Claim for benefits other than Disability benefits Sample Clauses

Claim for benefits other than Disability benefits. The Corporation shall consider a Claimant’s claim within a reasonable time, but no later than ninety (90) days after receiving the claim. If the Corporation determines that special circumstances require an extension of time for processing the claim, written notice of the extension shall be furnished to the Claimant prior to the termination of the initial ninety (90) day period. In no event shall such extension exceed a period of ninety (90) days from the end of the initial period. The extension notice shall indicate the special circumstances requiring an extension of time and the date by which the Corporation expects to render the benefit determination.
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Claim for benefits other than Disability benefits. On or before sixty (60) days after receiving a notice from the Corporation that a claim has been denied, in whole or in part, a Claimant (or the Claimant’s duly authorized representative) may file with the Corporation a written request for a review of the denial of the claim. The Claimant (or the Claimant’s duly authorized representative): (a) may, upon request and free of charge, have reasonable access to, and copies of, all documents, records and other information relevant to the claim for benefits; (b) may submit written comments or other documents; and/or (c) may request a hearing, which the Corporation, in its sole discretion, may grant. The Corporation shall render its decision on review promptly, and no later than sixty (60) days after the Corporation receives the Claimant’s written request for a review of the denial of the claim. If the Corporation determines that special circumstances require an extension of time for processing the claim, written notice of the extension shall be furnished to the Claimant prior to the termination of the initial sixty (60) day period. In no event shall such extension exceed a period of sixty (60) days from the end of the initial period. The extension notice shall indicate the special circumstances requiring an extension of time and the date by which the Corporation expects to render the benefit determination. In rendering its decision, the Corporation shall take into account all comments, documents, records and other information submitted by the Claimant relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. The decision must be written in a manner calculated to be understood by the Claimant, and it must contain: (1) specific reasons for the decision; (2) specific reference(s) to the pertinent provisions of this Appendix A upon which the decision was based; (3) 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 (as defined in applicable ERISA regulations) to the Claimant’s claim for benefits; and (4) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a).
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Related to Claim for benefits other than Disability benefits

  • Disability Benefits Technology Errors and Omissions Not less than $1,000,000 each claim Not less than $2,000,000 in aggregate At the time of the first transaction with an Authorized User and updated in accordance with Contract Crime Insurance Not less than $50,000 Commercial General Liability Not less than $5,000,000 each occurrence Updated in accordance with Contract General Aggregate $2,000,000 Products – Completed Operations Aggregate $2,000,000 Personal and Advertising Injury $1,000,000 Business Automobile Liability Insurance Not less than $5,000,000 each occurrence

  • Long Term Disability Benefits A benefit level of seventy percent (70%) of monthly earnings shall apply. Benefits would commence after a waiting period of seventeen (17) weeks, when Short Term Disability Benefits terminate. Terms of the Master Policy with the Insurance Company shall apply. In order to go on LTD, the person must: (a) Be off work for seventeen (17) consecutive weeks with the same or unrelated illness or injury. (b) Be off work for a total of seventeen (17) weeks with the same illness or injury providing that the return to work was less than twenty (20) consecutive days.

  • Disability Benefit If the Executive terminates employment due to Disability prior to Normal Retirement Age, the Company shall pay to the Executive the benefit described in this Section 2.3 in lieu of any other benefit under this Agreement.

  • Long Term Disability Benefit In the event an employee, while covered under this Plan, becomes totally disabled as a result of an accident or a sickness, then, after the employee has been totally disabled for seven (7) months, including periods approved in Sections 1.3(a) and (c), he/she shall be eligible to receive a monthly benefit as follows: (a) while the employee has a time bank balance to be used on a day-for-day basis, full monthly earnings will continue until the time bank is exhausted, and Section 2.6 will not apply; (b) effective March 1, 2001, when an employee has no time bank, or after it is exhausted, the employee shall receive a monthly benefit equal to the sum of: (1) seventy-five percent (75%) of monthly earnings; (2) annual cost-of-living adjustment of the benefit equal to the consumer price index to a maximum of two percent (2%); (3) for the purpose of the above, earnings shall mean basic monthly earnings of the employee's classification. The date of disability for determining the commencement of the first two (2) years of disability shall be the day following the last month of the Short Term Plan period, or an equivalent seven (7) month period. (c) The Long Term Disability benefit payment will be made as long as an employee remains totally disabled in accordance with Section 2.3, and will cease on the date the employee recovers, or at the end of the month in which the employee reaches age sixty-five (65), or resigns or dies, whichever occurs first. (d) An employee in receipt of long term disability benefits will be considered an employee for purposes of pension and will continue to be covered by group life, extended health, dental and medical plans. Employees will not be covered by any other portion of a collective agreement but will retain the right of access to rehabilitative employment as per Article 12.1 and will retain seniority rights should they return to employment within six (6) months following cessation of benefits. (e) When an employee is in receipt of the benefit described in (b) above, contributions required for benefit plans in (d) above and contributions for pension plan will be waived by the Employer. (f) An employee engaged in rehabilitative employment with the Employer and who is receiving partial Long Term Disability benefit payments will have contributions required for benefit plans in (d) above and contributions for pension waived by the Employer, except that pension contributions shall be deducted from any salary received from the Employer to cover the period of rehabilitative employment.

  • Employment Benefits In addition to the Salary payable to the Executive hereunder, the Executive shall be entitled to the following benefits:

  • Retirement Benefits Due to either investment or employment during the marriage, either the Husband or Wife: (check one)

  • Application for Benefits Requests for short-term leaves shall be in writing, upon the appropriate form prescribed and provided by the District, and shall be filed with the unit member's supervisor and the appropriate manager five (5) days in advance of the intended leave (except in emergency situations), unless otherwise stated by the provisions of the specific leave.

  • Eligibility for Benefits 1. Sick Leave Bank benefits are available only when the member personally has a severe medical hardship (catastrophic illness or serious accident). 2. Benefits can be received only after all accumulated sick leave and vacation days have been exhausted. 3. Any member receiving Worker's Compensation or disability benefits shall not be eligible to receive benefits from the Sick Leave Bank. 4. A member who is on leave of absence, suspended, or terminated from the Xxxxxxx County Board of Education shall not be eligible for Sick Leave Bank benefits. 5. The form, entitled "Request For Sick Leave Benefits" and physician's statement are required before the SLB Review Committee will consider a request for benefits. The physician's statement shall include a history of the illness, date the illness began, a diagnosis and prognosis, and any other related information. 6. Approval by the Sick Leave Bank Review Committee is required prior to the receiving of benefits. 7. Normal pregnancies, childbirth, childcare, or child adoption shall not be considered as eligible reasons for Sick Leave Bank benefits. 8. A four (4)-member Sick Leave Bank Review Committee, consisting of two (2) members appointed by the President of the Association and two (2) appointed by the Superintendent, shall have the responsibility of receiving requests, verifying the validity of requests and approval or denial of requests. Any approval of a request must have the support of at least three (3) members of the committee Sick Leave Bank Review Committee. The Sick Leave Bank Review Committee shall develop its rules of procedure and shall give wide distribution to said rules upon approval of the President of the Association and the Superintendent.

  • Short Term Disability Benefits The Board shall provide short-term disability benefits as set forth in the short term disability summary plan description. 1. Rate of Benefits and Waiting Period Short term disability benefits for disabilities resulting from non-occupational illness or injury, shall be paid at the rate of 70% of the employee’s regular rate subject to all applicable deductions. Following the exhaustion of temporary leave, there is a five (5) day waiting period before short term disability benefits begin. The five (5) day waiting period will be waived for absences greater than thirty (30) consecutive calendar days and short term disability payments shall be paid retroactively. (See also Temporary Leave.)

  • Survivor Benefits 1. A surviving dependent of a retiree who was eligible to receive a Retiree Medical Grant, as stated above in A through C, and who qualifies for a monthly allowance shall be eligible for fifty (50) percent of the Grant authorized for the retiree. 2. A surviving eligible retiree who qualifies for a monthly retirement allowance who was married to a retiree who was also eligible for a Grant shall receive the survivor benefit described in D.1., above, or his or her own Grant, whichever is greater. Such retiree shall not be eligible for both Grants.

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