Summary Plan Description Table of Contents
Claim Denials
If your claim for SUB Fund benefits is denied by the Administrative Manager, the Administrative Manager will provide you with a notice stating the reason or reasons for the denial, the pertinent parts of the Plan Document and/or Trust Agreement upon which denial is based, a description of the materials or information necessary to perfect your claim, with an explanation of the necessity for such information, a detailed explanation of the SUB Fund appeals procedure, and a statement of your right to bring a civil action under section 502(a) of ERISA. If applicable, the notice will give the specific internal rule, guideline, protocol or similar criterion the Administrative Manager relied on to make the decision. If the claim denial occurs at the time of your in-person application, the Administrative Manager, if possible, will attempt to provide you with this notice at that time. If this is not possible, or if the denial occurs later, the notice will be provided to you, either in person or by mail, as soon as possible, within the time frames described in the “Applying for SUB Fund Benefits” section. An extension may be necessary due to matters beyond the control of the Fund. You will be notified prior to the expiration of the normal approval/denial time period if an extension is needed. If an extension is needed, it will not last more than 30 days. (A second 30-day extension may be needed in special circumstances beyond the Fund's control).