SUPPLEMENTAL MEDICAL: click to download form

EBS RMSCO is converting to a new record keeping system effective June 6, 2011.

Your current flex cards will be deactivated on May 31, 2011 at 12:01am.

Please destroy your old cards on May 31 st . During the week of May 31st, two new EBS “One Cards” will be issued in your name and mailed to your home address. Sign the back of one Card and have your eligible dependent sign the back of the second Card. The Cards are activated upon first use—no call in activation is required. If you need additional dependent Cards, you can order them directly on the

new website beginning on June 6th free of charge. A $5 processing fee will be applied to your account to reissue lost or stolen Cards.

Please do not use the new Cards prior to June 6, 2011 . Please note that from May 31st to June 6th you will not have a Flex Card.

Eligible expenses incurred during this week-long blackout must be paid for out-of pocket. You may then submit a paper claim form to receive repayment from your account.

If your existing Card is currently blocked or suspended because you need to submit receipts to verify the eligibility of an expense,

your new Card will remain blocked until you submit the requested receipts.

Starting June 6 th please access your account online at www.ebsrmsco.com .

Their claims processing center has moved. All claim forms should be sent their new address at FSA Dept., PO Box 2330 Blasdell ,

NY 14219 . New forms can be found online in the forms section of your online account.

Questions regarding the conversion can be directed to EBS customer service by phone (800) 327-7130 or e mail at ebs.customerservice@ebsrmsco.com

HEALTH REIMBURSEMENT ACCOUNT (HRA) - FLEX CARD

The Flex card will be administered by EBS-RMSCO, INC.

Effective 3/1/10 we switched to flex cards for Supplemental claims.

This convenient, efficient debit card will allow you to pay providers immediately.

A few highlights:

    - Prescription drug claims will be increased from six months to twelve months. 

    - The mandatory minimum balance will decrease from $250 to $100 but no longer can go to zero when self paying for          

       Insurance, unless retired.

    - For claims submitted manually checks will be cut or direct deposited weekly.

    - Accounts will be charged a $5 monthly fee.

NEW LIST   Click on the link for a full listing of qualifying and non-qualifying expenses    ExpenseList2011           

1. Supplemental Medical Forms
   
   1. 2011 Claim Form
   2. Supplemental Self-Pay Payment Request
   3. Supplemental Medical Transfer Request Form
   
   
2. Plan Summary Information
   
   1. Medical Supplemental Summary
      
3. Summary Annual Report Information
   
   1. Supplemental Medical Plan
      
4. Supplemental Medical News & Information