149.320—Universe of claims that must be submitted.
(a)
Claims submitted for an early retiree, as defined in § 149.2, must include claims below the applicable cost threshold for the plan year.
(b)
Claims must not be submitted until claims are submitted for amounts that exceed the applicable cost threshold for the plan year for the early retiree.
(c)
Sponsors must not submit claims for health benefits for an early retiree to the extent the sponsor has already submitted claims for the early retiree that total more than the applicable cost limit for the applicable plan year.