2006-041-RES-Health Reimbursement

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2.4 The Plan Supervisor shall render periodic reports to each participant, which shall include the following: a. Receipts of the Participant's Plan Contributions; b. Disbursement of Plan Contributions through claims payments; and c. Statements of (a) and (b) above shall automatically be provided each Participant following the submission and payment of a qualified claim. 2.5 The Plan Supervisor, shall prepare a Plan Document for the Flexible Benefits Plan sponsored by the Member. The Plan Sponsor shall assume the responsibility of obtaining legal review of the Plan Document. 2.6 Unless otherwise provided, the Plan Supervisor is authorized to do all the things necessary or convenient to carry out the terms and purposes of the Plan. SECTION III PROCEDURE FOR MAKING AND PAYMENT OF CLAIMS FOR BENEFITS FROM THE FUND 3.1 Any covered person may make application for benefits from the Plan as provided by the Plan upon the form or forms provided by the Plan Supervisor. The applicant shall fully and truthfully complete such application for benefits and the applicant shall supply all such pertinent information including copies of paid receipts, as may be required under the Section 125 rules and specified by the Plan Supervisor. 3.2 The Plan Supervisor shall accept copies of any application for benefits made in the appropriate manner, shall duly investigate and verify the statements made on the application and determine benefit eligibility. If the facts as stated in such application entitle the covered person to receive, payment of benefits from the Plan, the Plan Supervisor shall forthwith arrange for the proper payment. 3.3 Claim filings shall be mailed to the person or department designated by the Plan Supervisor. Claims checks are processed each week. Only claims that equal or exceed twenty-five dollars ($25.00) or more shall be filed with the Plan Supervisor unless said claim is being submitted during the last Plan Month of the Plan Year. During the last month, eligible claims of any amount shall be processed by the Plan Supervisor. 3.4 All Plan benefits processed by the Plan Supervisor shall be mailed to the qualified Plan Participant within ten (10) days of approval. If the Plan Supervisor finds that the Plan Participant is not entitled to a claim payment under the Plan, the claim application shall be denied, all or in part, and returned to the Plan Participant with the Plan Supervisor's reason for denial. The Plan Participant may appeal a denial by the Plan Supervisor to the Plan Sponsor. The Plan Sponsor's determination is final and conclusive upon the covered person. 3.5 The Plan Supervisor shall not be liable for any failure or refusal to payor honor any application for benefits made pursuant to this Agreement; and the Plan Supervisor must be indemnified by the Plan Sponsor for any liability related to its duties herein, and shall be reimbursed by the Plan, Sponsor for any expense, loss, damage, or legal fees incurred by the Plan Supervisor in defending any claims or demands made against the Plan Sponsor, the Plan Sup~rvisor or the Plan. This paragraph will not apply for any loss due to the gross negligence or willful misconduct of the Plan Supervisor. Page 3