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Participant Rights and Responsibilities
Upon Transfer or Termination

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Page contents:

Summary

Eligibility

Discontinuation of Participation

Rights and Privileges After Participation Ends

Continuation Coverage

Participant Responsibilities

Customer Service


 

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Indiana University

Participant Rights and Responsibilities Upon Transfer or Termination

Section V.
Wellness Health Reimbursement Arrangement (HRA) Plan

Wellness HRA Plan Summary

The Wellness HRA is an IU-funded account set up under IRS regulations that allow preferential tax treatment for contributions that can be used to pay for eligible health care expenses, such as deductibles, copays, non-covered medical expenses, and over-the-counter medications. IU contributes to the account monthly for those individuals who sign a tobacco-free affidavit during Open Enrollment.

Eligibility

All full-time appointed employees of Indiana University can elect participation in the Wellness HRA Plan by completing a tobacco-free affidavit during Open Enrollment.

Discontinuation of Participation

An employee is no longer eligible for participation in Wellness HRA when the employee:

Rights and Privileges After Participation Ends

A participant will not be eligible to receive any further contributions as of the date of termination except as described in the Continuation of Coverage section below. A terminated participant may continue to submit claims for the payment of qualifying medical expenses in accordance with the procedures specified in the following section, Continuation of Coverage.

Continuation Coverage

An employee who loses eligibility for the plan has two options following termination of participation in the Wellness HRA.

Run-out Period Default Option. A participant who loses eligibility will be considered to have elected a run-out period in lieu of COBRA coverage unless the participant elects COBRA in writing. The run-out period is defined as the period between the termination date and the end of the plan year in which the termination occurred. The employee makes no payment of premium for this period and no further employer contributions will be made in the employee's account. During the run-out period the employee can continue to incur eligible expenses. Eligible expenses must be submitted by the Claim Deadline following the Coverage Period. Employees whose participation ends due to a Reduction in Force (RIF) will have an additional three months to incur and submit claims beyond the run-out period.

COBRA Option. A participant whose eligibility ends due to a COBRA qualifying event may decline the default run-out period and instead elect to pay a monthly premium for COBRA continuation of the coverage that was in effect on the date prior to the qualifying event. Such coverage is available for the periods prescribed by COBRA, generally 18 months, subject to the conditions and limitations of COBRA. The employee pays a monthly premium, University contributions continue, and the employee can continue to incur eligible expenses. Eligible expenses must be submitted by the Claim Deadline following the Coverage Period.

Upon a COBRA qualifying event, the employee will receive a written COBRA notice including details about coverage, monthly premiums, and enrollment. COBRA must be elected within 60 days of losing eligibility. If a COBRA enrollment form is not submitted within 60 days, the participant loses the right to COBRA and is defaulted to the run-out period option.

Participant Responsibilities

Summary of actions the participant must take:

  • To continue participation, submit the COBRA election form to Nyhart within 60 days of the date that coverage would have otherwise ended.
  • Pay initial COBRA contributions to date to Nyhart within 45 days of electing COBRA.
  • Pay monthly COBRA contributions to Nyhart on time.
  • Submit claims for eligible expenses to Nyhart by April 15th following the end of the calendar year. Any unclaimed portions of reimbursement accounts are forfeited after that time.
  • Notify Nyhart of address changes.
  • Notify Nyhart of a "change in status" within 30 days of the event.

Customer Service

Forms for filing claims can be obtained from a Human Resources office, the University Human Resource Services Web site (www.indiana.edu/~uhrs/benefits/hra.html), or by calling Nyhart, the plan administrator.

Nyhart Customer Service:

The Nyhart Company, Inc.
8415 Allison Pointe Boulevard, Suite 300
Indianapolis, IN 46250-4201
(800) 284-8412 phone
(888) 887-9961fax
iutsb.nyhart.com

 

Page updated: July 2009
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