Authority: IC 5-10.5-4-2; IC 5-10-8.5-11

Affected: IC 5-10-8.5; IC 5-10.3-2; IC 5-10.3-12-14

Sec. 2. The following definitions apply throughout this article, unless the context otherwise clearly requires:

1. (1) "Claims administrator" means the third party administrator appointed by INPRS to handle the administration of the plan.

2. (2) "Covered dependent" means:

   1. (A) a surviving spouse legally married to the retired participant on the date of the retired participant's death; or
   2. (B) an unmarried person who is a dependent child of the retired participant as defined under the state's health plans.

3. 3) "Employer" means:

   1. (A) for an elected officer, appointed officer, or employee of the executive branch of state government who is in a position covered by the plan as described in section 3 of this rule, the state, including any board, commission, department, division, authority, institution, establishment, facility, or governmental unit under the supervision of the state, having a payroll in relation to persons it immediately employs;

   2. (B) for a member of the Indiana general assembly or an employee of the legislative branch of state government:

      1. (i) the president pro tempore of the senate, for a member or an employee of the senate;
      2. (ii) the speaker of the house of representatives, for a member or an employee of the house of representatives; or
      3. (iii) the personnel subcommittee of the legislative council, for an employee of the legislative services agency.

   3. (C) the Indiana supreme court, for a member or employee of the judicial branch of state government, including:

      1. (i) a justice;
      2. (ii) a judge;
      3. (iii) a prosecuting attorney;
      4. (iv) an officer described in section 3(b)(6) of this rule; and
      5. (v) an employee of the judicial branch of state government, including an employee of any board, commission, department, division, authority, institution, establishment, facility, or governmental unit under the supervision of the judicial branch, having a payroll in relation to persons it immediately employs.
4. (4) "Plan" means the retirement medical benefits account plan established under IC 5-10-8.5.
5. (5) "Plan year" means the twelve (12) month period commencing each July 1 and ending the following June 30.

6. (6) "Qualifying expenses" means:

   1. (A) premiums paid under part B of title XVIII of the Social Security Act, relating to supplementary medical insurance for the aged;
   2. (B) contributions under a fully-insured policy or self-funded plan or program providing group or individual coverage to the retired participant or covered dependents covering medical care as defined in section 213(d)(1)(A) and (B) of the Social Security Act for medical, dental, and vision benefits; and
   3. (C) premiums paid for tax-qualified long-term care insurance subject to limitations in section 213(d)(10) of the Internal Revenue Code;

   4. (D) the following amounts that are excluded from qualifying benefits:

      1. (i) expenses paid, reimbursed, or reimbursable by any insurance, accident, health, or workers' compensation plan;
      2. (ii) expenses paid, reimbursed, or reimbursable under an Internal Revenue Code Section 125 plan;
      3. (iii) expenses incurred while the individual was neither a retired participant nor a covered dependent; and
      4. (iv) expenses the individual is not legally obligated to pay; and
   5. (E) expenses for the purchase of a policy, plan, or program providing coverage for expenses in addition to medical care, as defined by section 213(d) of the Internal Revenue Code are qualifying expense only to the extent that such expenses are directly related to the cost of the medical care component. The cost for the medical care component must be reasonable for the type and amount of coverage purchased as determined by the claims administrator and must be separately stated in the insurance contract, billing statement, or other documentation accepted by the claims administrator.

7. (7) "Retired participant" means:

   1. (A) a participant who is eligible for a normal, an unreduced, or a disability benefit of the public employees' retirement fund established under IC 5-10.3-2 on the participant's last day of service;

   2. (B) a participant who has completed at least ten (10) years of service as an elected or appointed officer on the participant's last day as an elected or appointed officer. For purposes of calculating whether a participant has sufficient years of service under this clause:

      1. (i) if a participant has years of service with more than one (1) employer in a position covered by the plan, the years of service are the sum of all the participant's years of service in a position covered by the plan with all employers; and
      2. (ii) effective July 1, 2013, a partial year of service completed by the participant shall be considered to be one (1) complete year of service; or
   3. (C) a participant who is a member of the public employees' defined contribution plan established under IC 5-10.3-12 who is of normal retirement age as defined by IC 5-10.3-12-14 on their last day of service, and whose last day of service is after June 30, 2021. Years of service that are purchased by or on behalf of a participant in order for the participant to be eligible for a benefit will not be included in determining the participant's eligibility for benefits or amount of benefits under this plan.

(Board of Trustees of the Indiana Public Retirement System; 35 IAC 23-1-2; adopted Sep 10, 2021: 20210915-IR- 035210420ONA)