The Flex Plan Is a Benefit Through JIT Services to All Full Time Employees Who Have Been

JIT Services, LLC

Flexible Benefit Plan

The Flex Plan is a benefit through JIT Services to all full time employees who have been here at least 90 days. This plan allows you to have money withheld from your check before taxes. This money corresponds with your estimates made at the beginning of the year for medical, dependant health, and/or dental insurance expenses. Using the money before taxes to pay for these bills saves you approximately 25%

All of our insurance deductions are withheld through our Flex Plan. You must participate in the Flex Plan if you have any type of insurance through JIT Services.

The maximum amount of withholding for medical expenses is $2,000.00. The following fall under the category of medical expenses:

Over the counter medications (Tylenol, Motrin, Cough medicines, etc)

Prescriptions

Copays

Dental expenses not covered by insurance

Eye care (eye exams, glasses, contacts, etc…)

Dependent care is any type of childcare expenses: Day care, mother’s day out, etc...

Reimbursements for the amounts withheld can be obtainedonce each payperiod from Tonya Gordon. You must have valid receipts (no handwritten receipts) in order to obtain your reimbursements.

Do not put an amount for expenses that you think may exceed your actual expenses for the year. If you do not turn in enough receipts to total the amount withheld the money is lost.

The amount of money you request to be withheld in each category will be divided by 26, (there are 26 paychecks peryear). This number is the amount withheld per check.

If you do not wish to participate in the Flex Plan please mark the appropriate blank at the bottom of page one and sign above Employee Signature located on the bottom of page two. Either way, if you are or are not participating in the plan you must sign the second page.

Please return these forms to Human Resources.

JIT Services, LLC

Flexible Benefit Plan

Participation Agreement

THIS AGREEMENT, entered into on ______, 20___, between JIT Services, LLC (herein after referred to as the “Employer”), and______(hereinafter referred to as the “Employee”)

WHEREAS, Employer has adopted the JIT Services, LLC Flexible Benefit Plan (herein after referred to as the “Plan”) for the benefit of its employees; and

WHEREAS, Employee the benefits of IRC Sections 79, 105, 106, 125, 129, and any other Sections, as amended, that provide benefits; and in accordance with IRC Section 125.

NOW, THEREFORE, it is mutually agreed as follows:

SECTION I: Employee hereby revokes any prior election made under the Plan and the related Participation Agreement.

SECTION II: The Employer and the Employee agree that this Participation Agreement is subject to the terms, conditions, and limitations as provided in the Plan as in effect from time to time.

SECTION III: Employee is entitled to apply a portion of Employee’s cash compensation each pay period during the Plan Year, as defined in the Plan.

SECTION IV: The Employee hereby elects under the terms of the Plan to reduce Employee’s compensation as herein provided and to apply the amount in the following manner:

DESCRIPTION OF BENEFITS CASH ALLOCATION

Medical Care Expenses

(Flexible Spending Account -
Annual Maximum Limitation: $2,000) $______

Dependent Care Expenses

(Annual Maximum Limitation: $5,000) $______

Employer-sponsored

_____ I do not wish to participate in the Plan

SECTION V: The Employer agrees on each pay period to reduce the Compensation of the Employee pursuant to Section IV above and to pay to the Employee those benefits to which Employee is entitled under the terms of the Plan and under each of the plans covered by the provision of the Plan.

SECTION VI: The Employee acknowledges and understands that:

(A) A description of each benefit option under the Plan which he/she has chosen has been made available and explained, and that benefits will be available only as provide in the Plan.

(B) No change of revocation of this Participation Agreement can be made at any time during the Plan Year unless there is a change in family status (including marriage, divorce, death of a spouse or child, birth, adoption of a child, termination of employment of a spouse and such other events as the Administrator determines will permit a change or revocation.)

(C) The amount of Compensation reduced as a result of the Participation Agreement will reduce the Employee’s Social Security base wage which is used in calculating Social Security benefits during the period that it is effect and, accordingly, a reduction in Social Security benefit in respect to the Employee can result

(D) This Agreement will automatically terminate if the Plan is terminated or discontinued or if the Employee ceases to be a Participant in the Plan.

(E) The reduction in Compensation under the Agreement shall be in addition to any reduction under other agreements or benefit plans.

SECTION VII: The Employee aggress to notify the Employer if there is areason to believe that any item for which reimbursement has been made is not allowable under the terms of the Plan.

SECTION VIII: The Employee agrees on demand to indemnify and reimburse the Employer for any liability which it may incur for failure to withhold federal and state income tax or Social Security Tax.

IN WITNESS WHEREOF, the undersigned have read, understand, and agree to comply with the terms of the Plan and this Participation Agreement and have hereunto set their hands and seals effective as of the day and year first above written.

JIT Services, LLC

By: ______

Employee’s Signature

Its: ______

HROP-1.3.17 Version 1