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For the 2022 Benefits YearAbout Ford’s Health Savings Account

What is a Health Savings Account (HSA)?Why contribute to an HSA?Am I eligible to open an HSA?What kinds of expenses can I pay with my HSA?How much can I contribute to my HSA for 2022?The Health Savings Account — show me the money!How HSA and LPFSA work togetherHow much can I contribute to my HSA and LPFSA?The HSA together with the LPFSA — show me MORE money!How do I access my funds?How do I use my Smart-Choice Card?Tips for using your Smart-Choice CardHow can I keep track of my account?What if I want to save my HSA funds for the future?This is great! How do I sign up?

The Fine PrintHealth Savings Account rules

The policies, plans and programs described in this guide are not contracts, and do not alter any at-will relationship the Company has with its employees. The Company may modify or terminate these policies, plans and programs at any time. You can request a printed copy of any benefits Summary Plan Description or Summary of Material Modification, at no charge, by contacting the National Employee Services Center (NESC) at 1-800-248-4444.

health savings account

what’s in it for me?

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› A tax-advantaged account that lets you save for current and future health care expenses.

› HSAs are only available when you enroll in a High Deductible Health Plan (HDHP). Ford’s HDHP options are the HSA Plan and the HSA Plus Plan.

Covers in-network preventive care at 100%

Covers serious illness/injury after deductible is met

HSA-ELIGIBLE HEALTH PLAN

HEALTH SAVINGS ACCOUNT

Helps you pay your deductible

Allows tax-deductible contributions

Has potential for tax-deferred growth

Tax-free when used for qualified health care expenses

What is a Health Savings Account (HSA)?

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HSA and FSA: They’re not the same!

Here are some important differences between an HSA and a Health Care FSA:

y HSA has no “use-it-or-lose-it” rule

y HSA withdrawals are limited to money already deposited into your account

y All money in your HSA carries forward to use for qualified expenses — even in retirement

Why contribute to an HSA?

y Because it offers a triple-tax advantage!

1. HSA contributions are deducted from your pay before taxes are taken out, so you save on Federal income tax and Social Security (FICA) taxes by reducing your taxable income

2. The money you spend on eligible health care expenses is also tax-free at the time it comes out of your HSA

3. Your HSA balance can grow tax-free through interest and investment earnings

y You can make direct payments from your HSA for eligible expenses by using the Smart-Choice Card

y Your HSA belongs to you, even if you leave the Company or retire*

*Contributing to an HSA is a REALLY important part of getting ready for retirement!

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Am I eligible to open an HSA?

The eligibility rules are complicated but in general you are eligible if the following is true:

y You enroll in an HSA-eligible plan

› Eligible plans are the HSA Plan and HSA Plus Plan

y You are not enrolled in Medicare

For more information on eligibility:

y Read the Health Savings Account rules at the end of this guide

y Visit irs.gov

y Consult a tax advisor

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What kinds of expenses can I pay with my HSA?

Dental and vision not covered by

insurance

Over-the-counter and prescription

drugsDoctor’s office

visits X-ray and lab

Amounts in excess of reasonable

and customary charges

Annual deductible

Medicare premiums

after retirement

For a complete list, visit irs.gov.

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How much can I contribute to my HSA for 2022?

Note: You must be HSA-eligible to receive the Company contribution. If you elect the HSA Plus Plan, the maximum amount you can contribute is reduced by the amount Ford contributes.

HSA Plan HSA Plus Plan

You only $3,650 $3,150

You + one or more $7,300 $6,300

Catch-up for age 55+ $1,000 $1,000

2022 contribution limits to your Health Savings Account

The amount you can contribute is reduced by the amount Ford contributes.

How much Ford contributes to your 2022 Health Savings Account

HSA Plan HSA Plus Plan

You only No contribution $500

You + one or more No contribution $1,000

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Beginning January 1, 2022, calculate how much YOU can save with an HSA at myfordbenefits.com > Health Savings Account.

The Health Savings Account — show me the money!

Without Health Savings Account With Health Savings Account

Gross annual pay (estimate) $60,000 Gross annual pay (estimate) $60,000

Estimated tax (30%) – $18,000 Maximum annual Health Savings Account contribution (you + family)

– $7,300*

Net annual pay = $42,000 Adjusted gross pay = $52,700

Estimated annual health care expenses

– $7,200 Estimated tax (30%) – $15,810

Final take-home pay = $34,800 Final take-home pay = $36,890

Save this much in taxes! $2,090

*If you elect the HSA Plus Plan, the amount you can contribute is reduced by the amount Ford contributes.

HSA Accelerated Contribution OptionYou have the option to increase your payroll contributions on myfordbenefits.com so you can reach your full contribution amount up to the annual limit earlier in the year.

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But WAIT — there’s a way to keep even MORE of your hard-earned pay!

When it comes to saving money, TWO tax-advantaged accounts are better than one.

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HSA LPFSA

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Note: IRS rules state you cannot have an HSA and a General Purpose Health Care FSA at the same time. You can, however, enroll in a Limited Purpose Flexible Spending Account (LSFSA).

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How HSA and LPFSA work together

*You must complete the HSA/HDHP Deductible form. You can access the form when you log in to your Smart-Choice account.**The carryover provision is a result of the Consolidated Appropriations Act, 2021.

Smart-Choice Mobile AppSmart-Choice Claim Form

One Card

Smart-Choice will automatically deduct funds from the appropriate account as follows:

HSA LPFSAmyfordbenefits.com > Health Savings Account myfordbenefits.com > Flexible Spending Accounts

Expenses before or after medical deductible is met: y Medical y Rx & OTC drugs y Dental y Vision y Other OTC items

Expenses before medical deductible is met:

y Dental y Vision

Expenses after the medical deductible is met:*

y Medical y Rx & OTC drugs y Dental y Vision y Other OTC items

You never lose the funds and it would be great to save for health care expenses you’ll have in retirement!

You can carry over the full unused balance of your 2021 FSA to the 2022 plan year.** So, factor that in when

deciding how much to contribute for 2022; you’ll forfeit any unused balance over $550 at the end of 2022.

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During 2022 Annual Enrollment or your new-hire enrollment period, you elect to contribute pre-tax dollars through payroll deduction to an FSA, HSA or both

How much can I contribute to my HSA and LPFSA?

Health Care Flexible Spending Account Contributions

y Minimum: $50

y Maximum: $2,750

You can carry over the full unused balance of your 2021 FSA to the 2022 plan year.* So, factor that in when deciding how much to contribute for 2022; you’ll forfeit any unused balance over $550 at the end of 2022.

Health Savings Account Maximum Contribution

yYou only: $3,650

yYou + one or more: $7,300

yCatch-up for age 55+: $1,000

If you elect the HSA Plus Plan, the amount you can contribute is reduced by the amount Ford contributes.

+ =

lower taxes

*The carryover provision is a result of the Consolidated Appropriations Act, 2021.

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The HSA together with the LPFSA — show me MORE money!

With Health Savings Account alone With HSA and Limited Purpose FSA

Gross annual pay (estimate)

$60,000 Gross annual pay (estimate)

$60,000

Maximum annual Health SavingsAccount contribution (you + family)

– $7,300* Maximum annual LPFSA contribution

– $2,750

Adjusted gross pay = $52,700 Maximum annual HSA contribution (you + family)

– $7,300*

Estimated tax (30%) – $15,810 Adjusted gross pay = $49,950Estimated annual dental/visionexpenses

– $2,750 Estimated tax (30%)

– $14,985

Final take-home pay

= $34,140 Final take-home pay

= $34,965

Save this much MORE in taxes! $825

*If you elect the HSA Plus Plan, the amount you can contribute is reduced by the amount Ford contributes.

Beginning January 1, 2022, calculate how much YOU can save with an HSA at myfordbenefits.com > Health Savings Account.

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How do I access my funds?

Smart-Choice Card

y Use your Smart-Choice Card to pay for all eligible products or services

Smart-Choice Mobile App

y Beginning January 1, 2022, download the app on the Smart-Choice portal

y File claims and submit required documentation from anywhere

y Check your balance anytime

Smart-Choice Portal

y Pay your health care expenses yourself

y Submit an online claim and required documentation to Smart-Choice

y Get reimbursed by check or direct deposit

OR OR

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How do I use my Smart-Choice Card?

Medical services

y Doctor’s office visits

y Hospital inpatient and outpatient charges

y Medical tests

Over-the-counter and prescription drugs

y Drugs purchased from:

› Local retail pharmacies

› Mail-order pharmacy services

Other eligible items

y Health care-related goods purchased from retailers with an Inventory Information Approval System

y Medical equipment

y Menstrual care products

You can use your Smart-Choice Card instead of cash or credit for eligible HSA expenses

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Tips for using your Smart-Choice Card

If you’re paying for medical services...

OR

If you’re paying for prescription/OTC drugs

and/or eligible non-Rx items…

1. Ask your health care provider to file a claim with your medical insurance carrier

1. Present your medical ID card first so the retailer can determine how much of the cost is covered by your plan and how much should be charged to your Smart-Choice Card

2. Once the claim is processed and the plan has paid its share, watch for a statement from your health care provider

2. Swipe your Smart-Choice Card at the checkout and choose “credit”

3. Then, use your Smart-Choice Card to pay your portion of the medical services bill

3. The retailer’s Inventory Information Approval System verifies automatically whether an item is eligible for purchase with your card

Be sure to save your paper and digital receipts for tax records!

Don’t want to pay with your Smart-Choice Card? No problem! Just pay your health care expenses yourself, submit an online claim and required documentation, and get reimbursed by check or direct deposit.

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Using the Smart-Choice Portal

y Check balances

y Withdraw funds from your account to reimburse yourself for eligible health care expenses

y Review eligible expenses

y Upload receipts to support manual claims

› Select a reimbursement method (check or direct deposit)

y Choose email or text for account alerts

Using the Smart-Choice Mobile App

y Everything you can do using the secure web portal, plus

› Snap photos of receipts

› Scan items to determine eligibility

How can I keep track of my account?

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y You can begin investing once you have a minimum of $1,000 in your Smart-Choice HSA. Only HSA balances above $1,000 can be invested.*

› Competitive interest rates

› Low fees

› Attractive investment options

› Online management tools

y To use invested funds for current eligible expenses, just transfer some or all of the money back into your HSA

y Log in to your Smart-Choice account to see your mutual fund options

What if I want to save my HSA funds for the future?

y Professional management

y Diverse portfolio

y Affordability

y Liquidity

y Tax savings

Key benefits of mutual funds

*Note: You will be charged a monthly $2.50 investment account fee.

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This is great! How do I sign up?

y You can enroll in (or continue) your HSA and/or FSA during Annual Enrollment1. Review the 2022 Annual Enrollment eGuide at fordeguide.com2. Decide how much you want to contribute to your account(s)3. Visit myfordbenefits.com to complete your enrollment between October 26 and November 12, 2021

y If you’re just starting your career at Ford, you can sign up during your new hire enrollment period

Visit myfordbenefits.com. Sign in if you’re outside the network using your Ford Benefits User ID and PIN. Note: If you currently have an HSA balance with HealthEquity, you can consent to transfer your existing balance, at no cost, to Smart-Choice during Annual Enrollment. This way, all of your HSA funds will be in one account in 2022.

Select Make your Annual Enrollment choices on the home page.

Select Research and Enroll on the Annual Enrollment welcome page.

View, compare or change your benefits on the benefits summary page. Don’t forget to make decisions about your spending and savings accounts here as well. Note: You’ll need to agree to the Terms and Conditions during the enrollment process to have a Smart-Choice HSA opened for you.

When you are ready to submit your elections, select Confirm Choices. You must submit your elections by November 12, 2021 at 11:59 p.m. ET to complete your 2022 enrollment.

When you receive a confirmation email, visit myfordbenefits.com to confirm your elections and make changes if needed. After November 12, contact the NESC immediately if there are errors.

How to enroll2 3 5 61 4

To make your HSA account fully functional (and in compliance with the USA PATRIOT Act), Smart-Choice needs to verify your identity. If they, for some reason, are not able to complete this process at the time of your enrollment, they may request additional information from you. This can happen for several reasons (e.g., you recently moved and your address changed, you recently changed your name).

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y If you elect an HSA-eligible plan — either the HSA Plan or HSA Plus Plan — during Annual Enrollment, you can open an HSA at any time throughout the plan year as long as you remain HSA-eligible. You can contribute to your HSA as long as you remain in the HSA Plan or HSA Plus Plan and remain HSA-eligible.

y If you elect an HSA-eligible plan with an HSA during your new-hire enrollment, your HSA will become effective the first day of the following month. For example, if you are hired in December 2021:

› Your HSA would become effective January 1, 2022

› You would not receive a Company contribution for 2021

› You would receive a Company contribution for 2022 if you enroll in the HSA Plus Plan for 2022

y You must be HSA-eligible and have your HSA through Ford to receive the Company contribution.

y If you change from an HSA-eligible to a non-HSA-eligible plan (UnitedHealthcare Global) or drop Ford medical coverage during the year due to a Qualifying Life Event, you will no longer be eligible to contribute to your HSA.

› Even though you won’t be able to add money to your HSA, your account will remain open and you’ll be able to use your funds to pay for eligible expenses.

y You’re not eligible to make or receive contributions to an HSA if you have non-HSA-eligible health care coverage elsewhere. For example:

› If you have coverage through your spouse’s employer’s non-HSA-eligible medical plan, or

› If your spouse’s health care Flexible Spending Account or HRA reimburses your medical expenses, or

› If you are covered by TRICARE

y You’re not eligible to make or receive contributions to an HSA if you’re enrolled in Medicare. It’s your responsibility to discontinue your HSA contributions before you’re enrolled in Medicare. IRS penalties may apply if you don’t cancel your HSA contributions upon enrolling in Medicare.

y Wealthcare Saver, Ford’s HSA custodian, may charge a fee for some transactions, such as transferring assets to another custodian.*

y If you are contributing to an HSA, you have the option to start, stop, increase or decrease your contribution at any time during the year.

Health Savings Account rules

*The Custody and Administrative fee is subject to change at the discretion of Smart-Choice. 10/21