Well-Being Wallet

Cupertino Electric, Inc., Inc. provides the Well-Being Wallet designed to support and encourage a well-rounded healthy lifestyle for all employees. The program covers expenses for a variety of eligible activities. This document outlines the program policy.

Who is Eligible?
All office employees (regular, full-time, part-time, temporary full-time, and office union) are eligible to participate in the program. You must be employed by Cupertino Electric, Inc., Inc when eligible expenses are incurred (paid for).

Program Administration
Forma is the administrator for the Fitness Incentive Benefit. For general FAQs, please refer to the help center. You can reach Forma's Member Experience Team by emailing support@joinforma.com or through the live-chat feature directly in your Forma account.

Benefit Amount
All eligible employees will receive $100 per quarter for eligible lifestyle expenses. Any unused amount can be accrued up to $400 annually. Any unused amount expires at the end of the calendar year. If you choose to participate, the benefit amount you use will be included in your income for tax reporting and withholding purposes.

How the Program Works
$100 will be deposited into your Forma Account during the first week of each quarter. You may spend the allowance through the Forma Store or be reimbursed for eligible claims.

Forma Store
The Forma Store includes vendors that are automatically considered eligible under this program policy.
For a single-time store purchase that exceeds your Forma balance at any given time, you may pay the difference by adding your personal credit card to your Forma profile.
For a complete list of products/services that are eligible to be expensed under the Fitness Incentive Benefit, please view the Well-Being Wallet Eligibility List.
FSA/HSA items are not eligible under this program policy.

Tax Treatment
As required by IRS regulations (see IRS Publication 15-B), Cupertino Electric, Inc. treats this program as a taxable fringe benefit. You will only be taxed on the amount you receive under the program, and the amount will be included in your income for tax reporting and withholding purposes. Accordingly, there are some tax costs to you associated with your participation in this program.

Participation in the Well-Being Wallet Program is voluntary. By participating, you acknowledge that you are opting into this Program. Further, you acknowledge that Cupertino Electric, Inc., Inc., will not endorse or verify the credentials, health and safety, and price of any services you receive using the program. If you elect to participate in this program, you are responsible for ensuring a safe, healthy, and affordable program.

Termination Policy
If you have an active membership or subscription at the time you terminate employment, the membership or subscription will stay active until the current billing cycle ends. You may find information on the billing cycle in the Settings section under Subscriptions or reach out to Forma's Member Experience Team for this information. Your eligibility to participate in the Well-Being Wallet Program ends on the day of your termination and you will no longer be eligible to participate or submit reimbursement claims.

Questions? Email benefits@cei.com