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Services & Fees Overview for City of Santa Ana <br />Spending Account Services <br />Fee Guarantee Period: Begins on January 1, 2024, and ends December 31, 2026 <br />Annual Anniversary Date': January 15t <br />Minimum Monthly Feel: $100 <br />FSA Administration (Section 125 Services} 3 <br />Includes Limited and Full Purpose Health FSA and Dependent Care Assistance Plans. Bundled rate. <br />FSA Monthly Participation Rate: $3.85 per participant per month <br />Commuter Benefit Administration <br />Includes Qualified Transportation and Parking Plans. Bundled Rate. <br />Commuter Monthly Participation Rate: $3.85 per participant per month (rate bundled with FSA <br />Monthly Participation Rate for those enrolled in multiple plans) <br />Commuter Program Design Requirements: <br />Below is a list of administrative requirements that must be in place in order to maintain the Fee Guarantee outlined <br />herein. Custom Plan Designs are available and upon written request. Fees for custom services will be made <br />available at the time of the request. <br />• Connection to approved WireclCommute vendors <br />• Automatic update to current federal monthly limits <br />• Fund rollover with annual re -enrollment <br />• Manual claim remittance (participant will receive a check mailed home or can opt in to direct deposit) <br />• 180-day claim submission period (the termination run out will be invoked for employment termination) <br />• First of the month funding <br />• Eligibility changes must be submitted prior to the 20th of the month and will be effective the 1st of the following month <br />'Once the Fee Guarantee Period expires, fees will renew as is on an annual basis unless new fee offerings are presented In writing 60 days prior to the Annual Anniversary <br />Date. <br />2 Minimum monthly billing for a single contracted Spending Account Service is $75. It additional Spending Account Services are contracted, the total minimum monthly <br />billing for all combined services is $100. <br />'Participation fees are assessed by Plan Year and will remain billable until the Plan year has closed administration. Section 125 Services include standard and limited <br />Health Flexible Spending Accounts as well as Dependent Care Reimbursement Account administration. A participant is billable as long as they are enrolled In at least one <br />of the aforementioned account types. Igoe reserves the right to increase the monthly participation rate at any time due to increases in Federal Postage rates, changes to <br />Federal legislation governing the provision of these services, or as a result of CPI adjustments (not to exceed 3% annually). <br />'Participation fees are assessed by Plan year and will remain billable until the Plan year has closed administration. Section 125 Services include standard and limited <br />Health Flexible Spending Accounts as well as Dependent Care Reimbursement Account administration. A participant is billable as long as they are enrolled in at least one <br />of the aforementioned account types. Igoe reserves the right to increase the monthly participation rate at any time due to increases in Federal Postage rates, changes to <br />Federal legislation governing the provision of these services, or as a result of CPI adjustments (not to exceed 3% annually). <br />�--- <br />%GOE <br />Document Generated on June 5, 2023 for City of Santa Ana <br />Internal Use Only: PEPM17 <br />Page 2 <br />