h. Contract approval
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h. Contract approval
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<br />(e) Correction methods. If such purchase is later determined by the <br />Administrator to not qualify as an Employment-Related Dependent Care <br />Expense, the Administrator, in its discretion, shall use one of the following <br />correction methods to make the Plan whole. Until the amount is repaid, the <br />Administrator shall take further action to ensure that further violations of the <br />terms of the card do not occur, up to and including denial of access to the card. <br /> <br />(1) Repayment of the improper amount by the Participant; <br /> <br />(2) Withholding the improper payment from the Participant's wages or <br />other compensation to the extent consistent with applicable federal or <br />state law; <br /> <br />(3) Claims substitution or offset of future claims until the amount is <br />repaid; and <br /> <br />(4) if subsections (1) through (3) fail to recover the amount, consistent <br />with the Employer's business practices, the Employer may treat the <br />amount as any other business indebtedness. <br /> <br />ARTICLE VIII <br />BENEFITS AND RIGHTS <br /> <br />8.1 CLAIM FOR BENEFITS <br /> <br />(a) Insurance claims. Any claim for Benefits underwritten by the <br />self-funded plan shall be made to the Employer. If the Employer denies any <br />claim, the Participant or beneficiary shall follow the Employer's claims review <br />procedure. <br /> <br />(b) Dependent Care Flexible Spending Account or Health Flexible <br />Spending Account claims. Any claim for Dependent Care Flexible Spending <br />Account or Health Flexible Spending Account Benefits shall be made to the <br />Administrator. For the Health Flexible Spending Account, if a Participant fails to <br />submit a claim within 90 days after the end of the Plan Year, those claims shall <br />not be considered for reimbursement by the Administrator. For the Dependent <br />Care Flexible Spending Account, if a Participant fails to submit a claim within 90 <br />days after the end of the Plan Year, those claims shall not be considered for <br />reimbursement by the Administrator. If the Administrator denies a claim, the <br />Administrator may provide notice to the Participant or beneficiary, in writing, <br />within 90 days after the claim is filed unless special circumstances require an <br />extension of time for processing the claim. The notice of a denial of a claim shall <br />be written in a manner calculated to be understood by the claimant and shall set <br />forth: <br /> <br />(1) specific references to the pertinent Plan provisions on which the <br />denial is based; <br /> <br />(2) a description of any additional material or information necessary <br />for the claimant to perfect the claim and an explanation as to why such <br />information is necessary; and <br /> <br />(3) an explanation of the Plan's claim procedure. <br /> <br />21 <br />
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