Recently, the Department of Labor issued a new claims procedure regulation applicable to ERISA-governed employee welfare benefit plans. For group health claims, the new regulation will be effective for our plan for claims submitted on or after July 1, 2002. Contact Human Resources (5172) if you have questions about the effective date.

The regulation provides many protections to you and your covered dependents as participants in an ERISA plan. Generally, the plan is required to:
· Establish and maintain reasonable claims procedures;
· Process claims and appeals within specified timeframes;
· Provide you with certain information when a claim is not paid, in whole or in part; and
· Provide you with certain appeals rights.

For group health claims, according to the new regulation, you must be given at lease 180 days to file an initial appeal. In addition, our plan will:
· Provide for a second appeal before a civil action can be filed under Section 502(a) of ERISA;
· Allow 60 days for filing the second appeal;
· Allow for unlimited voluntary appeals, when medical review is not involved, as long as new information is presented with each voluntary appeal.

You'll notice some other changes to the claims and appeals process. For instance, for group health claims, if your claim is denied, in whole or in part, you'll receive an explanation of benefits or other communication informing you of your right to appeal within 180 days of the initial claim denial. Also, effective July 1, 2002, all appeals requests related to group health claims must be submitted to a specified appeals address. This address will be provided to you on the back of any explanation of benefits and on any appeal determination notifications.

At our next plan renewal you will be receiving a new booklet (summary plan description) or attachment to your current booklet which will include this claims and appeals information.

We hope you find this information helpful. Please contact Human Resources if you have any questions.