A company wants to put in place a self-funded health plan under which only certain costs associated with hospital co-pays will be reimbursed. In general, the company wants to give employees 6 months after the end of the year or after termination of employment to request reimbursement for eligible expenses incurred during employment. However, if the company terminates the participant's coverage "for cause", the employee will lose his right to seek reimbursement after employment terminates, even if the expenses were incurred while employed.
Other than all of the issues regarding defining "for cause", can anyone see any problems with this? I can seek an increased risk for a claim under ERISA Section 510, and possibility of discriminatory benefits depending on how this is operated, but is there any problem with having a benefit being reimburseable unless you subsequently are terminated for cause?