Orange County NC Website
DocuSign Envelope ID: EA6C45CD-7691-43D8-B939-A4300A7DD233 <br /> IIViedical IIII"" iii IIII <br /> iii iii <br /> IIIC .. III .. iii .. hint Care Adrniinistratiuri <br /> 2. Claims Administration Services. Flores shall act as claims administrator for the <br /> Plan. As such, it shall process and pay reimbursement claims to Plan participants. It shall maintain <br /> the necessary records and accounts to operate the Plan. Flores shall prepare and deliver to the <br /> Company all reports and returns which are required for the Company to properly report to <br /> governmental agencies regarding the Plan. <br /> In its role as claims administrator, Flores shall process claims within a framework of policies, rules <br /> and interpretations of appropriate governmental agencies for reimbursement of applicable <br /> expenses, and within the framework of the Plan documentation as reviewed and approved by the <br /> Company. To the extent any claims payment issue is not addressed by an appropriate <br /> governmental agency or by Plan documentation, or is unclear, the claims administrator shall act in <br /> accordance with instruction of the Company. <br /> 3. Company Account. To facilitate claims administration, Flores maintains a master <br /> checking account. Within this account it shall maintain a sub-account for the Company(the <br /> "Company Account")for all transmittals of Company monies and for reimbursements to <br /> participants.The Company shall transmit all Company monies to the Company Account on a timely <br /> basis and as requested by Flores. Flores shall use such Company transmittals to reimburse <br /> participants for claims. Flores shall keep such records as are necessary to reflect transmittals, <br /> disbursements, and account balances attributable to each participant. <br /> 4. Claims. All claims for Medical Reimbursements shall be submitted by the <br /> participants to Flores in accordance with the instructions. Flores shall pay Medical Reimbursement <br /> claims in accordance with instructions provided to participants during enrollment. Flores shall not <br /> make any Medical Reimbursement claims payment to a participant if the amount of the aggregate <br /> Medical Reimbursement claims exceeds the balance credited to the aggregate participant's <br /> accounts in the Company Account. In such event, Flores shall immediately notify the Company of <br /> the amount by which the Medical Reimbursement claims exceed the aggregate amount credited to <br /> the participant's accounts. The Company shall then transmit such amount to Flores for credit to the <br /> participant's account so that the Medical Reimbursement claim can be paid. <br /> ORANGE COUNTY 14 Flores <br />