SECTION XXI. MISCELLANEOUS PROVISIONS
- Extension to New Bargaining Units: The Trustees may extend the benefits of the Plan to the employees in new and additional collective bargaining units but only if in the judgment of the actuary the admission of such additional units will not adversely affect the soundness of the Plan with respect to units already covered thereby. In no event, however, shall past service credits be allowed to the employees in any such new unit admitted to participation on or after June 1, 1971, unless fully funded, except upon the express agreement in writing of the Employer or Employers in the new unit to assume the entire liability therefor and to make such payments to the Trust Fund, in addition to the regular rates of contribution required of all Employers, as shall be sufficient in the judgment of the actuary to fund the same within actuarially acceptable limits. The effective date of the Plan as to any such new unit shall be the first day of the month during which Employers are first required to make payments with respect to the employees in the unit.
- The Plan shall be construed, regulated and administered under the applicable laws of the United States.
- Qualified Domestic Relations Orders: The benefits provided by this Plan are subject to any qualified domestic relations order which creates or recognizes the existence of an alternate payee's right to, or assigns to an alternate payee the right to, receive all or a portion of the benefits payable with respect to a Participant under the Plan. It includes any judgment, decree or order (including approval of a property settlement agreement) which relates to the provision of child support, alimony payments or marital property rights to a spouse, child or other dependent of a Participant and is made pursuant to a State Domestic Relations Law (including a community property law). In the event that the Plan should be served with an order, it shall promptly notify the Participant and any other alternate payee of the order and of the Plan Administrator's procedures for determining the qualified or unqualified status of the order.
- If, prior to a Participant's annuity starting date, the Lump Sum Present Value of the Participant's vested benefit is $5,000 or less, the amount due may be paid by the Trust in one lump sum distribution without the consent of the Participant or the Participant's spouse.
- The effective date of this Restatement is July 1, 2004, except that provisions of the Plan adopted before that date shall be effective in accordance with the amendment or restatement in which they were adopted.
- Rollovers of Distributions.
- This Section applies to distributions made on or after January 1, 1993. Notwithstanding any provision of the Plan to the contrary that would otherwise limit a distributee's election under this Section, a distributee may elect, at the time and in the manner prescribed by the Plan Administrator, to have any portion of an eligible rollover distribution paid directly to an eligible retirement plan specified by the distributee in a direct rollover.
- Eligible rollover distribution: An eligible rollover distribution is any distribution of all or any portion of the balance to the credit of the distributee, except that an eligible rollover distribution does not include:
- any distribution that is one of a series of substantially equal periodic payments (not less frequently than annually) made for the life or life expectancy of the distributee or the joint lives or joint life expectancies of the distributee and the distributee's designated beneficiary; or for a specified period of ten years or more;
- any distribution to the extent that such distribution is required under section 401(a)(9) of the Internal Revenue Code; and
- the portion of any distribution that is not includible in gross income (determined without regard to the exclusion for net unrealized appreciation with respect to employer securities).
- Eligible retirement plan: An eligible retirement plan is an individual retirement account described in section 408(a) of the Internal Revenue Code, an individual retirement annuity described in section 408(b) of the Code, an annuity plan described in section 403(a) of the Code, or a qualified trust described in section 401(a) of the Code, that accepts the distributee's eligible rollover distribution. However, in the case of an eligible rollover distribution to the surviving spouse, an eligible retirement plan is an individual retirement account or individual retirement annuity.
- Distributee: A distributee includes an employee or former employee. In addition, the employee's or former employee's surviving spouse and the employee's or former employee's spouse or former spouse who is the alternate payee under a qualified domestic relations order, as defined in section 414(p) of the Code, are distributees with regard to the interest of the spouse or former spouse.
- Direct Rollover: A direct rollover is a payment by the plan to the eligible retirement plan specified by the distributee.
- Special Claims and Appeals Procedures for Disability Retirement Benefits.
These special claims and appeals procedures shall apply to all claims for Disability Retirement benefits filed on or after January 1, 2002.
- Filing a Claim for Disability Retirement Benefits: To file a claim for Disability Retirement benefits, the Participant must submit a completed application form, with proof of disability, to the Trust Fund Office. Along with the claim form, the claimant may submit written comments, documents, records or other information relating to his or her claim. The Plan will provide access to and/or copies of all documents, records and other information relevant to the claim, upon request and free of charge. An authorized representative may act on behalf of the claimant in filing a claim for Disability Retirement benefits under this Plan.
- Notification Rules If The Claim For Benefits is Denied
- Time Limits and Requests for Additional Information. If a claim for Disability Retirement benefits is denied, the Plan will notify the claimant as soon as reasonably possible, but no later than 45 days after the Plan received the claim. That time period may be extended for up to two additional 30-day periods, but only due to matters beyond the Plan's control. If the Plan needs a 30-day extension, it will notify the claimant, within 45 days of receiving the claim, of the following:
The claimant will then have up to 45 days to provide the specified information. The Plan's response period will be extended by any additional time it takes for the claimant to provide the requested information.
- the reason for the delay,
- the expected date of decision,
- the basis on which the decision will be made,
- any unresolved issues preventing a decision now, and
- any additional information the Plan needs to make the decision.
- Contents of Notice. The Plan will provide the claimant with written notice if his or her claim for disability benefits is denied. The notice will include the following information:
- a statement of the specific reason(s) for the denial;
- reference to the specific Plan provision(s) on which the denial was based;
- if the Plan's decision relied upon an internal Plan rule, guideline, protocol or similar criterion, either the specific rule, or a statement that the specific rule was relied upon and that a copy of such rule will be provided free of charge upon request;
- a description of any additional information or documents that the claimant will need to submit if he or she wants the claim to be reconsidered, and an explanation of why that information is necessary;
- a description of the Plan's appeal procedures. These will be found in a separate document, and must be followed in appealing the denial of benefits; and
- a statement of the claimant's right to bring a civil action under ERISA ' 502(a), if the appeal is unsuccessful.
- Appeal Procedures
- If a claim for Disability Retirement benefits has been denied, the claimant may appeal the denial to the Board of Trustees. Appeals must be in writing, and state in detail the matter or matters involved. To submit an appeal, the claimant must send a letter with any documents and information that he or she wants the Board to consider, to:
California Winery Workers' Pension Trust Fund
P.O. Box 9800
Fresno, CA 93794
Claimants must submit their appeals within 180 days of receiving a denial of benefits. If a claimant does not submit an appeal within 180 days of receiving a denial, he or she will be deemed to have waived any objection to the denial.
- The Board of Trustees has full discretionary authority to decide upon Plan benefits, to interpret the Plan language conclusively and to make a final determination of the rights of any Participant, beneficiary, assignee, or other person with respect to Plan benefits.
- Standard for Review. In deciding the appeal, the Board of Trustees will take into account everything that the claimant submitted, even material that was submitted or considered in the initial benefit determination. The Board of Trustees will not give deference to the initial determination. Neither a person who made the initial determination nor such a person's subordinate will take part in the decision on appeal.
- In deciding an appeal that is based in whole or in part on a medical judgment, the Board of Trustees will consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment. The Board of Trustees will identify to the claimant any medical or vocational experts whose advice was obtained by the Plan in connection with the decision, whether or not the advice was relied upon in making the decision. The health care professional consulted on appeal will not be an individual who was consulted in connection with the initial benefit denial, or such a person's subordinate.
- Notification of the Board's Decision on Appeal
- Time Limits. The Board of Trustees will render a decision on appeal at the meeting immediately following the filing of the appeal, unless the appeal is filed within 30 days of the meeting, in which case the decision may be made at the second meeting following the appeal.
- If special circumstances (such as the need for a hearing) require further extension, the decision will be made no later than the third meeting following the filing of the appeal. In such cases, the Plan will notify the claimant in writing of the extension, describing the special circumstances and the date the determination will be made, before the extension begins.
- The Plan will notify the claimant of the decision as soon as possible, but no later than 5 days after the decision is made. The Plan's response period will be extended by any additional time it takes for the claimant to provide the requested information.
- Contents of Notice. The Plan will send the claimant written notice of the Board of Trustees' decision on appeal. If the appeal has been denied, the notice will include the following information:
- the specific reason(s) for the denial;
- reference to the specific Plan provision(s) on which the denial is based;
- if the decision relied upon an internal Plan rule, guideline, protocol or similar criterion, either the specific rule, or a statement that the specific rule was relied upon and that a copy of such rule will be provided free of charge upon request;
- a statement that the claimant may view and receive copies of documents, records or other information relevant to the claim, upon request and free of charge; and
- a description of any further appeal procedures, and the claimant's right to receive information about the procedures, and the claimant's right to bring a civil action under ERISA ' 502(a).
- The procedures specified in this section shall be the sole and exclusive procedures available to any such individual who is dissatisfied with an eligibility determination or benefit award, or who is adversely affected by any action of the Trustees, the Trust Fund Office or any other Plan fiduciary. The Board of Trustees shall have full discretionary authority to interpret Plan language and to decide all claims or disputes regarding right, type, amount or duration of benefits, or claim to any payment from this Trust. The decision of the Board of Trustees on any matter within its discretion shall be final and binding on all parties.