SERVICES BY PLAN ADMINISTRATOR Sample Clauses

SERVICES BY PLAN ADMINISTRATOR. Services specifically required in the management and adjustment of LTD claims submitted by or on behalf of covered City employees by the Plan Administrator are listed below: 1. Ensure claims are managed effectively, efficiently and consistently with the scope of services. 2. Establish and maintain records and books of account for all claims submitted. All such records and books of account shall be kept at a location suitable and accessible to City representatives and other authorized individuals. 3. Analyze and investigate claims submitted by or on behalf of covered employees in accordance with the provisions of the Plan, and determine the amount of benefits properly payable thereunder, if any. Analysis and investigation are to include both initial evaluation of a claim and ongoing review to verify continued disability. 4. Provide, issue, and mail or direct deposit checks for all benefits properly payable under the plan or deny payment of benefits. Recipients must receive checks by the first of the month for which the benefit is due. 5. Provide enrollment forms, claim forms, change forms, medical forms, and other forms to the City as may be necessary for the management and adjustment of claims under the terms of the LTD plan. No form shall be used or distributed without the prior approval of the City. 6. Provide exceptional customer service to the City’s members. 7. Submit a copy of the letter describing the payment of benefits to the claimant and to the City. 8. In the event a claim is denied in whole or in part, notify the claimant and the City’s representative of such denial, clearly describing: Z:\Contracts\LPN\Sample Contract_Long-Term Disability TPA for RFP_2021 a. the specific reason for the denial; b. the specific reference to the Plan provision on which the denial is based; c. any additional materials or information needed for the claimant to appeal his claim; d. an explanation of the Plan’s claims review procedure; and e. the timeframe during which the appeal must be filed. 9. Advise and assist claimants in applying for Social Security Disability Benefits, including informing claimants of appropriate procedures for appeal of denied claims. 10. Notify the City or its representative of each request for review of denied claim received. Provide all relevant documentation of each such claim to the City or its representative within five (5) working days after the receipt of such request; and provide such advice and counsel as may be requested from time...
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Related to SERVICES BY PLAN ADMINISTRATOR

  • Stock Plan Administration Service Provider The Company transfers the Optionee's Personal Information to Fidelity Stock Plan Services LLC, an independent service provider based in the United States, which assists the Company with the implementation, administration and management of the Plan (the “Stock Plan Administrator”). In the future, the Company may select a different Stock Plan Administrator and share the Optionee's Personal Information with another company that serves in a similar manner. The Stock Plan Administrator will open an account for the Optionee to receive and trade Shares acquired under the Plan. The Optionee will be asked to agree on separate terms and data processing practices with the Stock Plan Administrator, which is a condition to the Optionee’s ability to participate in the Plan.

  • Stock Plan Administration Service Providers The Company transfers participant data to Xxxxxx Xxxxxxx, an independent service provider based in the United States, which assists the Company with the implementation, administration and management of the Plan. In the future, the Company may select a different service provider and share the Participant’s data with another company that serves in a similar manner. The Company’s service provider will open an account for the Participant to receive and trade Shares. The Participant will be asked to agree on separate terms and data processing practices with the service provider, which is a condition to the Participant’s ability to participate in the Plan.

  • Plan Administrator Duties The Plan Administrator shall administer this Agreement according to its express terms and shall also have the discretion and authority to (i) make, amend, interpret and enforce all appropriate rules and regulations for the administration of this Agreement and (ii) decide or resolve any and all questions, including interpretations of this Agreement, as may arise in connection with this Agreement to the extent the exercise of such discretion and authority does not conflict with Code Section 409A.

  • Plan Administrator Employees must elect a plan administrator during their initial enrollment in Advantage and may change their plan administrator election only during the annual open enrollment and when permitted under Section 5. Dependents must be enrolled through the same plan administrator as the employee.

  • Named Fiduciary and Plan Administrator The “Named Fiduciary and Plan Administrator” of this Director Plan shall be Heritage Bank of Commerce until its resignation or removal by the Board. As Named Fiduciary and Plan Administrator, the Bank shall be responsible for the management, control and administration of the Director Plan. The Named Fiduciary may delegate to others certain aspects of the management and operation responsibilities of the Director Plan including the employment of advisors and the delegation of ministerial duties to qualified individuals.

  • Plan Administration AvMed may from time to time adopt reasonable policies, procedures, rules and interpretations to promote the orderly and efficient administration of this Contract.

  • Developer Compensation for Emergency Services If, during an Emergency State, the Developer provides services at the request or direction of the NYISO or Connecting Transmission Owner, the Developer will be compensated for such services in accordance with the NYISO Services Tariff.

  • Compensation for Basic Services A. Owner shall make payment for Part I and Part II services monthly. The payments shall be in proportion to the progress of Engineer's work. Final payment for each phase shall become due and payable upon completion and approval by Owner of that phase of Engineer's work. B. Owner shall make payment for Construction Phase services not more frequently than monthly in proportion to the amount of the gross progress payments to Contractor(s). C. Owner shall make no deduction from Engineer's compensation on account of penalties, liquidated damages or other sums withheld from Contractor(s) through no fault of Engineer. D. Owner shall make payment for Construction Completion Phase services upon completion of the requirements set forth in subsections II. F. 1, 2 and 3. E. Engineer shall submit requests for payment monthly on forms provided and in a manner prescribed by Owner.

  • Indemnity of Plan Administrator The Bank shall indemnify and hold harmless the members of the Plan Administrator against any and all claims, losses, damages, expenses or liabilities arising from any action or failure to act with respect to this Agreement, except in the case of willful misconduct by the Plan Administrator or any of its members.

  • Timing of Plan Administrator Response The Plan Administrator shall respond in writing to such claimant within 60 days after receiving the request for review. If the Plan Administrator determines that special circumstances require additional time for processing the claim, the Plan Administrator can extend the response period by an additional 60 days by notifying the claimant in writing, prior to the end of the initial 60-day period, that an additional period is required. The notice of extension must set forth the special circumstances and the date by which the Plan Administrator expects to render its decision.

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