Executive Medical Reimbursement Plan Template

This executive medical reimbursement plan template has 2 pages and is a MS Word file type listed under our human resources documents.

Sample of our executive medical reimbursement plan template:

EXECUTIVE MEDICAL REIMBURSEMENT PLAN This Executive Medical Reimbursement Plan (the "EMRP") is effective [DATE]. ELIGIBILITY To be eligible for EMRP, an employee must be an officer of the [YOUR COMPANY NAME] (the "Company"). The employee must elect coverage for himself/herself and any eligible dependents under the Company's [GROUP HEALTH PLAN NAME] Group Health Plan. ENROLLMENT Upon becoming eligible for the EMRP, an employee will automatically be enrolled in the plan provided he/she is currently enrolled in the [GROUP HEALTH PLAN NAME] Group Health Plan. COVERAGE Coverage will be extended by the plan for any medical expense which would be a deductible medical expense under [Federal/STATE/PROVINCIAL] Income Tax regulations. This can include expenses not reimbursed by the [GROUP HEALTH PLAN NAME] Group Health Plan due to deductibles, co-insurance, plan exclusions, eyeglasses, orthodontics, medically necessary additions and alterations to a home, or [SPECIFY]. These and other expenses would be covered by the EMRP if they qualify under applicable [IRS or YOUR COUNTRY REVENUE AGENCY] regulations. BENEFITS The EMRP does not require satisfaction of a deductible. Eligible medical expenses will be reimbursed at 100%. CLAIM FILING Bills for medical expenses should be submitted to [CLAIMS ADMINISTRATOR] in the special MRP (Medical Reimbursement Plan) envelopes provided. The administrator will first pay benefits under the [GROUP HEALTH PLAN NAME] Group Health Plan. Reimbursement for expenses not fully covered (or not covered at all) by the [GROUP HEALTH PLAN NAME] Group Health Plan will then be paid for the EMRP. MAXIMUM ANNUAL BENEFIT