- The views of medical or vocational experts whose advice was obtained on behalf of the STD Plan in connection with the adverse determination on your claim, without regard to whether the advice was relied upon in making the benefit determination; and
- Any Social Security Administration disability determination regarding you that you presented to the STD Plan.
if your appeal was denied based on a medical necessity or experimental treatment or similar exclusion, an explanation of the scientific or clinical judgment for the determination, applying the terms of the Plan to your medical circumstances (or a statement of your right to receive such an explanation upon request); a statement disclosing any internal rule, guidelines, protocol or similar criterion relied on in making the adverse determination or, alternatively, a statement that such rules, guidelines, protocols, standards or other similar criteria do not exist; and a statement describing your right to bring a civil suit under ERISA Section 502(a), including a description of the contractual limitations period described under “ What are the time limits for legal proceedings ?,” above, and the calendar date on which your right to bring an action on the denial of your claim for benefits under the STD Plan expires.
Exhaustion of Administrative Remedies
Before filing any claim or action in court or in another tribunal with respect to the STD Plan, you must first fully exhaust all of your actual or potential rights under the claims procedures provided above by filing an initial claim and then seeking a timely appeal of any denial. This relates to claims for benefits under the STD Plan and to any other issue, matter, or dispute with respect to the STD Plan (including any eligibility, interpretation or amendment issue). This exhaustion requirement will apply even if the Plan Administrator has not previously defined or established specific claims procedures that directly apply to the submission and consideration of a particular issue, matter or dispute. After you have filed your initial claim, the Plan Administrator will inform you of any specific claims procedures that will apply to your particular issue, matter or dispute, or it will apply the claims procedures above that apply to claims for benefits.
ERISA PROVISIONS
NAME OF PLAN The Short-Term Disability Plan of Mid-America Apartments, LP, a component of the Mid- America Apartments, LP Employee Welfare Benefits Plan
NAME AND ADDRESS OF EMPLOYER/PLAN SPONSOR Mid-America Apartments, LP 6815 Poplar Avenue, Suite 500 Germantown, Tennessee 38138
13
Made with FlippingBook - Online Brochure Maker