(effective January 1,2018) or
HEALTH EXPENSE REIMBURSEMENT BENEFIT
**you can selecteither (but not both)
- The Benefit shall be $200.00 per calendar year for Full-Time Employees and Retired Employees
- The Benefit shall be $100.00 per calendar year for Part-Time Employees
Who is Eligible:
- Full-Time Employees
- Part-Time Employees
- Retired Employees
Premium contributionstoward NYSHIP or any other New York State issued Health Plan applicable toCourt Employees, such as employee co-payments, up to $200.00 per calendar year.Payment is limited to such premium contribution required to be made by anemployee. To receive reimbursement of a premium contribution, you will need toprovide the Fund Office with supporting documentation such as a record of yoursalary payment. (i.e., a copy of your most recent pay stub indicating ayear-to-date payment of the Health Insurance Premium totaling at least $200)
Claims can besubmitted at any time until the maximum is met, but not later than December31st of the year in which reimbursement of the premium contribution is sought.
HEALTHEXPENSE REIMBURSEMENT BENEFIT (ALTERNATE)
The HealthExpense Reimbursement Benefit can be used for reimbursement ofprescription drug benefits, and Health Insurance Copayments. The benefit shallbe $200.00 per calendar year, effective January 2016. All prescription drugsand health insurance copayment claims shall be processed as part of thisbenefit.
To receivereimbursement from eligible expenses you incur on or after January 1st -December 31st of the calendar year, you will need to complete aclaim form and send it to the Fund Office along with all supporting originaldocumentation (Explanation of Benefits (EOB) or other proof of your eligiblehealth care or prescription expenses) that will verify the claim.
No reimbursement will be made without, at minimum, (1) a writtenstatement of an independent 3rd party such as an EOB for you stating that theexpense had been incurred and the amount of the expense and (2) awritten statement and documentation (e.g., pharmacy receipts or print outs fromthe participant that the expense has not been reimbursed and is notreimbursable under another health plan coverage.
No reimbursement of eligible health care expenses under this benefitprovision shall be made if such expenses have been reimbursed by any otherhealth care insurance, provider or entity or if you have filed a claim for apremium/contribution reimbursement claim during the calendar year.
Claims can be submitted only ONCE A YEAR at any time after the maximum expenseamount ($200) but in no event later than the last business day of that calendaryear in which the claim was incurred.