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Summary Plan Description (SPD)
Exhaustion of the Appeal Process
Under a Federal Law known as ERISA a participant or beneficiary whose claim for benefits has been denied may file suit against the Plan seeking the denied benefit. However, prior to filing such a suit the appeal process under the Plan described above must be pursued and exhausted. Thus, following any initial denial of benefits, if you disagree, it is important you file a timely appeal. In all cases, your appeal must be filed no later than 180 days after the initial denial of your claim as received by you. If you do not file an appeal within the required time frame you will have failed to exhaust your appeal rights. The Trustees may extend the 180 day limit upon your showing good cause for the delay, but to protect your rights you should file any appeal promptly after your receipt of the initial denial.
In the event that you disagree with the decision of the Trustees, you may submit the matter to arbitration in accordance with the Employee Benefit Plan Arbitration Rules of the American Arbitration Association. The questions for the arbitration shall be:
- whether the Trustees were in error upon an issue of law;
- whether the Trustees acted arbitrarily or capriciously in the exercise of their discretion; and
- whether the Trustees findings of fact were supported by substantial evidence.