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2017 Plan Specifications

Supplement to the Summary Plan Description

Communities In Schools of Atlanta

Plan Name:

Communities In Schools of Atlanta Flexible Benefits Plan

ID Number:

58-1152807

Employer Benefits Coordinator:

Lisa Williams-Coleman

Contract Third Party Administrator:

Advantage Benefits Plus

17316 N May Ave, Suite A, Edmond OK 73012

Phone: (405) 341-7587 Fax: (405) 341-7588

Plan Year:

January 1st through December 31st

Flex Card:

Available

Medical FSA Grace Period: Not Elected

Medical FSA Plan Carryover: Up to $500 annually

Benefits Available Under the Plan:

Employee’s portion of Employer provided Group Insurance Plans

Health Flexible Spending Account (Health FSA)

Dependent Care Flexible Spending Account (DCAP)

Eligibility Requirements:

To be eligible for the Plan, employees must:

1) Have 30 days of service

2) Work a minimum of 30 hours per week

Annual Minimum / Maximum Salary Deferral:

$ 0

/ $ 2,500

Health Flexible Spending Account

$ 0

/ $ 5,000

Dependent Care Flexible Spending Account