Any disputes to eligibility, type, amount, or duration of benefits or any right or claim to payments from the Plan will be resolved by the Board of Trustees or a subcommittee of the Board of Trustees—the Appeals Committee. The Trustees will, subject to the requirements of applicable law, be the sole judges of proof required in any case, and the application and interpretation of the Plan. Any decision of the Trustees is final and binding on all parties thereto, subject only to judicial review and only after applicable administrative remedies have been exhausted.

If your application for benefits is denied, in whole or in part, you will be sent a written notice of the denial within 90 days of the date your application was received. (Special circumstances may require up to an additional 90 days, in which case you will be notified of the delay/extension, the special circumstances requiring the extension, and the expected date of a decision within the initial 90-day period.)

You or your authorized representative may petition the Trustees for review of the denial. A petition for review shall:

• Be in writing;
• State, in clear and concise terms, the reason or reasons for disputing the denial;
• Be accompanied by any pertinent or relevant document or material not already furnished to the Plan; and
• Be filed by the petitioner or the petitioner’s duly authorized representative with the Fund Office within 180 days after the petitioner receives notice of the initial denial.

The Fund Office shall present all petitions for review to the Trustees.

Upon request and free of charge, you will be allowed to review relevant documents and submit issues and comments to the Trustees in writing. A document, record, or other information is “relevant” only if it: (i) was relied upon by the Trustees in making the benefit determination; (ii) was submitted, considered, or generated in the course of making the benefit determination; or (iii) demonstrates compliance with the Plan’s administrative processes and safeguards required under Federal law.

The failure to file a petition within such 180-day period shall constitute a waiver of your right to a review of the denial.

The Trustees shall make their decision on their review of the denial promptly, generally at the next scheduled meeting (quarterly). However, if the Fund Office receives your appeal less than 30 days before the next regularly scheduled meeting, the decision may be made at the next meeting following receipt of your written appeal. Notwithstanding the foregoing, if special circumstances require an extension of time for processing the review, notice of such extension shall be furnished to the petitioner no later than 90 days after the date the Fund Office receives your written appeal. The notice of extension shall indicate the special circumstances requiring an extension of time and the date by which the Trustees expect to render the determination on review. In the event that a period of time is extended as permitted under this section due to a claimant’s failure to submit information necessary to decide a claim, the period for making the benefit determination on review shall be tolled from the date on which the notification is sent to the claimant until the date on which the claimant responds to the request for additional information. A decision shall then be rendered as soon as possible, but not later than the regularly scheduled Appeals Committee meeting after the receipt of the petition for review.

The review decision shall be provided to you (the petitioner) in writing. The notice of decision shall include specific reasons for the decision, written in a manner designed to be understood by the petitioner and with specific references to the particular Plan provisions on which the decision is based, and will include 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. If you do not receive notice of a decision within the appeal period, the appeal is considered to be denied.

The denial of an application or claim as to which the right of review has been waived as well as any decision of the Trustees with respect to a petition for review, shall be final and binding on all parties including the applicant, claimant, or petitioner of any person or entity claiming under the application, claim, or petition, subject only to judicial review as provided in the Plan. The provisions of the Plan shall apply to and include any and every claim for benefits from the Plan and any claim or right asserted under or against the Plan, regardless of the basis asserted for the claim or right, regardless of when the act or omission on which the claim or right is based occurred, and regardless of whether or not the claimant or applicant is a “Participant” or “Beneficiary” of the Plan within the meaning of those terms as defined in ERISA.

If your appeal is denied, in whole or in part, you will receive a written notice stating:

• The specific reason or reasons for the decision;
• The Plan provisions upon which the decision is based;
• A statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents and other information relevant to the claim; and
• A statement describing your right to bring a civil action under Section 502(a) of ERISA.

Under the terms of the Plan document, no civil action may be brought with respect to your claim for benefits more than one year after you receive the denial of your appeal. You must comply with the Fund’s claims procedures, including the exhaustion of your appeal rights, before you bring any civil action regarding your claim.