Common use of ERISA Requirements Clause in Contracts

ERISA Requirements. 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: The Employer. b. The funding policy under this Plan is that all premiums on the Policy be remitted to the Insurer when due. c. Direct payment by the Insurer is the basis of payment of benefits under this Plan, with those benefits in turn being based on the payment of premiums as provided in the Plan. d. For claims procedure purposes, the “Claims Manager” shall be the Employer. i. If for any reason a claim for benefits under this Plan is denied by the Employer, the Claims Manager shall deliver to the claimant a written explanation setting forth the specific reasons for the denial, pertinent references to the Plan paragraph 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: 1. The claimant’s claim shall be deemed filed when presented orally or in writing to the Claims Manager. 2. The Claims Manager’s explanation shall be in writing delivered to the claimant within 90 days of the date of the claim filed. e. The claimant shall have 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. f. The Claims Manager shall decide the issue on review and furnish the claimant with a copy within 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 Plan provisions on which the decision is based. If a copy of the decision is not so furnished to the claimant within such 60 days, the claim shall be deemed denied on review.

ERISA Requirements. The following provisions are part of this Agreement agreement and are intended to meet the requirements of the Employee Retirement Income Security Act of 1974;: a. (a) The named fiduciary: The Employer. b. (b) The funding policy under this Plan is that all premiums on the Policy be remitted to the Insurer when due. c. (c) Direct payment by the Insurer is the basis of payment of benefits under this Plan, with those benefits in turn being based on the payment of premiums as provided in the Plan. d. For claims procedure purposes, the “Claims Manager” shall be the Employer. i. (1) If for any reason a claim for benefits under this Plan is denied by the Employer, the Claims Manager shall deliver to the claimant a written explanation setting forth the specific reasons for the denial, pertinent references to the Plan paragraph section on which the denial is based, such other data as may be pertinent or required under ERISA, 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: 1. (A) The claimant’s 's claim shall be deemed filed when presented orally or in writing to the Claims Manager. 2. (B) The Claims Manager’s 's explanation shall be in writing delivered to the claimant within 90 days of the date of the claim is filed. e. (2) The claimant shall have 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. f. (3) The Claims Manager shall decide the issue on review and furnish the claimant with a copy within 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 Plan provisions on which the decision is based. If a copy of the decision is not so furnished to the claimant within such 60 days, the claim shall be deemed denied on review.

ERISA Requirements. 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. (a) The Employer shall be the named fiduciary: The Employerfiduciary for purposes of ERISA and this Agreement. b. (b) The funding policy under this Plan is that all premiums on the Policy be remitted to the Insurer when due. c. (c) Direct payment by the Insurer is the basis of payment of benefits under this Plan, with those benefits in turn being based on the payment of premiums as provided in the Plan. d. (d) For claims procedure purposes, the “"Claims Manager” " shall be the Employer, unless another person or organizational unit is designated by the Employer as Claims Manager. i. If for any reason a (e) An initial claim for benefits under this Plan is denied Agreement must be made by the EmployerEmployee or his or her beneficiary in accordance with the terms of this Agreement or the Policy through which the benefits are provided. Not later than 90 days after receipt of such a claim, the Claims Manager will render a written decision on the claim to the claimant, unless special circumstances require the extension of such 90-day period. If such extension is necessary, the Claims Manager shall deliver to provide the claimant a Employee or the Employee's beneficiary with written explanation setting forth notification of such extension before the specific expiration of the initial 90-day period. Such notice shall specify the reason or reasons for such extension and the denial, pertinent references to date by which a final decision can be expected. In no event shall such extension exceed a period of 90 days from the Plan paragraph on which end of the denial is based, such other data as may be pertinent and information on initial 90-day period. In the procedures to be followed by event the claimant Claims Manager denies the claim of an Employee or the beneficiary in obtaining a review of his claim, all written in a manner calculated to be understood by the claimant. For this purpose: 1. The claimant’s claim shall be deemed filed when presented orally whole or in writing to part, the Claims Manager. 2. The Claims Manager’s explanation 's written notification shall be in writing delivered to the claimant within 90 days of the date of the claim filed. e. The claimant shall have 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 reviewspecify, the claimant or his representative may submit pertinent documents and written issues and comments. f. The Claims Manager shall decide the issue on review and furnish the claimant with a copy within 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 the reason for the denial; a reference to the Agreement or insurance Policy that is the basis for the denial; a description of any additional material or information necessary for the claimant to perfect the claim; an explanation as to why such information or material is necessary; and an explanation of the applicable claims procedure. Should the claim be denied in whole or in part and should the claimant be dissatisfied with the Claims Manager's disposition of the claimant's claim, the claimant may have a full and fair review of the claim by the Employer upon written request therefor submitted by the claimant or the claimant's duly authorized representative and received by the Employer within 60 days after the claimant receives written notification that the claimant's claim has been denied. In connection with such review, the claimant or the claimant's duly authorized representative shall be entitled to review pertinent Plan provisions on which documents and submit the decision is basedclaimant's views as to the issues, in writing. The Employer shall act to deny or accept the claim within 60 days after receipt of the claimant's written request for review unless special circumstances require the extension of such 60-day period. If a copy such extension is necessary, the Employer shall provide the claimant with written notification of such extension before the expiration of such initial 60-day period. In all events, the Employer shall act to deny or accept the claim within 120 days of the decision is not so furnished receipt of the claimant's written request for review. The action of the Employer shall be in the form of a written notice to the claimant within such 60 days, and its contents shall include all of the claim shall be deemed denied requirements for action on reviewthe original claim. In no event may a claimant commence legal action for benefits the claimant believes are due the claimant until the claimant has exhausted all of the remedies and procedures afforded the claimant by this paragraph.

ERISA Requirements. The following provisions are part of this Agreement agreement and are intended to meet the requirements of the Employee Retirement Income Security Act of 1974;: a. (a) The named fiduciary: The Employer. b. (b) The funding policy under this Plan is that all premiums on the Policy be remitted to the Insurer when due. c. (c) Direct payment by the Insurer is the basis of payment of benefits under this Plan, with those benefits in turn being based on the payment of premiums as provided in the Plan. d. (d) For claims procedure purposes, the “"Claims Manager” " shall be the Employer.be: . ------------- i. (1) If for any reason a claim for benefits under this Plan is denied by the Employer, the Claims Manager shall deliver to the claimant a written explanation setting forth the specific reasons for the denial, pertinent references to the Plan paragraph section on which the denial is based, such other data as may be pertinent or required under ERISA, 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: 1. (A) The claimant’s 's claim shall be deemed filed when presented orally or in writing to the Claims Manager. 2. (B) The Claims Manager’s 's explanation shall be in writing delivered to the claimant within 90 days of the date of the claim is filed. e. (2) The claimant shall have 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. f. (3) The Claims Manager shall decide the issue on review and furnish the claimant with a copy within 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 Plan provisions on which the decision is based. If a copy of the decision is not so furnished to the claimant within such 60 days, the claim shall be deemed denied on review.

ERISA Requirements. The following provisions are part of this Agreement agreement and are intended to meet the requirements of the Employee Retirement Income Security Act of 1974;: a. (a) The named fiduciary: The Employer. b. (b) The funding policy under this Plan is that all premiums on the Policy be remitted to the Insurer when due. c. (c) Direct payment by the Insurer is the basis of payment of benefits under this Plan, with those benefits in turn being based on the payment of premiums as provided in the Plan. d. (d) For claims procedure purposes, the “"Claims Manager” " shall be the Employer.be: . ---------------- i. (1) If for any reason a claim for benefits under this Plan is denied by the Employer, the Claims Manager shall deliver to the claimant a written explanation setting forth the specific reasons for the denial, pertinent references to the Plan paragraph section on which the denial is based, such other data as may be pertinent or required under ERISA, 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: 1. (A) The claimant’s 's claim shall be deemed filed when presented orally or in writing to the Claims Manager. 2. (B) The Claims Manager’s 's explanation shall be in writing delivered to the claimant within 90 days of the date of the claim is filed. e. (2) The claimant shall have 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. f. (3) The Claims Manager shall decide the issue on review and furnish the claimant with a copy within 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 Plan provisions on which the decision is based. If a copy of the decision is not so furnished to the claimant within such 60 days, the claim shall be deemed denied on review.