider

You can pay many of your eligible health care expenses directly from your FSA with no need to fill out paper forms*. It’s quick, easy, secure and available online at any time.

To pay a provider:

• Go to www.wageworks.com/ge or the Savings Accounts tab on OneHR.ge.com, log into your account. • Click “Submit Receipt or Claim.”

• Select “Pay My Provider” and follow the instructions.

• Make sure to provide an invoice or appropriate documentation. When you’re done, WageWorks will schedule the checks to be sent in accordance with the payment guidelines. If you pay for eligible recurring expenses, follow the online instructions to set up automatic payments.

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III. Pay Me Back

You also can file a claim online to request reimbursement for your eligible expenses.

• Select “Pay Me Back.”

• Fill in all the information requested on the form and submit.

• Scan or take a photo of your receipts, EOBs and other supporting documentation. • Attach supporting documentation to your claim by using the upload utility.

• Make sure your documentation includes the five following pieces of information required by the IRS:

DDate of service or purchase

DDetailed description

DProvider or merchant name

DPatient name

DPatient portion or amount owed

Most claims are processed within one to two business days after they are received, and payments are sent shortly thereafter.

If you prefer to submit a paper claim by fax or mail, download a Pay Me Back claim form and follow the instructions for submission.

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Five ways to use your FSA money (Cont.)

NEW!

New Shortcut to your claims. Click on the new Pick & Process button to access your healthcare claims more quickly.

IV. Pick & Process

With the Pick & Process feature, you can review claims received from your health plan(s) and tell us how to process them. WageWorks accepts claim information from various health plan administrators; you have the option to pick the process.

• Select “Pick & Process.”

• Have your provider invoice(s) and Explanation of Benefits (EOB) in front of you for reference. OR

• NEW shortcut to your Pick & Process claims. Directly from the Dashboard.

After you review the instructions, click “Next” to be taken to the Pick a Transaction page. This shows the available carrier claims, with the most recent one displayed first. Simply click on the claim that you would like to process.

The next page shows the chosen claim and the options for processing the claim. Click on the button for your processing choice:

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a) Health Care Card Receipt

To connect a carrier claim to a Health Care Card transaction that needs verification, select Health Care Card Receipt as your process. After choosing the applicable carrier claim for processing, you will be presented with a list of the Health Care Card transactions that need receipt verification. Click on the applicable card transaction. Both the chosen carrier claim and Health Care Card transaction will display on the screen. Enter the amount of card transaction you would like to verify, and follow the steps to complete the process

When to use...

When you have received a Card Use Verification. This is when you have paid your provider with your WageWorks Health Care Card but the transaction was not automatically verified as eligible per IRS rules.

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b) Pay My Provider

To use a carrier claim and send payment to your provider, choose Pay My Provider. The selected carrier claim will display at the top of the screen. Enter the amount of the payment. If your claim is eligible for payment from more than one account, you will be able to choose which account to pay from. Verify your provider’s payment information, and follow the steps to complete the process.

When to use...

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c) Pay Me Back

To use a carrier claim and reimburse yourself, choose Pay Me Back. The selected carrier claim will display at the top of the screen. Enter the amount of the payment. If your claim is eligible for payment from more than one account, you will be able to choose which account to pay from. Follow the steps to complete the process.

When to use...

Use Pay Me Back when you paid your provider using a form of payment other than your WageWorks Health Care Card and your Explanation of Benefits (EOB) reflects the service was processed by your health plan. You can request a reimbursement payment to yourself.

Five ways to use your FSA money > Pick & Process (Cont.)

Remember

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V. EZ Receipts®

You can pay many of your eligible health care expenses directly from your FSA with no need to fill out paper forms. With the EZ Receipts mobile app from WageWorks, you can file and manage your reimbursement claims and Card usage paperwork on the spot, with a click of your smartphone or mobile device camera, from anywhere.

To use EZ Receipts:

• Download the app from your app store. (Available for iPhone, iPad and iPod Touch devices with iOS versions 3.1.3 and greater, Android and Blackberry.)

• Log into your account using your website username and password. • Choose the type of receipt from the simple menu.

• Enter some basic information about the claim or Card transaction. • Use your smartphone camera or device to capture the documentation. • Submit the image and details to WageWorks.

Five ways to use your FSA money (Cont.)

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Submitting Documentation

Whether you are submitting a claim for reimbursement or providing verification for a Card transaction, it is important to follow these simple steps.

The #1 reason a claim, a payment request or a Card Use Verification is not approved is because of illegible or incomplete documentation. Use this documentation checklist and submission tips to ensure your request is processed promptly.

Documentation Checklist

All documentation MUST include these five key pieces of information:

• Provider’s Name – Facility name or person who provided the service, or if a purchase, where item was purchased (i.e. hospital, doctor, pharmacy).

• Service Date(s) – Date services occurred or date item was purchased. • Patient’s Name - Person who received the service or whom the item is for. • Type of Service – Detailed description of the service provided or item purchased.

• Amount Billed – The amount charged for services or product and/or the portion not reimbursed by your insurance carrier.

Helpful Tips for Submitting Documentation

• Use your Explanation of Benefits (EOBs), especially if your insurance paid a portion of the expense. • Make sure documentation is legible; check that it isn’t too dark or light and that information is not cut off. • Do not use highlighters on documentation.

• Handwritten documentation must include stamped provider information.

• Do not send carbon copies or cancelled checks, they typically do not include all five key pieces of information.

If WageWorks is unable to automatically verify an expenses as eligible per IRS guidelines, you will be notified via email and will receive an alert in your Message Center when you log into your online account.

How long do I have to provide verification for my Card transaction?

This verification must be completed within 90 days from the date of the transaction. If supporting documentation for the Card transaction(s) is not received within 90 days, WageWorks will utilize an automatic offset process to resolve the unverified Health Care Card transaction(s).

How does the offset process work?

If you do not verify the transaction within 90 days, any claim you submit for reimbursement using the ‘Pay Me Back’ feature of the WageWorks portal will automatically be used to offset – and resolve – unverified FSA transactions made with your Health Care Card.

• This means reimbursement monies for any ‘Pay Me Back’ claims will be reduced by the amount of unverified transactions over 90 days old. The amount of the reduction will be applied to the unverified Card transaction.

• The process will continue until all unverified amounts of Health Care Card transactions over 90 days old are resolved.

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