ON
REVIEW PROMPTLY, AND NOT LATER THAN 60 DAYS (45 DAYS, IN THE EVENT OF A CLAIM
FOR DISABILITY BENEFITS) AFTER THE FILING OF A WRITTEN REQUEST FOR REVIEW OF THE
DENIAL, UNLESS A HEARING IS HELD OR OTHER SPECIAL CIRCUMSTANCES REQUIRE
ADDITIONAL TIME, IN WHICH CASE THE COMMITTEE'S DECISION MUST BE RENDERED WITHIN
120 DAYS (90 DAYS, IN THE EVENT OF A CLAIM FOR DISABILITY BENEFITS) AFTER SUCH
DATE.
SUCH DECISION MUST BE WRITTEN IN A MANNER CALCULATED TO BE UNDERSTOOD BY
THE CLAIMANT, AND IT MUST
22
CONTAIN: (A) SPECIFIC REASONS FOR THE DECISION; (B) SPECIFIC REFERENCE(S) TO THE
PERTINENT PLAN PROVISIONS UPON WHICH THE DECISION WAS BASED; AND (C) SUCH OTHER
MATTERS AS THE COMMITTEE DEEMS RELEVANT.
IN THE EVENT OF A CLAIM FOR DISABILITY
BENEFITS, THE NOTICE SHALL ALSO IDENTIFY ANY INTERNAL PROTOCOL, POLICY OR
GUIDELINE RELIED UPON OR STATE THAT SUCH A PROTOCOL, POLICY OR GUIDELINE WAS
RELIED UPON AND WILL BE PROVIDED FREE OF CHARGE UPON REQUEST, AND PROVIDE AN
EXPLANATION OF ANY SCIENTIFIC OR CLINICAL JUDGMENT UNDERLYING A "MEDICAL
NECESSITY" OR "EXPERIMENTAL TREATMENT" DETERMINATION (IF ANY) OR A STATEMENT
THAT SUCH A DETERMINATION WAS MADE AND THAT AN EXPLANATION WILL BE PROVIDED FREE
OF CHARGE UPON REQUEST, AND CONTAIN SUCH OTHER INFORMATION AS IS REQUIRED BY THE
DEPARTMENT OF LABOR REGULATIONS.
ALL DECISIONS ON REVIEW SHALL BE FINAL AND
BINDING WITH RESPECT TO ALL CONCERNED PARTIES.
10.05.
DISABILITY CLAIMS.
NOTWITHSTANDING THE FOREGOING, UNLESS OTHERWISE
REQUIRED BY LAW, THE SPECIAL RULES APPLICABLE TO DISABILITY CLAIMS SHALL NOT
APPLY IF THE PLAN TERMS OR THE COMMITTEE'S UNIFORMLY-APPLICABLE POLICY REQUIRE
RELIANCE EXCLUSIVELY ON DETERMINATIONS BY THE ENTITY RESPONSIBLE FOR DECIDING
SUCH MATTERS UNDER THE COMPANY'S LONG-TERM DISABILITY PLAN OR DETERMINATIONS BY
THE SOCIAL SECURITY ADMINISTRATION WHEN DECIDING WHETHER OR NOT A PARTICIPANT IS
DISABLED.
10.06.
ARBITRATION.
A CLAIMANT'S COMPLIANCE WITH THE FOREGOING PROVISIONS
OF THIS ARTICLE 10 IS A MANDATORY PREREQUISITE TO A CLAIMANT'S RIGHT TO COMMENCE
ANY ARBITRATION WITH RESPECT TO ANY CLAIM FOR BENEFITS UNDER THE PLAN.
ANY
DISPUTE, CLAIM OR CONTROVERSY THAT MAY ARISE BETWEEN A PARTICIPANT AND THE
COMPANY OR ANY OTHER PERSON (THE "CLAIMS") UNDER THE PLAN IS SUBJECT TO
ARBITRATION, UNLESS OTHERWISE AGREED TO IN WRITING BY THE PARTICIPANT AND THE
COMPANY.
THE CLAIMS SHALL BE FINALLY DECIDED BY ARBITRATION CONDUCTED PURSUANT
TO THE COMMERCIAL DISPUTE RESOLUTION PROCEDURES OF THE AMERICAN ARBITRATION
ASSOCIATION (THE "AAA"), AND ITS SUPPLEMENTARY RULES FOR SECURITIES ARBITRATION,
OR OTHER APPLICABLE RULES PROMULGATED BY THE AAA.
IN ADDITION, ALL CLAIMS,
STATUTORY OR OTHERWISE, WHICH ALLEGE DISCRIMINATION OR OTHER VIOLATION OF
EMPLOYMENT LAWS, INCLUDING BUT NOT LIMITED TO CLAIMS OF SEXUAL HARASSMENT, SHALL
BE FINALLY DECIDED BY ARBITRATION PURSUANT TO THE AAA UNLESS OTHERWISE AGREED TO
IN WRITING BY A PARTICIPANT AND THE COMPANY.
BY AGREEMENT OF A PARTICIPANT AND
THE COMPANY IN WRITING, DISPUTES MAY BE RESOLVED IN ARBITRATION BY A MUTUALLY
AGREED-UPON ORGANIZATION OTHER THAN THE AAA.
IN CONSIDERATION OF THE PROMISES
AND THE COMPENSATION PROVIDED IN THIS PLAN, NEITHER A PARTICIPANT NOR THE