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Flexible benefits plan (Section 125)

Dedicated to the educational community At Horace Mann, we believe educators are

taking care of our children's future, and we

need to take care of theirs. While other

companies may offer similar products and

services, ours are designed specifically to provide educators

the peace of mind they deserve through a lifetime of

changing needs - both in and out of the classroom.

What is an FSA? An FSA is a Flexible Spending Account that allows you to set aside money for eligible expenses on a pre-tax basis. There are two types of Flexible Spending Accounts available: a healthcare account and a dependent day care account.

An FSA is a smart way to save! An FSA can help reduce your taxes and increase your take-home pay - giving you extra dollars for the things you really want.

$1,500 $315.00

$1,750 $367.50

$2,000 $420.00

For purposes of this illustration, a savings of 21 % was used and assumes federal, state, and Social Security taxes. Actual tax savings depend on several variables including state and local tax rates and the tax bracket of the participant.

Flexible benefit plan services administered by PayFlex Systems USA, Inc.

Healthcare accounts A healthcare account reimburses you for out-of-pocket medical, dental, prescription or vision services, such as deductibles, co-pays, co-insurance and over-the-counter items. However, medicines and drugs require a written prescription from your doctor (OTC) OTC in order to get reimbursed.

Healthcare expenses must be for services received after the effective date of your FSA election and during the plan year to which it applies.

Individuals allowed to use your healthcare FSA contribution generally include your spouse and children you are entitled to claim as dependents on your federal tax return. This includes a child who is younger than age 19, or under age 24 and a full-time student, and a child of any age who is permanently and totally disabled. In addition, your child under the age of 27 may also be allowed to use your FSA dollars, if this feature is part of your plan.

All expenses must be for services received, not for services to be provided in the future. In addition, expenses cannot have been reimbursed and must not be reimbursable by insurance or any other source.

You cannot claim the same expenses as a deduction on your annual income-tax return.

Healthcare expenses Over-the-Counter expenses

Eligible expenses: • Medical and dental

Ineligible expenses: • Anti-bacterial soaps

OTC drugs and medicines OTC items eligible requiring a prescription: without a prescription:

deductibles, co-pays and co-insurance • Dandruff or dry skin

treatments

• Acid controllers

• Allergy and sinus

• Band aids

• Contact lens solutions • Prescriptions

• Teeth bleaching or • Antibiotic products and supplies

• Hospital expenses

• LASIK surgery, eye glasses, contact lenses

mouthwash

• Suntan/sunscreen lotion with SPF lower than 30

• Antidiarrheals

• Anti-gas

• Elastic bandages and wraps

• Rrst aid supplies

• Hearing aids and • Cosmetic surgery • Anti-itch

batteries • Dehumidifier • Anti-parasitic treatments

• Bridges, dentures, crowns, orthodontic care • Electronic cigarette • Baby rash ointments/

creams

• Chiropractic expenses/ • Missed appointment fee • Birth control

co-pays • Cold sore remedies

• Insulin, syringes for insulin • Cough

• Cold and flu

• Digestive aids

• Anti-fungal/anti-itch

• Hemorrhoid preps

• Laxatives

• Motion sickness

• Pain relief

• Respiratory treatments View a detailed listing of eligible expenses at horacemann.healthhub.com. • Sleep aids and sedatives

• Stomach remedies

Determining your contribution Start by reviewing your expenses from the prior plan year using the table below. Then estimate the amount that you will incur for eligible healthcare expenses during the plan year. The amount that will be deducted from your paycheck each pay period can be determined by dividing your annual contribution by the number of pay periods (e.g., 12, 24 or 26) in your plan year.

How to estimate medical expenses

Last year's expenses This year's projected expenses

Insurance deductibles

Medical/dental/prescription co-payments

Dental expenses

Eyeglasses and contacts

Routine examinations

Transportation to/from provider

Non-cosmetic surgery

Total expenses for year

Divide total by the number of regular pay periods

Amount to enter in election form

Dependent day care accounts A dependent day care account reimburses you for expenses such as day care, before and after school programs, nursery school or preschool, summer day camp and even adult day care.

• You and your spouse, if married must be actively working, seeking employment or a full-time student, in order to get reimbursed for your dependent day care expenses.

• Dependent day care expenses must be for services received after the effective date of your election and during the plan year to which it applies.

• Your expense(s) must be for a qualifying individual which includes a dependent younger than age 13, spouse or dependent who is physically or mentally incapable of self­care and whom you are entitled to claim as a dependent on your federal tax return.

• Dependent day care expenses must be for services received, not for services to be provided in the future.

• Dependent day care expenses can only be reimbursed up to the amount available in your account.

• You must file Form 2441 annually with your individual tax return identifying all your dependent care providers.

Dependent day care expenses Eligible expenses:

• Licensed day care provider

• In-home provider as tong as the care provider is not your child under age 19 or someone you claim as a tax dependent

• Summer camps (not overnight)

• Tuition through preschool

• Before and after school care (under age 13)

View a detailed listing of eligible expenses at horacemann.healthhub.com.

Determining your contribution Start by reviewing your expenses from the prior plan year using the table below. Then estimate the amount that you will incur for eligible dependent day care expenses during the plan year. The amount that will be deducted from your paycheck each pay period can be determined by dividing your annual contribution by the number of pay periods (e.g., 12, 24 or 26) in your plan year.

How to estimate dependent care expenses

Last year's expenses This year's expenses projected

Infant/toddler

Preschool

Before/after school care

School half days

In-service days (child not in school)

School holidays

Other dependent care

Total expenses for year

Divide total by the number of regular pay periods

Amount to enter in election form

ealth Hub

Logging in to HealthHub • At horacemann.healthhub.com, Account select Employee

Login.

• Enter your username and password and click Login.

• If you are a new participant, click on Register Now and enter your member ID (which is your Social Security number) and click home ZIP code, then click Register.

• Create a username and password, then re-enter password to confirm.

• Select a security question and answer.

• Enter your email address twice and click Confirm.

Filing a claim • At horacemann.healthhub.com, Account . select Employee Login

• Enter usemame and password and click login.

• Click on File a Claim under Quick Links. Then select Pay Me to reimburse yourself or select Pay Them to pay your provider directly.

Stay informed with eNotify If you are enrolled in eNotify, confirming you will receive an email from enotify@payflex.com that your claim has been processed.

Quick tip: Sign up for eNotify to receive important email notifications -Login to horacemann.healthhub.com > Settings> Change email

Access your account information you need on My Dashboard Login to horacemann.healthhub.com of your account: to view a snapshot

• Account Balance

• News You Can Use

• Upcoming Claim Payments

Quick tip: View your claim history and payments -Login to horacemann.healthhub.com > Financial Center> Select Account

Shop online with your FSA! Access our Consumer Center to buy items such as glasses, contacts, and eligible over-the-counter • items using your PayFlex Card (if offered by your employer) or any other major credit card. If an item is not identified as "FSA eligible," you will need to use

by PayFlex a form of payment other than your PayFlex Card.

If using your own credit card, make sure to keep the receipt you receive from your purchase and submit it along with a claim form for reimbursement.

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Payflex Mobile™ •-~-. You'll have real-time access to your FSA account wherever you go.

The mobile application is accessible on iPhone®, BlackBerrye and Android™ smartphones.

1. Log in online and click on the Consumer Center to find PayFlex Mobile™. Here you can view a full listing of smartphones that support the mobile application. If you do not have a HealthHub~ username and password, please visit horacemann.healthhub.com to register.

2. Download the Payflex Mobile™ Application to your phone from the app store of your mobile service provider.

3. Log in to your account on your mobile phone using your HealthHub$ username and password.

For more information Please refer to your Flexible Benefit Election Form or your employer's Summary Plan Description for more detailed information regarding your flex plan. Since this is a tax savings arrangement, you may want to consult your tax advisor before making a final decision about the flex plan.

Your connection to horacemann.healthhub.com Customer service Phone: 877-533-0220

Hours: Monday - Friday, 7 a.m. - 7 p.m. CT Saturday, 9 a.m. - 2 p.m. CT

Submitting a claim Online: Login to horacemann.healthhub.com > select File a Claim. Upload documentation or fax online claim form and itemized receipts to 866-932-2567.

Fax: 402-23 1-43 IO Fax for denied claims: 402-231-4303 Mail: PnyFlcx Systems USA, Inc. P.O. Box 981158, El Paso, TX 79998-1158 l earn more by visiting horacem,mn.l1ea/t/1/111b.com

Learn more by visiting horacemann.healthhub.com Resources. > My HealthHub

We're here for educators In addition to offering flexible benefit plan services1 Horace Mann can provide you with:

Insurance • Auto

• Home

• Renter

• Life

• Flood

• Disability income

Financial services • Retirement annuities

Flexible benefit plan services administered by PayF/ex Systems USA, Inc.

Horace Mann's auto and homeowner insurance are underwritten by Horace Mann Insurance Company and its affiliates. Horace Mann's annuity products are underwritten by Horace Mann Life Insurance Company. Horace Mann life insurance products are underwritten by Horace Mann Life Insurance Company.

We are Horace Mann, and we're proud to serve the heroes who are shaping America's future - teachers, school administrators

and all school employees.

Visit horacemann. com/ourstories