Common use of Notice of Decision Clause in Contracts

Notice of Decision. The Administrator shall notify the Claimant in writing of its decision on review. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the Claimant’s claim for benefits; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a); (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist.

Notice of Decision. The If the Administrator denies all or a part of the claim, the Administrator shall notify the Claimant in writing of its decision on reviewsuch denial in a culturally and linguistically appropriate manner. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement notice that the Claimant is entitled has a right to receive, upon request a review of the claim denial and free an explanation of charge, reasonable access to, the Plan’s review procedures and copies of, all documents, records and other information relevant (as defined in the time limits applicable ERISA regulations) to the Claimant’s claim for benefitssuch procedures; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a)) following an adverse benefit determination on review, and a description of any time limit for bringing such an action; (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and Administration (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist; and (viii) for any Disability claim, a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claimant’s claim for benefits. Whether a document, record, or other information is relevant to a claim for benefits shall be determined by Department of Labor Regulation Section 2560.503-1(m)(8).

Notice of Decision. The If the Administrator denies all or a part of the claim, the Administrator shall notify the Claimant in writing of its decision on reviewsuch denial in a culturally and linguistically appropriate manner. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement notice that the Claimant is entitled has a right to receive, upon request a review of the claim denial and free an explanation of charge, reasonable access to, the Agreement’s review procedures and copies of, all documents, records and other information relevant (as defined in the time limits applicable ERISA regulations) to the Claimant’s claim for benefitssuch procedures; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a)) following an adverse benefit determination on review, and a description of any time limit for bringing such an action; (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and Administration (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist; and (viii) for any Disability claim, a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claimant’s claim for benefits. Whether a document, record, or other information is relevant to a claim for benefits shall be determined by Department of Labor Regulation Section 2560.503-1(m)(8).

Notice of Decision. The Administrator shall notify the Claimant in writing of its decision on review. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the Claimant’s claim for benefits; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a); (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist;.

Notice of Decision. The Administrator If the Bank denies part or all of the claim, the Bank shall notify the Claimant claimant in writing or by electronic communication of its decision on reviewsuch denial. The Administrator Bank shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimantclaimant. The notification shall set forth: : (ia) the specific reasons for the denial; ; (iib) a reference to the specific provisions of this Agreement on which the denial is based; ; (iiic) a statement that description of any additional information or material necessary for the Claimant claimant to perfect the claim and an explanation of why it is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant needed; (as defined in applicable ERISA regulationsd) to the Claimant’s claim for benefits; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a); (v) for any Disability claim, a discussion of the decision, including an explanation of decision that includes the basis for disagreeing with or not following: (A) : i. the views presented by the Claimant of health care professionals treating the Claimant claimant and vocational professionals who evaluated the Claimant; (B) claimant; ii. the views of medical or vocational experts whose advice was obtained on behalf the Bank’s behalf, regardless of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon on in making the benefit determinationdenial; or (C) and iii. a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration, if presented to the Bank; (e) if the decision was based on medical necessity or experimental treatment (or a similar exclusion or limit), either: i. an explanation of the scientific or clinical judgment for the denial, applying the terms of this Agreement to the claimant’s medical circumstances; and or ii. a statement that this explanation will be provided free of charge upon request; (vif) for any Disability claim, either the specific internal rules, guidelines, protocols, standards standards, or other similar criteria of the Bank relied upon on in making the adverse determination ordenial, alternatively, a statement or notice that such rules, guidelines, protocols, standards standards, or other similar criteria of the Bank do not exist.; (g) notice that the claimant is entitled to receive (on request and free of charge) reasonable access to and copies of, all documents, records, and other information relevant to the claimant’s claim for benefits;

Notice of Decision. The Plan Administrator (or Appeals Fiduciary) shall notify the Claimant claimant in writing of its decision on review. The Plan Administrator (or Appeals Fiduciary) shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimantclaimant. The notification shall set forth: : (ia) the The specific reasons for the denial; ; (iib) a A reference to the specific provisions of this the Agreement on which the denial is based; ; (iiic) a A statement that the Claimant claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the Claimantclaimant’s claim for benefits; ; (ivd) a A statement of the Claimantclaimant’s right to bring a civil action under ERISA Section 502(a); ; (ve) In the case of a claim for any Disability claimbenefits due to the Executive’s Disability, a discussion of if an internal rule, guideline, protocol or other similar criterion is relied upon in making the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether either the advice specific rule, guideline, protocol or other similar criterion; or a statement that such rule, guideline, protocol or other similar criterion was relied upon in making the benefit determination; or (C) decision and that a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and (vi) for any Disability claimcopy of such rule, the specific internal rulesguideline, guidelines, protocols, standards protocol or other similar criteria relied criterion will be provided free of charge upon in making request; (f) In the adverse determination orcase of a claim for benefits due to the Executive’s Disability, alternativelyif a denial of the claim is based on a medical necessity or experimental treatment or similar exclusion or limit, an explanation of the scientific or clinical judgment for the denial, an explanation applying the terms of the Agreement to the claimant’s medical circumstances or a statement that such rulesexplanation will be provided free of charge upon request; and (g) In the case of a claim for benefits due to the Executive’s Disability, guidelines, protocols, standards or a statement regarding the availability of other similar criteria do not existvoluntary alternative dispute resolution options.

Notice of Decision. The Plan Administrator shall notify the Claimant in writing writing, or by electronic communication, of its the decision on review. The Plan Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: : (i) the The reviewer's decision; (ii) The specific reasons for the denial; ; (iiiii) a A reference to the specific provisions of this Agreement the Plan or insurance contract on which the denial decision is based; ; (iiiiv) a A statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the Claimant’s 's claim for benefits; (v) A statement describing any voluntary appeal procedures offered by the Plan; and (ivvi) a A statement of the Claimant’s 's right to bring a civil action under ERISA Section 502(a); ) which shall describe any applicable contractual limitations period that applies to the Claimant's right to bring such an action, including the calendar date on which the contractual limitations period expires for the claim. (vvii) for any In the case of an adverse benefit decision with respect to Disability claim, a benefits: (A) A discussion of the decision, including an explanation of the basis for disagreeing with or not following: : (A1) the The views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; ; (B2) the The views of medical or vocational experts whose advice was obtained on behalf of the Employer Plan in connection with a Claimant’s 's adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or and (C3) a disability A Disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and . (viB) If the adverse benefit determination is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for any Disability claimthe determination, applying the terms of the Plan to the Claimant's medical circumstances, or a statement that such explanation will be provided free of charge upon request; (C) Either the specific internal rules, guidelines, protocols, standards or other similar criteria of the Plan relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria of the Plan do not exist; and (D) The Plan Administrator shall write the notification in a culturally and linguistically appropriate manner (as described in Department of Labor Regulation Section 2560.503-1(o)).

Notice of Decision. The If the Plan Administrator denies the claim, in whole or in part, the Plan Administrator shall notify the Claimant in writing writing, or by electronic communication, of its decision on reviewsuch denial. Any electronic notification shall comply with the standards imposed by 29 CFR 2520.104b-1(c)(1)(i), (iii), and (iv). The Plan Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: : (i) the The specific reasons for the denial; ; (ii) a A reference to the specific provisions of this Agreement the Plan or insurance contract on which the denial is based; ; (iii) Notice that the Claimant has a right to request a review of the claim denial and an explanation of the Plan's review procedures and the time limits applicable to such procedures; (iv) A statement of the Claimant's right to bring a civil action under ERISA Section 502(a) following an adverse benefit determination, and a description of any time limit that applies under the Plan for bringing such an action. (v) In the case of an adverse benefit determination with respect to Disability benefits, on the basis of the Plan Administrator's independent determination of the Participant's Disability status, the Plan Administrator will provide: (A) A discussion of the decision, including an explanation of the basis for disagreeing with or not following: (1) The views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (2) The views of medical or vocational experts whose advice was obtained on behalf of the Plan in connection with a Claimant's adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; and (3) A Disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration. (B) If the adverse benefit determination is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the determination, applying the terms of the Plan to the Claimant's medical circumstances, or a statement that such explanation will be provided free of charge upon request; (C) Either the specific internal rules, guidelines, protocols, standards or other similar criteria of the Plan relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria of the Plan do not exist; and (D) A statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records records, and other information relevant (as defined in applicable ERISA regulations) to the Claimant’s 's claim for benefits; (iv) . Whether a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a); (v) for any Disability claimdocument, a discussion of the decisionrecord, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon information is relevant to a claim for benefits shall be determined by Department of Labor Regulation Section 2560.503-1(m)(8). (E) The Plan Administrator shall write the notification in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not existculturally and linguistically appropriate manner (as described in Department of Labor Regulation Section 2560.503-1(o)).

Notice of Decision. The If the Administrator denies all or a part of the claim, the Administrator shall notify the Claimant in writing of its decision on reviewsuch denial in a culturally and linguistically appropriate manner. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: : (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement notice that the Claimant is entitled has a right to receive, upon request a review of the claim denial and free an explanation of charge, reasonable access to, the Agreement’s review procedures and copies of, all documents, records and other information relevant (as defined in the time limits applicable ERISA regulations) to the Claimant’s claim for benefitssuch procedures; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a)) following an adverse benefit determination on review, and a description of any time limit for bringing such an action; (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and Administration (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist; and (viii) for any Disability claim, a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claimant’s claim for benefits. Whether a document, record, or other information is relevant to a claim for benefits shall be determined by Department of Labor Regulation Section 2560.503-1(m)(8).

Notice of Decision. The Administrator shall notify the Claimant in writing of its decision on review. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the Claimant’s claim for Mid Penn Bank Director Deferred Fee Agreement Exhibit 10.13 benefits; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a); (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist.

Notice of Decision. The Plan Administrator shall notify the Claimant in writing of its decision on review. The Plan Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the Claimant’s claim for benefits; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a); (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer Company in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist;.

Notice of Decision. The Administrator shall notify the Claimant in writing of its decision on review. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the Claimant’s claim for benefits; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a); (v) for any Disability disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and (vi) for any Disability disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist.

Notice of Decision. The If the Administrator denies all or a part of the claim, the Administrator shall notify the Claimant in writing of its decision on reviewsuch denial in a culturally and linguistically appropriate manner. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement notice that the Claimant is entitled has a right to receive, upon request a review of the claim denial and free an explanation of charge, reasonable access to, the Agreement’s review procedures and copies of, all documents, records and other information relevant (as defined in the time limits applicable ERISA regulations) to the Claimant’s claim for benefitssuch procedures; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a)) following an adverse benefit determination on review, and a description of any time limit for bringing such an action; (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and Administration (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist; and (viii) for any Disability claim, a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claimant’s claim for benefits. Whether a document, record, or other information is relevant to a claim for benefits shall be determined by Department of Labor Regulation Section 2560.503-l(m)(8).

Notice of Decision. The If the Administrator denies all or a part of the claim, the Administrator shall notify the Claimant in writing of its decision on reviewsuch denial in a culturally and linguistically appropriate manner. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement notice that the Claimant is entitled has a right to receive, upon request a review of the claim denial and free an explanation of charge, reasonable access to, the Agreement’s review procedures and copies of, all documents, records and other information relevant (as defined in the time limits applicable ERISA regulations) to the Claimant’s claim for benefitssuch procedures; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a)) following an adverse benefit determination on review, and a description of any time limit for bringing such an action; (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and Administration (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist.; and

Notice of Decision. The If the Administrator denies all or a part of the claim, the Administrator shall notify the Claimant in writing of its decision on reviewsuch denial in a culturally and linguistically appropriate manner. The Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement notice that the Claimant is entitled has a right to receive, upon request a review of the claim denial and free an explanation of charge, reasonable access to, the Agreement’s review procedures and copies of, all documents, records and other information relevant (as defined in the time limits applicable ERISA regulations) to the Claimant’s claim for benefitssuch procedures; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a)) following an adverse benefit determination on review, and a description of any time limit for bringing such an action; (v) for any Disability disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and Administration (vi) for any Disability disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist; and (viii) for any disability claim, a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the Claimant’s claim for benefits. Whether a document, record, or other information is relevant to a claim for benefits shall be determined by Department of Labor Regulation Section 2560.503-1(m)(8).

Notice of Decision. The Plan Administrator shall notify the Claimant in writing of its decision on review. The Plan Administrator shall write the notification in a culturally and linguistically appropriate manner calculated to be understood by the Claimant. The notification shall set forth: (i) the specific reasons for the denial; (ii) a reference to the specific provisions of this Agreement on which the denial is based; (iii) a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant (as defined in applicable ERISA regulations) to the Claimant’s claim for benefits; (iv) a statement of the Claimant’s right to bring a civil action under ERISA Section 502(a); (v) for any Disability claim, a discussion of the decision, including an explanation of the basis for disagreeing with or not following: (A) the views presented by the Claimant of health care professionals treating the Claimant and vocational professionals who evaluated the Claimant; (B) the views of medical or vocational experts whose advice was obtained on behalf of the Employer in connection with a Claimant’s adverse benefit determination, without regard to whether the advice was relied upon in making the benefit determination; or (C) a disability determination regarding the Claimant presented by the Claimant made by the Social Security Administration; and (vi) for any Disability claim, the specific internal rules, guidelines, protocols, standards or other similar criteria relied upon in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist.