Common use of Enforce Member’s Rights Clause in Contracts

Enforce Member’s Rights. If a Member’s Claim for a plan Benefit is denied or ignored, in whole or in part, the Member has a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to Appeal any denial, all within certain time schedules. Under XXXXX, there are steps the Member can take to enforce the above rights. A Member must exhaust all Claims and Appeal procedures available to him before filing any suit. For instance, if the Member requests a copy of plan documents or the latest annual report from the plan and does not receive them within thirty (30) days, the Member may file suit in Federal Court. In such a case, the court may require the plan administrator to provide the materials and pay the Member up to one hundred and ten dollars ($110.00) a day until he receives the materials, unless the materials were not sent because of reasons beyond the control of the plan administrator. If the Member has a Claim for Benefits, which is denied or ignored, in whole or in part, he may file suit in a state or Federal court. In addition, if he disagrees with the plan’s decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, such Member may file suit in Federal Court. If it should happen that plan fiduciaries misuse the plan’s money, or if the Member is discriminated against for asserting his rights, he may seek assistance from the United States Department of Labor, or he may file suit in a Federal Court. The court will decide who should pay court costs and legal fees. If the Member is successful, the court may order the person he has sued to pay these costs and fees. If the Member loses, the court may order him to pay these costs and fees, for example, if it determines that his claim is frivolous. Assistance with Member Questions If a Member has any questions about his plan, he should contact the plan administrator. If a Member has any questions about this statement or about his rights under XXXXX, or if he needs assistance in obtaining documents from the plan administrator, he should contact the nearest office of the Employee Benefits Security Administration, United States Department of Labor, listed in the telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, United States Department of Labor, 000 Xxxxxxxxxxxx Xxxxxx X.X., Xxxxxxxxxx, X.X. 00000. The Member may also obtain certain publications about his rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.

Appears in 5 contracts

Samples: Limited Benefit Contract, Benefit Contract, Limited Benefit Contract

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Enforce Member’s Rights. If a Member’s Claim for a plan Benefit is denied or ignored, in whole or in part, the Member has a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to Appeal any denial, all within certain time schedules. Under XXXXX, there are steps the Member can take to enforce the above rights. A Member must exhaust all Claims and Appeal procedures available to him before filing any suit. For instance, if the Member requests a copy of plan documents or the latest annual report from the plan and does not receive them within thirty (30) days, the Member may file suit in Federal Court. In such a case, the court may require the plan administrator to provide the materials and pay the Member up to one hundred and ten dollars ($110.00) a day until he receives the materials, unless the materials were not sent because of reasons beyond the control of the plan administrator. If the Member has a Claim for Benefits, which is denied or ignored, in whole or in part, he may file suit in a state or Federal court. In addition, if he disagrees with the plan’s decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, such Member may file suit in Federal Court. If it should happen that plan fiduciaries misuse the plan’s money, or if the Member is discriminated against for asserting his rights, he may seek assistance from the United States Department of Labor, or he may file suit in a Federal Court. The court will decide who should pay court costs and legal fees. If the Member is successful, the court may order the person he has sued to pay these costs and fees. If the Member loses, the court may order him to pay these costs and fees, for example, if it determines that his claim is frivolous. frivolous.‌‌‌ Assistance with Member Questions If a Member has any questions about his plan, he should contact the plan administrator. If a Member has any questions about this statement or about his rights under XXXXX, or if he needs assistance in obtaining documents from the plan administrator, he should contact the nearest office of the Employee Benefits Security Administration, United States Department of Labor, listed in the telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, United States Department of Labor, 000 Xxxxxxxxxxxx Xxxxxx X.X., Xxxxxxxxxx, X.X. 00000. The Member may also obtain certain publications about his rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.

Appears in 1 contract

Samples: Benefit Contract

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Enforce Member’s Rights. If a Member’s Claim for a plan Benefit is denied or ignored, in whole or in part, the Member has a right to know why this was done, to obtain copies of documents relating to the decision dec ision without charge, and to Appeal any denial, all within certain time schedules. Under XXXXX, there are steps the Member can take to enforce the above rights. A Member must exhaust all Claims and Appeal procedures available to him before filing any suit. For instance, if the Member requests a copy of plan documents or the latest annual report from the plan and does not receive them within thirty (30) days, the Member may file suit in Federal Court. In such a case, the court may require the plan administrator to provide the materials and pay the Member up to one hundred and ten dollars ($110.00) a day until he receives the materials, unless the materials were not sent because of reasons beyond the control of the plan administrator. If the Member has a Claim for Benefits, which is denied or ignored, in whole or in part, he may file suit in a state or Federal court. In addition, if he disagrees with the plan’s decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, such Member may file suit in Federal Court. If it should happen that plan fiduciaries misuse the plan’s money, or if the Member is discriminated against for asserting his rights, he may seek assistance from the United States Department of Labor, or he may file suit in a Federal Court. The court will decide who should pay court costs and legal fees. If the Member is successful, the court may order the person he has sued to pay these costs and fees. If the Member loses, the court may order him to pay these costs and fees, for example, if it determines that his claim is frivolous. Assistance with Member Questions If a Member has any questions about his plan, he should contact the plan administrator. If a Member has any questions about this statement or about his rights under XXXXX, or if he needs assistance in obtaining documents from the plan administrator, he should contact the nearest office of the Employee Benefits Security Administration, United States Department of Labor, listed in the telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, United States Department of Labor, 000 Xxxxxxxxxxxx Xxxxxx X.X., Xxxxxxxxxx, X.X. 00000. The Member may also obtain certain publications about his rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.

Appears in 1 contract

Samples: Limited Benefit Contract

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