Defined Contribution Plan SPD

BENEFIT APPLICATION AND APPEALS PROCEDURE

Benefit Application

If you are planning to retire, you should apply about 3 months before you expect to stop working. For a distribution following termination of employment, you should apply about 9 months after you stop working.

You may obtain benefit application forms from the Administrative Office. The address and telephone number of the Administrative Office are shown on the inside front cover. Application forms are also available on the Trust Funds' website at www.scibew-neca.org.

No benefits will be paid unless and until an application has been filed. An application shall be considered to be filed as soon as it is received by the Administrative Office, if you have provided all of the information and the documents (such as birth certificates) required by the application form. If you have not provided all of the necessary information and documents, the Administrative Office will inform you of the additional information and/or documents needed, as soon as reasonably possible.

Notice of Claim Denial

If your benefit application or loan application is denied, the Administrative Office will send you a written notice of denial which will contain the following information:

  • The specific reason for the denial.
  • Specific references to the Plan provisions on which the denial is based.
  • A description of any additional material or information which would be needed to have your benefit application approved and an explanation of why such material or information is needed.
  • An explanation of the review procedure described in the following paragraph.
  • A statement of the claimant's right to bring a civil action under ERISA section 502(a) following exhaustion of the Plan's appeal procedures.

A notice of denial, if any, generally will be sent to you within 90 days after your benefit application is filed. If, because of special circumstances, more time is needed to approve or deny your application or calculate the amount of your benefit, the Administrative Office will send you a notice which will describe the special circumstances and tell you how much more time is needed.

Appeals

If you believe that you have wrongfully been denied a benefit to which you are entitled, you may appeal the benefit denial. If you wish to appeal, you must submit a written request for your appeal to the Administrative Office within 60 days after you have received the notice that your benefit application was denied. However, for appeals pertaining to denials of disability benefits not based on a Social Security award, a written request for an appeal shall be made to the Administrative Office within 180 days after receipt of notice of the denial of an application for disability retirement benefits.

You or your authorized representative may then review the documents related to your case and submit any written comments and additional information which will support your claim.

The Trustees, or a Committee set up for this purpose, will then review your benefit application and its denial and will notify you in writing of the decision regarding your benefits within 120 days of receipt of the appeal. Your appeal will be considered at the Board of Trustees' Meeting that immediately follows the Plan's receipt of your appeal, unless the request is made within 30 days of the Board of Trustees Meeting. In such case, the Board may make a decision on appeal at the second meeting following receipt of your appeal. However, if special circumstances require an extension of time for processing, you will be notified in writing and the decision shall be rendered not later than the third meeting following receipt of the appeal. Whenever special circumstances require an extension of time for processing, you will receive written notice of the extension before the extension period begins. The Board of Trustees will notify you of the benefit determination as soon as possible after the meeting, but not later than five (5) days after the benefit determination is made. You will be advised of the Trustees' decision in writing.

If, after the appeal has been decided, you still believe you have wrongfully been denied benefits, you have the right to file an action in Court under Section 502(a) of ERISA.