The United Media Guild asked our benefits consultant, Jack Alheim, to explain the Medical Retirement Account that many of our members have gained through their insurance at the Post-Dispatch.
Here is his disclaimer, then his report:
Following is a summary of the Annual Deductible Account and Medical Retirement Account (MRA) offered by Lee Enterprises as a company paid benefit. The following summary is intended to be accurate, however, if terms in the following summary or the Summary Plan Description (SPD) are inconsistent, the SPD or the Lee Medical Plan document will govern. Participants should refer to the Summary Plan Description (SPD) for terms and conditions not outlined below.
What is the benefit?
Each year that you are enrolled in an Eligible Plan, Lee Enterprises will credit a certain amount to a Deductible Account on your behalf. Such amount can be used to reimburse you for expenses incurred which count toward your plan deductible.
What is an Eligible Plan and who is an eligible for this benefit?
Employees enrolled in the Low-Deductible Medical Plan or the Mid-Deductible Medical Plan offered under the Lee Enterprises Welfare Benefit Plan are eligible to receive the employer paid benefit. Employees enrolled in the High-Deductible Medical Plan are not eligible to receive the benefit.
What is the amount of the benefit offered?
If you are enrolled in individual coverage, the amount credited to your Deductible Account is $500 per year.
If you are enrolled in family coverage, the amount credited to your Deductible Account is $1,000 per year. Reimbursements are permitted for expenses incurred by the employee and eligible dependents covered under the plan. The maximum amount that can be used for medical expenses attributable to any one person may not exceed $500 each year.
What can the benefit be used for?
You may be reimbursed from your Deductible account only for out of pocket medical expenses that count toward your plan deductible for the plan year. See the main SPD for information regarding your deductible. To be reimbursed for deductible expenses incurred in a particular plan year, you must submit claims for reimbursement for such expenses on or before March 31 of the next year.
I was in an eligible plan but switched to another Lee medical plan, what does that do to my benefits under the Deductible Account and MRA?
See the SPD for details on changes from individual coverage to family coverage, family coverage to individual coverage, disenrollment, termination and other changes.
How do I submit claims for reimbursement?
Eligible claims incurred by each participant are automatically submitted by United Healthcare to Tri-Star Systems, the Deductible Account Plan Administrator. As you incur eligible medical expenses, United Healthcare reports eligible expenses to Tri-Star Systems for you. Tri-Star will send you and email reimbursement notification confirming the expense. When you receive this notification, you must log on to http://www.link.lee.net and approve the claim for reimbursement. If approved, you will be reimbursed by direct deposit or check.
What if I don’t approve the claim or chose not to be reimbursed, do I lose the benefit?
No. Amounts credited to you Deductible Account for a year that are not used for reimbursement of claims during the year are automatically rolled over to a Medical Retirement Account (MRA). You may use amounts credited to the MRA to reimburse post-retirement medical expense, if certain vesting requirements are satisfied. If you chose not to approve the claim from the Deductible Account, this will preserve more of your benefit to roll over to your MRA.
What can the MRA be used for?
You may be reimbursed from your MRA account for retiree and/or eligible depended medical out of pocket medical expenses. Routine medical expenses including premiums paid for an employer-sponsored plan or other plan including Medicare Part B, C and D premiums.
Are there restrictions on the MRA benefits?
In order to be eligible to use the amounts transferred to your MRA, you must satisfy the following requirements:
- You must be age 55 or older.
- You must not be an active employee of Lee Enterprises or an affiliate of Lee Enterprises.
You must also satisfy certain vesting service requirements. You will vest in the amounts deposited into your MRA and such amounts will be available for your use after you have earned four (4) years of service. Each year you work at least 1,000 hours, and were enrolled in a Lee medical plan and were an active employee on the last day of the year equals one year of service. Note Years of service earned prior to January 1, 2008, do not count toward satisfaction of the years of service requirement.
How do I claim reimbursements under the MRA?
The Administrator of the MRA is Tri-Star Systems. Claims for reimbursement from your MRA should be made by submitting a claims form to Tri-Star Systems. The claims form is available on Tri-Star Systems website (http://www.tri-starsystems.com) and on LINK (http://link.lee.net) and may be submitted online or via facsimile. You should contact Tri-Star Systems for more information.
Is the Deductible Account and MRA considered “my account” and can I receive the unused amounts as a cash distribution?
No. The Deductible Account and MRA are notational accounts maintained solely for bookkeeping. Benefit distributions are only allowed for medical reimbursements as outlined in the plan.
If I die, can my spouse and dependents use this account?
Yes, but it is limited. Upon your death, any dependent child or spouse may use the amounts in your MRA, but only to the extent such amounts are vested as of the date of your death, to pay premiums for his or her own COBRA continuation coverage with respect to the plan in which he or she was enrolled. If any amounts remain in the MRA account after your dependent’ COBRA continuation coverage terminates, those amounts will be forfeited.
Are the Deductible Account and MRA benefits guaranteed?
No. While Lee Enterprises states that it intends to continue the Deductible Account and the MRA portions of the Eligible Plans, it reserves the right, in its sole discretion, to modify, change, revise, amend or terminate such portions at any time, for any reason, without prior notice. This includes vested MRA balances.