The Lane Public Library
INTRODUCTION
Lane Public Library (the "Employer") is pleased to sponsor an employee benefit program known as a "Health Reimbursement Arrangement" (the "Plan") for you and your fellow full-time employees.
This Summary Plan Description describes the basic features of the HRA, how it operates, and how you can get the maximum advantage from it. This is only a summary of the key parts of the Plan, and a brief description of your rights as a Participant. It is not a part of the official plan documents. If there is a conflict between the plan documents and this booklet, the plan documents will apply.
Q-1. What is the purpose of the Plan?
The purpose of the Plan is to supplement the benefits provided under Lane’s group health insurance plan, Anthem.
Q-2. What benefits are provided by the Plan?
The plan provides the following benefits:
The Plan will reimburse eligible participants for eligible in-network medical deductible expenses after the payment of the first $250 of the in-network medical insurance deductible to a maximum of $750 per single contract or after the payment of the first $500 of in-network medical insurance deductible expenses to a maximum of $1,500 per family contract per calendar year.
Q-3. Who can participate in the Plan?
Employees who participate in Lane’s group medical insurance plan (Anthem) are eligible to participate in the HRA. Eligible Employees will be considered a Participant in the Plan effective the same day as they may become eligible for Lane's group health insurance plan.
Q-4. How is my Health Care Reimbursement benefit paid for?
Lane Public Library pays the entire cost.
Q-5. How do I become a Participant?
You automatically become a Participant by enrolling in Anthem’s group medical insurance plan.
Q-6. Can I still benefit from the Plan if I am terminated from my employer?
If your employment has been terminated, you may submit claims for reimbursement which were incurred prior to and including your termination date. (COBRA rules do apply to the HRA)
Q-7. How long will the Plan remain in effect?
Although Lane Library expects to maintain the Plan indefinitely, it has the right to modify or terminate the program at any time. It is also possible that future changes in state or federal tax laws may require that the Plan be amended accordingly.
Q-8. How do I receive reimbursement under the Plan?
You will have to take certain steps to be reimbursed for your Medical Expenses. When you incur an expense that is eligible for payment, you must submit a claim to the Business Office on a Claim Form that can be obtained on the staff intranet. In addition, you must include a copy of the Explanation of Benefits (EOB) Form(s) from Anthem indicating the amount(s) that you are obligated to pay.
You will have until March 31 after the end of the calendar year (December 31) to submit all claims with the EOB dates for the last quarter (October, November, and December) of the previous year. Any EOB dated prior to October 1, of the previous year will not be reimbursed.
To have your claims processed as soon as possible, please read the claims instructions on the form which you obtained from the intranet. Please note that it is not necessary for you to have actually paid the bill an amount due for a Medical Expense- - -only for you to have incurred the expense and that it is not being paid for or reimbursed from any other source.
Q-9. What is an eligible "Medical Expense"?
An eligible "Medical Expense" is an expense that is approved by Anthem and is applied towards your deductible.
Q-10. When must the expenses be incurred?
Medical Expenses must have been incurred during the Plan Year (January 1st thru December 31st). A medical expense is incurred when the service that gives rise to the expense is provided; when the expense is paid is irrelevant. Note that if you have paid for the expense but if the services have not yet been rendered, then the expense has not been incurred for this purpose. For example, if you pay for medical care on the first day of the month for care given during that month, the expense has not been incurred until the end of that month. You may not be reimbursed for any expenses arising before the Plan became effective, or after a separation from service
Q-11. Will I be taxed on the Health Reimbursement Arrangement Benefits I receive?
You will not be taxed on your Health Reimbursement Arrangement Benefits.
If you have additional questions regarding the HRA, please contact the Human Resources Department.
