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5. Trust Policy 410 - Claims and Appeals Procedure REVISED
Handle: Version-78999
Owner: Newcomb, Kellee (User-147, 02075:EVERETT)DS
Friday, June 9, 2017 03:13:31 PM PDT
Saturday, June 10, 2017 08:33:41 PM PDT
Modified By:
- 410.1P Page 1 of 43 COMPLIANCE AND RISK MANAGEMENT Claims and Appeals Procedure Any Trust participant or covered dependent or beneficiary claiming a benefit or questioning an interpretation, ruling or provision under any Trust benefit option (“Claimant”) shall follow the procedure specified in the applicable document listed in Appendix I of the Trust agreement; if the document does not include claims procedures or they include procedures that do not satisfy the minimum requirements of Section 2719 of the PHSA (defined below), then the procedures in Section 2719 of the PHSA shall apply. - If a Claimant submits a claim and the claim is denied in full or in part, the Claimant will be notifie...
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Appears In: 5. Trust Policy 410 - Claims and Appeals Procedure REVISED