Frequently Asked Questions - All FAQs

A Medical Reimbursement Plan is a fully insured reimbursement plan that allows an employer to reimburse key employees for most medical, vision, hearing and dental expenses not otherwise covered by their existing benefit plan.

BeniComp Select allows employers to reimburse their key employees for most medical expenses not otherwise covered by their base health insurance plan. Rather than reward all employees at a company, the employer is able to reward individual employees or groups of employees by class. For example, an employer could create three classes:

• $100,000 policy for the president
• $50,000 policies for the vice presidents
• $10,000 policies for the directors

These "classes" are created by the employer.

An employer pays a $350 for each of the executive participants. This includes a $250 annual premium plus access to unlimited telemedicine. When a participant has eligible reimbursable expenses, they are submitted to BeniComp Select for reimbursement. The approved claim + 11% is paid by the employer, and BeniComp Select reimburses the key executive directly if they have signed up for direct deposit. 

No. The underlying plan can be an employer group plan, individual policy, spousal policy or Medicare.

The employer selects the desired benefit level for each of the classes designated to the participating employees from the plan maximum schedule.

Plan Maximums: $10,000, $15,000, $20,000, $25,000, $35,000, $50,000, $75,000, $100,000, $200,000

Accidental Death Benefit: Included with each BeniComp Select policy equal to the plan maximum up to $100,000

The policy covers the participant and any qualified dependents, and is based on specific state mandates.

BeniComp Select follows the primary plan. If the primary plan allows for dependents up to the age of 26, then so does the BeniComp Select policy.   

*The following individuals are ineligible to participate in a Cafeteria Plan, including a Premium Only Plan (POP) or any of its qualified benefits, which include FSAs and HRAs:

• More than 2% shareholder of an S-Corp (or any family member)
• Sole Proprietor
• Partner in a partnership

A BeniComp Select policy reimburses eligible medical expenses not otherwise covered by health insurance. 

Generally, if an expense is medically necessary and qualifies under Section 213(d) of the Internal Revenue Code, it would be eligible for reimbursement under this insurance plan. Some covered charges include, but are not limited to:

• Deductibles, co-pays, prescription drugs
• Private-duty nursing and home health care
• Hospital expenses, including private-room charges
• Dental and orthodontic expenses
• Alcoholism and drug-abuse treatment and facilities
• Vision care, including all types of frames
• Inpatient and outpatient psychiatric care
• Charges for the diagnosis of infertility
• Charges for the treatment of infertility up to 10% of the annual maximum per calendar year
• Medical transportation, including air services and hotel
• Medical supplies and equipment
  • This also includes the expenses of operating and maintaining a wheelchair
• Speech therapy for speech loss or impairment due to illness or surgery
• Pregnancy
• Smoking Cessation Programs
• Chiropractic services
• X-Rays
• Wigs purchased upon the advice of a physician for the mental health of a patient who has suffered hair loss due to a disease
• Acupuncture
• Prescribed Birth Control
• Lasik Surgery 
• Contact Lenses
• Breast Pumps & Supplies
• Hearing Aids
• Vasectomy

No benefits are payable unless the individual is under the direct care of a legally qualified physician for reasonable and necessary treatment.

Any premiums including, but not limited to Base Plan (or Cobra Continuation of the Base Plan), Medicare Part B, Medicare Part D, Prescription Drug Plans

Non-prescription drugs

Losses due to war

Expenses the individual is not legally obligated to pay in the absence of insurance

Charges for appointments not kept

Hospitalization, services, treatments or supplies furnished by the U.S. or foreign government agency, unless otherwise prohibited by law

Service contracts or warranties relating to vision care

Custodial care

Accident or illness for which the individual is entitled to benefits under any worker’s compensation or occupational disease law

Health club dues or exercise equipment

Blood Storage

Hospital charges for confinement in a long-term care unit or skilled nursing facility unless confinement commences within 14 days after discharge from a qualifying hospital confinement

Baby sitting, childcare, and/or nursing services for a healthy child. You cannot include any amount paid for childcare even if this enables you, your spouse, and/or dependent(s) to receive medical treatment. 

No. If vision, dental, and hearing are not covered by the underlying plan; BeniComp Select will reimburse the charges.