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, AND 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.
15.7.
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 FREE OF
CHARGE, REASONABLE ACCESS TO, AND COPIES OF, ALL DOCUMENTS, RECORDS, AND OTHER
INFORMATION RELEVANT TO THE CLAIM FOR BENEFITS; AND (IV) DESCRIBE THE CLAIMANT'S
RIGHT TO BRING AN ACTION UNDER SECTION 502(A) OF ERISA.
THE DECISION SHALL BE
FINAL AND BINDING UPON THE CLAIMANT AND THE PLAN ADMINISTRATOR AND ALL OTHER
PERSONS HAVING OR CLAIMING TO HAVE AN INTEREST IN THE PLAN OR IN ANY ACCOUNT
ESTABLISHED UNDER THE PLAN.
15.8.
NOTICES.
ANY NOTICE FROM THE COMPANY OR THE COMMITTEE TO AN
EMPLOYEE, PARTICIPANT, INACTIVE PARTICIPANT, OR BENEFICIARY REGARDING THIS PLAN
MAY BE ADDRESSED TO THE LAST KNOWN RESIDENCE OF SAID PERSON AS INDICATED IN THE
RECORDS OF THE COMPANY.
ANY NOTICE TO, OR
10
ANY SERVICE OF PROCESS UPON, THE COMPANY OR THE COMMITTEE WITH RESPECT TO THIS
PLAN MAY BE ADDRESSED AS FOLLOWS:
Chief Financial Officer
First Financial Bank
100 E. Lancaster Avenue
Downington, PA 19335
15.9.
INDEMNIFICATION.
TO THE EXTENT PERMITTED BY