SUMMARY PLAN DESCRIPTION Mid-America Apartment Communities, Inc. Employees' Stock Ownership Plan
Table of Contents Introduction............................................................................................................................................. 1 Type of Plan .............................................................................................................................................................. 1 Plan Sponsor ............................................................................................................................................................. 1 Additional Adopting Employers ................................................................................................................................ 1 Purpose of this Summary .......................................................................................................................................... 1 Plan Administration ................................................................................................................................. 1 Plan Trustees............................................................................................................................................................. 1 Plan Administrator .................................................................................................................................................... 1 Plan Number ............................................................................................................................................................. 1 Plan Year ................................................................................................................................................................... 1 Service of Legal Process ............................................................................................................................................ 2 Service Crediting ...................................................................................................................................... 2 Hour of Service.......................................................................................................................................................... 2 Year of Entry Service ................................................................................................................................................. 2 Year of Vesting Service.............................................................................................................................................. 2 Break in Vesting Service ............................................................................................................................................ 2 Discretionary Contributions ..................................................................................................................... 2 How the Contribution Is Determined........................................................................................................................ 2 How You Become a Participant ................................................................................................................................. 2 How You Qualify for a Contribution Allocation ......................................................................................................... 3 How the Contribution Is Allocated ............................................................................................................................ 3 How Your Compensation Is Determined................................................................................................................... 3 How Your Vested Interest Is Determined ................................................................................................................. 3 Top Heavy Requirements ......................................................................................................................... 3 Maximum Allocation Limitations ............................................................................................................. 3 Distributions ............................................................................................................................................ 4 Additional Distribution Information......................................................................................................... 4 Distributions for Reasons Other Than Death ............................................................................................................ 4 Distributions Upon Death ......................................................................................................................................... 4 Distribution Policy ..................................................................................................................................................... 5 Cash-Outs of Small Accounts.................................................................................................................... 5 In-Service Withdrawals ............................................................................................................................ 5 Investment of Accounts ........................................................................................................................... 5 Tax Withholding on Distributions ............................................................................................................ 6 Direct Rollovers not Subject to Tax ........................................................................................................................... 6 20% Withholding on Taxable Distributions ............................................................................................................... 6 Participants Absent Because of Military Duty .......................................................................................... 6 Participants Who Die During Military Absence ......................................................................................................... 6 Participants Who Become Disabled During Military Absence................................................................................... 6 Other Information.................................................................................................................................... 7 Attachment of Your Account .................................................................................................................................... 7 Amendment or Termination of the Plan ................................................................................................................... 7 Accounts Are Not Insured ......................................................................................................................................... 7 Payment of Plan Expenses ........................................................................................................................................ 7 Voting of Company Stock .......................................................................................................................................... 7
Claims Procedure ..................................................................................................................................... 7 Exhaustion of Remedies ............................................................................................................................................ 7 Grounds for Judicial Review ...................................................................................................................................... 8 Written Claims .......................................................................................................................................................... 8 Review of Non-Disability Benefit Claims ................................................................................................................... 8 Review of Disability Benefit Claims ........................................................................................................................... 9 Statement of ERISA Rights ..................................................................................................................... 11 Your Right to Receive Information .......................................................................................................................... 11 Duties of Plan Fiduciaries ........................................................................................................................................ 12 Enforcement of Rights ............................................................................................................................................ 12 Assistance with Your Questions .............................................................................................................................. 12 Glossary ................................................................................................................................................. 12 Highly Compensated Employee .............................................................................................................................. 13 Nonhighly Compensated Employee ........................................................................................................................ 13
Introduction
Type of Plan Beginning December 30, 2010, no contributions will be made to this plan. Prior to that date, contributions were made according to the below sections. No individuals will become Participants after this date. The plan is named the Mid-America Apartment Communities, Inc. Employees' Stock Ownership Plan, but it will be referred to in this summary as the Plan . Plan Sponsor Mid-America Apartment Communities, Inc. is the sponsor of the Plan, and will sometimes be referred to in this summary as the "Sponsoring Employer," the "Employer," "we," "us" or "our". Our address is 6815 Poplar Avenue, Suite 500, Germantown, Tennessee 38138; our telephone number is (901) 682-6600; and our employer identification number is 62-1543819. Additional Adopting Employers Mid-America Apartments, L.P. and Post Asset Management, Inc. have also adopted this Plan as Adopting Employers for the benefit of any of their employees who are eligible to participate. Any reference to the Employer in this summary will generally also be a reference to any Adopting Employer. Purpose of this Summary This booklet is called a Summary Plan Description (the "SPD") and it is meant to describe highlights of the Plan in understandable language. It is not, however, meant to be a complete description of the Plan, nor is it meant to interpret, extend or change the provisions of the Plan in any way. If there is a conflict between this SPD and the Plan, the provisions of the Plan control your right to benefits. A copy of the Plan and related documents are on file with the Plan Administrator and you can read them at any reasonable time. Also, no provision of the Plan or this SPD is intended to give you the right to continued employment or to prohibit changes in the terms or conditions of your employment. If you have any questions that are not addressed in this SPD, you can contact the Plan Administrator (who is described in the next section) during normal business hours. Plan Administration Plan Trustees The Plan is administered under a written plan and trust agreement, with Andrew Schaeffer, Melanie Carpenter, and Leslie Wolfgang as the trustees. The trustees can be contacted at 6815 Poplar Avenue, Suite 500, Germantown, Tennessee 38138. Plan Administrator All matters other than investments that concern the operation of the Plan are the responsibility of the Plan Administrator (also referred to as the Administrator). The Employer is the Plan Administrator. The Plan Administrator's address is 6815 Poplar Avenue, Suite 500, Germantown, Tennessee 38138; the telephone number is (901) 682-6600; and the Tax Identification Number is 62-1543819. The Plan Administrator has the power and discretionary authority to interpret the terms of the Plan based on the Plan document and existing laws and regulations, as well as the power to determine all questions that arise under the Plan. Such power and authority include, for example, the administrative discretion necessary to resolve issues with respect to an Employee’s eligibility for benefits, credited service, Disability, and retirement, or to interpret any term contained in the Plan and related documents. The Plan Administrator’s interpretations and determinations are binding on all Participants, employees, former employees, and their beneficiaries. Plan Number For identification purposes, we have assigned number 002 to the Plan. Plan Year The Plan Year is the accounting year of the Plan, and it begins each January 1st and ends twelve consecutive months later on December 31st.
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Service of Legal Process If you have to bring legal action against the Plan for any reason, legal process can be served on the Administrator at 6815 Poplar Avenue, Suite 500, Germantown, Tennessee 38138. You must exhaust the Plan's claims procedure (see the Section titled Claims Procedure) before you can bring legal action against the Plan. Service Crediting Your Service refers to the portion of your employment with us or with an Adopting Employer that may be used in some instances to determine your eligibility to participate in the Plan, to determine the Vested Interest in your Account, and to determine whether you are entitled to a contribution allocation for an Allocation Period, as described in more detail below. Hour of Service You are credited with an Hour of Service for each hour that you have a right to be paid by us for the performance of your duties. This includes the actual number of hours that you work and hours for which you are paid but are not at work, such as paid vacation, paid holidays, or paid sick leave. If the Employer does not maintain hourly records for you, then your Hours of Service will be determined on the basis of months worked, and you will be credited with 190 Hours of Service for each month in which you would otherwise be credited with at least one Hour of Service. Year of Entry Service A Year of Entry Service is a period of time used to determine your eligibility to participate in one or more parts of the Plan. You will be credited with a Year of Entry Service for each a 12-consecutive month eligibility computation period in which you are credited with at least 1,000 Hours of Service. Your initial eligibility computation period begins on your date of hire. Your second eligibility computation period overlaps your first eligibility computation period and begins on the first day of the Plan Year which begins prior to the first anniversary of your date of hire. If you complete 1,000 Hours of Service in both the initial eligibility computation period and in the second eligibility computation period, you will be credited with 2 Years of Entry Service for eligibility purposes. Whenever your eligibility to participate in a particular portion of the Plan is determined by the length of your service, you will not be credited with a Year of Entry Service until the last day of the applicable 12-month eligibility computation period during which you are credited with at least 1,000 Hours of Service. Year of Vesting Service A Year of Vesting Service is a period of time used to determine your Vested Interest in one or more of your Accounts. You will be credited with a Year of Vesting Service for each Vesting Service Period during which you are credited with at least 1,000 Hours of Service. The Vesting Service Period is a 12-month period ending on the last day of the Plan Year. Break in Vesting Service You will incur a Break in Vesting Service if you are credited with 500 Hours of Service or less during a Vesting Service Period. Discretionary Contributions How the Contribution Is Determined Discretionary Contributions may be made for each Plan Year in an amount determined by the Employer. They will be allocated as of the last day of the Plan Year. The allocation will be made for each person meeting the requirements described below in the section titled How You Qualify for a Contribution Allocation . How You Become a Participant To become a Participant in the Discretionary Contribution portion of the Plan, (a) you must be an Eligible Employee; (b) you must satisfy the age requirement; (c) you must also satisfy the service requirement; and (d) you must be employed by us, or by an Adopting Employer, on the applicable entry date.
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● Eligible Employees. All employees are Eligible Employees for this part of the Plan except (a) Non-Resident Alien Employees; (b) an individual considered by us to be an independent contractor, even if such individual is later determined by the Internal Revenue Service to be an employee; (c) Bargaining Employees, unless the collective bargaining agreement provides for participation in the plan; and (d) any Employee who was not eligible or a Participant as of January 1, 2011. ● Age Requirement. You must be at least 21 years of age. ● Service Requirement. You must be credited with 1 year of Entry Service determined by the Counting of Hours Method. A year of Entry Service is an Entry Service Period in which you are credited with at least 1,000 Hours of Service. ● Entry Date. You will actually enter this portion of the Plan as a Participant retroactive to the January 1st on which you first satisfy the entry requirements. How You Qualify for a Contribution Allocation Discretionary Contributions will be allocated to each person who was an Active Participant on the last day of the Plan Year and has at least 1,000 Hours of Service during the latest Accrual Service Period ending on or before that date. Discretionary Contributions will also be made for or allocated to each person who was an Active Participant at any time during the Plan Year and (a) dies or (b) has a Severance from Employment after he reaches his Normal Retirement Date or becomes Disabled. Such amounts will also be made for or allocated to each person who was an Active Participant at any time during the Plan Year and has died or become Disabled while performing Qualified Military Service during the Plan Year. For purposes of this paragraph, Disabled means the disability is subsequently determined to meet the definition of Totally Disabled. How the Contribution Is Allocated The amount allocated to each eligible Participant’s account will be equal to the Discretionary Contribution multiplied by the ratio of such person’s Annual Compensation to the total Annual Compensation for all such persons. How Your Compensation Is Determined In general, the Compensation used to determine a Discretionary Contribution for any Plan Year is the amount that is paid or made available to you during the Plan Year However, no Discretionary Contributions can be made with respect to Compensation in excess of the annual dollar limit on Compensation, which is announced annually by the IRS and is $360,000 for calendar year 2026. How Your Vested Interest Is Determined Your Vested Interest in your Discretionary Contribution Account is 100% at all times. Top Heavy Requirements Under certain circumstances, you may be entitled to a minimum allocation for any Plan Year in which the Plan is considered "top-heavy." The Plan is considered top-heavy for any Plan Year in which more than 60% of Plan assets are allocated to the Accounts of Participants who are Key Employees. For each Plan Year in which the Plan is considered top-heavy and in which you are a non-Key Employee who is employed by us on the last day of the Plan Year, you may receive a minimum allocation equal to the lesser of 3% of your Compensation or the highest percentage of Compensation allocated for that Plan Year to the Accounts of Participants who are Key Employees. Maximum Allocation Limitations The amount of contributions and forfeitures that can be allocated to your Account for any Plan Year is limited by law to the lesser of 100% of your Compensation or the annual dollar limit on allocations, which is announced annually by the IRS and is $72,000 for calendar year 2026. However, this dollar limit does not apply to the amount of earnings that can be allocated to your Account, or to the amount of any funds transferred to this Plan on your behalf from another qualified plan.
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Distributions If you terminate employment for any reason, your vested Account balance attributable to the ESOP Portion of the Plan will be distributed in a single sum payment or in substantially equal annual installments over a period not to exceed 5 years. The 5-year period may be extended up to 5 years for accounts whose value for calendar year 2026 exceeds $1,455,000, or 5 years plus 1 additional year (but not more than 5 additional years) for each $290,000 or fraction thereof by which your ESOP Portion of the Plan account exceeds $1,455,000. The dollar amounts in the preceding sentence are adjusted annually by the IRS. If you terminate employment because you reach Normal Retirement Age, because you become Disabled, or because you die, then distribution of your vested Account balance attributable to the ESOP Portion of the Plan will begin no later than one year after the close of the Plan Year in which you terminate employment unless you are able to elect otherwise. If you terminate employment for any reason other than retirement on or after reaching Normal Retirement Age, death or Disability, and you are not reemployed by the Company at the end of the fifth Plan Year following the Plan Year in which you terminated, then distribution of your vested Account attributable to the ESOP Portion of the Plan must begin no later than one year after the close of the fifth Plan Year following the Plan Year in which you terminated employment. However, if you are reemployed by the Company as of the last day of the fifth Plan Year following the Plan Year in which you terminated, distribution of your vested Account attributable to the ESOP Portion of the Plan will be postponed until you are otherwise entitled to a distribution under the Plan. Your vested Account attributable to the ESOP Portion of the Plan will generally be distributed in the form of Company Stock. However, if the stock is not readily tradable, you can sell it back to us at its current fair market value during the 60-day period immediately following the distribution (or during an additional 60-day period in the year following the distribution). Additional Distribution Information Distributions for Reasons Other Than Death In addition to the payments described above, there are rules which require that certain minimum distributions be made from the Plan. Generally, these minimum distributions must begin no later than (a) the April 1st following the end of the calendar year in which you reach age 70½ or (b) the April 1st following the end of the calendar year in which you retire. However, if you are a 5% owner, you must begin receiving these distributions by the April 1st following the end of the calendar year in which you reach age 70½ even if you are still employed by the Employer. For Participants who attain age 70½ in calendar year 2020, age 70½ is increased to age 72. For Participants who attain age 72 in calendar year 2023, age 72 is increased to age 73. Distributions Upon Death Your vested Account attributable to the Non-ESOP Portion of the Plan will be distributed to your beneficiary as soon as administratively feasible after your death. If you are not married, you can name anyone to be your beneficiary. If you are married, your Spouse by law is your beneficiary unless he or she waives the death benefit in writing. Your beneficiary can elect to receive a single sum payment. If your death occurs before the date minimum distributions must begin (as described in the preceding section), the distribution to your beneficiary must be made within certain legal timeframes that are dependent upon several factors, including (a) whether you have a designated beneficiary, (b) your relationship to the beneficiary (spousal or non-spousal beneficiary), and (c) certain elections that your beneficiary may make after your death. However, if your death occurs after the date that minimum distributions must begin, the minimum death benefit that must be paid to your beneficiary each year after your death is based on the longer of your remaining life expectancy (had you survived) or the remaining life expectancy of your beneficiary. Your beneficiary may also choose to accelerate the payment rate. Contact the Administrator for more information regarding payments to beneficiaries.
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Any death benefit received by your Spouse can be rolled over to an IRA. A non-Spouse beneficiary may establish a special IRA (an "Inherited IRA") that can receive a direct rollover of all (except for any required minimum distributions) or a portion of the death benefit distributed upon your death to that non-Spouse beneficiary. Certain portions of a death benefit may not be eligible to be rolled over into an Inherited IRA. If you needed to take a required minimum distribution in the year of your death but you had not taken it at the time of your death, then that required minimum distribution cannot be rolled over from the Plan into an Inherited IRA. Similarly, if the non- Spouse beneficiary needs to take any required minimum distribution from the Plan for the year in which the direct rollover occurs (or any prior year), then the non-Spouse beneficiary cannot roll over that required minimum distribution into an Inherited IRA. If the non-Spouse beneficiary elects to roll over the death benefit to an Inherited IRA, then the inherited IRA will be subject to complicated required minimum distribution rules. You should inform your non-Spouse beneficiary that (a) he or she is designated to receive your death benefit, and (b) your death benefit can be rolled over to an Inherited IRA. The non-Spouse beneficiary should discuss any planning issues and tax consequences with their professional tax advisor with respect to a direct rollover of your death benefit into an Inherited IRA. Distribution Policy Distributions are subject to a distribution policy set by the Plan Administrator. Additionally, a terminated participant’s Company Stock may be converted to non-stock assets. A copy of the distribution policy may be requested. Distribution alternatives will be described at the time a distribution is available to you. Cash-Outs of Small Accounts If your employment is terminated for any reason and your Vested Account does not exceed $1,000, your entire Vested Account will be distributed within an administratively reasonable time as of the earliest of your Retirement Date, the date you die, or the date you have a Severance from Employment for any other reason. Your Vested Account will be distributed in a lump sum, or, at your election, will be rolled over to another qualified retirement plan or to an individual retirement account (IRA) specified by you. If you fail to make the election and your Vested Account exceeds $1,000, the Plan Administrator will pay the distribution to an individual retirement account established with an affiliate of Principal Life Insurance Company. However, in making this distribution, any portion that is invested in Company Stock that is not Readily Tradable may only be distributed subject to the Plan’s available liquidity and distribution policy. In-Service Withdrawals You may, at any time after you attain age 59½, withdraw any part of your Vested Interest in your Discretionary Contribution Account. You may make such a withdrawal at any time. Investment of Accounts Your Account will be placed in a Trust fund (or an Annuity Contract) maintained by us, which will be invested primarily in Company Stock. Your Account will share in the investment performance of the Trust fund (or Annuity Contract), which is valued at least annually. Investment results will reflect any fees and investment expenses that may be charged against yours and other Participants' Accounts. You may request more information on any fees and expenses associated with the Plan from the Administrator.
The Employer will direct the investment of all Contributions (and the earnings thereon) allocated to your Account.
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Once you reach age 55 and you have been a Participant in the Plan for at least 10 years, you have the right during the following five years to diversify up to 25% of the Company Stock in your Account that was acquired after December 31, 1986. During the sixth year, you can diversify up to 50% of the Company Stock in your account that was acquired after December 31, 1986, minus any previously diversified shares. To satisfy this requirement, the Plan will offer you at least one of the following options: (a) three investment alternatives, (b) transfer of that amount to another qualified plan, or (c) distribution of that amount (either in cash or Company Stock). However, this right only applies if your Company Stock Account exceeds $500. Tax Withholding on Distributions Due to the complexity and frequency of changes in the federal laws that govern benefit distributions, penalties and taxes, the following is only a brief explanation of the law and IRS rules and regulations as of the date this summary is issued. You will receive additional information from the Administrator at the time of any benefit distribution, and you should consult your tax advisor to determine your personal tax situation before taking the distribution. Direct Rollovers not Subject to Tax Any eligible distribution that is directly rolled over to another eligible retirement account (either another qualified retirement plan or an individual retirement account) is not subject to income tax withholding. Generally, any part of a distribution from this Plan can be directly rolled over to another eligible retirement account unless the distribution (1) is part of a series of equal periodic payments made over your lifetime, or over the lifetime of you and your beneficiary, or over a period of 10 years or more; or (2) is a minimum benefit payment which must be paid to you by law. There are other distributions that are not eligible for direct rollover treatment, and you should contact the Administrator if you have questions about a particular distribution. 20% Withholding on Taxable Distributions If you have your benefit paid to you and it's eligible to be rolled over, you only receive 80% of the benefit payment. The Administrator is required to withhold 20% of the benefit payment and remit it to the Internal Revenue Service as income tax withholding to be credited against your taxes. If you receive the distribution before you reach age 59½, you may also have to pay an additional 10% tax. You can still rollover all or a part of the 80% distribution that is paid to you by putting it into an IRA or into another qualified retirement plan within 60 days of receiving it. If you want to rollover 100% of the eligible distribution to an IRA or to another qualified retirement plan, you must find other money to replace the 20% that was withheld. You cannot elect out of the 20% withholding (1) unless you are permitted (and elect) to leave your benefit in this Plan, or (2) unless you have 100% of an eligible distribution transferred directly to an IRA or to another qualified retirement plan that accepts rollover contributions. Withholding does not apply to distributions made in the form of Company Stock. Participants Absent Because of Military Duty Participants Who Die During Military Absence If you die while you are performing Qualified Military Service, you will be treated as having returned to employment on the day before your death for Vesting purposes. You will also receive any additional benefits and contributions to which you would have been entitled during your period of Qualified Military Service had you been able to return to work with us following your Qualified Military Service. For this purpose, you will be treated as if your employment with us terminated on your date of death. Participants Who Become Disabled During Military Absence If you become Disabled while you are performing Qualified Military Service and you cannot return to work, you will be treated as if you returned to employment with us on the day before the date you became Disabled (your "Disability Date") for purposes of determining your Vested Interest and your eligibility for, and the amount of, any additional benefits and contributions to which you would have been entitled during your period of Qualified Military Service had you been able to return to work with us. For this purpose, you will be treated as if your employment with us terminated on your Disability Date.
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Other Information
Attachment of Your Account Your creditors cannot garnish or levy upon your Account except in the case of a proper IRS tax levy, and you cannot assign or pledge your Account except as directed through a Qualified Domestic Relations Order as part of a divorce, child support or similar proceeding in which a court orders that all or part of your Account be transferred to another person (such as your ex-Spouse or your children). The Plan has a procedure for processing QDROs, which you can obtain free of charge from the Administrator. Amendment or Termination of the Plan Although we intend for the Plan to be permanent, we can amend or terminate it at any time. If we do terminate the Plan, all Participants will have a 100% Vested Interest in their Accounts as of the Plan termination date, and all Accounts will be available for distribution at the same time and in the same manner as would have been permissible had the Plan not been terminated. Accounts Are Not Insured Your Account is not insured by the Pension Benefit Guaranty Corporation (PBGC) because the insurance provisions of ERISA do not apply to employee stock ownership plans. For more information on PBGC coverage, ask the Plan Administrator or contact the PBGC. Written inquiries should be addressed to: Technical Assistance Division, PBGC, 1200 K Street NW, Suite 930, Washington, D.C. 20005-4026. You can also call them at (202) 326-4000. Payment of Plan Expenses The Plan routinely incurs expenses for the services of lawyers, actuaries, accountants, third party administrators, and other advisors. Some of these expenses may be paid directly by us while other expenses may be paid from the assets of the Plan. The expenses that are paid from Plan assets will either be shared by all Participants or will be charged directly to the Account of the Participant on whose sole behalf the expense is incurred. Voting of Company Stock If the Company Stock in your Account is publicly traded, you can direct how it will be voted on any matter put before the shareholders of the Company. If the Company Stock is not publicly traded, voting rights for such stock will be passed through to you and you can direct how it will be voted on any matter put before shareholders of the Company. Claims Procedure If you feel that you are entitled to a benefit that you are not receiving from the Plan, you can make a written request to the Administrator (or its delegate) for that benefit. Plan Benefits fall into two categories – Disability related benefits and non-Disability related benefits. A Disability-related benefit means a benefit that is available under the Plan and that becomes payable upon a determination of a Participant's Disability by the Administrator. A Disability-related benefit does not include a benefit that, under the terms of this Plan, becomes payable upon a determination of a Participant's Disability by the Social Security Administration or under a long term Disability plan sponsored by the Employer. The claims procedure for Disability-related benefits and non-Disability benefits are similar, but there are differences. While the claims procedure for each benefit is described below, this is just a summary, and the Administrator can supply you with a more detailed claims procedure. Exhaustion of Remedies No civil action for benefits under the Plan will be brought unless and until you have (a) submitted a timely claim for benefits in accordance with the provisions of this Section; (b) been notified by the Administrator that the claim has been denied; (c) filed a written request for a review of the claim in accordance with the applicable provisions below; and (d) been notified in writing of an adverse benefit determination on review.
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Grounds for Judicial Review Any civil action will be based solely on your advanced contentions in the administrative review process, and judicial review will be limited to the Plan document and the record developed during the administrative review process as set forth in this Section. Written Claims Any claim for benefits must be filed in writing with the Administrator, but the Administrator may permit the filing of a claim for benefits electronically as the Administrator complies with certain Department of Labor requirements. Any Employee, Participant or Beneficiary who files a claim for benefits under the Plan is a "Claimant" under this claims procedures. As a Claimant, you may authorize a representative to act on your behalf with respect to any claim under the Plan. The representative must provide satisfactory evidence to the Administrator of its authority to act on your behalf, such as a letter of authority with your notarized signature. To the extent consistent with the authority you grant to your representative, references to “you” or to "Claimant" in these claims procedures include your representative. The Administrator may review claims under the Plan or may delegate that authority to an appropriate adjudicator. References in these claims procedures to the Administrator include any claims adjudicator acting on behalf of the Administrator. Benefit claim determinations will be made based on the applicable provisions of the Plan document and any documents of general application that interpret the Plan provisions and are maintained by the Employer or the Administrator for purposes of making benefit determinations. The Administrator will take such steps as are necessary to ensure and verify that benefit claim determinations are made in accordance with such documents and the Plan provisions are being applied consistently with respect to similarly situated Claimants. All notices to Claimants will be written in a manner calculated to be understood by the Claimant. Review of Non-Disability Benefit Claims The provisions of this paragraph will apply if your claim for a benefit does not require a determination as to whether or not you are disabled or if a claim requires a Disability determination, but that determination is made outside the Plan for reasons other than determining eligibility for a Plan Benefit. Examples of this are where the Disability determination is based solely on whether you are entitled to disability benefits under either the Social Security Act or the Employer’s long term disability plan. ● Initial Denial. Whenever the Administrator decides for any reason to deny a claim in whole or in part, the Administrator will give you a written or electronic notice of its decision within 90 days of the date the claim was filed, unless an extension of time is necessary or you voluntarily agree to an extension. If special circumstances require an extension, the Administrator will notify you before the end of the initial review period that additional review time is necessary. The notice for an extension (a) will specify the circumstances requiring a delay and the date that a decision is expected to be made; and (b) will describe any additional information needed to resolve any unresolved issues. Unless the Administrator requires additional information from you to process the claim, the review period cannot be extended beyond an additional 90 days unless you voluntarily agree to a longer extension or the Administrator determines that special circumstances require a further extension. If special circumstances require a further extension, the Administrator will notify you before the end of the extended review period that further additional review time is necessary and such notice will describe the special circumstances requiring a further delay and specify the date a decision is expected to be made. The Administrator cannot extend the review period beyond an additional 90 days unless you voluntarily agree to a longer extension. If the Administrator requires additional information from you to process the claim and a timely notice requesting the additional information is transmitted to you, it must be provided within 90 days of the date that the notice is provided by the Administrator. ● Notice of Denial. If your claim is denied, the notice will contain the following information: (a) the specific reasons for the denial; (b) reference to the specific Plan provisions on which the denial is based; (c) a description of any additional material or information necessary for you to perfect your claim and an explanation of why such material or information is necessary; (d) 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; (e) a description of the Plan's review (i.e., appeal) procedures, the time limits applicable to such procedures, and in the event of an adverse review decision, a statement describing any voluntary review
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procedures and your right to obtain copies of such procedures; and (f) a statement that if you request a review of the Administrator's decision and the reviewing fiduciary's decision on review is adverse to you, there is no further administrative review following the initial review, and that you then have a right to bring a civil action under ERISA §502(a). The notice will also include a statement advising you that, within 60 days of the date on which you receive such notice, you may obtain review of the decision as explained in the next paragraph. ● Right to Appeal. Within the 60-day period beginning on the date you receive notice regarding disposition of your claim, you may request that the claim denial be reviewed by filing with the Administrator a written request for such review. The written request must contain the following information: (a) the date on which your request was received by the Administrator; (b) the specific portions of the denial of your claim which you request be reviewed; (c) a statement setting forth the basis upon which you believe the Administrator's denial of your claim should be reversed and your claim should be accepted; and (d) any other written information (offered as exhibits) which you want to be considered to explain your position, without regard to whether such information was submitted or considered in the initial benefit determination. ● Review on Appeal. In general, your appeal will be reviewed within 60 days of the date it is received by the Administrator (unless special circumstances require an extension to 120 days and you are so notified before the end of the 60-day review period). The review will take into account all comments, documents, records, and other information submitted by you relating to the claim, without regard to whether such information was submitted or considered in the initial determination. The decision on review will contain the following: (a) the specific reasons for the denial on review; (b) reference to specific Plan provisions on which the denial is based; (c) 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; (d) a statement describing any voluntary review procedures and your right to obtain copies of them; and (e) a statement that there is no further administrative review of decision and that you have a right to bring a civil action under ERISA §502(a). Review of Disability Benefit Claims The provisions of this paragraph will apply if your claim for a benefit requires a determination as to whether or not you are Disabled. These provisions will not apply if a Disability determination is made outside the Plan for reasons other than determining eligibility for a Plan Benefit. Examples of this are where the Disability determination is based solely on whether you are entitled to disability benefits under either the Social Security Act or the Employer’s long term disability plan. ● Initial Denial. Whenever the Administrator decides for any reason to deny a claim for a Disability benefit in whole or in part, the Administrator will transmit to you a written or electronic notice of its decision within 45 days of the date the claim was filed, unless an extension of time is necessary or you voluntarily agree to an extension. If, prior to the expiration of the initial 45-day period, the Administrator determines that a decision cannot be made within that initial 45-day period due to matters beyond the control of the Plan, the Administrator will provide you a notice before the end of the 45-day review period that a 30-day extension of time is necessary. If, prior to the end of the first 30-day extension period, the Administrator determines that a decision cannot be made within that first 30-day extension period due to matters beyond the control of the Plan, the Administrator will provide you a notice before the end of the first 30-day extension period that an additional 30-day extension of time is necessary. Any notice of an extension of time will (a) specify the circumstances requiring the extension of time and the date a decision is expected to be rendered; (b) explain the standards on which entitlement to a Disability Benefit is based; (c) state the unresolved issues that prevent a decision on the claim; and (d) describe any additional information needed to resolve those issues. If the Administrator requires additional information from you to process the Disability Benefit claim and a timely notice requesting the additional information is transmitted to you, you must provide the additional information within 45 days of the date the notice is provided. The claims review period will be temporarily suspended until the earlier of the date you provide the required information or the end of your permitted response period. The notice requesting additional information may also serve as notice of a claim denial if the notice clearly states that unless you provide the requested information within the prescribed time period, the claim will be denied for failure to provide sufficient information. A combined notice must provide both the information described above and the information under Notice of Denial below. If you are required to provide additional information, the Administrator has discretion to decide whether to request the information and extend the initial review
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period as described in this section or, instead, to deny the claim on the basis that there is not sufficient information to proceed. ● Notice of Denial. If your claim is denied, the notice will contain the following information: (a) the specific reasons for the denial; (b) reference to the specific Plan provisions on which the denial is based; (c) a description of any additional material or information necessary for you to perfect your claim and an explanation of why such material or information is necessary; (d) 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; (e) either (1) if the claim denial is based on an internal rule, guideline, protocol, or other similar provision, either the specific rule, guideline, protocol, or other similar criterion or a statement that such a rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination and that a copy thereof is available upon request, free of charge or (2) an affirmative statement that the claim denial is not based on an internal rule, guideline, protocol, or other similar criterion; (f) if the claim denial is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the determination, applying the terms of the plan to the Claimant's medical circumstances, or a statement that such explanation is available upon request, free of charge; (g) a discussion of the decision, including an explanation for disagreeing with or not following (1) the views you presented of health care professionals who treated you and vocational professionals who evaluated you; (2) the views of medical or vocational experts whose advice was obtained on behalf of the Plan in connection with the adverse benefit determination, without regard to whether the advice was relied on in making the determination; and (3) any Disability determinations made by the Social Security Administration; (h) a description of the review (i.e., appeal) procedures, the time limits applicable to such procedures, and in the event of an adverse review decision, a statement describing any voluntary review procedures and your right to obtain copies of such procedures; and (i) a statement that if you request a review of the Administrator's decision and the review is adverse to you, that there is no further administrative review following such initial review, and that you have a right to bring a civil action under ERISA §502(a). The notice will also include a statement advising you that, within 180 days of the date you receive the notice, you may obtain review of the decision as explained in the next paragraph. ● Right to Appeal. Within the 180-day period beginning on the date you receive notice regarding disposition of your claim, you may request that the claim denial be reviewed by filing with the Administrator a written request for such review. The written request for such review must contain the following information: (a) the date on which your request was received by the Administrator; (b) the specific portions of the denial of your claim which you request be reviewed; (c) a statement setting forth the basis upon which you believe the Administrator's denial of your claim should be reversed and your claim should be accepted; and (d) any other written information (offered as exhibits) which you want to be considered to explain your position, without regard to whether such information was submitted or considered in the initial benefit determination. ● Review by Alternate Reviewer. Review of a Disability Benefit claim that has been denied under the procedures described in the preceding two paragraphs will be conducted by a reviewer who is neither the individual who made the adverse benefit determination that is the subject of the appeal, nor the subordinate of such individual. The reviewer will not afford deference to the initial adverse benefit determination, but will take into account all comments, documents, records, and other information submitted by you relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. If the adverse benefit determination was based on a medical judgment, the reviewer will consult with an appropriate health care professional who (a) was not consulted on the original adverse benefit determination, (b) is not subordinate to someone who was consulted on the original adverse benefit determination, and (c) has appropriate training and experience in the field of medicine involved in the medical judgment. The reviewer will either (1) provide you with a list of any experts whose advice was obtained on the original adverse determination, without regard to whether the advice was relied upon in making the determination or (2) notify you that you may request, in writing, a list of such experts. You must also be provided reasonable access to, and copies of, all documents, records and other information relevant to your claim. No fee may be charged for such access and/or copies. ● Review on Appeal. In general, your appeal will be reviewed within 45 days of the date it is received by the Administrator (unless special circumstances require an extension to 90 days and you are so notified before the end of the 45-day review period). The reviewer will conduct a full and fair review of the Administrator’s decision denying your claim for benefits and will render its written decision. If the reviewer anticipates denying your
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