HII Newport News Operations Summary Plan ... - Benefits Connect

Within 60 days after the date of the written denial notice, the employee, a
beneficiary, or an authorized representative of either may submit a request in
writing for a review of the denial. The request should contain facts that support the
claim for benefits, and reasons why it should not have been denied. The request for
review should be addressed and sent to:
CIGNA Group Insurance
1601 Chestnut Street
Philadelphia, PA 19192
The request for review will be considered by the insurance company’s Claims
Group who will provide a written response, usually within 60 days, including
specific reasons for the decision. If the claim is denied on review, the written
response will include:
• The reasons for the denial
• Reference to the Plan provisions upon which the denial was based
• A statement that you are entitled to receive, upon request and free of charge,
reasonable access to and copies of all documents, records, and other information
relevant to your claim for benefits
• A statement of your right to begin a lawsuit under the Employee Retirement
Income Security Act (ERISA) of 1974.
The notice of denial will be provided within 60 days after the claim for benefits is
received, unless the insurance company determines that special circumstances
require an extension of time for processing the claim. If the insurance company
determines that an extension of time is required, written notice of the extension will
be provided prior to the end of the initial 60-day period, indicating the special
circumstances that require an extension and the date by which a decision will be
rendered.
Additional Information about the Appeals Process In filing an appeal, you
have the opportunity to:
• Submit written comments, documents, records and other information relating to
your claim for benefits
• Have reasonable access to and review, upon request and free of charge, copies
of all documents, records and other information relevant to your claim,
including the name of any medical or vocational expert whose advice was
obtained in connection with your initial claim
• Have all relevant information considered on appeal, even if it wasn’t submitted
or considered in your initial claim.
The decision on the appeal will be made by a person or persons at the claims
administrator who is not the person who made the initial claim decision and who is
not a subordinate of that person. In making the decision on the appeal, the claims
Accidental Death & Dismemberment Insurance Plan
April 2011
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