1. ® The Flex Convenience ® Card Reimbursement Process The Flex Convenience ® Card

2. ® Receive Instant Reimbursement for your Eligible Expenses ProBusiness will provide you with a reimbursement account FLEX CONVENIENCE ® CARD, enabling you to access your funds immediately upon receipt of services

3. ® Receive Instant Reimbursement for your Eligible Expenses The Flex Convenience ® Card can be used for Health Care Spending Accounts Dependent Care Accounts Transportation Reimbursement Accounts

4. ® Where Can I Use My Flex Convenience ® Card? Examples of qualified locations and providers include:  Hospitals  Physician offices  Dental offices  Vision Service providers  Pharmacies  Parking Garages/Lots  Participating Transportation Offices Anywhere MasterCard ® is accepted as a form of payment.* *If your qualified provider does not accept MasterCard ® as a form of payment, cardholders will need to pay by cash or check and submit a manual claim form.

5. ® IMPORTANT! Keep Your Card Transaction Receipts IRS regulations require eligibility review of all card transactions You will not need to complete and submit a reimbursement claim form You will be requested to submit your card transaction receipts for eligibility determination on most purchases

6. ® Can I Use the Flex Convenience ® Card at an ATM? The Flex Convenience ® Card is NOT eligible for use at ATM’s, or other unqualified merchant locations and the purchase will be denied at point of sale if attempted

7. ® What Happens if I Mistakenly Use My Flex Card ® for Unqualified Purchases? Example: Pharmacy Transaction Medication co-paySoda An eligible expenseNOT an eligible expense

8. ® Flex Convenience ® Card User Responsibilities Upon enrollment and with each use of your Flex Convenience ® Card, you are bound under the terms of the cardholder user agreement, which is provided upon receipt of your card. The user agreement outlines your responsibility as a cardholder. Please be sure to read your agreement carefully. ProBusiness can provide this agreement to you at any time, if you have misplaced it. If you use the Flex Card ® for an unqualified purchase, your account will be considered overpaid and your card will be temporarily deactivated. You will be requested to reimburse your account for the full amount of the ineligible expense. ProBusiness will provide detailed instructions with regard to the payback process should you purchase an ineligible item. Until such time you have satisfied the overpayment on your account, your card will be denied at point of sale if use of the card is attempted. *Continued misuse of the card is considered a violation of the cardholder agreement which will result in permanent deactivation of your card.

9. ® Reimbursement Process If You Are Unable to Use the Flex Convenience ® Card If you are unable to use your Flex Convenience ® Card, complete & sign a reimbursement claim form For Health Care: include EOBs, co-payment receipts, “super bills” with a description of the service provided, service date(s) and out of pocket costs (copies are recommended) For Dependent Care: include receipts for expenses or have the care provider sign the claim form. The provider’s tax ID number or social security number must be provided on the claim form. For Transportation expense reimbursement: include receipts for parking, transit and vanpool (copies are recommended)

10. ® Don’t Forget... If you are submitting a paper claim….. To sign the claim form To indicate the $ amount being requested Supporting claim documentation - the IRS does not allow:  cancelled checks  credit card receipts  balance-due statements

11. ® Paper Claim Reimbursement Process Mail or fax your signed reimbursement form & documentation to us Reimbursements will occur according to the reimbursement schedule in your welcome packet Questions?  Call us: 1-800-269-0020  Fax us: 1-800-269-5231  bsa@probusiness.com  www.probusiness.com

12. It Pays to participate! Enroll in your Reimbursement Account Plans today! A Division of ADP National Accounts