Agenda - Council - 12/17/1991 - Laserfiche WebLink

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(b) accounts. To establish and revise the method of accounting for the Plan and to maintain the (c) To establish rules for the administration of the Plan and to prescribe any forms required to administer the Plan. Section 6.4. Actions of the City. All determinations, interpretations, rules, and decisions of the City shall be conclusive and binding upon all persons having or claiming to have any interest or right under the Plan. Section 6.5. Finances. The costs of the Plan shall be borne as provided herein. For purposes of this Plan, pay conversion contributions shall be deemed contributions by the City. ARTICLE VII Claims Procedure Section 7.1. Claims Procedure. (a) Claims for benefits under the Plan shall be made in writing to the City. (b) If such claim for benefits is wholly or partially denied, the City shall, within a reasonable period of time, but no later than ninety (90) days after receipt of the claim, notify the claimant of the denial of the claim. Such notices of denial (1) shall be in writing, (2) shall be written in a manner calculated to be understood by the claimant, and (3) shall contain (A) the specific reason or reasons for denial of the claim, (B) a specific reference to the pertinent Plan provisions upon which the denial is based, (C) a description of any additional material or information necessary for the claimant to perfect the claim, along with an explanation why such material or information is necessary, and (D) an explanation of the Plan's claim review procedure. (c) Within one hundred twenty (120) days of the receipt by the claimant of the written notice of denial of the claim, or such later time as shall be deemed reasonable taking into account the nature of the benefit subject to the claim and any other attendant circumstances or if the claim has not been granted within a reasonable period of time, the claimant may file a written request with the City that it conduct a full and fair review of the denial of the claimant's claim for benefits, including conducting a hearing, if deemed necessary by the reviewing party. In connection with the claimant's appeal of the denial of benefit, the claimant may review pertinent documents and may submit issues and comments in writing. (d) The City shall deliver to the claimant a written decision on the claim promptly, but not later than sixty (60) days, after the receipt of the claimant's request for review, except that if there are special circumstances (such as the need to hold a hearing, if necessary) which require an extension of time for processing, the aforesaid sixty (60) day period shall be extended to one hundred twenty (120) days. Such decision shall (1) be written in a manner calculated to be understood by the claimant, (2) include specific reasons for the decision, and (3) contain specific references to the pertinent Plan provisions upon which the decision is based. Decisions by the City shall be final. 8 1 2/1 I/9 1 i I I ! I I ! I I I I I I I I i I ! I