07-D TML Health Reimbursement Acct

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b. Changes. For subsequent plan years, the maximum dollar limit may be changed by fhe Employer and shall be communicated to Employees through the Enrollment Form, the Schedule of Medical Expense Benefits or Plan document. c. Nondiscrimination. Reimbursements to highly compensated Individuals may be limited or treated as taxable compensation to comply with Code ~ 105(h), as may be determined by the Administrator in its sole discretion. 6.4 Establishment of Account The Administrator will establish and maintain an HRA Account. The HRA Account so established will reimburse eligible medical expenses per Section 213. a. Crediting of Accounts. A Participant's HRA Account will be credited at the beginning of each month with an amount equal to the applicable maximum dollar limit for the Period of Coverage divided by the number of months in that Period of Coverage (e.g., divided by 12 in a 12-month Plan Year), increased by any carryover of unused HRA Account balance from a prior Period(s) of Coverage. b. DeMing of Accounts. A Participant's HRA Account will be debited during each Period of Coverage for any reimbursement of Medical Care Expenses incurred during the Period of Coverage. c. Available Amount. The amount available for reimbursement of Medical Care Expenses is the amount credited to the Participant's HRA Account under subsection (a) reduced by prior reimbursements debited under subsection (b). 6.5 Carryover of Accounts If any balance remains in the Participant's HRA Account for a Period of Coverage after all reimbursements have been made for the Period of Coverage, such balance shall be carried over to reimburse the Participant for Medical Care Expenses incurred during a subsequent Period of Coverage. 6.6 Reimbursement Procedure a. Timing. In cases where a debit card tied to the HRA Account is not used: within 30 days a~er receipt by the Administrator of a reimbursement claim from a Participant, the Employer will reimburse the Participant for the Participant's Medical Care Expenses (if the Administrator approves the claim), or the Administrator will notify the Participant that his or her claim has been denied (see Section 8.1 regarding procedures for claim denials and appeals procedures). This time period may be extended for an additional 15 days for matters beyond the control of the Administrator, including in cases where a reimbursement claim is incomplete. The Administrator will provide written notice of any extension, including the reasons for the extension, and will allow the Participant 45 days in which to complete an incomplete reimbursement claim. b. Claims Substantiation. A Participant who seeks Benefits may apply for reimbursement by submitting an application in writing to the Administrator in such form as the Administrator may prescribe, by no later than the last day of the third month following the close of the Plan Year in which the Medical Care Expense was incurred, setting forth: · The person or persons on whose behalf Medical Care Expenses have been incurred; · The nature and date of the Medical Care Expenses so incurred; · The amount of the requested reimbursement; and · A statement that such Medical Care Expenses have not otherwise been reimbursed and are not reimbursable through any other source and that Health Flexible Spending Account coverage, if any, for such Medical Care Expenses has been exhausted. The application shall be accompanied by bills, invoices or other statements from 'an independent third party showing that the Medical Care Expenses have been incurred and the amounts of such Medical Care Expenses, together with any additional documentation that the Administrator may request. c. Claims Denied. For reimbursement claims that are denied, see the appeals procedure in Article VIII. Page 6