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:
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.
|Participation*||Everyone||Everyone||Everyone||Class defined by Employer|
|Use it/Lose it||Yes||No||No||No|
|Admin Premium||Monthly||Monthly||Monthly||$250 + 11% of Claims|
*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:
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:
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
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
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
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.