N.J. Admin. Code § 17:1-13.6

Current through Register Vol. 56, No. 23, December 2, 2024

Section 17:1-13.6 - Claims for payment from plan accounts

(a) Claims for payment of expenses eligible for payment from plan accounts shall be submitted to the plan administrator. Information about the plan administrator and claim forms are available from the Division.

(b) In each plan year, the total payments from a plan account shall not exceed the total salary reduction amount elected by the employee for that account for that plan year. Under the unreimbursed medical spending account (UMSA), the employee will be reimbursed for the maximum amount of the elected total contribution to the plan, whether or not the deductions from the employee's pay have totaled the amount of the filed claim. Conversely, under the Dependent Care Spending Account, the maximum amount of reimbursement available to the employee during the period of coverage shall be the amount posted to the employee's account at the time the employee files a reimbursement claim.

(c) The program period is based on a calendar year from January 1 to December 31; however, the plans have adopted the 2 1/2 month grace period rule permitted under the Federal tax code that extends the period of time for incurring qualifying expenses through March 15 of the following year. The employee may continue to submit claims for expenses incurred in the plan year through April 30 of the following year.

(d) To qualify for reimbursement from an employee's plan account, an eligible expense must be incurred during the plan year for which the employee's election was made, or during the 2 1/2 month period immediately following the end of the calendar year, from January 1 through March 15. Expenses incurred before an employee becomes eligible to participate in the plan, for periods that an employee is not contributing to the plan, or after the employee's termination date are not eligible for reimbursement through the employee's plan account.

N.J. Admin. Code § 17:1-13.6

Amended by R.2006 d.65, effective 2/21/2006.
See: 37 N.J.R. 3631(a) 38 N.J.R. 1225(b).
In (b) and (c), substituted "plan" for "calendar"; in (d), deleted sentence pertaining to plan accounts; rewrote the section.
Amended by R.2009 d.25, effective 1/5/2009.
See: 40 N.J.R. 4928(a), 41 N.J.R. 277(a).
In (a), substituted "are" for "shall at all times be" and deleted "of Pensions and Benefits" following "Division"; in (b), inserted the last two sentences; and rewrote (c).