ERISA Information. The following provisions are part of this Agreement and are intended to meet the requirements of the Employee Retirement Income Security Act of 1974: (a) The named fiduciary under this Agreement is the Corporation. The named fiduciary shall be responsible for the management, control and administration of this Agreement. The named fiduciary may allocate to others certain aspects of the management and operational responsibilities of this Agreement, including the employment of advisors and the delegation of any ministerial duties to qualified individuals. (b) The funding policy under this Agreement is that all premiums on the Policy be remitted by the Corporation to the Insurer when due. (c) Direct payment by the Insurer is the basis of payment of benefits under this Agreement, with those benefits in turn being based on the payment of premiums as provided in this Agreement. (d) For claims procedure purposes, the "Claims Manager" shall be the Corporate Human Resources Department of the Corporation or its delegee. (i) The claimant's claim for benefits shall be deemed filed when presented orally or in writing to the Claims Manager. (ii) If for any reason a claim for benefits under this Agreement is denied by the Corporation, the Claims Manager shall deliver to the claimant a written explanation setting forth the specific reasons for the denial, specific references to the pertinent Agreement provisions on which the denial is based, such other data as may be pertinent and information on the procedures to be followed by the claimant in obtaining a review of his claim, all written in a manner calculated to be understood by the claimant. For this purpose: (A) The Claims Manager's explanation shall be in writing delivered to the claimant within ninety (90) days of the date the claim is filed. (B) If the Claims Manager does not either respond to a claim within ninety (90) days of the date the claim is filed or notify the claimant within that 90-day period that an extension of time for processing the claim will be required, the claim will be deemed denied and the claimant shall be permitted to proceed to the review stage described in the following paragraph (iii). (iii) The claimant shall have sixty (60) days following his receipt of the denial of the claim to file with the Claims Manager a written request for review of the denial. For such review, the claimant or his representative may submit pertinent documents and written issues and comments. (iv) The Claims Manager shall decide the issue on review and furnish the claimant with a copy within sixty (60) days of receipt of the claimant's request for review of his claim. The decision on review shall be in writing and shall include specific reasons for the decision, written in a manner calculated to be understood by the claimant, as well as specific references to the pertinent Agreement provisions on which the decision is based. If a copy of the decision is not so furnished to the claimant within such sixty (60) days, the claim shall be deemed denied on review.
Appears in 7 contracts
Samples: Split Dollar Life Insurance Agreement (Wachovia Corp/ Nc), Split Dollar Life Insurance Agreement (Wachovia Corp/ Nc), Split Dollar Life Insurance Agreement (Wachovia Corp/ Nc)
ERISA Information. The following provisions are part of this Agreement and are intended to meet the requirements of the Employee Retirement Income Security Act of 1974:
(a) The named fiduciary under this Agreement is the Corporation. The named fiduciary shall be responsible for the management, control and administration of this Agreement. The named fiduciary may allocate to others certain aspects of the management and operational responsibilities of this Agreement, including the employment of advisors and the delegation of any ministerial duties to qualified individuals.
(b) The funding policy under this Agreement is that all premiums on the Policy be remitted by the Corporation to the Insurer when due.
(c) Direct payment by the Insurer is the basis of payment of benefits under this Agreement, with those benefits in turn being based on the payment of premiums as provided in this Agreement.
(d) For claims procedure purposes, the "Claims Manager" shall be the Corporate Human Resources Department Personnel Group of the Corporation or its delegee.
(i) The claimant's claim for benefits shall be deemed filed when presented orally or in writing to the Claims Manager.
(ii) If for any reason a claim for benefits under this Agreement is denied by the Corporation, the Claims Manager shall deliver to the claimant a written explanation setting forth the specific reasons for the denial, specific references to the pertinent Agreement provisions on which the denial is based, such other data as may be pertinent and information on the procedures to be followed by the claimant in obtaining a review of his claim, all written in a manner calculated to be understood by the claimant. For this purpose:
(A) The claimant's claim shall be deemed filed when presented orally or in writing to the Claims Manager.
(B) The Claims Manager's explanation shall be in writing delivered to the claimant within ninety (90) days of the date the claim is filed.
(B) If the Claims Manager does not either respond to a claim within ninety (90) days of the date the claim is filed or notify the claimant within that 90-day period that an extension of time for processing the claim will be required, the claim will be deemed denied and the claimant shall be permitted to proceed to the review stage described in the following paragraph (iii).
(iiiii) The claimant shall have sixty (60) days following his receipt of the denial of the claim to file with the Claims Manager a written request for review of the denial. For such review, the claimant or his representative may submit pertinent documents and written issues and comments.
(iviii) The Claims Manager shall decide the issue on review and furnish the claimant with a copy within sixty (60) days of receipt of the claimant's request for review of his claim. The decision on review shall be in writing and shall include specific reasons for the decision, written in a manner calculated to be understood by the claimant, as well as specific references to the pertinent Agreement provisions on which the decision is based. If a copy of the decision is not so furnished to the claimant within such sixty (60) days, the claim shall be deemed denied on review.
Appears in 5 contracts
Samples: Split Dollar Life Insurance Agreement (Bank of America Corp /De/), Split Dollar Life Insurance Agreement (Bankamerica Corp/De/), Split Dollar Life Insurance Agreement (Bankamerica Corp/De/)
ERISA Information. The following provisions are part of this Agreement and are intended to meet the requirements of the Employee Retirement Income Security Act of 1974, as amended:
(a) The named fiduciary under this Agreement is the Corporation. The named fiduciary shall be responsible for the management, control and administration of this Agreement. The named fiduciary may allocate to others certain aspects of the management and operational responsibilities of this Agreement, including the employment of advisors and the delegation of any ministerial duties to qualified individuals.
(b) The funding policy under this Agreement is that all premiums on the Policy replacement benefit shall be remitted by paid from the general assets of the Corporation to the Insurer when due.
(c) Direct payment by the Insurer is the basis of payment of benefits under this Agreement, with those benefits in turn being based on the payment of premiums as provided in this Agreement.
(d) For claims procedure purposes, the "“Claims Manager" ” shall be the Corporate Human Resources Department Compensation Committee of the Board of Directors of the Corporation or its delegee.
(i) The claimant's claim for benefits shall be deemed filed when presented orally or in writing to the Claims Manager.
(ii) If for any reason a claim for benefits under this Agreement is denied by the Corporation, the Claims Manager shall deliver to the claimant a written explanation setting forth the specific reasons for the denial, specific references to the pertinent Agreement provisions on which the denial is based, such other data as may be pertinent and information on the procedures to be followed by the claimant in obtaining a review of his claim, all written in a manner calculated to be understood by the claimant. For this purpose:
(A) The claimant’s claim shall be deemed filed when presented orally or in writing to the Claims Manager's .
(B) The Claims Manager’s explanation shall be in writing delivered to the claimant within ninety (90) 90 days of the date the claim is filed.
(B) If the Claims Manager does not either respond to a claim within ninety (90) days of the date the claim is filed or notify the claimant within that 90-day period that an extension of time for processing the claim will be required, the claim will be deemed denied and the claimant shall be permitted to proceed to the review stage described in the following paragraph (iii).
(iiiii) The claimant shall have sixty (60) 60 days following his the claimant’s receipt of the denial of the claim to file with the Claims Manager a written request for review of the denial. For such review, the claimant or his the claimant’s representative may submit pertinent documents and written issues and comments.
(iviii) The Claims Manager shall decide the issue on review and furnish the claimant with a copy within sixty (60) 60 days of receipt of the claimant's ’s request for review of his claim. The decision on review shall be in writing and shall include specific reasons for the decision, written in a manner calculated to be understood by the claimant, as well as specific references to the pertinent Agreement provisions on which the decision is based. If a copy of the decision is not so furnished to the claimant within such sixty (60) 60 days, the claim shall be deemed denied on review.
Appears in 1 contract
ERISA Information. The following provisions are part of this Agreement and are intended to meet the requirements of the Employee Retirement Income Security Act of 1974, as amended:
(a) The named fiduciary under this Agreement is the Corporation. The named fiduciary shall be responsible for the management, control and administration of this Agreement. The named fiduciary may allocate to others certain aspects of the management and operational responsibilities of this Agreement, including the employment of advisors and the delegation of any ministerial duties to qualified individuals.
(b) The funding policy under this Agreement is that all premiums on the Policy replacement benefit shall be remitted by paid from the general assets of the Corporation to the Insurer when due.
(c) Direct payment by the Insurer is the basis of payment of benefits under this Agreement, with those benefits in turn being based on the payment of premiums as provided in this Agreement.
(d) For claims procedure purposes, the "“Claims Manager" ” shall be the Corporate Human Resources Department Compensation Committee of the Board of Directors of the Corporation or its delegee.
(i) The claimant's claim for benefits shall be deemed filed when presented orally or in writing to the Claims Manager.
(ii) If for any reason a claim for benefits under this Agreement is denied by the Corporation, the Claims Manager shall deliver to the claimant a written explanation setting forth the specific reasons for the denial, specific references to the pertinent Agreement provisions on which the denial is based, such other data as may be pertinent and information on the procedures to be followed by the claimant in obtaining a review of his claim, all written in a manner calculated to be understood by the claimant. For this purpose:
(A) The claimant’s claim shall be deemed filed when presented orally or in writing to the Claims Manager's .
(B) The Claims Manager’s explanation shall be in writing delivered to the claimant within ninety (90) days of the date the claim is filed.
(B) If the Claims Manager does not either respond to a claim within ninety (90) days of the date the claim is filed or notify the claimant within that 90-day period that an extension of time for processing the claim will be required, the claim will be deemed denied and the claimant shall be permitted to proceed to the review stage described in the following paragraph (iii).
(iiiii) The claimant shall have sixty (60) days following his the claimant’s receipt of the denial of the claim to file with the Claims Manager a written request for review of the denial. For such review, the claimant or his the claimant’s representative may submit pertinent documents and written issues and comments.
(iviii) The Claims Manager shall decide the issue on review and furnish the claimant with a copy within sixty (60) days of receipt of the claimant's ’s request for review of his claim. The decision on review shall be in writing and shall include specific reasons for the decision, written in a manner calculated to be understood by the claimant, as well as specific references to the pertinent Agreement provisions on which the decision is based. If a copy of the decision is not so furnished to the claimant within such sixty (60) days, the claim shall be deemed denied on review.
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