AgdaPkt 2011-05-23 - Laserfiche WebLink

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6.3.B. - Page 19 7.�2 Requ�rement far Wr�tten Notice af ��a�m Den�al ' The Plan Administrat�r shall pr�vide,to�very claimant who is denied a claim f�r benefits,written n�tice setting fQrth in a mann�r calculat�d t�be underst��d by the claimant: a} The specif�c reason�r reasons for the denial; b} Specific referen�e t�pertinent PIan pr�visi�ns�n which th�denial is bas�d; c} A descripti�n�f any a.ddiri�nal mat�rial of inf�rmation necessary for the claimant t�p�rfect th�claim and an explanatioi� of why such material is necessary,and d} An explanati�n�f the Plaris claun review pr�c�dur�. 7.�3 Right to Request Hearing an Benef it Denia! �ithin one-hundred eighty(18�} days after the receipt by the claimant�f written notificati�n�f the denial�in whQle or in part}�f his claim,the claimant or his duly auth�riz�d representative,up�n written application to the Plan Administrator,in person or by certified mail,postage prepaid,may request a r��iew�f such denial,may review pertinent documents,and may submit issues and comments in writing. 7.�4 D�spas�ti�n af D�sputed Cla�ms y Up�n its receipt�f n�tice of a request f�r re�iew,the Plan Administrat�r shall make a pr�mpt decisi�n�n the review The d�cisi�n �n review shall be written in a manner cal�ulated to be under�tood by th�claimant and sha11 include specific reas�ns for the decision and specific reFerences to the pertinent plan pr�visi�ns�n which the d�cisi�n is ba.s�d.The de�ision on review shall he made not later than sixty(GU}days after the Plan Administrat�r's receipt�f a r�quest f�r a review,unless special circumstances require an extensi�n �f time for pr�cessing,in which case a decision sha11 be rendered n�t Iater than on�hundred-twenty(��}days after receipt�f a r�quest fvr revi�w.�f an ext�nsi�n is necessary,the r.laimant shall be given written n�ti��f th�ext�nsi�n pri�r t�th�expirati�n of the uutial sixty�G�}day peri�d.If n�tice�f the d�cisi�n on the re,view is n�t furnished in accordance with�his Section,the claim shall be deemed denied and the c.�aimant shall be permitted to exercise his right to legal remedy pursuant to Secti�n 7.Q5. 7.�5 Preser�atian af qther Remed�es After exhaustion�f the claims pr��dures pr�vided under this Plan,n�thing shall prevent any p�rson fram pursuing any�ther legal or equitable remedy otherwise available. ARTlCLE V!�! Amendment ar Term�nat�on af Plan 8.�] Permanen�y �hile the Employer fully expects that this Plan wi11 continue ind�finitely,du�to unforeseen,future business contingen�ies, p�rman�ncy�f th�Plan will be subject t�the Empl�yer's right to amend or terminat�th�P�an,as pr�vid�d in Secti�ns$.�� and 8.�3,below.