ANY DISPUTE WITH THE BANK, NOR MAY ANY COMMITTEE
MEMBER OR OTHER PERSON REIMBURSE HIMSELF, HERSELF, OR ITSELF FROM ANY PLAN
CONTRIBUTIONS FOR ANY SUCH COST, LIABILITY, LOSS, FEE, OR EXPENSE.
14.5.
INSURANCE. THE BANK MAY, BUT NEED NOT, OBTAIN
LIABILITY INSURANCE TO PROTECT ITS DIRECTORS, OFFICERS, EMPLOYEES, OR
REPRESENTATIVES AGAINST LIABILITY IN THE OPERATION OF THE PLAN.
14.6.
CLAIMS PROCEDURE.
A.
A CLAIM FOR BENEFITS SHALL BE
CONSIDERED FILED ONLY WHEN ACTUALLY RECEIVED BY THE PLAN ADMINISTRATOR.
B.
ANY TIME A CLAIM FOR BENEFITS IS WHOLLY
OR PARTIALLY DENIED, THE PARTICIPANT, INACTIVE PARTICIPANT, OR BENEFICIARY
(HEREINAFTER "CLAIMANT") SHALL BE GIVEN WRITTEN NOTICE OF SUCH DENIAL WITHIN 90
DAYS AFTER THE CLAIM IS FILED, UNLESS SPECIAL CIRCUMSTANCES REQUIRE AN EXTENSION
OF TIME FOR PROCESSING THE CLAIM. IF THERE IS AN EXTENSION, THE CLAIMANT SHALL
BE NOTIFIED OF THE EXTENSION AND THE REASON FOR THE EXTENSION WITHIN THE INITIAL
90-DAY PERIOD. THE EXTENSION SHALL EXPIRE WITHIN 180 DAYS AFTER THE CLAIM IS
FILED. SUCH NOTICE WILL INDICATE THE REASON FOR DENIAL, THE PERTINENT PROVISIONS
OF THE PLAN ON WHICH THE DENIAL IS BASED, AN EXPLANATION OF THE CLAIMS APPEAL
PROCEDURE AND APPEAL TIME LIMITS SET FORTH HEREIN, A DESCRIPTION OF ANY
ADDITIONAL MATERIAL OR INFORMATION NECESSARY TO PERFECT THE CLAIM, AND AN
EXPLANATION OF WHY SUCH MATERIAL OR INFORMATION IS NECESSARY. THE DENIAL WILL
ALSO INCLUDE A STATEMENT DESCRIBING THE CLAIMANT'S RIGHT TO BRING AN ACTION
UNDER SECTION 502(A) OF ERISA FOLLOWING AN ADVERSE DETERMINATION ON REVIEW.
11
14.7.
APPEAL PROCEDURES
A.
ANY PERSON WHO HAS HAD A CLAIM FOR
BENEFITS DENIED BY THE PLAN ADMINISTRATOR, OR IS OTHERWISE ADVERSELY AFFECTED BY
THE ACTION OR INACTION OF THE PLAN ADMINISTRATOR, SHALL HAVE THE RIGHT TO
REQUEST A REVIEW BY THE PLAN ADMINISTRATOR. SUCH REQUEST MUST BE IN WRITING AND
MUST BE RECEIVED BY THE PLAN ADMINISTRATOR WITHIN 60 DAYS AFTER SUCH PERSON
RECEIVES NOTICE OF THE PLAN ADMINISTRATOR'S ACTION. IF WRITTEN REQUEST FOR A
REVIEW IS NOT MADE WITHIN SUCH 60-DAY PERIOD, THE CLAIMANT SHALL FORFEIT HIS OR
HER RIGHT TO A REVIEW. THE CLAIMANT OR A DULY AUTHORIZED REPRESENTATIVE OF THE
CLAIMANT MAY REVIEW ALL PERTINENT DOCUMENTS AND SUBMIT ISSUES AND COMMENTS IN
WRITING.
B.
THE PLAN ADMINISTRATOR SHALL THEN REVIEW
THE CLAIM. THE PLAN ADMINISTRATOR MAY ISSUE A WRITTEN DECISION REAFFIRMING,
MODIFYING, OR SETTING ASIDE ITS FORMER ACTION WITHIN 60 DAYS AFTER RECEIPT OF
THE WRITTEN REQUEST FOR A REVIEW, OR 120 DAYS IF SPECIAL CIRCUMSTANCES REQUIRE
AN EXTENSION. THE CLAIMANT SHALL BE NOTIFIED IN WRITING OF ANY SUCH EXTENSION
WITHIN 60 DAYS FOLLOWING THE REQUEST FOR A REVIEW. AN ORIGINAL OR COPY OF THE
DECISION SHALL BE FURNISHED TO THE CLAIMANT. A NOTIFICATION OF ADVERSE BENEFIT
DETERMINATION SHALL SET FORTH, IN A MANNER CALCULATED TO BE UNDERSTOOD BY THE
CLAIMANT, (I) THE SPECIFIC REASON OR REASONS FOR THE ADVERSE DETERMINATION; (II)
REFERENCES TO THE SPECIFIC PLAN PROVISIONS ON WHICH THE BENEFIT DETERMINATION IS
BASED; (III) A STATEMENT THAT THE CLAIMANT IS ENTITLED TO RECEIVE, UPON REQUEST
AND