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ORD 1993-15 - Amending Cafeteria Plan - Medical Reimbursement 05-04-1993ORDINANCE NO. 93 -15 AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF HUNTSVILLE, TEXAS, AMENDING ITS CAFETERIA PLAN TO PROVIDE A MEDICAL EXPENSES REIMBURSEMENT PROGRAM; AND MAKING OTHER PROVISIONS RELATED THERETO. BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF HUNTSVILLE, TEXAS, that SECTION 1: Ordinance 88 -13, An Ordinance of the City of Huntsville, Texas, Establishing a Cafeteria Plan for the City of Huntsville, is hereby amended as follows: (a) Section 4.02, Benefit options, is amended by the addition of a new subsection (2) (and by renumbering the subsequent subsections) which shall read as follows: "2. Medical expense reimbursement program;". (b) Article XI, Group Term Life Insurance, and Article XII, Miscellaneous, are renumbered Article XII and XIII, respectively, and a new Article XII is added which shall read as follows: XII. Election to Receive Medical Care Expense Reimbursements. 12.1. Election procedure. A Participant may elect to receive reimbursements of his or her Qualifying Medical Care Expenses under this Plan by filing an election and compensation reduction agreement. An election to receive reimbursements of Qualifying Medical Care Expenses may not be revoked by the Participant during the Plan Year. 12.2. Coverage amount. A Participant may elect to receive payments or reimbursements of Qualifying Medical Care Expenses incurred in any Plan Year up to any dollar amount specified by the Participant, but not exceeding $2,400. 12.3. Establishment. The Administrator will establish and maintain on its books a Medical Reimbursement Account for Each Plan Year with respect to each Participant who has elected to receive reimbursement of Qualifying Medical Care Expenses incurred during the Plan Year. 12.4. Crediting of accounts. There shall be credited to a Participant's Medical Reimbursement Account for each Plan Year, as of the beginning of such Plan Year, an amount equal to the Participant's Coverage Amount for such Plan Year. Except as otherwise required by law, the amount credited for each Plan Year shall be the property of the Administrator until paid out pursuant to Sections 12.7 and 12.8. 12.5. Debiting of accounts. A Participant's Medical Reimbursement Account for each Plan Year shall be debited from time to time in the amount of any payment under Section 12. to or for the benefit of the Participant for Qualifying Medical Care Expenses incurred during such Plan Year. 12.6 Forfeiture of accounts. The amount credited to a Participant's Medical Reimbursement Account for any Plan Year shall be used only to reimburse the Participant for Qualifying Medical Care Expenses incurred during such Plan Year while a Participant, and only if the Participant applies for reimbursement on or before the September 30th following the close of the Plan Year. If any balance remains in the Participant's Medical Reimbursement Account for a Plan Year after all reimbursements hereunder, such balances shall not be carried over to reimburse the Participant for any Qualifying Medical Care Expenses incurred during a subsequent Plan Year, and shall not be available to the Participant in any other form or manner, but shall remain the property of the Administrator, to the extent permitted by law, and the Participant shall forfeit all rights with respect to such balance. 12.7. Claims for payment of medical care expense reimbursements. A Participant who has elected to receive medical care reimbursements for a Plan Year may apply to the Administrator for reimbursement of Qualifying Medical Care Expenses incurred while a Participant during the Plan Year by making application in writing to the Administrator, in such form as the Administrator may prescribe, setting forth: a) the amount, date and nature of each expense; b) the name of the person, organization or entity to which the expense was or is to be paid; c) the name of the person for whom the expense was incurred and, if such person is not the Participant requesting the benefit, the relationship of such person to the Participant; d) the amount recovered or expected to be recovered, under any insurance arrangement or other plan, with respect to the expense; and e) a statement that the expense (or the portion thereof for which reimbursement is sought under the Plan) has not been reimbursed and is not reimbursable under any other health plan coverage. Such application shall be accompanied by a written statement from an independent third party, stating that the expense has been incurred and the amount of the expense, and by such other bills, invoices, receipts, cancelled checks or other statements or documents that the City may request. Such application may be made before or after the Participant has paid such expense, but not before the Participant has incurred such expense. 12.8. Reimbursement or payment of expenses. The City shall reimburse the Participant from the Participant's Medical Reimbursement Account, at such time and in such manner as the Administrator may prescribe, but no less frequently than monthly, for Qualifying Medical Care Expenses incurred during the Plan Year while a Participant, for which the Participant makes written application and submits documentation in accordance with Section 12.7. The Administrator may, at its option, pay any such Qualifying Medical Care Expenses directly to the person providing or supplying medical care in lieu of reimbursing the Participant. No reimbursement or payment will be made if the Participant's claim is for an amount less than $50 or such lesser minimum reimbursable amount as may be established by the Administrator. The amount of any Qualifying Medical Care Expenses not reimbursed or paid as a result of the minimum reimbursable amount shall be carried over and reimbursed or paid only if and when the Participant's un- reimbursed claims equal or exceed such minimum. Notwithstanding the preceding sentence, claims and expenses incurred during a Plan Year that are submitted for reimbursement during the last month of the Plan Year or within the three months following the close of the Plan Year shall be paid regardless of whether they equal or exceed the minimum reimbursable amount, provided they do not exceed the remaining balance of the Participant's Medical Reimbursement Account. 12.9. Cessation of participation. In the event that a Participant ceases to be a Participant in this Plan for any reason during a Plan Year, the Participant's compensation reduction agreement relating to this Plan shall terminate. The Participant shall be entitled to reimbursement only for Qualifying Medical Care Expenses incurred within the same Plan Year and before he or she ceased to be a Participant. 12.10. Limits on time and amount of reimbursements. Reimbursements shall be made for any Plan Year under this Article, only if the Participant applies for such reimbursement in accordance with Section 12.7 on or before the September 30th following the close of the Plan Year. In the event of the Participant's death, the Participant's executor or administrator) may apply reimbursements permitted under this Article. shall exceed the remaining balance, if Reimbursement Account for the Plan Year spouse (or, if none, the Participant's on the Participant's behalf for No reimbursement under this Article any, in the Participant's Medical in which the expenses were incurred. SECTION 2: The Ordinance shall take effect July 1, 1993. PASSED by the City Council of the City of Huntsville, Texas on this the 4th day of May, 1993. AI I EST: Danna Welter, City Secretary APPRO AS TO FORM: Scott unds, City Attorney CITY OF HUNTSVILLE, TEXAS . H. Hodges, M yor