Extension Health Subsidy
(downloadable guidelines in word document)
To assist in the expenditure and to encourage County Extension
Councils (Councils) in offering health benefits, the University of
Missouri Extension will provide an Extension Health Subsidy
(Subsidy) to participating Councils.
The Councils, as individual
employers, must determine if they will offer health
benefits to their county office support staff (hereafter
referred to as secretary). If the Council already
has or will adopt secretary health benefits, it may, as
the employer, restrict or broaden what type of health
benefits it will offer. However, the Subsidy can
only be used as outlined below.
Beginning January 1, 2013, the Subsidy may be
used toward only one of the following for a benefit-eligible
health insurance premiums OR
deductibles, co-pays and co-insurance for
health insurance not obtained through the employee
- For example, if the secretary is covered under the spouse's
insurance, the secretary cannot seek reimbursement for any part
of the spouse's premium but could request reimbursement for an
out-of-pocket expense for the secretary's own deductible.
The Subsidy may only be used for allowable
expenses incurred for the secretary, not for other family members.
Health Insurance Premiums
Employer sponsored health insurance is usually
invoiced at least one month in advance of coverage (invoiced in July
for August coverage). For this reason, the Extension Health
Subsidy will be provided in advance on a quarterly basis to
participating Councils (December for 1st quarter of the
year; March for the 2nd quarter, etc.). The
Extension Health Subsidy cannot be used toward:
and/or vision insurance premiums
and/or dependent portion of the medical premium
(Parts A, B, C and D)
medications not included and/or covered by a medical/health
A Medical Insurance Enrollment Verification
must be completed and submitted to the Secretary Benefits
Administrator before the subsidy will be issued (both to start
the subsidy and on an annual basis). The secretary must
complete the employee section of the form agreeing to release
the information (per HIPAA regulations, the information cannot
be released to a non-employer without the secretary’s
The Council will be responsible for
obtaining and maintaining evidence of premium billing/payment.
Employer health providers, such as Missouri Consolidated Health
Plans (MCHCP), will bill the Council directly. Private
health insurers may send the bill to the secretary or the
Council. If the premium bill is sent to the secretary, it
is recommended the Council obtain a copy of the bill before
payment is rendered.
A semi-annual subsidy report will be
required on the subsidy deposit and usage for premiums.
Payment of Deductibles, Co-pays and Co-insurance for Health
Insurance not obtained through the employer
The Extension Subsidy may be used for
reimbursement toward deductibles, co-pays and
co-insurance for health insurance not obtained through the
employer for benefit-eligible secretaries.
It is for the out-of-pocket expenses the
secretary incurs for his/her own deductible, co-pays and
The Subsidy is not to be used for
out-of-pocket expenses for other family members (i.e., spouse,
If the Subsidy is used for deductibles,
co-pays and co-insurance, it cannot be used toward the
secretary's health insurance premium.
- If the Council has two or more benefit-eligible
secretaries, the Council must decide whether or not to permit
the Subsidy to be used toward a health premium for one secretary
and out-of-pocket expenses (as defined above) for another
The Council, as the employer, will be
responsible for obtaining and maintaining all required documentation
for out-of-pocket expenses for secretary’s deductibles, co-pays, and
co-insurance. The Council may, at their own expense,
contract with a third party to handle the claim administration
(i.e., a Health Reimbursement Account).
from the Extension Subsidy must be for services rendered during
the plan year, January 1 through December 31.
Expenses incurred before the Council adopts the plan or the
secretary joins the plan will not be reimbursable. The amount of
available subsidy will be based on a cumulative amount through
the year. Examples are provided in Appendix B.
Additionally, funds will not carry over for use in the following
calendar year expenses.
Extension Health Subsidy will be reimbursed at the end of each
calendar year quarter, Councils may elect to reimburse the
secretary as soon as secretary files a claim with the Council.
They may also determine a minimum accumulated expense amount
before a claim may be submitted and/or how often they will
process a claim.
submit claims for reimbursement from the Extension Subsidy at
the end of each quarter (i.e., end of March, end of June, end of
September and end of December). In all cases, any claim
for Extension Subsidy reimbursement should be made by March 1 of
the following calendar year (i.e., all 2013 claims must be
submitted by March 1, 2014). However, in the event a
secretary leaves employment, the Council should submit all
claims within 30 days of separation.
Original or a
copy of itemized bills or receipts that clearly state each
of the services (related to deductibles, co-pays and
Name of the
provider of the service
Name of the
person (secretary) receiving the service
for the service
of the service
Explanation of Benefits (EOB) from each applicable health
plan showing the amount of out-of-pocket deductibles,
co-pays and/or co-insurance.
(The EOB may be used in
place of the itemized bills or receipts, if it contains all
submission will be in two parts:
will submit a Medical Expense Reimbursement Claim for to the
Council with required documentation.
will submit an Extension County Council Reimbursement Claim
for to the County Secretary Benefits Administrator.
are to be submitted based on the following:
At the end of
each calendar quarter (end of March, end of June, end of
September, end of December) or shortly thereafter.
Upon receipt of
the Extension County Council Reimbursement Claim form, a voucher
will be processed to send an Extension Health Subsidy check for
the specified amount. [Note reimbursement will be
restricted to cumulative amount of the Extension Health Subsidy
(cumulative amount to date minus any paid claims – see Appendix
elect to reimburse (out of Council funds) the secretary as soon
as a Medical Expense Reimbursement Claim is submitted. Or,
they may elect to wait until after the Extension Health Subsidy
is received. The Extension Health Subsidy will be deposited into
an account and the Council will issue a check to the
secretary(ies) for appropriate reimbursement.
Appendix A - Definitions
B - Examples of Subsidy Usage for Deductibles, Co-Pays and
Appendix C - Form Examples (refer Forms
Section for downloadable forms)
Extension Health Subsidy
NRS Retirement Plan
Policy and Procedures