INTERNATIONAL UNION OF OPERATING ENGINEERS LOCAL 15, 15A, 15B, 15C, 15D, 15G & 15H
The Health Reimbursement Arrangement allows members and participants to put aside pre-taxed monies to use to offset or pay down health-care expenses beyond the coverage the Welfare Fund provides. Money in this account is available to you and any eligible dependents tax-free to cover qualified medical expenses only. Monies not utilized are carried over from year to year to be used to offset future medical expenditures. This benefit is available to you and your eligible dependents under the Plan. Your eligible dependents will be able to access the account to offset his or her out-of-pocket health related expenses after your death.
Who does not participate in this program?
Participants working under the following agreements have voted not to participate within this program.
> Local 15C- Stewart and Stevenson
> Local 15C- H.O. Penn Poughkeepsie
> Local 15C- Sims/Hugo Neu Bronx Metal Recycling Agreement
> Local 15D- Nelson and Pope Agreement
When could you use your Health Reimbursement Arrangement?
1. Whenever you have any balance billing, which is when your provider bills your health plan and then bills you for the amount your health plan (the Local 15 Welfare Fund) does not cover for you or any eligible dependent; or
2. Whenever you have a regularly scheduled payment for an eligible expense such as orthodontic care, physical therapy care, or C.O.B.R.A. premiums for you or any eligible dependent.
How much can I be reimbursed for?
You will be reimbursed up to the total amount of the balance bill. (Which is when your provider bills your health plan and then bills you for the amount your health plan does not cover) not to exceed the amount of credits in your account.
What if I have expenditure that is not on the approved list of qualified expenses?
You should be aware that the Internal Revenue Service heavily regulates what is considered a qualified expense. Why? Because, the credits in this account are tax free. As a result, the I.R.S. prohibits you from using these credits for non- medical services and items.
However, the I.R.S. has compiled a comprehensive list of items that are covered. Although, if you have an expenditure that is not on the list of qualified expenses and you wish to seek reimbursement, you must submit an appeal letter to the Board of Trustees of the Welfare Fund. Along with the letter you must submit the proof of payment and any other documentation that you think would enhance your appeal.
Upon receipt, you will be notified of the next date of the meeting of the Trustees and when your letter will be reviewed. At that meeting your appeal letter will be presented. The Trustees will determine whether or not the expenditure meets the I.R.S. definition of a qualified expense as well as the Funds definition of a qualified expense.
All appeal letters should be submitted by certified mail.