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2013 2014 Flexible Spending Accounts (FSA) Health Care and Dependent Care

Eligibility Associates who are scheduled to work at least 30 hours per week and have also attained 60 days of continuous service are eligible to participate in the programs described below. The effective date of participation will be the 1st of the month following attainment of 60 days of continuous service. Associates scheduled to work less than 30 hours per week and Temporary Associates are ineligible to participate in Mattress Firm benefit plans. Dependents Eligible dependents can enroll in Mattress Firms benefits plans; however, supporting documentation will be required to validate eligibility. Please contact the Benefits Department to determine the required supporting documentation. An eligible dependent includes: 1. 2. 3. 4. Spouse (not fianc, but your legal spouse as determined by applicable law) Common Law Spouse Legal Dependent An Associates child up to age 26 (birth, adoption, or stepchild) Qualified Medical Child Support Order

United Healthcare FSA Allows you to set aside a portion of your salary, before taxes, to pay for qualified medical expenses as well as dependent daycare expenses. You may review a list of eligible expenses and a worksheet to help you determine your estimated expenses on the FSA website at Important Note: If you want to participate in the FSA, you must re-enroll each year. Health Care FSA $2,500 maximum contribution per calendar year Can be used for qualified medical expenses such as (co-pays, prescriptions, deductibles, etc) Optional Debit Card to pay for eligible expenses Use it or Lose It Rule Not available to Associates enrolled in the Medical High Deductible Plan

Dependent Care FSA $5,000 maximum contribution per calendar year Eligible for expenses related to Dependent Day Care or Adult Day Care Members must work or attend school full-time to be eligible to claim dependent daycare expenses Associates enrolled in the High Deductible plan are eligible for the Dependent Care account

Information contained in this document are summarizations and not intended to replace the full details regarding eligibility, covered expenses, exclusions, limitations, definitions and other provisions of each plan contained in legal documents, handbooks and group contracts. Legal documents shall govern any differences.