Initial Claim for Benefits. Each Participant may submit a claim for benefits to the Administrator as provided in Section 12.08. A Participant shall have no right to seek review of a denial of benefits, or to bring any action in any court to enforce a claim for benefits prior to his filing a claim for benefits and exhausting his rights to review under this section. When a claim for benefits has been filed properly, such claim for benefits shall be evaluated and the claimant shall be notified of the approval or the denial within (90) days after the receipt of such claim unless special circumstances require an extension of time for processing the claim. If such an extension of time for processing is required, written notice of the extension shall be furnished to the claimant prior to the termination of the initial ninety (90) day period which shall specify the special circumstances requiring an extension and the date by which a final decision will be reached (which date shall not be later than one hundred and eighty (180) days after the date on which the claim was filed.) A claimant shall be given a written notice in which the claimant shall be advised as to whether the claim is granted or denied, in whole or in part. If a claim is denied, in whole or in part, the claimant shall be given written notice which shall contain (a) the specific reasons for the denial, (b) references to pertinent plan provisions upon which the denial is based, (c) a description of any additional material or information necessary to perfect the claim and an explanation of why such material or information is necessary, and (d) the claimant's rights to seek review of the denial.
Appears in 6 contracts
Samples: Section 125 Flexible Benefit Plan Adoption Agreement, Section 125 Flexible Benefit Plan, Section 125 Flexible Benefit Plan
Initial Claim for Benefits. Each Participant In the event the Company fails to pay a benefit hereunder when due and you believe you were entitled to receive such a benefit, you may submit a your claim for benefits to the Administrator Compensation Committee (or to such other person as provided may be designated by the Compensation Committee) in Section 12.08writing in such form as is permitted by the Company. A Participant shall You will have no right to seek review of a denial of benefits, or to bring any action in any court to enforce a claim for benefits prior to his your filing a claim for benefits and exhausting his your rights to review under this sectionSections 8(a) and 8(b). When a claim for benefits has been filed properly, such claim for benefits shall be evaluated and the claimant shall you will be notified of the approval or the denial within ninety (90) days after the receipt of such claim unless special circumstances require an extension of time for processing the claim. If such an extension of time for processing is required, written notice of the extension shall be furnished to the claimant you prior to the termination of the initial ninety (90) day period which shall specify the special circumstances requiring an extension and the date by which a final decision will be reached (which date shall not be later than one hundred and eighty (180) days after the date on which the claim was filed.) A claimant shall ). You will be given a written notice in which the claimant shall you will be advised as to whether the claim is granted or denied, in whole or in part. If a claim is denied, in whole or in part, the claimant shall you will be given written notice which shall contain (a) the specific reasons for the denial, (b) references to pertinent plan provisions of this Agreement upon which the denial is based, (c) a description of any additional material or information necessary to perfect the claim and an explanation of why such material or information is necessary, necessary and (d) the claimant's your rights to seek review of the denial.
Appears in 3 contracts
Samples: Retention Bonus Agreement (Wiltel Communications Group Inc), Retention Bonus Agreement (Wiltel Communications Group Inc), Retention Bonus Agreement (Wiltel Communications Group Inc)
Initial Claim for Benefits. Each Participant may submit a claim for benefits to the Administrator as provided in Section 12.087.01. A Participant shall have no right to seek review of a denial of benefits, or to bring any action in any court to enforce a claim for benefits prior to his filing a claim for benefits and exhausting his rights to review under this sectionSection. When a claim for benefits has been filed properly, such claim for benefits shall be evaluated and the claimant shall be notified of the approval or the denial within (90) days after the receipt of such claim unless special circumstances require an extension of time for processing the claim. If such an extension of time for processing is required, written notice of the extension shall be furnished to the claimant prior to the termination of the initial ninety (90) day period which shall specify the special circumstances requiring an extension and the date by which a final decision will be reached (which date shall not be later than one hundred and eighty (180) days after the date on which the claim was filed.) A claimant shall be given a written notice in which the claimant shall be advised as to whether the claim is granted or denied, in whole or in part. If a claim is denied, in whole or in part, the claimant shall be given written notice which shall contain (a) the specific reasons for the denial, (b) references to pertinent plan provisions upon which the denial is based, (c) a description of any additional material or information necessary to perfect the claim and an explanation of why such material or information is necessary, and (d) the claimant's rights to seek review of the denial.
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Samples: Section 125 Flexible Benefit Plan Adoption Agreement