Claim ProceduresYou or your beneficiary may claim Plan benefits by filing a written request for such benefits with the Plan Administrator for the Plan. Forms are available from the Human Resources Department. The Plan Administrator decides whether you or your beneficiary are entitled to any benefits and, if so, the amount to which you are entitled. To evaluate your claim, the Plan Administrator may request additional information from you. If the Plan Administrator determines that your claim is valid, you will receive a statement specifying the amount of your benefit, the methods of payment, when benefits will begin, and other information related to the payment of your benefits. If your claim for benefits is denied in full or in part, the Plan Administrator will notify you in writing within 90 days after receiving your claim. In special cases, the deadline may be extended for another 90 days, but you will be notified before the end of the initial 90-day review period of the reasons for the delay and the date by which you may expect a decision. If Your Claim Is DeniedIf your claim is denied, the notice of denial will state the reasons for the denial and the plan provisions on which the denial is based. It will also inform you of any additional information or material required to perfect your claim, why the information or material is necessary, and the procedure you must follow to have the Review Panel review the denial of your claim. If you do not receive a notice of delay or a notice of denial within the applicable deadline described above, you can assume that your claim was denied. You then can proceed to the appeal stage. Please refer to Claim Deadlines below for a concise list of the claim and appeal deadlines. AppealsIf your claim is denied (or considered denied because you did not receive a written response from the Plan Administrator), you or your beneficiary may write to the Review Panel, in care of Alexander & Baldwin, Inc., to appeal the denial. You generally must appeal a denial within 90 days. Your appeal will be given a full and fair review by the Review Panel consisting of Plan fiduciaries who are neither the same individuals who originally denied your claim nor the subordinates of those individuals. You or your beneficiary will be allowed to see all documents, guidelines and other materials that relate to your claim, submit any issues and comments, in writing, to the Review Panel and, if you wish, have someone act as your representative in the review procedure. If your appeal is denied, the Review Panel must provide you with written notice of this denial within 60 days after the Review Panel’s receipt of your appeal. There may be times when this 60-day period has to be extended. However, this extension is allowed only when there are special circumstances, which must be communicated to you in writing within the initial 60-day period. If there is an extension, a decision will be made as soon as possible, but not later than a total of 120 days after the Review Panel receives your appeal. The Review Panel’s final decision on your appeal of the denial of your claim will be communicated to you in writing and will include references to the specific Plan provisions on which the decision was based. If the Review Panel’s decision on your appeal is not submitted to you by the deadlines described above (and summarized in the table below), you should consider your appeal to have been denied. If you fail to appeal in the manner and by the deadlines specified above, you waive your right to request a review and you are barred from again asserting the claim. Claim DeadlinesClaim deadlines apply to the evaluation of a claim and to claims appeals as follows...
Legal ProcessIf you have a claim for benefits that is denied or ignored, in whole or in part, and you followed the Plan’s claim and appeal procedures as described above (and in Article 6 of the Plan Document, available from Human Resources), you may sue in a state or federal court. In addition, if you disagree with the Plan’s decision or lack thereof concerning the qualified status of a domestic relations order, you may file suit in federal court. Back to Top |
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