M.J. Day – Debit Card

Eligible Health Care Expenses under the Plan may be paid or reimbursed with a Debit Card that the Trust Fund Office will provide to you when you become eligible for benefits. Prior to receiving the care, you must agree, in writing, to:

• only use the Debit Card to pay for eligible expenses incurred by the Employee, or his or her spouse or Dependents;
• not use the Debit Card for any medical expense that has already been reimbursed;
• not seek reimbursement under any other health Plan for any expense paid for by the Debit Card; and
• acquire and maintain documentation, such as invoices and receipts, to substantiate any expenses paid for with the Debit Card.

The Plan will limit use of the Debit Card to:

• physicians, dentists, vision care offices, hospitals, or other medical providers (as identified by their merchant category code);
• stores with a merchant category code for drugstores and pharmacies that comply with applicable IRS regulations;
• stores that have implemented an inventory information approval system consistent with applicable IRS regulations.

All claims for eligible expenses paid with your Debit Card need to be substantiated in a manner consistent with IRS guidance.

Correction Procedures for Improper Debit Card Payments

If a Covered Employee receives payments under this Plan via a Debit Card that exceed the amount of Eligible Health Care Expenses substantiated by the retiree, the Trust Fund Office will immediately notify the retiree in writing of any such improper payment and de-activate the Debit Card until the full amount of the improper payment is recovered.