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2009_0921_Packet
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2009_0921_Packet
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1/9/2012 3:13:41 PM
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10/13/2009 9:30:05 AM
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As noted earlier, you can be reimbursed only for expenses incurred during your Period of <br />Coverage for that Plan Year. In addition, no medical expense will be reimbursed under <br />this Plan to the extent that either the expense is covered by any health or accident plan or <br />insurance policy covering you, your spouse, or any Dependent or you will be reimbursed <br />for the expense from another source. <br />Limitations placed on your Medical Reimbursement Account when Participatin� in a <br />Health Savin�s Account (HSA) <br />If you choose to participate in the HSA offered through the Cafeteria Plan, you may be <br />limited to the type of expenses for which you can be reimbursed from the medical <br />reimbursement account. If you have elected to participate in the medical reimbursement <br />account and are covered under the HSA and High Deductible Health Plan, <br />reimbursements under the medical reimbursement account are limited to the following <br />expenses: <br />• Vision expenses <br />• Dental expenses <br />• Preventative care benefits that are not otherwise paid for by the <br />health care plan <br />• Qualified medical expenses that are incurred after the deductible <br />amount of the High Deductible Health Plan in which you are <br />enrolled has been met. Certification that the deductible has been <br />met must be provided to the Claims Administrator before these <br />expenses would be eligible for reimbursement. <br />If you participate in an HSA outside the Plan, no such limitations for reimbursement will <br />be applied by the Plan. The Plan assumes no responsibility for monitoring distributions <br />subject to the HSA rules when you participate in the Plan and in an HSA outside of the <br />Plan. However, you will still be individually responsible for not taking ineligible <br />reimbursements from the Medical Reimbursement Account when participating in an HSA <br />regardless of who administers the HSA. <br />5. Dependent Care Reimbursement Expenses. You may also set aside Pay Conversion <br />Contributions in a dependent care reimbursement account. This account can be used to <br />reimburse you for amounts paid for household services or for the care of a Qualifying <br />Individual if those amounts are paid to permit you to be gainfully employed during a <br />period for which there is a Qualifying Individual with respect to you. If expenses are <br />incurred outside of your household, they will be eligible for reimbursement only if they <br />are incurred for the care of a Qualifying Individual under the age of thirteen (13) or a <br />Qualifying Individual that spends at least eight (8) hours per day in your household. A <br />Qualifying Individual is generally your dependent under the age of 13 or a dependent who <br />
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