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DocuSign Envelope ID: CFCE3443-EF37-4FD4-8DCD-D85D559F77AE <br />Exhibit B: Client Spending Account Program Design <br />Medical Care Reimbursements Account: ® Yes ❑ No <br />Dependent Care Assistance Account: <br />Limited Purpose Reimbursement Account: <br />Health Reimbursement Account: <br />Health Savings Account: <br />Transit Reimbursement Account: <br />Parking Reimbursement Account: <br />® Yes <br />❑ No <br />❑ Yes <br />❑ No <br />❑ Yes <br />❑ No <br />❑ Yes <br />❑ No <br />N Yes ❑ No <br />® Yes ❑ No <br />i Commuter Program Design Requirements: <br />Below is a list of administrative requirements that must be in place in order to maintain the Fee <br />Guarantee outlined herein. Custom Plan Designs are available and upon written request. Fees <br />for custom services will be made 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 into <br />direct deposit) <br />• 180-day claim submission period (the termination run out will be invoked for employment <br />termination) <br />• First of the month funding <br />• Eligibility changes must be submitted prior to the 20th of the month and will be effective <br />the 1st of the following month <br />V— <br />AGUE <br />',i.n,.vn..riven.. <br />City of Santa Ana Spending Account Administrative Services Agreement <br />Client Initials: <br />PEPM17 <br />Page 20 <br />Sava+ V. PtA <br />