As of January 1, 2002, the Trustees of the Sheet Metal Workers’ Local 73 Pension Fund have adopted a new set of Claim and Appeal Procedures. These procedures, which are printed below, describe how claims are filed, how much time the Pension Fund can spend deciding a claim, and what your appeal rights are in the event that the Pension Fund denies your claim.

Claim and Appeal Procedures

1. These Claim and Appeal Procedures (“Procedures”) apply to the Sheet Metal Workers’ Local 73 Pension Fund (“Plan”). They are effective for claims filed on or after January 1, 2002.
   
   
2. If you are a Participant or Beneficiary (called a “claimant”) for purposes of these Procedures) and you wish to receive a benefit from the Plan, you must file a claim with the Plan. You may obtain the application and any other necessary forms by telephoning or writing the Fund Office. You can also visit the Fund Office or send an e-mail to obtain application forms. If you visit the Fund Office, an employee of the Plan can help you complete the forms and answer any questions regarding the application process. You should submit all required forms, documents and information in advance of the date you wish payment of your pension benefit to begin.
   
   
3. A claim for a benefit is considered to have been received on the date the signed application form is received at the Fund Office.
   
   
4. Non-Disability Claims.
   Approval or denial of a claim for any type of benefit other than a disability pension will normally be made within 90 days after the claim has been received by the Plan. If additional time is required in special cases, the claimant will be notified in writing of the special circumstances requiring an extension of time and of the date by which the Plan expects to make final decision on the claim. The extension of time to decide a claim is 90 days so the maximum processing time is 180 days (the initial 90 days plus one 90-day extension). If the Plan needs an extension of time, you will be given a written notice of the extension prior to the end of the initial 90-day period.
   
   
5. Disability Claims.
   Approval or denial of a claim for a disability pension will normally be made within 45 days after the claim has been received by the Plan. If additional time is required because of circumstances beyond the control of the Plan, the Plan can extend the 45-day time period by 30 days. If the 30-day extension is not sufficient, the Plan can apply a second 30-day extension. Before the end of the original 45-day period (or, for a second extension, before the end of the first 30-day extension), you will be notified in writing of the circumstances requiring an extension of time and of the date by which the Plan expects to make a final decision on the claim. If the Plan needs additional information or material to process your disability claim and if the Plan requests that material in writing, you will be given up to an additional 90 days to obtain the information the Plan has asked you to provide. The time for the Plan to decide your claim is extended by the time it takes you to provide the requested information. When you respond to the Plan’s request for additional information, the ordinary time limits (the 45-day period or the 30-day extension) will again start to run. If you do not respond to the Plan’s request within 90 days, the Plan will decide without that information, which may result in the denial of your claim.
   
   
6. If your claim is denied, the Plan will send you a written notice stating the specific reason or reasons for the denial, making reference to pertinent Plan provisions on which the denial was based. If applicable, the notice will describe any additional material or information necessary to process your claim, along with an explanation of why such material or information is necessary. A Notice of claim denial will also include an explanation of the Plan’s appeal procedures.
   
   
7. Any claimant whose claims have been denied in whole or in part may request a full and fair review (referred to in these Procedures as an “appeal”) by filing a written notice of appeal with the Fund Office. If you are a pensioner and your pension payments are suspended or stopped for any reason, you have the right to appeal that decision. A notice of appeal must be received by the Fund Office not more than 60 days (180 days for a disability claim) after receipt by the claimant of written notification of denial of the claim or, if applicable, suspension of the pension. Your appeal is considered to have been filed on the date the written notice of appeal is received by the Fund Office.
   
   
8. If you wish, another person may represent you in connection with an appeal. If another person claims to be representing you in your appeal, the Trustees have the right to require that you give the Plan a signed statement, advising the Trustees that you have authorized that person to act on your behalf regarding your appeal. Any representation by another person will be at your own expense.
   
   
9. In connection with your appeal, you or your authorized representative may review pertinent documents and may submit issues and comments in writing.
   
   
10. The appeal will be decided by the Board of Trustees. The Trustees hold regular meetings at least four times per year. If your appeal is filed more than 30 days prior to a regular meeting of the Trustees, your appeal will be decided at that meeting unless special circumstances require an extension of time for processing, in which case a decision will be made on your appeal at the next following meeting of the Trustees. If your appeal is filed within the 30-day period immediately preceding a regular meeting of the Trustees, the appeal will not be decided at that meeting but will be decided at the next following meeting, unless special circumstances require an extension of time for processing your appeal. In that case, a decision will be made on your appeal at the third regular meeting following the date your appeal was filed.
    
    
11. Whenever there are “special circumstances” that require that the decision be delayed until the next following regular meeting, you will be advised in writing of why the extension of time was needed and when the appeal will be decided.
    
    
12. Once the Board of Trustees has decided your appeal, the Plan will send you a written notice of the decision. The notice will be mailed within five days of the Trustees’ decision. If the Trustees uphold the denial of your claim, you will then have the right to file suit, under the authority of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”). Also, if your appeal is denied, you are entitled to receive, upon request at no cost, copies of documents and information that the Plan relied on in denying your claim.
    
    
13. If the decision on a claim or the decision on appeal is not furnished within the time limits stated in these Procedures, the claim or appeal is deemed to have been denied. No claim shall be considered to have been denied until the claimant has exhausted all of the procedures described in these Claim and Appeal Procedures