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Frequently Asked Questions, continued
Q.
What does not count towards the annual out of pocket maximum for the PPO Plan?
A.
The Out-of-Pocket Maximum does not apply to, or include, charges in excess of the Usual, Customary
and Reasonable charges, or expenses which become the Covered Person's responsibility for failure to
comply with the requirements of the Utilization Management program.
Q.
EBS has mailed me a "Request for Substantiation Documentation," what do I do?
A.
Substantiation of FSA reimbursements is a requirement for all Plan Participants. Substantiation is
not optional. To substantiate your transactions you will need to send EBS an Explanation of Benefits,
or an itemized receipt. You can upload your receipts by logging in to EBS' FSA user administration
website
(http://ebsbenefits.Lh1ondemand.com)or by faxing your information to the number provided in
your letter.