4.13 SR 05-06-2024 - Laserfiche WebLink

Home Browse Search

© 2012 Hitesman & Wold, P.A. City of Elk River Flexible Benefits Plan 42 in accordance with the Cafeteria Plan Regulations, the Plan may reimburse expenses for orthodontia care in advance. 17.7 Reimbursement of Expense. The Participant shall be reimbursed as specified in Section 6.7 from the Participant’s Limited Scope ME Account for eligible Limited Scope Medical Expenses incurred during the applicable Plan Year, and the Grace Period, if applicable, for which the Participant submits the documentation required under Article VI. An amount up to the sum of the Participant’s Election and the Employer Contribution, if any, and reduced as of any particular time for prior reimbursements for the same Plan Year, shall be available for reimbursement at all times during the Plan Year, and the Grace Period, if applicable. Claims for reimbursement within a Plan Year, and the Grace Period, if applicable, must be submitted prior to the close of the Claims Run-Out Period for such Plan Year. In no case shall a payment be made which exceeds the annual balance remaining in the Participant’s Limited Scope ME Account at the time reimbursement is processed. If a claim for reimbursement exceeds the balance in the Participant’s Limited Scope ME Account, the excess part of the claim will be denied. Under no circumstances (a) will any balance remaining in a Participant’s Limited Scope ME Account at the end of the Plan Year, and the Grace Period, if applicable, be carried over to the next Plan Year; or (b) will an otherwise eligible Limited Scope Medical Expense be carried over to the next Plan Year. 17.8 Maximum Reimbursement. The maximum reimbursement a Participant may receive for a Plan Year under this portion of the Plan shall be the lesser of: (1) $3,000; or (2) the maximum amount of salary reduction contribution that may be made to the Medical Expense Reimbursement Plan under applicable law. The maximum reimbursement amount applies to the Participant, Spouse, and Dependent on an aggregate basis, not an individual basis. 17.9 Reimbursement Upon Termination of Participation. If an individual ceases to be a Participant in this portion of the Plan, coverage shall cease (which means that reimbursements shall cease) unless benefits under the Plan are continued as provided in Section 17.14. If coverage ceases, reimbursements for eligible Limited Scope Medical Expenses incurred before participation terminated may be reimbursed if submitted within thirty (30) days of the date on which participation was terminated. 17.10 Participant’s Death. In the event a Participant dies having incurred an eligible Limited Scope Medical Expense (a) which would have been reimbursable out of the Participant’s Limited Scope ME Account had the Participant not died; and (b) for which a person or the Participant’s estate has paid for or assumed liability for the expense, reimbursement may be made to that person or the estate for that payment or assumption. The remainder of the Participant’s Limited Scope ME Account shall be forfeited in accordance with Section 5.6. 17.11 Nondiscrimination. This portion of the Plan shall not discriminate in favor of Highly Compensated Individuals as to eligibility to participate or benefits. If the Plan Administrator determines that this portion of the Plan is or may be discriminatory, the Plan Administrator may take action permitted by law to avoid such result. If the Plan fails any applicable nondiscrimination requirements, Highly Compensated Individuals shall have taxable income imputed to the extent required by law. 17.12 Limited Scope ME Account Forfeiture. (a) Limited Scope ME Claims Grace Period. The Claims Grace Period for the Medical Expense Reimbursement Plan shall expire on March 15th of the following year. (b) Limited Scope ME Account Claims Run-Out Period. Amounts attributed to a Participant’s Limited Scope ME Account for any Plan Year shall be used only to reimburse the Participant for eligible Limited Scope Medical Expenses incurred during such Plan Page 135 of 254