AMEND AND RESCIND SUCH RULES AS IT DEEMS NECESSARY
FOR THE PROPER ADMINISTRATION OF THE PLAN AND (IV) TO MAKE ALL OTHER
DETERMINATIONS NECESSARY OR ADVISABLE FOR THE ADMINISTRATION OF THE PLAN,
INCLUDING DETERMINATIONS REGARDING ELIGIBILITY FOR BENEFITS PAYABLE UNDER THE
PLAN. ALL INTERPRETATIONS OF THE ADMINISTRATOR WITH RESPECT TO ANY MATTER
HEREUNDER SHALL BE FINAL, CONCLUSIVE AND BINDING ON ALL PERSONS AFFECTED
THEREBY.
NO MEMBER OF THE ADMINISTRATOR SHALL BE LIABLE FOR ANY DETERMINATION,
DECISION, OR ACTION MADE IN GOOD FAITH WITH RESPECT TO THE PLAN.
THE COMPANY
WILL INDEMNIFY AND HOLD HARMLESS THE MEMBERS OF THE ADMINISTRATOR FROM AND
AGAINST ANY AND ALL LIABILITIES, COSTS, AND EXPENSES INCURRED BY SUCH PERSONS AS
A RESULT OF ANY ACT, OR OMISSION, IN CONNECTION WITH THE PERFORMANCE OF SUCH
PERSONS' DUTIES, RESPONSIBILITIES, AND OBLIGATIONS UNDER THE PLAN, OTHER THAN
SUCH LIABILITIES, COSTS, AND EXPENSES AS MAY RESULT FROM THE BAD FAITH, WILLFUL
MISCONDUCT, OR CRIMINAL ACTS OF SUCH PERSONS.
10.2
CLAIMS PROCEDURE.
ANY PARTICIPANT, FORMER PARTICIPANT OR
BENEFICIARY MAY FILE A WRITTEN CLAIM WITH THE ADMINISTRATOR SETTING FORTH THE
NATURE OF THE BENEFIT CLAIMED, THE AMOUNT THEREOF; AND THE BASIS FOR CLAIMING
ENTITLEMENT TO SUCH BENEFIT.
THE ADMINISTRATOR SHALL DETERMINE THE VALIDITY OF
THE CLAIM AND COMMUNICATE A DECISION TO THE CLAIMANT PROMPTLY AND, IN ANY EVENT,
NOT LATER THAN NINETY (90) DAYS AFTER THE DATE OF THE CLAIM.
THE CLAIM MAY BE
DEEMED BY THE CLAIMANT TO HAVE BEEN DENIED FOR PURPOSES OF FURTHER REVIEW
DESCRIBED BELOW IN THE EVENT A DECISION IS NOT FURNISHED TO THE CLAIMANT WITHIN
SUCH NINETY (90) DAY PERIOD.
IF ADDITIONAL INFORMATION IS NECESSARY TO MAKE A
DETERMINATION ON A CLAIM, THE CLAIMANT SHALL BE ADVISED OF THE NEED FOR SUCH
ADDITIONAL INFORMATION WITHIN FORTY-FIVE (45) DAYS AFTER THE DATE OF THE CLAIM.
THE CLAIMANT SHALL HAVE UP TO ONE HUNDRED AND EIGHTY (180) DAYS TO SUPPLEMENT
THE CLAIM
11
INFORMATION, AND THE CLAIMANT SHALL BE ADVISED OF THE DECISION ON THE CLAIM
WITHIN FORTY-FIVE (45) DAYS AFTER THE EARLIER OF THE DATE THE SUPPLEMENTAL
INFORMATION IS SUPPLIED OR THE END OF THE ONE HUNDRED AND EIGHTY (180) DAY
PERIOD.
EVERY CLAIM FOR BENEFITS WHICH IS DENIED SHALL BE DENIED BY WRITTEN
NOTICE SETTING FORTH IN A MANNER CALCULATED TO BE UNDERSTOOD BY THE CLAIMANT
(I) THE SPECIFIC REASON OR REASONS FOR THE DENIAL, (II) SPECIFIC REFERENCE TO
ANY PROVISIONS OF THE PLAN (INCLUDING ANY INTERNAL RULES, GUIDELINES, PROTOCOLS,
CRITERIA, ETC.) ON WHICH THE DENIAL IS BASED, (III) DESCRIPTION OF ANY
ADDITIONAL MATERIAL OR INFORMATION THAT IS NECESSARY TO PROCESS THE CLAIM, AND
(IV) AN EXPLANATION OF THE PROCEDURE FOR FURTHER REVIEWING THE DENIAL OF THE
CLAIM.
10.3
REVIEW PROCEDURES.
WITHIN SIXTY (60) DAYS AFTER THE RECEIPT OF A
DENIAL ON A CLAIM, A CLAIMANT OR HIS/HER AUTHORIZED REPRESENTATIVE MAY FILE A
WRITTEN REQUEST FOR REVIEW OF SUCH DENIAL.
SUCH REVIEW SHALL BE UNDERTAKEN BY
THE ADMINISTRATOR AND SHALL BE A FULL AND FAIR REVIEW.
THE CLAIMANT SHALL HAVE
THE RIGHT TO REVIEW ALL