McKesson 2005 Annual Report Download - page 197

Contribution due if the amount paid is less than or equal to the lesser of $50 (or such other amount as the Commissioner may provide in an IRS
revenue ruling, notice, or other guidance published in the Internal Revenue Bulletin) or 10% of the actual COBRA Contribution due.
J. CLAIMS AND APPEALS
The claims procedures described in this Section J shall apply except to the extent that there are alternate claims procedures described in the
Certificate of Coverage issued by the Insurance Company.
1. Claims Procedure.
a. Application for Benefits. To entitle himself to the payment of any benefits for which he is eligible under the Plan, the Participant shall
comply with such rules and procedures as the Company and the Insurance Company may prescribe with reference to the completion and filing
of a claim form or forms and the furnishing of such pertinent information as the Insurance Company may request, together with documentary
evidence in support of his claim to the Insurance Company. The Insurance Company may require that itemized bills, receipts and other proof of
the loss be submitted in addition to the claim form. The Insurance Company may request that the Participant give the Insurance Company
written authorization to obtain information from the Participant’s Physician pertaining to the diagnosis and related matters. Except as otherwise
stated below, claims for benefits under this Plan must be submitted to the Insurance Company within 20 days after the date of the loss causing
the claim or as soon as reasonably possible. The Insurance Company will furnish the Participant with a claim form within 15 days of the notice
of the claim
All claims must be filed no later than 90 days after the date of the loss causing the claim. If a Participant is not able to meet this deadline for
filing a claim, a claim will still be accepted if the Participant’s delay was not caused by the Participant’s own fault and the Participant files the
claim as soon as possible. If a Participant is legally incapacitated, a late claim will still be accepted if it is filed no more than two years after the
deadline.
b. Health Care Examinations. While a certification or claim is pending, the claimant must undergo a health care examination whenever
reasonably required by the Insurance Company. No benefits will be paid if a claimant refuses to undergo such health care examination. The
Insurance Company will have the right to have a physician or dentist of its choice conduct the examination. Such examinations shall be at the
Insurance Company’s expense.
c. Timing of Claims Decision. The Insurance Company shall adhere to certain time limits when processing a claim for a Plan benefit. If a
claimant does not follow the proper procedures for submitting a claim, the Insurance Company shall notify the claimant of the proper
procedures within the time frames shown in the chart below. If additional information is needed to process a claimant’s claim, the Insurance
Company shall notify the claimant within the time frames shown in the chart below, and the claimant shall be provided additional time within
which to provide the requested information.
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