07-D TML Health Reimbursement Acct

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TABLE OF CONTENTS TML INTERGOVERN'MENT AL .............................................................................................................................1 INTRODUCTION .......................................................................................................................................................4 GENERAL INFORMATION .....................................................................................................................................4 NAME AND TYPE OF PLAN AND FISCAL yEAR............................................................................................................4 ADMINISTRATION OF THE PLAN. ... ........... ...... ..... .......... ...... ... ........ ........... ... ........... ... ......... ........ .............. .... ...... ....... 4 AGENTS FOR SERVICE OF LEGAL PROCESS ... ........... ............... ............... ..... ............. ..... .................. ....... .......... ...... ..... 4 AMENDMENTS TO OR TERMINATION OF THE PLAN .....................................................................................................4 FLEXIBLE BENEFIT PLAN ....................................................................................................................................5 How THE PROGRAM WORKS......................................................................................................................................5 WHAT ARE BEFORE-TAX DOLLARS? ................... ........................... ........................................ ........ ............................5 ELIGffiILITY............................................................................................................................. ...... ............................. 5 CHANGES IN ELIGffiILITY ............ ............................. ...... ........... ........ ....... ............... ............ ............ ....... ........ ... .........5 CHOOSING A DEPOSIT AMOUNT .. ..... ......... .......... ... ................... ........ ....... .... .................................. ........ ........... .........5 RESTRICTIONS ON CHANGING YOUR DEPOSIT AMOUNTS .......................................................................................... 6 SEP ARA nON FROM SERVICE... ..................... .......... ............ .................. ............... ............ .......... ............. .................... 6 FORFEITURE OF BENEFITS ... ............ ......... ...... ........ ...... ................ .... ............. ............... ... ...... ............ ..... ...... ....... ....... 7 No TRANSFER BETWEEN ACCOUNTS..........................................................................................................................7 REIMBURSEMENTS .. ..... .... ...... ....... ........... ........................................ .................... ...... ................ .......... ..... ...... ........... 7 FLEXffiLE SPENDING ACCOUNT STATEMENTS ...... .................... ......... ............ ............. .................. ...... ....... .......... ....... 7 ACTIVE DuTY REsERVIST .......... ..... .................................... ......... .... ....................................... .............. .... ....... .......... 7 THE EFFECT OF THE PLAN ON OTHER BENEFITS ....................................................................................... 8 CLAIMS INFORl\1A TION ........................................................................................................................................8 PAYMENT OF CLAIMS ................................................................................................................................................. 8 PREMIUM CONVERSION PLAN ...........................................................................................................................8 UNREIMBURSED HEALTH CARE SPENDING ACCOUNT .............................................................................8 WHAT EXPENSES ARE ELIGffiLE FOR REIMBURSEMENT?............................................................................................8 How TO GET REIMBURSED ........................................................................................................................................9 PRIVACY OF YOUR HEALTH INFORl\1ATION .................................................................................................9 DEPENDENT CARE REIl\fBURSEMENT ACCOUNT ......................................................................................10 WHY You SHOULD BUDGET CAREFULLY ................................................................................................................1 0 How TO GET REIMBURSED ......................................................................................................................................1 0 TYPICAL ELIGmLE MEDICAL OR MEDICAL-RELATED EXPENSES .....................................................11 DEFINITIONS ....................................................................................................................c..................................... 21 CAPITAL EXPENSES .............................................................................................................................................23 OPERATION AND MAINTENANCE ... ........... ....... .... ........ ..... ............. ............ .......................... ............. ........ ..... ..........23 IMPROVEMENTS TO PROPERTY RENTED BY A PERSON WITH DISABILITIES............................................................... 23 El\ IPLO YEE ENROLLMENT FO Rl\1.. .................................. ....................................................................... ........ 24 UNREIMBURSED HEALTH CARE REIMBUR.SEMENT FORl\1....................................................................25 DEPENDENT CARE REIMBURSEMENT FORl\1..............................................................................................26 Page 3