Sprint - Nextel 2011 Annual Report Download - page 199

8.4.4 Notice of Adverse Determination for Claim on Review. A notice of an adverse determination for a claim on review shall set
forth in a manner calculated to be understood by the claimant:
8.5 Claims and Review Procedure for Disability Claims Filed under the Plan. Until modified by the Committee, the claims and review
p
rocedure for employees for disability claims shall be that set forth in the Sprint Nextel Long Term Disability Plan. Similar procedures shall
be used for Board Members, except that no statements referencing ERISA rights will be provided.
8.6 Rules.
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(a) The sixty (60) day period for deciding the claim on review may be extended for sixty (60) days if the BAC determines that
special circumstances require an extension of time for determination of the claim, provided that the BAC notifies the claimant,
p
rior to the expiration of the initial sixty (60) day period, of the special circumstances requiring an extension and the date by
which a claim determination is expected to be made.
(b) In the event that the time period is extended due to a claimant's failure to submit information necessary to decide a claim on
review, the claimant shall have sixty (60) days within which to provide the necessary information and the period for making
the claim 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 or, if earlier, the expiration o
f
sixty (60) days.
(c) The BAC's review of a denied claim shall take into account all comments, documents, records, and other information
submitted by the claimant relating to the claim, without regard to whether such information was submitted or considered in the
initial benefit determination.
(a) the specific reasons for the denial;
(b) references to the specific provisions of the Plan Statement (or other applicable Plan document) on which the adverse
determination is based;
(c) 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;
(d) a statement describing any voluntary appeal procedures offered by the Plan and the claimant's right to obtain information about
such procedures; and
(e) a statement of the claimant's right to bring an action under ERISA Section 502(a).
(a)
N
o inquiry or question shall be deemed to be a claim or a request for a review of a denied claim unless made in accordance
with the claims procedure. The BAC