Previous Contents    Next

Printable PDF Version of SPD/Plan Document                 

SECTION XX. APPEALS

  1. Any Participant or beneficiary aggrieved by any act or omission to act or decision of the Board of Trustees, the Administrator or any other Plan Fiduciary, including the denial in whole or in part of a claim for benefits, may request a review of the same by notice in writing to the Administrator.
  2. The notice must set forth the substance of the grievance and must be sent no later than sixty (60) days after receipt of notice of a claim denial or after the grievant first knew, or in the exercise of reasonable care should have known, of the circumstances giving rise to the grievance. Upon receiving such notice, the Administrator shall place the matter on the agenda of the next meeting of the Board of Trustees or, if there is not sufficient time, the next meeting thereafter, and shall notify the grievant of the time and place of the meeting. The grievant may appear in person and/or be represented by his attorney and may submit any written material or oral testimony he wishes. The grievant may review all relevant non-confidential documents in the Plan Administration office before the meeting. The Board of Trustees shall then, without reasonable delay, decide the matter and send a written decision to the grievant. In the case of an appeal of a claim denial, the decision shall under no circumstances be rendered later than the third regular quarterly meeting after notice of appeal has been received in the Plan Administration office.
  3. The Board of Trustees shall have full and exclusive discretionary authority to interpret Plan language and to resolve all claims or disputes regarding right, type, amount or duration of benefits, or claim to any payment from this Trust, and the Board's decision shall be final and binding on all parties.
  4. Claims and appeals for Disability Retirement benefits filed on or after January 1, 2002 shall be governed by the "Special Claims and Appeals Procedures for Disability Retirement Benefits," set out in Section XXI, subsection 7.
 

© California Winery Workers Pension Plan, 2003-2018, powered by MultiEmployer.com
Site Index | Terms of Use/Disclaimer | Privacy Policy