BENEFIT APPLICATION AND APPEALS PROCEDURE

If you are planning to retire, you should apply about 3 months before you expect to stop working. For a distribution following termination of employment, you should apply about 9 months after you stop working.

You may obtain benefit application forms from the Administrative Office. The address and telephone number of the Administrative Office are shown on the inside front cover.

No benefits will be paid unless and until an application has been filed. An application shall be considered to be filed as soon as it is received by the Administrative Office, if you have provided all of the information and the documents (such as birth certificates) required by the application form. If you have not provided all of the necessary information and documents, the Administrative Office will inform you of the additional information and/or documents needed, as soon as reasonably possible.

Notice of Claim Denial

If your benefit application is denied, the Administrative Office will send you a written notice of denial which will contain the following information:

• The specific reason for the denial.
• Specific references to the Plan provisions on which the denial is based.
• A description of any additional material or information which would be needed to have your benefit application approved and an explanation of why such material or information is needed.
• An explanation of the review procedure described in the following paragraph.

Appeals

If you believe that you have wrongfully been denied a benefit to which you are entitled, you may appeal the benefit denial. If you wish to appeal, you must submit a written request  for your appeal to the Administrative Office within 60 days after you have received the notice that your benefit application was denied.

You or your authorized representative may then review the documents related to your case and submit any written comments and additional information which will support your claim.

The Trustees, or a Committee set up for this purpose, will then review your benefit application and its denial and will notify you in writing of the decision regarding your benefits within 120 days of receipt of the application.  If any more information is needed, or if, because of special circumstances, extra time is required, you will be notified in writing.

If, after the appeal has been decided, you still believe you have wrongfully been denied benefits, you may proceed to arbitration before the American Arbitration Association by sending a written request for arbitration to the Trust Fund within sixty (60) days of receiving the Trustees’ decision on your appeal.  The questions for the arbitrator shall be: (1) whether the Trustees were in error on an issue of law; (2) whether the Trustees acted arbitrarily or capriciously in the exercise of their discretion and (3) whether the Trustees’ findings of fact were supported by substantial evidence.