6.5. ERMUSR 01-15-2008 - Laserfiche WebLink

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ARTICLE XI. MEDICAL EXPENSE REIMBURSEMENT PLAN 11.1 Separate Written Plan. For purposes of Section 105 of the Code, this Article shall constitute a separate written plan, the Medical Expense Reimbursement Plan ("ME Plan"), providing for the reimbursement of Medical Expenses. To the extent necessary, other provisions of the Plan are incorporated by reference. 11.2 Purpose. The purpose of this Article is to provide Participants with the option of being reimbursed for eligible Medical Expenses. This Article is intended to qualify as a medical reimbursement plan under Section 105(h) 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. 11.3 Definitions. (a) Dependent means an individual who is a "dependent" under Section 152 of the Code, determined without regard to subsections (b)(1), (b)(2), and (d)(1)(B) thereof. (b) Highly Compensated Individual means an individual who is highly compensated as defined in Section 105(h)(5) of the Code. (c) Medical Expense means an expense incurred during the applicable Plan Year by a Participant, Spouse, or Dependent for medical care as defined in Section 213 of the Code, excluding premiums for health coverage, health reimbursement arrangements ("HRAs"), medical savings accounts ("MSAs'~, and long-term care coverage. Medical care generally refers to the diagnosis, cure, treatment, or prevention of disease or for the purpose of affecting any structure or function of the body. Also included, are transportation expenses for and essential to medical care. (d) Medical Expense Account ("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. 11.4 Medical Expense Account. The 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 ME Account will be decreased from time to time in the amount of payments made to the Participant for eligible Medical Expenses incurred during the Plan Year. 11.5 Claims for Reimbursement. A Participant who has made an Election for a Plan Year may apply to the Claims Administrator for reimbursement of eligible Medical Expenses incurred during such Plan Year by submitting a claim form provided by the Claims Administrator setting forth at least the following: (a) the amount, date and nature of the expense, (b) the name of the person or entity to which the expense was paid, (c) the Participant's statement that the expense has not been reimbursed or is not reimbursable from any other source, and (d) such other information as the Claims Administrator may require. Such claim form shall be accompanied by bills, invoices, receipts, or other statements from an independent third party stating the eligible Medical Expense has been incurred and the amount of ©2007 Hitesman & Associates, P.A. 24 Elk River Municipal Utilities 122707 Flexible Benefits Plan