Ill. Admin. Code tit. 80 § 2120.520

Current through Register Vol. 48, No. 43, October 25, 2024

Section 2120.520 - Reimbursement of Participant

a) The Plan Administrator shall reimburse the Participant from the Participant's medical care assistance account for medical care expenses incurred during the Plan Year through September 15 of the following Plan Year for which the Participant submits documentation in accordance with Sections 2120.510 and 2120.525.

b) The reimbursement schedule will be established by the Plan Administrator in a manner that allows the Participant to receive reimbursement no less than once a month.

c) The Plan Administrator will reimburse Participants who have filed claims in the prescribed manner:

1) at least once a month if the claim equals or exceeds $5, and if there is eligibility for reimbursement remaining in the account; and

2) at least once the twelfth month (or the final month of participation) regardless of the amount.

d) If a claim for reimbursement under this Section exceeds the balance of the Participant's medical care assistance account, the Participant will be paid the amount of the claim as long as the claim is no greater than the annual election amount less any reimbursements paid to date.

e) Claims for expenses incurred between July 1 and September 15 will be paid, first, from any funds remaining from the previous Plan Year and, then, from funds available under the current Plan Year.

Ill. Admin. Code tit. 80, § 2120.520

Amended at 33 Ill. Reg. 11791, effective August 3, 2009