We, the Board of Trustees, are fellow police officers, selected by the membership of Alhambra POA. We are very pleased to distribute to you this “Summary Plan Description” booklet, which gives general information regarding the operation of the Medical Expense Reimbursement Plan in a Paragraph-and-answer format, a brief summary of the Plan, as well as rights and protections to which you are entitled under federal law.
The Board of Trustees is totally committed to the successful operation of this Plan, with a goal of helping police officers and their families lessen the burden of retiree health costs. We welcome your input and comments.
Forms:
- Monthly Verification Benefit Claim Form - Premium Reimbursement
- IRS Guide to Medical & Dental Expenses
- COBRA Election Form (Notice G)
- Expense Claim Form – Medical Reimbursement
Notices:
- April 2024 SMM – HIPAA Notice
- SMM – Pre-Tax Premium Prohibition
- SMM – Regarding Amendment No. 18
- SMM – Regarding Amendment No. 17
- SMM – Regarding Amendment No. 16
Trust Documents:
- Summary Plan Description (2021)
- SBC
- Restated Plan Document (2021)
