Okla. Admin. Code § 260:40-27-9

Current through Vol. 42, No. 6, December 2, 2024

Section 260:40-27-9 - Reimbursement of health care expenses

(a) Subject to limitations contained in this section, the Plan Administrator shall reimburse the participant from the participant's health care reimbursement account for health care expenses incurred during the eligible period of coverage, for which the participant submits documentation, in accordance with OAC 260:40-27-8. No reimbursement of health care expenses incurred during a Plan Year shall exceed the maximum amount defined in the salary adjustment agreement.

(b) Participants shall be reimbursed for medical care expenses on a weekly or other reasonable basis during the Plan Year in accordance with Flexible Benefits Plan Administration Rules. Reimbursement can also be made for expenses incurred by any participant during the Grace Period. The final payment of benefits for any Plan Year may be made following the close of such Plan Year based on accepted claims filed with the Plan Administrator no later than the end of the Run Out Period.

(c) Upon demand a participant shall immediately refund any overpayment made by the Plan Administrator on behalf of the participant. Likewise, items charged to a debit card that are unacceptable to the Plan Administrator will require a participant to immediately refund such an overpayment to the Plan Administrator.

(d) If a participant ceases to be a participant or terminates employment, the participant shall be entitled to continue receiving benefits pursuant to this health care option to the extent of the amount remaining in the participant's health care reimbursement account for expenses incurred during the eligible period of coverage of the current Plan Year.

(e) If a participant ceases to be a participant or terminates employment, claims incurred after the last day of the month of termination or the date participation ceased shall not be considered for reimbursement, unless the participant elects to continue participation in this option by elected coverage continuation as provided for in this section.

(f) Any participant may continue this option under the coverage continuation guidelines for COBRA, as provided under OAC 260:40-33-1 on a post tax basis.

Okla. Admin. Code § 260:40-27-9

Adopted by Oklahoma Register, Volume 31, Issue 24, September 2, 2014, eff. 9/12/2014