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     The Employee Retirement Income Security Act of 1974 (ERISA)

protects the interests of participants and their beneficiaries who depend

on benefits from private employee benefit plans. ERISA sets standards

for administering these plans, including a requirement that financial and

other information be disclosed to plan participants and beneficiaries and

requirements for the processing of claims for benefits under the plans.

Although some employee benefit plans are not covered by the Act (such

as church or government plans, etc.), if you are one of the millions of

participants and beneficiaries in employee benefit plans that fall under

the Act's protection, you have certain rights if your claim for benefits is

denied. Your plan must give you the reason for denial in writing and in

a manner you can understand. It also must give you a reasonable

opportunity for a fair and full review of the decision.   This folder

outlines the steps you may take to file a claim and what to do if you are

denied benefits.


     The first step you should take is to carefully read your plan's

summary plan description. This is a document which your plan

administrator must furnish you. It gives you a detailed summary of your

plan--how it works, what benefits it provides, how they may be obtained

and how they may be lost. The summary plan description also is

required to spell out your rights and protections under ERISA.


     You or your beneficiary may be required to first file a claim to

receive the benefits you are entitled to under an employee welfare

benefit plan or a pension plan. An employee welfare benefit plan is a

plan, fund, or program which provides medical, surgical, hospital,

sickness, accident, disability, death, severance, unemployment, vacation,

apprenticeship, day care center, scholarship funds, pre-paid legal

benefits, etc. A pension plan is a fund or program which provides

retirement income to employees, or results in a deferral of income by

employees for periods extending to the termination of covered employment

or beyond. Each plan covered by ERISA must have procedures for filing

a claim and must tell you what those procedures are. This information

must be included in the summary plan description. If for any reason

information concerning the filing of a claim has not been provided, you

may give notification that you have a claim by writing to an officer of

your employer, or the unit where claims are normally filed, or the plan



     All plans have standards you must meet to qualify for benefits. Your

pension plan will probably say that you must have worked a certain

number of years and/or be a certain age before you can start receiving

benefits. Some employee welfare benefit plans may require you to file a

claim or notify the plan administrator immediately when you enter a

hospital or see a doctor. Some plans may require that you pay a medical

bill and the plan will repay you when it is presented with a copy of the

bill marked "paid."

      But be sure to contact your plan administrator or other plan official

for complete information on filing a claim for your benefits.


     Within 90 days after you have filed a claim for benefits, your plan

must tell you whether or not you will receive the benefits. Also, if

because of special circumstances your plan needs more time to examine

your request, it must tell you within the 90 days that additional time is

needed, why it is needed and the date by which the plan expects to

render a final decision. If your claim is denied, the plan administrator

must notify you in writing and explain in detail why it was denied. If

you receive no answer at all in 90 days -- or 180 days when an extension

of time was needed -- the claim is considered a denial and you can use

the plan's rules for appealing the denial.


     Your claim may have been denied because you are not eligible for

benefits under the plan. Perhaps you haven't been a participant long

enough, or you are not the required age. Perhaps you needed to file

additional information about your claim.   When you have been notified

that your claim has been denied, your plan administrator also must tell

you how to submit your denied claim for a full and fair review. You

have at least 60 days (the plan may provide you with more time) in

which to do this. Be sure to include all related information, particularly

any additional information or evidence, and get it to the specified person

and address.


     If review of your appeal is going to take longer than 60 days, you

must be notified in writing of the delay. Except where the review is

made by a committee or board of trustees which meets at least quarterly,

a decision on your appeal must be made within 120 days of your appeal.

    Once the final decision has been made, you must be told the reason

and the plan rules upon which the decision was based. This explanation

must be written in a manner that you can understand. If you do not

receive a notice within the waiting time, you can assume that your claim

has been denied after it was reviewed.


     If you disagree with the final decision upon appeal, you may seek

legal assistance. You also may wish to get in touch with the Department

of Labor concerning your rights under ERISA.


     By carefully reading your summary plan description and

understanding your relationship to your plan, you can be an informed

participant. So know your plan, what it requires of you, how to become

eligible for its benefits, and what steps you can take to assure that you

will receive your earned benefits.

U.S. Department of Labor

Pension and Welfare Benefits Administration

Washington, D.C. 20210


1. File claim for benefits

   with person designated

   by plan to receive claims.

   Check your benefits with

   your plan administrator.

2. Benefits approved

   payment will be made.


2. Wait for reasonable time,

   usually 90 days for outcome

   of claim If no decision and

   the plan did not extend the

   period based on special

   circumstances you may

   consider claim denied.

3. Request review of your

   claim. Explanation is

   required for a denied


4. You may file claim for full

   and fair review Be sure and

   include all related

   information, especially new

   evidence or information.

5. If appeal review will take

   longer than 60 days you must

   be notified. Generally, a

   decision must be made within

   120 days of your appeal.

6. If you have not received

   notice within time set, you

   can assume appeal denied You

   may seek legal assistance or

   you may wish to get in touch

   with the nearest PWBA office

   concerning your rights under


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