4.9. SR 12-16-2013 - Laserfiche WebLink

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ARTICLE XVII. LIMITED SCOPE MEDICAL EXPENSE REIMBURSEMENT PLAN 17.1 Purpose. The purpose of this Article is to provide Participants with the opportunity to be reimbursed for certain eligible Limited Scope Medical Expenses as an Optional Benefit under the Plan. This Article is intended to qualify as a medical reimbursement plan under Section 105 of the Code so that payments received under this portion of the Plan are excludable from the gross income of the Participant under Section 105(b) of the Code. This Article is also intended to be 'permitted coverage" for purposes of determining eligibility for health savings account contributions under Section 223 of the Code. 17.2 Separate Written Plan. For purposes of Section 105 of the Code, this Article shall constitute a separate written plan providing for the reimbursement of Limited Scope Medical Expenses. This is a separate and distinct 'plan" from the Medical Expense Reimbursement Plan described under Article XV. To the extent necessary, other provisions of the Plan are incorporated by reference. 17.3 Definitions. (a) Claims Run-Out Period means the period beginning on the first day following the close of the Grace Period and ending on thirty (30) days from the close of the Grace Period. (b) Dependent means an individual who is a Tax Dependent. (c) Highly Compensated Individual means an individual who is highly compensated as defined in Section 105(h)(5) of the Code. (d) Limited Scope Medical Expense Account ("Limited Scope ME Account") means the record keeping account established by the Plan Administrator for each Plan Year for each Participant from whom an Election to create such an account is received. (e) Limited Scope Medical Expense means an expense incurred during the applicable Plan Year by a Participant or by the Spouse or Dependent of a Participant for dental and vision within the meaning of 'medical care" as defined in Section 213(d) of the Code. However, a Participant may not be reimbursed for dental and vision care of the type covered under the"qualifying high deductible plan" under Section 223(c)(2) of the Code, and a Participant may not be reimbursed for the cost of other dental or vision coverage such as premiums paid under plans maintained by an employer of the Participant's Spouse or individual policies maintained by the Participant or his or her Spouse or Dependent. 'Limited Scope Medical Expense" shall include drugs and medicine only to the extent allowed by Section 106(f) of the Code. 17.4 Limited Scope Medical Expense Account. The Limited Scope ME Account will be credited with the amount elected by the Participant and the Employer Contribution, if any, at the beginning of the Plan Year. A Participant's Limited Scope ME Account will be decreased from time to time in the amount of payments made to the Participant for eligible Limited Scope Medical Expenses incurred during the Plan Year and Grace Period, if applicable. 17.5 Claims Determination. Claim submission, determination, and appeals shall be handled in accordance with Article VI. 17.6 Incurred Expenses. To be reimbursable, an eligible Limited Scope Medical Expense must have been incurred after participation in this portion of the Plan began and during the Plan Year for which reimbursement is claimed or the Grace Period related to such Plan Year, if applicable. An expense is 'incurred" when the Participant is provided with the care which gives rise to the eligible Limited Scope Medical Expense, not when the service is billed or paid. Reimbursement shall not be made for future projected expenses. Notwithstanding the foregoing, pursuant to and ©2012 Hitesman&Wold, P.A. 41 City of Elk River Flexible Benefits Plan