Sheet Metal Workers' International Association
Local Union No.73
Pension Welfare and Annuity Funds

 











 



ARTICLE 10. ADMINISTRATION

10.1 RESPONSIBILITY FOR ADMINISTRATION.
The Trustees will be the named fiduciary and Plan Administrator of the Plan, with full power and authority shall be the sole judges of the standard of proof to determine all matters arising in the administration and application and interpretation of the Plan. The determination of any such matters by the Trustees will be conclusive and binding on all persons. Wherever in the Plan the Trustees are given discretionary powers, the Trustees shall exercise such powers in a uniform and non discriminatory manner. The Trustees will have such duties, powers and discretionary authority as may be necessary, including, but not by way of limitation to:

(a) construe and interpret the Plan, decide all questions of eligibility and determine the amount, manner and time of payment of any benefits hereunder; and

(b) prescribe procedures to be followed by Participants, Spouses, or Beneficiaries in filing a claim for benefits; and

(c) appoint or employ individuals to assist in the administration of the Plan and any other agents it deems advisable, including legal, accounting and actuarial counsel; and

(d) formulate written procedures to determine the qualified status of domestic relations orders and to administer payment of benefits in accordance with such orders as are determined to be qualified; and

(e) direct the Insurer or other investment provider, if applicable, to make payment of benefits; and select the types of investments for self directed accounts; and

(f) determine when a benefit should be paid to a person other than the Participant or Spouse pursuant to Article 8.9.

Notwithstanding the foregoing, the Trustees may name, by an instrument in writing, one or more fiduciaries, including a Plan Administrator, who individually or severally will have authority to control and manage the operation and administration of the Plan with the duties and powers outlined in (a) through (f) above, and the remaining provisions of this Article 10. The Trustees may, at their discretion, include in such written instrument an allocation of fiduciary responsibilities among the fiduciaries named. In addition, the fiduciaries may delegate to any other person or organization any of their rights, powers, duties and responsibilities with respect to the administration of the Plan. Any such delegation of responsibilities by the named fiduciaries will be reviewed periodically by the appropriate fiduciary. Nothing in this Article 10.1 will be construed to prevent an individual from serving in more than one fiduciary capacity. In the event that no fiduciaries are named, the Trustees will be deemed to be the named fiduciary.

10.2 CHANGE OF FIDUCIARY AND REALLOCATION OF RESPONSIBILITIES.
The Trustees reserve the right at any time, by an instrument in writing, to discharge any fiduciary and to appoint a successor fiduciary. Any fiduciary may resign at any time by giving appropriate written notice to the Trustees. In addition, the Trustees reserves the right, by a written instrument, to change any allocation of responsibilities among named fiduciaries at any time that it is deemed reasonable and prudent to do so.

10.3 RESPONSIBILITY FOR APPOINTING TRUSTEE.
The Union's President and Business Manager will be responsible for appointing the Trustees, and any successor Trustees as may be required from time to time to fill vacancies created by the resignation, discharge or removal of a Trustee, unless a named fiduciary other than the President and Business Manager has been designated to appoint the Trustees.

10.4 DIRECTIONS TO TRUSTEE.
The Trustee is subject to the direction of the appropriate fiduciary, named in accordance with Article 10.1. All directions to the Trustee must be in 'writing'. As used herein, "direction" will include any certification, notice, authorization or instruction of the fiduciary appropriately communicated to the Trustee. Direction will be implied if the fiduciary, having knowledge of the Trust4ee's intentions, fails to file a written objection within a reasonable time prior to the completion of procedures contemplated.

10.5 APPOINTMENT OF INVESTMENT MANAGER.
The Trustees or other named fiduciary, may appoint an Investment Manager to direct the investment and management of the Investment Fund. Such Investment Manager must be either (1) registered as an investment advisor under the Investment Advisors Act of 1940, or (b) a bank, as defined in such Act.

The appointment of such Investment Manager must be in writing. If the Investment Manager accepts the appointment, his acceptance, and his acknowledgement that he is a fiduciary with respect to the Employer's Plan, must be given to the appropriate fiduciary in writing. The Investment Manager may resign at any time by giving thirty (30) days' prior written notice to the appropriate fiduciary.

The Trustees or other named fiduciary, may remove the Investment Manager at any time by giving the Investment Manager thirty (30) days prior written notice. The Trustees or other named fiduciary, will deliver a copy of the instruments appointing the Investment Manager and evidencing his acceptance and acknowledgement that he is a fiduciary with respect to the Plan, and a copy of the Investment Manager's current registration under the Investment Advisors Act of 1940. The Trustees will be fully protected in relying upon such instruments and certificates until otherwise notified in writing by the appropriate fiduciary.

All directions given to the Trustees by the Investment Manager will be in writing. The Trustee will follow the Investment Manager's instructions concerning the management, investment, and reinvestment of the Investment Fund. However, the Trustees will not be liable for the acts or omissions of the Investment Manager, and will be under no obligation to invest or otherwise manage any asset of the Plan which is subject to the Investment Manager's direction in the absence of such direction.

10.6 COMMUNICATION TO EMPLOYEES.
The latest copies of the Plan, announcement material, annual report, Collective Bargaining Agreement, Trust Agreement, Contract, or other instruments under which the Plan was established or is operated, will be made available for inspection at the office of the Fund to any Participant or Beneficiary who so requests. Each Participant, and each Beneficiary receiving benefits under the Plan, will be provided with announcement material setting forth a statement of the essential features of the Plan and the rights of Participants and Beneficiaries under the Plan.

Each Participant, and each Beneficiary who is receiving benefits under the Plan, will be furnished with a summary of the latest annual report as of the close of each Plan Year. In addition, each Participant will receive an annual statement showing the benefits accumulated under the Plan on his behalf, and either his Vested Interest in such benefits or the earliest day on which he will be entitled to a Vested Interest.

10.7 CLAIMS & APPEALS PROCEDURE.
Any Participant or Beneficiary who thinks that he is entitled to receive a distribution of a benefit under the Plan will have the right to file with the appropriate fiduciary a written notice of claim for such benefit. Such notice will state the date on which the distribution is requested to be made. Within ninety (90) days after the fiduciary's receipt of a claim, any Participant or Beneficiary whose claim for benefits has been denied will, unless special circumstances require an extension of time for processing the claim, be furnished with adequate written notice of the denial of his claim. Such notice will contain the reasons for the denial of the claim, with specific references to Plan provisions, a description of additional material which is needed to complete the claim and an explanation of the Plan's review procedure.

If an extension of time is required for processing the claim, the fiduciary will, prior to the end of the initial 90 day period, furnish the claimant written notice of the extension, stating the special circumstances requiring the extension and the date by which the fiduciary expects to furnish a final decision on the claim. Such extension will in no event exceed a period of 90 days from the end of the initial 90 day period. Within sixty (60) days after the receipt of a notice that his claim was denied, the Participant or Beneficiary will have the opportunity to appeal the denial of his claim to the appropriate fiduciary. The Trustees, on receipt of the request for review made by the Claimant, provide for a decision by the Trustees within 60 days, unless special circumstances exist requiring an extension of time, in which event the decision shall be rendered not later than 120 days from the date of receipt of the written request for review.

Each decision made by the Trustees shall be in writing, in plain and concise language understandable by the applicant, and shall set forth therein the reason or reasons for the decision made and the pertinent provision of the Plan and/or Trust Agreement on which such decision is based.

If a benefit is forfeited because the Participant or Beneficiary cannot be found, such benefit will be reinstated if a claim is made by the Participant or Beneficiary.

10.8 DISABILITY BENEFIT PROCEDURES.
For disability benefit claims submitted prior to January 1, 2002, the rules set forth in Section 10.7 shall apply. For disability benefit claims submitted on or after January 1, 2002, the following appeal procedure shall apply:

a) The Claimant shall submit in writing to the Fund such claim on a form authorized by the Trustees.

b) Unless an extension applies, the Trustees shall issue its decision in writing to the applicant within 45 days of the claim receipt.

c) The Trustees shall extend a decision for an initial appeal by two separate periods of 30 days each, provided such extension is due in part to circumstances beyond the control of the Plan. Such circumstances shall include a delay in obtaining medical information from a provider or physician.

d) The Fund shall notify the applicant in writing prior to the end of the 45 days if the first extension shall be used or prior to 75 days if the second extension shall be used.

e) Any Claimant who has been denied benefits, or his duly authorized representative shall have the following rights in appealing the initial decision:

(i) The right to submit additional documentation, including comments and statements for additional proof of entitlement to benefits.

(ii) The right to examine all relevant documentation in possession of the Plan free of charge.

(iii) The right within 180 days of receipt of the notice of the denial of benefits, to appeal the decision to the Trustees by submitting a written statement setting forth which of the reasons for denial of the application he disagrees with along with any supporting documents or additional comments related to his appeal.

(iv) The right to authorize a representative to act on his behalf The authorization to use a representative must be submitted in writing to the Fund and shall immediately be forwarded to the Trustees.

(v.) The right within 45 days after the submission of the written appeal, to receive a decision in writing from the Trustees. If circumstances require an extension of time the applicant shall be notified within the 45 day period. A decision shall be rendered no later than 90 days after a receipt of a request for review.

10.9 RESPONSIBILITY FOR FURNISHING INFORMATION.
The Employer or Union, as applicable, will be required to provide any named fiduciary with such personnel data as is required to carry out the provisions of the Plan.

The named fiduciary has the right to required submission of all necessary information before any benefit is paid, including, but not limited to, records of employment, proofs of dates of birth, disability or death, and evidence of existence. No benefit dependent in any way upon such information will be payable unless and until the information so required has been furnished.

10.10 LIMITATION OF LIABILITY OF FIDUCIARY.
No fiduciary will be liable for any act or failure to act of any other fiduciary, person, or organization with respect to the carrying out of a responsibility which has been allocated to such other fiduciary, person, or organization in accordance with the provisions of this Article 10.

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