Benefits for Participants

TO:                Participants in the Rainbow Plan

FROM:          Brian C. Meekhof, Benefits Administrator

  

 

Reduction in Monthly Administration Fee

       As part of our continuing efforts to reduce costs to our schools and participants we are happy to announce a reduction in the monthly administration fee for participants in the Premium Account only.  Effective January 1, 1997, the monthly administration fee will be reduced to $1.00 from $2.00.  The school monthly minimum and all other fees remain the same.

 

Submission of Claims

      You are encouraged to submit claims on a regular basis, as expenses are incurred.  This will help you in several ways: 

      -     You will receive your reimbursement check promptly. 

      -     If additional documentation is required, it will be easier to provide now rather than in 6 or 8 months. 

      -     It gives you a better picture of the funds remaining in your account and will lessen your risk of forfeiting funds at the end of the plan year.

 

 Claim Documentation Requirements 

      In order to process your reimbursement requests as quickly as possible, please remember these general guidelines for submitting claims.

      Complete a Request for Reimbursement form (available from your school office) and attach documentation of the claim.

 

What is proper documentation?

      -     If the expense is partially covered by insurance (medical, dental or vision), submit a copy of the Explanation of Benefits (EOB) from your insurance carrier.  The EOB is a statement sent to you showing how a claim was processed.

      -     If you do not have insurance coverage for the expense, submit an itemized statement showing the date of service, provider’s name, services provided and the amount of the charge.  Be sure with vision claims that the itemized statement shows a breakdown of the lenses, frames, etc.  Vision warranty charges are not eligible for reimbursement.

      -     If you belong to an HMO, submit a paid receipt for your co-payments.  If the expense is not covered by the HMO, submit an itemized statement.

      -     When submitting for reimbursement of orthodontia expenses, submit a copy of the Truth in Lending Statement (treatment plan/contract) from the orthodontist.  This statement must reference the treatment period, amount payable by insurance, if any, and payment plan.

 

Questions regarding specific claims can be directed to our administrator, HRM Claim Management, Inc., at:

                                                (800) 451-4426 (MI)

                                                (800) 533-9266 (National)

Contact our office at (800) 635-8288, x267 with any other inquiries.