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7/15/2005 10:12:56 AM
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<br />(d) If the services are being performed by a child of the Participant, <br />the age of the child; <br /> <br />(e) A statement as to where the services were performed; <br /> <br />(f) If any of the services were performed outside the home, a <br />statement as to whether the Dependent for whom such services were <br />performed spends at least 8 hours a day in the Participant's household; <br /> <br />(g) If the services were being performed in a day care center, a <br />statement: <br /> <br />(1) that the day care center complies with all applicable laws and <br />regulations of the state of residence, <br /> <br />(2) that the day care center provides care for more than 6 <br />individuals (other than individuals residing at the center), and <br /> <br />(3) <br /> <br />(h) <br />following: <br /> <br />of the amount of fee paid to the provider. <br /> <br />If the Participant is married, a statement containing the <br /> <br />(1 ) <br />(2) <br /> <br />the Spouse's salary or wages if he or she is employed, or <br /> <br />if the Participant's Spouse is not employed, that <br /> <br />(i) he or she is incapacitated, or <br /> <br />(ii) he or she is a full-time student attending an <br />educational institution and the months during the year which he <br />or she attended such institution. <br /> <br />(i) If a Participant fails to submit a claim within the 30 day period <br />immediately following the end of the Plan Year, those claims shall not be <br />considered for reimbursement by the Administrator. <br /> <br />ARTICLE VIII <br />BENEFITS AND RIGHTS <br /> <br />8.1 CLAIM FOR BENEFITS <br /> <br />(a) Any claim for Benefits underwritten by an Insurance Contract <br />shall be made to the Insurer. If the Insurer denies any claim, the Participant or <br />beneficiary shall follow the Insurer's claims review procedure. Any other claim <br />for Benefits shall be made to the Administrator. If the Administrator denies a <br />claim, the Administrator may provide notice to the Participant or beneficiary, <br />in writing, within 90 days after the claim is filed unless special circumstances <br />require an extension of time for processing the claim. If the Administrator <br /> <br />21 <br />
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