02-08-1999 Council Packet - Laserfiche WebLink

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v/ould be paid without regard to this Plan. Taxable cash compensation under this Section 5.3 shall be deemed a benefit. Article VI. Claims Procedure Section 6.1 Written Claim for Benefits . Benefit payments shall not be made under this Plan until the Employer has received a written claim for reimbursement from the Participant. In that written claim, the Participant must certify that the amount of the claim will not be reimbursed by any other source and will not be claimed for tax credit or deduction purposes on the Participant’s income tax return. The Participant must furnish substantiation of the claim amount in a form satisfactory to the Employer. Substantiation shall include a written certification from an independent third party provider that the expense was incurred and the amount of the expense. In addition, in the case of a claim for reimbursement of Employment Related Dependent Day Care Expenses, the Participant must make any and all representations to the Internal Revenue Service as may be required by law with respect to the provider of dependent day care services to a Qualifying Individual. Section 6.2 Claims Procedure. The Employer shall notify a person within ninety (90) days of receipt of a written claim for benefits of that person ’s eligibility or noneligibility for benefits under the Plan. If it is determined that a person is not eligible for benefits or for full benefits, the notice shall set forth (1) the specific reasons for the denial, (2) a specific reference to the provision of the Plan on which the denial is based, (3) a description of any additional information or material necessary for the claimant to perfect the claim and an explanation of why it is needed, and (4) an explanation of the Plan’s claims review procedure and other appropriate information as to the steps to be taken if the Participant wishes to have the claim reviewed. If the Employer determines that there are special circumstances requiring additional time to make a decision, the Employer shall notify the Participant of the special circumstances and the date by which a decision is expected to be made, and may extend the time for up to an additional ninety (90) days. If a Participant is determined by the Employer not to be eligible for benefits, or if the Participant believes that he is entitled to greater or different benefits, the Participant shall have the opportunity to have the claim reviewed by the Employer