eTrade 2008 Annual Report Download - page 237

In the event the benefit determination is being made by a committee or board of trustees that hold regularly scheduled meetings
at least quarterly, the above paragraph shall not apply. The benefit determination must be made by the date of the meeting of the
committee or board that immediately follows the Plan’s receipt of a request for review, unless the request for review is filed within 30
days preceding the date of such meeting. In such case, the benefit determination must be made by the date of the second meeting
following the Plan’s receipt of the request for review. The date of the receipt of the request for review shall be determined without
regard to whether all of the information necessary to make a benefit determination on review is received. The Claimant shall be
notified in writing within this initial period if special circumstances require an extension of the time needed to process the claim. The
notice shall indicate the special circumstances requiring an extension of time and the date by which the committee or board expects to
render the determination on review. In no event shall such benefit determination be made later than the third meeting of the
committee or board following the Plan’s receipt of the request for review. The Plan Administrator shall provide adequate written
notice to the Claimant of the Plan’s benefit determination on review as soon as possible, but not later than five days after the benefit
determination is made.
To the extent that a period of time is extended due to a Claimant’s failure to submit information necessary to decide a claim, the
period for making the benefit determination on review shall be tolled from the date on which the notification of the extension is sent
to the Claimant until the date on which the Claimant responds to the request for additional information.
If the claim for disability benefits is wholly or partially denied on review, the Plan Administrator’s notice to the Claimant shall:
(i) specify the reason or reasons for the denial; (ii) reference the specific Plan provisions on which the denial is based; (iii) include a
statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents,
records, and other information relevant to the Claimant’s claim for benefits; (iv) include a statement of the Claimant’s right to bring a
civil action under ERISA section 502(a); (v) provide the Claimant with any internal rule, guideline, protocol, or other similar criterion
that was relied upon in making the adverse determination or a statement that such rule, guideline, protocol, or other similar criterion
was relied upon and a copy will be provided free of charge upon request; (vi) provide the Claimant with an explanation of any
scientific or clinical judgment for the determination if benefit determination is based on a medical necessity or experimental treatment
or similar exclusion or limit or a statement that the benefit is based on such an exclusion or limit and such explanation will be
provided free of charge; and (vii) provide the Claimant with the following statement: “You and your plan may have other voluntary
alternative dispute resolution options, such as mediation. One way to find out what may be available is to contact your local U.S.
Department of Labor Office and your State insurance regulatory agency.”
SECTION 9.06—DELEGATION OF AUTHORITY.
All or any part of the administrative duties and responsibilities under this article may be delegated by the Plan Administrator to a
retirement committee. The duties and responsibilities of the retirement committee shall be set out in a separate written agreement.
RESTATEMENT DECEMBER 15, 2006 70 ARTICLE IX (5-19047)