Health Reimbursement Account Program

HEALTH REIMBURSEMENT ACCOUNT PROGRAM

The Trustees have established the Health Reimbursement Account Program (HRAP) to allow Participants and their Dependents to withdraw amounts from their individual HRAs to cover certain medical care expenses and self-contribution expenses (as defined by Internal Revenue Code §213 – which can be deducted as an itemized expense on your income tax return – see the 3^rd paragraph) which are related to, but not covered under, the regular provisions of the NECA Local 145 IBEW Welfare Plan or another plan providing benefits to a Participant or their Dependents. 

HRAs are not savings accounts from which the Participant can withdraw at will.  Participants and their Dependents are not vested in their HRA balances.  No interest will be paid on HRAs.  Amounts accumulated in a Participant’s HRA can only be used for qualified medical expenses and self-contribution expenses, subject to the rules and provisions set forth in the Plan.

Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body. They include the costs of equipment, supplies, and diagnostic devices needed for these purposes. They also include dental expenses.  Medical expenses include the premiums you pay for insurance that covers the expenses of medical care, and the amounts you pay for transportation to get medical care. Medical expenses also include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract.

Self-contributions are the payments made to the Fund - NECA Local No. 145 IBEW Welfare Plan for the purpose of continuation of eligibility for Plan benefits.

No amounts for which payment has been or will be made by another benefit or insurance plan, including benefit plans provided by any government program (including but not limited to Medicare) will be reimbursable under this program.  The total combined reimbursement from all benefit/insurance plans when added to the amount of the HRA reimbursement cannot exceed 100% of the allowable amount.

The Trustees reserve the right to eliminate or modify this program at any time and in their sole discretion.  It is the intention of the Board of Trustees that the appropriate governing documents be amended to reflect the inclusion of the Health Reimbursement Account Program (HRAP).  Further, it is the intention of the Board of Trustees that, if for some reason, it becomes prudent to terminate the program, they will do so.  In the event of termination, Participants and their Dependents will be allowed to file claims against their individual accounts until they are depleted, understanding that the Health Reimbursement Account (HRA) is not a vested benefit.

ELIGIBILITY

The eligibility rules applicable to the regular Plan do not apply to the HRAP.  A Participant who has a balance in his HRA is eligible to use his HRA for the qualified medical expenses and self-contribution expenses specified above.  In order to receive a Health Reimbursement the Participant does not have to be eligible for regular Plan benefits when the qualified medical expense is incurred, when the reimbursement request is submitted or received, or when the Health Reimbursement check is issued.

If the reimbursement request is for a Dependent the reimbursement will be sent to the participant along with the “Health Reimbursement Account Report”.  The term Dependent is defined as the following:  the Dependent was or will be claimed as a Dependent on my Federal Income Tax Return for the period during which the expense was incurred.  Proof may be required.  

Entitlement to reimbursement and the amount of any such reimbursement made by the Plan from the Participant’s Health Reimbursement Account will be based on the amount of the Participant’s individual HRA balance at the time the reimbursement check is issued.

If a Participant dies and there is a balance remaining in his HRA, the Spouse or other Dependents of the deceased Participant may use the balance remaining in the Participant’s HRA for the qualified medical expenses and self-contribution expenses specified above.  The balance shall be forfeited if there are no Dependents. 

HEALTH REIMBURSEMENTACCOUNT (HRAs)

1. The Plan will allocate hourly Health Reimbursement Contributions paid by an Employer on behalf of a Participant into the individual HRA established by the Plan for the Participant.

2. If the Participant is working outside the jurisdiction of the Fund under a reciprocity agreement, the Plan will allocate the first $0.55 (rate effective June 1, 2008) of each hourly reciprocal contribution as a Health Reimbursement Contribution.

3. If the Plan issues an HRA reimbursement check to a Participant for a qualified medical expense and/or self-contribution reimbursement, the Participant’s individual HRA will be reduced by the amount of such reimbursement.

4. HRA balances can be carried forward from year to year.

5. The balance remaining in a Participant’s individual HRA will be transferred back to the Plan and such Participant’s HRA balance will be reduced to zero if there is no account activity (i.e., no contributions to or benefits paid from the HRA) for five (5) consecutive calendar years.

6. No interest will be paid on HRAs.

7. HRAs are not savings accounts from which the Participant can withdraw at will.  Participants and their Dependents are not vested in their HRA balances.

REIMBURSEMENT REQUIREMENTS

1. Requests must be received by the Fund Office no later than one year (12 months) following the date on which the expense was incurred.

2. FOR MEDICAL REIMBURSEMENT the minimum amount a Participant can request is $100.  However, if a Participant incurs less than $100 in medical expenses during a calendar year, he may submit a request for less than $100 at the end of the calendar year in which the expense was incurred.

3. FOR SELF-CONTRIBUTIONS REIMBURSEMENT a Participant can request less or more than $100 towards continuation of coverage.   

4. Medical Reimbursement requests must be submitted to the Plan with the following items:
   1. A properly completed request form which will be provided to the Participant by the Fund Office upon request. 
   2. A copy of the itemized bill or receipt showing proof of payment or other evidence that Medical Expenses were incurred.
   3. All explanation of benefits (EOBs) from primary insurance company & with respect to any expenses for which another plan is secondary to this Plan, the reimbursement request must also include a copy of the secondary plan’s EOB.

5. Self-Contribution Reimbursement requests MUST BE submitted to the Plan with the following a properly completed request form which will be provided to the Participant by the Fund Office upon request and/or with each quarterly report.

6. For every reimbursement request a statement will be mailed to the member.  The statement will show the balance of the HRA before and after the reimbursement is issued (if applicable), the deduction (if applicable) of the reimbursement and a check (if applicable).  The member will also receive a quarterly statement showing any contributions, deductions, beginning and ending balance of your HRA. 

ALL HEALTH REIMBURSEMENTS

1. Requests received by the Fund Office on or before the last business day of the month will be processed early in the following month.  If the member is entitled to reimbursement under the rules & provisions of this Plan, the reimbursement check will be issued on or about the 15^th day of the month following the month in which the request was received.  Requests that are submitted to the Fund Office on a non-business day will be dated as being accepted on the next business day.

2. Upon receipt of a reimbursement request for a qualified medical expense and self-contribution expense that has been submitted in accordance with the provisions above, the Plan will issue a reimbursement check payable to the Participant and will deduct the amount of such reimbursement from the Participant’s HRA.  The amount of the reimbursement will be the amount of the qualified medical expense up to, but not to exceed, the amount in the Participant’s HRA at the time the check is issued.