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:

Participant Data Form

Monthly Verification Benefit Claim Form - Premium Reimbursement

IRS Guide to Medical & Dental Expenses

COBRA Election Form (Notice G)

- Expense Claim Form – Medical Reimbursement

 

Notices:

- 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)

Summary Annual Report

SBC

Restated Plan Document (2021)

 

www.bpabenefits.com

Southern California Public Safety

Retiree Medical Trust

c/o Benefit Programs

Administration

1200 Wilshire Blvd, 5th Floor

Los Angeles, CA 90017-1906

Phone: 833-504-3967

213-406-2380

Fax: 562-463-5894

Email:scpublicsafety@bpabenefits.com

 

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