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Glossary
Explanation of Benefits
An Explanation of Benefits is a statement that the Claims Administrator sends to you after you, one of your covered family members or your health care provider files a claim for benefits. The Explanation of Benefits shows the charges that were submitted, the amount paid or not paid, and your balance, if any. For the MMC Consumer Directed Health Plan, the Explanation of Benefits also shows whether you have met your MMC Consumer Directed Health Plan annual deductible.
Incurred
Expenses are treated as having been incurred when the care or service is provided, not when you are billed or pay for it.
Plan Year
The Plan year is January 1 through December 31.
Grace Period
The grace period is the additional 2 1/2-month period following the end of the Plan year. If you have a balance remaining in your Limited Purpose Health Care Flexible Spending Account after the end of the Plan year and you are still participating on December 31 of the Plan year, you may use that balance to be reimbursed for eligible dental, vision and preventive care expenses incurred during the grace period. For example, if you do not use the balance in your 2008 Plan year Limited Purpose Health Care Flexible Spending Account between January 1 and December 31, 2008, you may use the remaining balance to be reimbursed for eligible dental, vision and preventive care expenses incurred between January 1, 2009 and March 15, 2009 (the grace period).
You can be reimbursed only for eligible dental, vision and preventive care expenses incurred during the grace period. The Plan will not reimburse qualified medical expenses (e.g., copayments, coinsurance, over-the-counter prescription drugs) during the grace period, unless you have met the MMC Consumer Directed Health Plan deductible for the current Plan year.
Expenses incurred during the grace period but after your employment ends are not reimbursable.
Claims Filing Deadline
The claims filing deadline is May 31 following the end of the Plan year. For example, for the 2008 Plan year, your eligible expenses must be incurred no later than March 15, 2009 (the end of the grace period) and must be submitted to the Claims Administrator by May 31, 2009 (the claims filing deadline).
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Benefits effective June 6, 2008
© 2008 Marsh & McLennan Companies. All Rights Reserved. |
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