Self-standing MERP -FSA in conjunction with an HDHP?

[Appleby]

(1) Client offers a self-standing Section 105 medical expense reimbursement plan ("MERP"). They also allow employees to maintain HSAs. Can anyone confirm that Revenue Ruling 2004-45 allows a self-standing health FSA to provide limited purpose benefits in conjunction with an HDHP?

(2) The MERP was revised to provide limited purpose benefits (dental and vision). The client wants it also to reimburse preventive care expenses.

The HDHP already provides preventive care and in accordance with Notice 2004-23 the preventive care does not count towards the deductible, it is "first-dollar" coverage.

So is it possible to still have preventive care expenses be reimbursable under the MERP, presuming they are not the same expenses that are covered under the HDHP? Would it have to do so only after the HDHP deductible is met?

Example 1 - HDHP allows for one checkup visit per year. Employee gets a second checkup visit. Can the MERP reimburse the cost of the second checkup visit? If so can it do so only if the employee has met the deductible under the HDHP?

Example 2 - Employee gets a full body scan, which detects for cancer, even though it is not a covered preventive expense under the HDHP. Can the MERP reimburse the cost of the body scan? If so can it do so only if the employee has met the deductible under the HDHP?

All help would be greatly appreciated.