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10-10-2022 Council Packet
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10-10-2022 Council Packet
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© Hitesman & Wold, P.A. 2019 <br />Cafeteria Plan <br />Summary Description (3-11) <br />52 <br />Please note that it is not necessary that you have actually paid an amount for that expense to be <br />eligible for reimbursement. You only must have incurred the expense and not have been reimbursed or <br />paid from another source. An expense is "incurred" when the service which gives rise to the expense has <br />been provided, not when you are billed or when you pay the expense. <br /> <br />Special Rule: A special rule applies to expenses for orthodontia care. Such expenses may be <br />reimbursed before the orthodontia care has been provided if you have actually paid the healt hcare provider <br />in advance in order to receive the services (e.g., an upfront payment required to receive services). <br />7.8 What is the Grace Period? <br />“Grace Period” means the period beginning on January 1 and ending on March 15 each Plan Year. <br />Claims incurred during the Grace Period will be considered to have been incurred during both the preceding <br />Plan Year and the current Plan Year. For example, a claim incurred on March 1, 20 18 will be deemed to <br />have been incurred during both the Plan Year running from January 1 through December 31, 2017, and <br />the Plan Year running from January 1 through December 31, 2018. <br /> <br />Claims incurred during the Grace Period will be first allocated to and reimbursed from your Limited <br />Scope account for the preceding Plan Year until such account is exhausted. Thereafter, any such claims <br />will be allocated to and reimbursed from your Limited Scope account for the current Plan Year. Claims <br />incurred during the Grace Period will be allocated based upon the date the claim is received. Once a cl aim <br />is allocated to an account, no changes, modifications, or adjustments will be allowed. In addition, no <br />adjustment to your election for the current Plan Year may be made based upon the amount of claims <br />incurred during the Grace Period that are reimbursed from the prior Plan Year’s account. <br /> <br />NOTE: A claim incurred during the preceding Plan Year and submitted during the claims run -out period <br />will be processed subsequent to a previously submitted claim incurred during the Grace Period, even if your <br />Limited Scope account from the preceding Plan Year is exhausted by reimbursement of the claim incurred <br />during the Grace Period. <br />7.9 What if I am no longer eligible? <br />If your employment terminates, or you otherwise cease to be eligible for coverage under the <br />Limited Scope Health FSA, your benefits under the Limited Scope Health FSA stop. You may not make any <br />further contributions to your Limited Scope account, and you may not submit claims for reimbursement of <br />expenses incurred after you terminated employment or otherwise ceased to be eligible for coverage. You <br />may, however, continue to submit claims for expenses incurred before you terminated employment or <br />otherwise ceased to be eligible for coverage until the expiration of the claims run out period following the <br />end of the Plan Year described in Section 4.5. <br /> <br />NOTE: This rule may differ from the rule applicable to the Dependent Care FSA. Please refer to the part <br />of this summary describing the Dependent Care FSA for the rules that apply to the Dependent Care FSA. <br />7.10 Can coverage be continued? <br />If your employment terminates or you otherwise cease to be eligible for the Limited Scope Health <br />FSA, you and any others who receive their coverage through you may be able to continue that coverage. <br />Continuation coverage is available in accordance with the Consolidated Omnibu s Budget Reconciliation Act <br />of 1985 ("COBRA”) and the Uniformed Services Employment and Reemployment Rights Act of 1994 <br />("USERRA"). These continuation rights are described later in this summary.
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