Self Funded Medical Eligible Reimbursement Sample Clauses

Self Funded Medical Eligible Reimbursement. Plan (MERP). The District shall maintain a medical eligible prescription reimbursement Plan (MERP) administrated by SIEBA, Inc effective on September 1, 2005 and the plan years thereafter will begin on July 1st-June 30th of each year. The District will be responsible for all administrative fees and operating expenses affiliated with the Plan. The purpose of the Plan is to reimburse bargaining unit members eligible for the NOVA or Catt-Allegany Self-funded HMO under Article IX of the collective bargaining agreement. The reimbursement will be for the purchase of prescription drugs under the three-tier co-pay of two dollars ($2) generic/ twenty dollars ($20) preferred/ thirty-five dollars ($35) non-preferred brand name. The District’s annual contribution will be ten thousand dollars ($10,000) and will be placed in the MERP plan on July 1 of every school year. Commencing with the new enrollment period of July 1, the procedure for reimbursement will require eligible employees to use the appropriate claim forms from SIEBA, Inc. The required form along with pharmacy receipt(s) and major medical receipts if applicable must be sent to SIEBA, Inc. Receipts must be received as per current plan. For those employees enrolled in the Health Benefit Plan Administered by BCBS (POS 203): In conjunction with the prescription drug coverage of the Health Benefit Plan, the supplemental prescription reimbursement plan will reimburse the participant so the actual cost to the participant is ten dollars ($10) per non-generic prescription. As of June 30th of each year, any balance remaining in the Plan will roll over into the following school year that begins on July 1st. In the event that the member’s usage exceeds the District balance of ten thousand dollars ($10,000), the District agrees to contribute necessary funds to balance the account. A committee will be established consisting of the Superintendent and two (2) members of the RASSA appointed by the President, to annually oversee the District contributions and review the performance of the medical eligible reimbursement plan.
Sample 1
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