Claims Administration An employee will be required to comply with any and all rules and regulations and/or limitations established by the carrier or applicable third party administrator and contained in the policy, and employees and their dependents shall look solely to such carrier or third party administration for the adjudication of the payment of any and all benefits claims.
Claims Submission We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
Settlement Administration 42. The Parties have agreed to request that the Court appoint KCC LLC as the Settlement Administrator. 43. The Settlement Administrator will cooperate with and assist Wawa and Class Counsel with the Notice Program to be implemented in accordance with the terms of this Settlement Agreement and any orders of the Court. 44. The Settlement Administrator will administer and update the Settlement Website in accordance with the terms of this Settlement Agreement. Class Counsel and Wawa’s Counsel will agree on the format and content of the Settlement Website, and may agree to add information to the Settlement Website, so that it provides Class Members with accurate and timely information. 45. The Settlement Administrator will conduct Claims Administration services in accordance with the terms of the Settlement Agreement and as is typical in a settlement of this nature. The Settlement Administrator shall also conduct any additional processes jointly agreed to by Class Counsel and Wawa’s Counsel, subject to the Court’s supervision and direction as circumstances may require. 46. The Settlement Administrator shall, among other things: administer the claims submission and review process; document the number and type of claims submitted by Settlement Class Members; provide an automated call center that may include an option to request to be put in contact with one of the Interim Lead Counsel firms for more information and that will give callers the Wawa customer service number to call with any non-settlement related inquiries to Wawa’s customer service center; identify and follow up on deficient claims to give class members an opportunity to provide the necessary information; reject claims that appear to be duplicative based on the name, address, email address, and documentation provided; report to the Parties as requested regarding claims administration; permit the Parties to review and obtain supporting documentation as needed; update the Settlement Website and otherwise communicate with Class Members regarding claims administration procedures and deadlines; and prepare reports of its proposed and final determinations as to each claim in each settlement tier. 47. The Settlement Administrator may, at any time, request from each claimant, in writing, additional information as the Settlement Administrator may reasonably require in order to evaluate the claim, e.g., documentation requested on the Claim Form, and information regarding the claimed fraudulent transactions. For all claims, the Settlement Administrator’s initial review will be limited to a determination of whether the claim is duplicative of another claim. 48. Upon receipt of an incomplete or unsigned Claim Form or a Claim Form that is not accompanied by sufficient documentation to determine whether the claim is facially valid, the Settlement Administrator shall request additional information from the claimant and give the claimant thirty (30) days to cure the defect before rejecting the claim. The Settlement Administrator shall request any Claim Form supplementation within thirty (30) days of receipt of such Claim Form. In the event of unusual circumstances interfering with compliance with the 30-day cure period, the claimant may request and, for good cause shown (illness, military service, absence from the United States, delivery failures, lack of cooperation of third parties in possession of required information, etc.), shall be given a reasonable extension of the 30-day deadline in which to comply. However, in no event shall the deadline be extended to later than three months after the Claims Filing Deadline without express approval from the Parties. If the defect is not cured within the required period, then the claim will be deemed invalid and Wawa shall have no obligation to pay the claim. 49. On a bi-weekly basis, the Settlement Administrator shall make the claims it has accepted and that are not duplicative available electronically to Class Counsel and Wawa’s Counsel. Within one month of the Claims Filing Deadline, the Settlement Administrator shall make all such claims available to Class Counsel and Wawa’s Counsel. Class Counsel shall undertake a reasonable review of each claim to determine whether it meets the requirements of this Settlement Agreement, contains all of the required information on the Claim Form, and provides what appears to be the required documentation. Class Counsel may reject as invalid any claim that does not meet the foregoing requirements by notifying the Settlement Administrator and Wawa’s Counsel. Within 30 days of the Claims Filing Deadline, Class Counsel shall then certify to Wawa’s Counsel that any claims not rejected meet the requirements of this paragraph. Wawa’s Counsel may audit any or all of the claims so certified and may, within 30 days after Class Counsel’s certification, raise issues with any claims for discussion with Class Counsel. The parties shall meet and confer in good faith to resolve any disputed claims and shall, within 75 days after the Claims Filing Deadline either: (a) inform the Settlement Administrator of which accepted claims should be rejected; or (b) seek a ruling from the Court on any remaining disputed claims. The accepted claims not rejected by this process shall be the “Approved Claims.” The Parties mutually agree to extend these deadlines if the circumstances dictate that a reasonable extension is warranted. 50. Within one month after Class Counsel and Wawa’s Counsel complete the process above, the Settlement Administrator shall provide Class Counsel and Wawa’s Counsel with a final list of the Approved Claims for each Tier together with each approved claimant’s name, address, email address, and access to the Claim Form and related documentation submitted by the claimant. Wawa, the Settlement Administrator, and the third-party vendor assisting Wawa with distribution of the Wawa Gift Cards at Wawa’s expense shall work together to facilitate a commercially reasonable format for the transmission of this data. The Parties may mutually agree to extend this deadline if the circumstances dictate that a reasonable extension is warranted. 51. Within thirty (30) days of receiving the final report of approved claims for Tier One and Tier Two, Wawa will: (a) at its expense cause the Wawa Gift Cards to be distributed by email to those Settlement Class Members in Tier One and Tier Two on the final report of approved claims; and (b) make a payment as directed by the Settlement Administrator in the aggregate total amount of the accepted and approved Tier Three claims. 52. The Settlement Administrator will mail checks to Settlement Class Members in Tier Three within thirty (30) days of receiving payment from Wawa.
Grant Administration Grantee shall use the Grant funds only for the activities described in the approved Scope of Work. Grantee shall maintain financial records relating to the receipt and expenditure of all Grant funds in accordance with the terms set forth under this Agreement for a period of seven (7) years starting on the first day after final payment under the Agreement.
Program Administration An activity relating to the general management, oversight and coordination of community development programs. Costs directly related to carrying out eligible activities are not included.