THE DISTRIBUTION OF HIS SUPPLEMENTAL BENEFITS, THE SUPPLEMENTAL
BENEFITS OF SUCH A DECEASED PARTICIPANT SHALL BE PAID TO HIS BENEFICIARY AS SOON
AS ADMINISTRATIVELY FEASIBLE FOLLOWING THE PARTICIPANT'S DEATH.
6.
CLAIMS PROCEDURE.
(A)
ANY CLAIM BY A PARTICIPANT OR FORMER
PARTICIPANT OR BENEFICIARY ("CLAIMANT") WITH RESPECT TO ELIGIBILITY,
PARTICIPATION, CONTRIBUTIONS, BENEFITS OR OTHER ASPECTS OF THE OPERATION OF THE
PLAN SHALL BE MADE IN WRITING TO THE COMMITTEE FOR SUCH PURPOSE. THE COMMITTEE
SHALL PROVIDE THE CLAIMANT WITH THE NECESSARY FORMS AND MAKE ALL DETERMINATIONS
AS TO THE RIGHT OF ANY PERSON TO A DISPUTED BENEFIT.
IF A CLAIMANT IS DENIED
BENEFITS UNDER THE PLAN, THE COMMITTEE SHALL NOTIFY THE CLAIMANT IN WRITING OF
THE DENIAL OF THE CLAIM WITHIN NINETY (90) DAYS AFTER THE COMMITTEE RECEIVES THE
CLAIM, PROVIDED THAT IN THE EVENT OF SPECIAL CIRCUMSTANCES SUCH PERIOD MAY BE
EXTENDED.
THE NINETY (90) DAY PERIOD MAY BE EXTENDED UP TO NINETY (90) DAYS
(FOR A TOTAL OF ONE HUNDRED EIGHTY (180) DAYS).
IF THE INITIAL NINETY (90) DAY PERIOD IS EXTENDED, THE COMMITTEE SHALL NOTIFY
THE CLAIMANT IN WRITING WITHIN NINETY (90) DAYS OF RECEIPT OF THE CLAIM.
THE
WRITTEN NOTICE OF EXTENSION SHALL INDICATE THE SPECIAL CIRCUMSTANCES REQUIRING
THE EXTENSION OF TIME AND PROVIDE THE DATE BY WHICH THE COMMITTEE EXPECTS TO
MAKE A DETERMINATION WITH RESPECT TO THE CLAIM.
IF THE EXTENSION IS REQUIRED
DUE TO THE CLAIMANT'S FAILURE TO SUBMIT INFORMATION NECESSARY TO DECIDE THE
CLAIM, THE PERIOD FOR MAKING THE DETERMINATION WILL BE TOLLED FROM THE DATE ON
WHICH THE EXTENSION NOTICE IS SENT TO THE CLAIMANT UNTIL THE EARLIER OF (I) THE
DATE ON WHICH THE CLAIMANT RESPONDS TO THE COMMITTEE'S REQUEST FOR INFORMATION,
OR (II) EXPIRATION OF THE FORTY-FIVE (45) DAY PERIOD COMMENCING ON THE DATE THAT
THE CLAIMANT IS NOTIFIED THAT THE REQUESTED ADDITIONAL INFORMATION MUST BE
PROVIDED. IF NOTICE OF THE DENIAL
8
OF A CLAIM IS NOT FURNISHED WITHIN THE REQUIRED TIME PERIOD DESCRIBED HEREIN,
THE CLAIM SHALL BE DEEMED DENIED AS OF THE LAST DAY OF SUCH PERIOD.
If the claim is wholly or partially denied, the notice to the Claimant shall set
forth:
(I)
THE SPECIFIC REASON OR REASONS FOR THE
DENIAL;
(II)
SPECIFIC REFERENCE TO PERTINENT PLAN
PROVISIONS UPON WHICH THE DENIAL IS BASED;
(III)
A DESCRIPTION OF ANY ADDITIONAL MATERIAL OR
INFORMATION NECESSARY FOR THE CLAIMANT TO COMPLETE THE CLAIM REQUEST AND AN
EXPLANATION OF WHY SUCH MATERIAL OR INFORMATION IS NECESSARY;
(IV)
APPROPRIATE INFORMATION AS TO THE STEPS TO BE
TAKEN AND THE APPLICABLE TIME LIMITS IF THE CLAIMANT WISHES TO SUBMIT THE
ADVERSE DETERMINATION FOR REVIEW; AND
(V)
A STATEMENT OF THE CLAIMANT'S RIGHT TO BRING
A CIVIL ACTION UNDER SECTION 502(A) OF ERISA FOLLOWING AN ADVERSE DETERMINATION
ON REVIEW.
(B)
IF THE CLAIM HAS BEEN WHOLLY OR PARTIALLY
DENIED, THE CLAIMANT MAY SUBMIT THE CLAIM FOR REVIEW BY THE COMMITTEE.
ANY
REQUEST FOR REVIEW OF A CLAIM MUST BE MADE IN WRITING TO THE COMMITTEE NO LATER
THAN SIXTY (60) DAYS