The HRA Program

The Frontier Communications Corporation Health Reimbursement Arrangement (the “Plan”) provides eligible employees of Frontier Communications Corporation (“Frontier”) and any subsidiary or division designated by Frontier as a participating employer with reimbursements of qualifying medical expenses. Currently, Frontier is the only employer participating in the Plan.

The rules and operation of the Plan are described in the Summary Plan Description (“SPD”) as clearly as possible with minimal use of the technical terms appearing in the official legal documents (including applicable insurance contracts). However, the official legal documents remain the final authority and, in the event of a conflict with this SPD, shall govern in all cases. You may request a copy of the official legal documents from the Plan Administrator.

You are encouraged to read the SPD carefully. If you have any questions about the benefits provided under the Plan, you should contact your employer.

You are eligible for the Plan if you are classified as either a regular full-time employee or a regular part-time employee who is eligible for this Plan under the collective bargaining agreement between the International Brotherhood of Electrical Workers, AFL-CIO (IBEW), Local Unions 289, 986, 1106, and 1431 and, but only with respect to the National Buried Service Wire Group bargaining unit, IBEW Local Unions 21, 51, 89, 543, 702 and 723.

A regular full-time employee will be eligible to participate in the Plan after 90 days from the date of hire.

A regular part-time employee will be eligible to participate in the Plan after 12 months from the date of hire during which he/she worked an average of 25 hours or more per week. To maintain eligibility for each calendar year thereafter, the employee must work an average of 25 hours or more per week in the prior calendar year in order to participate in the Plan for the following calendar year.

You are not eligible to participate in the Plan if:

• You are paid from a non-U.S. payroll, either entirely or partly.
• You are classified by your employer as an intern, casual or temporary employee.
• You are classified by your employer as an independent contractor (without regard to how the individual may be classified by a court or administrative agency).
• You are not covered by the applicable collective bargaining agreement.

It is expressly intended that individuals not treated as eligible employees by their employer are to be excluded from participation in the Plan under all circumstances until the employer changes their classification. Therefore, an independent contractor or any other ineligible individual who is reclassified by a court, administrative agency or other party, as an eligible employee will not be considered an eligible employee for periods before his or her employer implements the reclassification decision, even if the decision applies retroactively.

The Plan Administrator, in its sole discretion and in accordance with the Plan documents and applicable collective bargaining agreements, will determine whether you are eligible to participate in the Plan.

The Plan allows you to be reimbursed for Qualifying Medical Expenses. Qualifying Medical Expenses include the following, as determined by the Claims Administrator (unless excluded below)

• Any expense that qualifies as a medical expense under Section 213(d) of the Internal Revenue Code for yourself and your eligible spouse and dependents; and
• Any premiums (or premium equivalents) for retiree health insurance or retiree health coverage that is paid for by you after-tax.

Qualifying Medical Expenses do not include the following –

• Any expense paid by another health plan (up to the dollar amount paid by the other health plan);
• Any expenses for over the counter medicines or drugs, unless you have a written prescription for such medicine or drug. Contact the Claims Administrator for additional information;
• Any expenses incurred before you begin to participate in the Plan;
• Any medical, dental or vision insurance premium (or premium equivalent) to the extent that you have paid for or could have paid for such premium (or premium equivalent) on a pre-tax basis through a Code Section 125 cafeteria plan;
• Any employee medical, dental or vision insurance premium (or premium equivalent) relating to coverage in a Frontier plan; and
• Any expenses or insurance premiums (or premium equivalents) for a domestic partner and his/her children, unless such individuals are your federal tax dependents.

Please keep in mind the following special rules regarding reimbursements and your Plan HRA Account –

• You must file any claims for eligible expenses by April 1 of the year following the year in which the eligible expense was incurred. Claims filed after April 1 of the year following the year in which the expense was incurred will not be paid. The April 1st deadline may be revised in the future by the Plan Administrator by communicating to Plan participants a different deadline date.
• Eligible expenses incurred for yourself may be reimbursed from the HRA Account. Expenses incurred for your spouse, your child or other dependent will only be reimbursed if your spouse, child or other dependent satisfies the provisions to be eligible for the Plan. Expenses for your domestic partner and your partner's children are not eligible for reimbursement from your HRA Account, unless they are considered your tax dependents for federal income tax purposes.
• If you are enrolled in a Frontier health flexible spending account (Health FSA), you will not be reimbursed for any Qualifying Medical Expenses from your HRA Account that are reimbursed by the Health FSA. Further, you will not be reimbursed from your HRA Account until the point in time when you have exhausted your Health FSA account for the year.
  • For example, if you elect to contribute $1,000 to your Health FSA for a year, you will not receive reimbursement from the HRA Account until you have received $1,000 in reimbursement from your Health FSA for that year. In the event that you only have $1,000 in unreimbursed expenses for that year, your HRA Account contribution will carry-over and be available in the following year for reimbursement.

Participants will be provided with a debit card by the Claims Administrator to pay for Qualifying Medical Expenses. Any debit card shall be subject to the debit card’s terms of use and any other requirements established by the Claims Administrator for this purpose. If a debit card is used to pay for an expense that is not a Qualifying Medical Expense, the Claims Administrator shall apply correction procedures as set forth in guidance under Section 125 of the Internal Revenue Code.

If a Plan participant is eligible for a Performance Award (as set forth below), such Plan participant's HRA Account will be credited with $600 each year at the time the Performance Award is otherwise paid. Whether a Plan participant is eligible for a Performance Award and the time that such Performance Award is paid, is determined by the Company pursuant to the applicable provisions of the governing collective bargaining agreement.

Any credits to the HRA Account will be reduced by Qualifying Medical Expenses that are properly reimbursed from the Plan participant’s HRA Account. HRA Account credits will also be reduced, on a pro rata basis, by the administrative fees paid by Frontier to the Claims Administrator for processing claims under the Plan. These fees will be withdrawn from HRA Accounts at one or more times during the year. Plan participants can contact the Company or the Plan Administrator to obtain the current amount of the fees.

Unused amounts from the prior calendar year may be carried forward to subsequent calendar years. You may not be reimbursed for an amount of eligible expenses that is greater than your HRA Account balance at the time the reimbursement is to be made. Any excess amount will be carried over to the next reimbursement cycle.

After your Plan eligibility terminates, no additional amounts will be credited to your HRA Account, with respect to periods after your termination. However, a contribution may be made to your HRA Account after termination of employment, if the contribution is required by the applicable collective bargaining agreement.

Reimbursement Requests

During the course of the calendar year, you may submit requests for reimbursement of expenses you have incurred. However, you must make your requests for reimbursements no later than April 1 following the year in which the expense is incurred. (The deadline of April 1 may be changed for future years by communicating a different date to you in advance.) The Claims Administrator will provide you with acceptable forms for submitting these requests for reimbursement. In addition, you must submit to the Claims Administrator proof of the expenses you have incurred and that they have not been paid by any other health plan or form of coverage. If the request qualifies as a benefit or expense that the Plan has agreed to pay, you will receive a reimbursement payment soon thereafter. Remember, reimbursements made from the Plan are generally not subject to federal income tax or withholding. Nor are they subject to Social Security taxes.
Reimbursement Request Form

Important Links

IRS Publication 502: Medical and Dental Expenses
Health Reimbursement Arrangement account Claim Form
comphra.lh1ondemand.com
www.fsastore.com

Forms and Documents

Reimbursement Request Form
Summary Plan Description (SPD)
Consumer Portal Quickstart Guide
Mobile App Announcement

Contact Us

CompuSys of Ut. Inc.
PO Box 26237
Salt Lake City, UT 84126
Toll-Free (877) 282-3209
Fax (801) 401-2716
Email: hradept@compusysut.com