Executive Medical Reimbursement FAQs

General Questions

A Medical Reimbursement Plan is a fully insured reimbursement plan that allows an employer to reimburse key employees for most medical, vision, hearing and dental expenses not otherwise covered by their existing benefit plan.

BeniComp Select allows employers to reimburse their key employees for most medical expenses not otherwise covered by their base health insurance plan. Rather than reward all employees at a company, the employer is able to reward individual employees or groups of employees by class. For example, an employer could create three classes:

  • $100,000 policy for the president
  • $50,000 policies for the vice presidents
  • $10,000 policies for the directors

These "classes" are created by the employer.

An employer pays a $250 annual premium for each of the executive participants. When a participant has eligible reimbursable expenses, they are submitted to BeniComp Select for reimbursement. The approved claim + 11% is paid by the employer, and BeniComp Select reimburses the key executive directly if they have signed up for direct deposit. 

No. The underlying plan can be an employer group plan, individual policy, spousal policy or Medicare.

The employer selects the desired benefit level for each of the classes designated to the participating employees from the plan maximum schedule.

Plan Maximums: $10,000, $15,000, $20,000, $25,000, $35,000, $50,000, $75,000, $100,000, $200,000

Accidental Death Benefit: Included with each BeniComp Select policy equal to the plan maximum up to $100,000

The policy covers the participant and any qualified dependents, and is based on specific state mandates.

This process will be managed based on the specific mandates of the state the application was submitted.  

 

 Flex/125105HRABeniComp Select
Eligibility* Everyone Everyone Everyone Class defined by Employer
Pre Funding Yes Yes Yes No
Use it/Lose it Yes No No No
Admin Premium Monthly Monthly Monthly $250 + 11% of Claims

 

*The following individuals are ineligible to participate in a Cafeteria Plan (including a Premium Only Plan [POP]) or any of its qualified benefits, which include FSAs and HRAs:

  • More than 2% shareholder of an S-Corp (or any family member)
  • Sole Proprietor
  • Partner in a partnership

No, this policy can be placed on as few or as many employees, based on class, as the company chooses. Further, the company has the option of choosing different benefit levels on different classes of employees. Classes are determined by the company. If a policy is being offered to a class, everyone eligible for the designated class must be offered the plan. 

A BeniComp Select policy does not have an age limit or a waiting period.

BeniComp Select Coverage

A BeniComp Select policy reimburses eligible medical expenses not otherwise covered by health insurance. 

Generally, if an expense is medically necessary and qualifies under Section 213(d) of the Internal Revenue Code, it would be eligible for reimbursement under this insurance plan. Some covered charges include, but are not limited to:

  • Deductibles, co-pays, prescription drugs
  • Private-duty nursing and home health care
  • Hospital expenses, including private-room charges
  • Dental and orthodontic expenses
  • Alcoholism and drug-abuse treatment and facilities
  • Vision care, including all types of frames
  • Inpatient and outpatient psychiatric care
  • Charges for the diagnosis of infertility
  • Charges for the treatment of infertility up to 10% of the annual maximum per calendar year
  • Medical transportation, including air services and hotel
  • Medical supplies and equipment
    • This also includes the expenses of operating and maintaining a wheelchair
  • Speech therapy for speech loss or impairment due to illness or surgery
  • Pregnancy
  • Smoking Cessation Programs
  • Chiropractic services
  • X-Rays
  • Wigs purchased upon the advice of a physician for the mental health of a patient who has suffered hair loss due to a disease
  • Acupuncture

No benefits are payable unless the individual is under the direct care of a legally qualified physician for reasonable and necessary treatment.

Any premiums including, but not limited to Base Plan (or Cobra Continuation of the Base Plan), Medicare Part B, Medicare Part D, Prescription Drug Plans

Non-prescription drugs

Losses due to war

Expenses the individual is not legally obligated to pay in the absence of insurance

Charges for appointments not kept

Hospitalization, services, treatments or supplies furnished by the U.S. or foreign government agency, unless otherwise prohibited by law

Service contracts or warranties relating to vision care

Custodial care

Accident or illness for which the individual is entitled to benefits under any worker’s compensation or occupational disease law

Health club dues or exercise equipment

Blood Storage

Hospital charges for confinement in a long-term care unit or skilled nursing facility unless confinement commences within 14 days after discharge from a qualifying hospital confinement

Baby sitting, childcare, and/or nursing services for a healthy child. You cannot include any amount paid for childcare even if this enables you, your spouse, and/or dependent(s) to receive medical treatment. 

 

No. If vision, dental, and hearing are not covered by the underlying plan; BeniComp Select will reimburse the charges.

Yes, master social services and psychologists are covered by BeniComp Select, even if the services are not covered by the underlying plan.

Generally, if an expense is medically necessary and qualifies under Section 213 (d) of the Internal Revenue Code, it is eligible for reimbursement. Elective procedures that are not medically necessary are not covered by BeniComp Select. 


You can include expenses you incur to lose weight if they are treatments for specific diseases diagnosed by a physician such as obesity, hypertension, or heart disease. This includes fees you pay for membership in a weight reduction group as well as fees for attendance at periodic meetings.

You cannot include membership dues in a gym, health club, or spa as medical expenses, but you can include separate fees charged there for weight loss activities.

You cannot include the cost of diet food or beverages in medical expenses because the diet food and beverages substitute for what is normally consumed to satisfy nutritional needs. You can include the cost of special food in medical expenses only if:

  1. The food doesn't satisfy normal nutritional needs,
  2. The food alleviates or treats an illness, and
  3. The need for the food is substantiated by a physician.

The amount eligible for reimbursement is limited to the amount by which the cost of the special food exceeds the cost of a normal diet.

Due to recent IRS regulations, BeniComp Select will no longer reimburse any premiums effective January 1, 2016 including, but not limited to:

  • Base Plan (or Cobra Continuation of the Base Plan)
  • Medicare Part B
  • Medicare Part D
  • Prescription Drug Plans

 

For more information and to view the revised policy form, please click here.  

Application Questions

Interested in BeniComp Select Executive Medical Reimbursement but have questions about the application process?

Classes of eligible employees are different "levels" you have designated for the company. For example, you might create levels for:

Class 4: President
Class 3: C-level employees
Class 2: Executives
Class 1: Directors

Based on the levels you designate, you assign a certain number of employees to each class.

classes of eligible employees

Please refer to the chart below. Based on the number of participants you have on the total plan, you can assign the number of participants to classes with corresponding plan maximums. For example, if you have 15 employees on BeniComp Select, you might have:

Class 4: 1 President with a plan maximum of $25,000
Class 3: 2 C-level employees with a plan maximum of $20,000
Class 2: 4 Executives with a plan maximum of $15,000
Class 1: 8 Directors with a plan maximum of $10,000

eligibility classes chart

plan maximum eligibility

The application premium is the total number of participants multiplied by $250. For example, if you have 10 participants on BeniComp Select, then the premium check submitted with the application should be $2,500.

amount of premium submitted

Yes, we support Apple products. By default, the Safari browser blocks pop-up windows. See below:

When you are on your iPhone, the safari browser defaults to no pop-ups. 

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Claims

Claims can be submitted online by going to www.benicompselect.com/claims

Supporting documentation needs to be included with any expense submitted for reimbursement. Examples of supporting documentation include, but are not limited to:

  • Explanation of Benefits (EOB) from the primary plan, including reason(s) for denial
  • Itemized Receipts and/or Bills are required for services not covered by the primary plan
  • Letter of Medical Necessity if applicable
  • Superbills or Physician Receipts are acceptable for co-payment amounts provided they include patient name, date of service, and co-payment amount
  • Prescription Drug Receipts must include patient name, name of prescription, date the prescription was filled and co-payment amount, if applicable 

All supporting documentation, including photocopies, must be legible and include the patient's name, date and type of service, and the dollar amount.

Claims cannot be processed from:

  • Balance forward/due statements
  • Charge card receipts
  • Cancelled checks

 

Yes. Claims can be printed when reviewing your claim by using the "Print" function in your browser. 

  1. Go to Settings
  2. Click on Print
  3. Review the Print Preview
  4. Click Print

The group name is the name of the employer submitted on the application. If you do not know your group name, please click here.

The group number is the number assigned to your group and can be found on the first page of your Certificate. If you do not know your group number, please click here.

You can submit up to 10 claim items on each claim form.

No, you do not need to upload each claim item's supporting documentation separately. You can upload all of the supporting documentation one time under Supporting Documentation Upload.

The online claim form can accept .pdf, .bmp, .tiff, .jpg, .gif, and .png. Please simplify the file name of your supporting documentation and exclude special characters. 

Submitting claims is based off your policy year. You have 90 days past your renewal to submit claims for the previous policy year. For example, if your policy ran from January 1, 2015 to January 1, 2016, you would have 90 days past January 1, 2016 to submit claims for the 2015 plan year. 

BeniComp Select can send your reimbursement by direct deposit if you have submitted an EFT form. EFT forms can be filled out by clicking here

Yes, when you submit your claims online they go directly into BeniComp's system for processing. This results in fewer handwritten processing errors and much faster reimbursement. 

When you sign up for Direct Deposit you are also enrolled in eBeniComp, which you can access by going to www.eBeniComp.com to view your Explanation of Benefits (EOBs) online. The Explanation of Benefits provides details for what claims have been processed; including both approved and denied claims. Your entire claims history is stored in eBeniComp in the form of EOBs and can be accessed at any time. 

For log in information, please refer to the confirmation email you received when your Direct Deposit was initially set up. If you do not have Direct Deposit and would like to enroll, please go to www.benicompselect.com/eft to sign up. 

If you cannot find your confirmation email, please call our customer service line at 866-797-3343 for assistance. 

Yes, as long as your group is domiciled in the United States and offers a group health plan, a participant can incur a claim outside of the United States' borders. In order to process these claims, the participant is responsible for translating the supporting documentation to English and converting the funds to American Dollars.