- Active Health
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- SUB Plan
You are responsible for paying any applicable federal, state and local taxes incurred as a result of the payment of benefits under the Plan. Supplemental Unemployment Benefits are subject to income tax withholding and other tax withholding by the Plan to the extent required by the IRS code or other applicable law. You should contact your tax adviser for more information.
Your right to benefits shall be determined in accordance with the terms of this Plan. Claims for benefits shall be submitted to the Fund Office. You will be notified by the Plan Administrator of a denial or partial denial of your claim within 14 days (or 180 days if the Trustees notify you that additional time is needed for processing your application) from the time the application is received by the Trustees. Such notice shall set forth the specific reasons for the denial, the Plan provisions relied upon in denying the claim, and how to appeal.
You may request a review by the Trustees no later than 60 days after a notice of denial is received. This request must be in writing and specify that it is an appeal for a review of a denied application for benefits. In connection with the review, you have the right to review pertinent documents and submit issues and comments in writing to the Trustees. You may request copies free of charge of all documents, records and other information relevant to your denied claim.
Your appeal will be decided by the Board of Trustees or sub-committee of the Board of Trustees. The Trustees hold regular meetings at least four (4) times per year. If your appeal is filed more than 30 days before a regular meeting of the Trustees, your appeal will be decided at that meeting unless special circumstances require an extension of time for processing, in which case the decision will be made on your appeal at the next following meeting of the Trustees. If your appeal is filed within the 30-day period immediately preceding a regular meeting of the Trustees, the appeal will not be decided at that meeting but will be decided at the next following meeting, unless special circumstances require and extension of time for processing your appeal. In that case, a decision will be made on your appeal at the third regular meeting following the date your appeal was filed.
Once the Board of Trustees or designated sub-committee has decided your appeal, the Plan will send you a written notice of the decision. This notice will be mailed within five (5) business days of the Trustee's decision. The determination made by the Board of Trustees is final and binding.
If the Trustees uphold the denial of your claim, you will then have the right to file suit under the authority of ERISA Section 502(a)(1). Also, if your appeal is denied, you are entitled to receive upon request at no cost, copies of the documents and information that the Plan relied on in denying your claim.
No lawsuit or other action against the Trust Fund or its Trustees may be filed until the matter has been submitted for review under these procedures.
The Plan is intended to pay benefits only to you. Your benefits cannot be used as collateral for loans or otherwise assigned, except in connection with certain qualified domestic relations orders issued by a court of law. A domestic relations order requires payment of alimony, child support or other marital assets (which could include all or a portion of your benefit from this Plan) to a spouse, former spouse, child or other dependent. You will be notified if such an order is received against you.
If you receive Supplemental Unemployment Benefits under this Plan that you are not entitled to, the Trustees have the right to recover such overpayments by offsetting future Supplemental Unemployment Benefit payments or by taking any other action permitted under any applicable law to collect such overpayments. If you knowingly misrepresent or falsify any information or matter in connection with a claim filed for Supplemental Unemployment Benefits, the Trustees have the right to deny all or part of the benefits which might otherwise be due in connection with your claim and to recover any benefits erroneously paid as a result of any misrepresentation or false information. Any knowing misrepresentation falsely made to secure benefits from an ERISA plan may constitute a federal crime punishable by imprisonment. In pursuing overpayments, the Trustees shall in any successful action recover reasonable attorney's fees and litigation costs in addition to any benefits overpaid.