Article 10 – Administration

10.1 Construction of Plan

This Retirement Plan is administered by the Trustees. The Trustees may establish rules for the transaction of their business and administration of the Retirement Plan. The Trustees will have the exclusive right to construe the provisions of the Retirement Plan and to determine any and all questions arising thereunder or in connection with the administration thereof, including the right to remedy possible ambiguities and inconsistencies or omissions, and any such construction or determination by the Trustees made in good faith shall be conclusive on all persons affected thereby, provided that in any such construction or determination, the Trustees shall not discriminate in favor of any Employee or class of Employees.

10.2 Employment of Specialists and Advisors

The Trustees may employ or appoint such accountants, actuaries, counsel, specialists, clerical services, medical services, and other persons or services as they may deem necessary or desirable in connection with the administration of this Plan. The Trustees may further enter into a group annuity contract with a life insurance company for the purpose of providing any or all of the benefits provided by this Plan.

10.3 Claims and Appeal Procedure

10.3.1 Claims. Claims or application for benefits under this Plan must be made in writing to the Plan Administrator at the address listed in the Plan Booklet on forms prescribed by the Administrator.

10.3.2 Denial of Claim

1. Timing of Benefit Denial (Other Than Claim For Disability Retirement Benefits). Any person whose application for benefits (other than Disability Retirement Benefits) under the Plan has been denied in whole or in part, or whose claim to benefits against the Fund is otherwise denied, will be notified in writing of the denial within 90 days after the Plan’s receipt of the application or claim. An extension of time, not to exceed an additional 90 days, may be required by special circumstances. If so, notice of the extension, indicating the special circumstances and the date by which a final decision is expected to be rendered, will be furnished the claimant before the expiration of the initial 90-day period.
   
   
2. Timing of Benefit Denial For Disability Retirement Benefits. Any person whose application for Disability Retirement Benefits is denied in whole or in part will be notified in writing of the denial within a reasonable period of time, but not later than 45 days after receipt of the claim. This period may be extended for up to 30 days (to a total of 75 days) if the Plan determines that an extension of time for making the determination is necessary due to matters beyond the control of the Plan, and notifies the claimant prior to the expiration of the initial 45-day period of the circumstances requiring the extension of time and the date by which the Plan expects to render a decision.
   
   If the Plan determines that an additional extension of time for making the benefit determination is necessary due to matters beyond the control of the Plan, and notifies the claimant prior to the expiration of the first 30-day extension period of the circumstances requiring the extension of time and the date by which the Plan expects to render a decision, then the period for making a benefit determination may be extended by the Plan for an additional 30 days (to a total of 105 days).
   
   If an extension of time is due to the claimant’s failure to submit the information necessary to decide a claim for Disability Retirement Benefits, the claimant will be afforded at least 45 days within which to provide the specified information. The period for making the benefit determination will 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.
   
   If an extension is necessary to consider a claim for Disability Retirement Benefits, the notification of the extension will specifically provide:
   
   
   1. An explanation of the standards on which entitlement to a benefit is based;
      
      
   2. The unresolved issues that prevent a decision on the claim; and
      
      
   3. The additional information needed to resolve the issues.
      
      
3. Notice of Denial. The notice of denial will set forth the following in a manner calculated to be understood by the claimant:
   
   
   1. The specific reason or reasons for the denial;
      
      
   2. Specific reference to pertinent Plan provisions on which the denial is based;
      
      
   3. A description of any additional material or information necessary for the claimant to perfect the claim and an explanation of why the material or information is necessary;
      
      
   4. An explanation of the Plan’s claim review procedure, and the time limits applicable to such procedures, and a statement of the claimant’s right to bring a civil action under ERISA § 502(a); and
      
      
   5. In the case of a claim for Disability Retirement Benefits, if an internal rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination, 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 determination and that a copy of the same will be provided free of charge to the claimant upon request.

10.3.3 Notice of Appeal to Trustees.
The claimant may appeal to the Board of Trustees for a review of the denial. The notice of appeal must be in writing and shall contain the following information:

Notice of Appeal

Notice is hereby given to the Trustees of the Carpenters Retirement Plan that: (claimant’s name, social security number, address and telephone number) hereby appeals from the decision or action of the Trustees or their representative (name of representative, if any) in (make a statement clearly identifying the decision or action being appealed) which decision was made or action taken on the _____ day of ____________________, 200__.

This appeal is based upon the rights accrued under the Plan by (name, address and social security number of the employee on the basis of whose accrued rights under the Plan the appeal is made, if made by a beneficiary other than such Employee).

I do (not) wish to present my appeal in person or with legal counsel in a hearing before the Board of Trustees.

Together with the Notice of Appeal, a claimant shall file with the Trustees a statement in writing containing the following additional information:

1. A statement as to each ground on which claimant believes the decision or other action appealed from to have been in error;
   
   
2. A list of the names and addresses of each person on whose testimony claimant will rely, in whole or in part, in support of the appeal, together with a short statement of the facts to which each such person is expected to testify;
   
   
3. A list of each document on which claimant will rely in support of the appeal.

In the case of a denial of Disability Retirement Benefits, notice must be filed by the claimant or his duly authorized representative with the Administrator of the Trust within 180 days after receipt of notice of a denial of Disability Retirement Benefits, and in the case of all other adverse determinations, within 60 days after receipt of notice of the determination.

The failure to file a written notice of appeal within the time period prescribed will operate as a complete waiver and will bar claimant’s right to appeal, and the decision or other action of the Trustees will be final.

10.3.4 Scheduling of Appeal
Upon the receipt of a timely-filed appeal, the Trustees will provide the claimant with a copy of Administrative Rules on Appeal which outline the hearing procedure. After claimant has filed with the Trustees the required written statement in support of appeal, the Trustees will set a date for hearing, if requested by claimant. All hearings will be conducted in accordance with the Administrative Rules on Appeal. The appeal will be conducted by the Board of Trustees, or by the Appeals Committee of the Board of Trustees, which has been allocated the authority for making a final decision in connection with the appeal.

The Trustees will review a properly filed appeal at the next regularly scheduled quarterly meeting of the Appeals Committee, unless the request for review is received by the Trustees within thirty (30) days preceding the date of such meeting. In such case, the appeal will be reviewed no later than the date of the second quarterly meeting following the Trustee’s receipt of the notice of appeal, unless there are special circumstances requiring a further extension of time, in which case a benefit determination will be rendered not later than the third quarterly meeting of the Appeals Committee following the Trustee’s receipt of the notice of appeal. If such an extension of time for review is required because of special circumstances, such as a request for a hearing on the appeal, then prior to the commencement of the extension, the Plan will notify the claimant in writing of the extension, describe the special circumstances and the date as of which the benefit determination will be made.

10.3.5 Appeal Procedures.
The claimant is entitled to present his position and any evidence in support thereof, and may appear in person at the appeal hearing. The claimant may be represented by an attorney or by any other representative of his choosing at his own expense. The claimant may submit written comments, documents, records, and other information relating to the claim. The claimant will be provided upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to his claim for benefits.

The claimant must introduce sufficient credible evidence on appeal to establish, prima facie, entitlement to the relief from the decision or other action from which the appeal is taken. The claimant will have the burden of proving his right to relief from the decision or action appealed, by a preponderance of evidence. The Trustees will review all comments, documents, records and other information submitted by the claimant related to the claim, regardless of whether such information was submitted or considered in the initial benefit determination. The Trustees will not afford deference to the initial adverse benefit determination.

When deciding an appeal of a claim for Disability Retirement Benefits that is based in whole or in part on a medical judgment, the Trustees will consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment. Any medical or vocational expert whose advice was obtained on behalf of the Plan in connection with the adverse benefit determination will be identified to the claimant. Any health care professional engaged for the purpose of a consultation will not be an individual who was consulted in connection with the initial adverse benefit determination that is the subject of the appeal, nor the subordinate of any such individual.

10.3.6 Decision of Trustees.
The Trustees will issue a written decision on review as soon as possible, but not later than five days after the determination is made. The decision will include:

1. The specific reasons for the decision, written in a manner calculated to be understood by the claimant;
   
   
2. Specific references to pertinent Plan provisions on which the decision is based;
   
   
3. 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;
   
   
4. In the case of a claim for Disability Retirement, a statement of the claimant’s right to bring a civil action under ERISA § 502(a); and
   
   
5. In the case of a claim for Disability Retirement, if an internal rule, guideline, protocol, or other similar criterion was relied upon in making the adverse determination, 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 determination and that a copy of the same will be provided free of charge to the claimant upon request.

10.3.7 Arbitration

1. Claim For Disability Retirement Benefits. Following issuance of the written decision of the Trustees on an appeal of a claim for Disability Retirement Benefits, there is no further right of appeal to the Trustees or right to arbitration. Instead, the claimant may bring a civil action under ERISA § 502(a).
   
   
2. Claim Other Than For Disability Retirement Benefits. If the claimant is dissatisfied with the written decision of the Trustees, other than a decision on a claim for Disability Retirement Benefits, the claimant may request a further appeal by arbitration in accordance with the Employee Benefit Plan Claims Arbitration Rules of the American Arbitration Association. However, the request must be submitted in writing to the Trustees within 60 days of receipt of the Trustees’ written decision. Failure of the claimant to initiate arbitration timely shall bar any further consideration of the appeal. If requested, the administrator will assist the aggrieved person in preparing the request for arbitration. In the event the matter is submitted to arbitration, the appeal will be limited to a transcript of witness testimony, the exhibits and the Findings and Decision of the Trustees (or Appeals Committee of the Trustees). The arbitrator shall not have the power or authority to add to, subtract from, or in any way modify the Plan, Trust Agreement, insurance contracts, if any, or the rules and regulations of the Trust. The question for consideration by the arbitrator will be whether, in the particular instance:
   
   
   1. The Trustees were in error upon an issue of law;
      
      
   2. The Trustees acted arbitrarily or capriciously in the exercise of their discretion; or
      
      
   3. The Trustees’ findings of fact were supported by substantial evidence.
      
      The expenses of arbitration will be borne equally by the appealing party, and by the Trust Fund unless otherwise ordered by the arbitrator. Each party is responsible for its own attorney fees. The decision of the arbitrator is final and binding on all parties, and judgment upon the award may be entered in any Court having jurisdiction thereof.

10.3.8 Exhaustion of Remedies.
A claimant must exhaust his remedies under the foregoing procedures as a condition precedent to the commencement of any suit.

10.4 Eligible Rollover Distributions

10.4.1 Direct Rollover.
Effective for distributions payable on and after January 1, 1993, an Employee entitled to a distribution or surviving spouse entitled to a distribution may elect to have any portion of an Eligible Rollover Distribution paid directly to an Eligible Retirement Plan in a Direct Rollover. Notwithstanding the foregoing, distributions less than $200 per calendar year are not eligible for Direct Rollover.

10.4.2 Eligible Rollover Distribution.
An Eligible Rollover Distribution is any distribution of all or any portion of the balance to the credit of the Employee or surviving spouse, provided that an Eligible Rollover Distribution does not include: any distribution that is one of a series of substantially equal periodic payments (not less frequently than annually) made for the life (or life expectancy) of the Employee and the Employee’s designated beneficiary, or for a specified period of ten years or more; any distribution that is one of a series of substantially equal periodic payments (not less frequently than annually) made for the life (or life expectancy) of the surviving spouse, or for a specified period of ten years or more; any distribution to the extent such distribution is required under Internal Revenue Code Section 401(a)(9); and the portion of any distribution that is not includable in gross income.

10.4.3 Eligible Retirement Plan.
In the case of distributions made to an Employee, an Eligible Retirement Plan is an individual retirement account described in Internal Revenue Code § 408(a), an individual retirement annuity described in Internal Revenue Code § 408(b), an annuity plan described in Internal Revenue Code § 403(a), or a qualified trust described in Internal Revenue Code § 401(a), that accepts the Eligible Rollover Distribution. In the case distributions made to a surviving spouse, an Eligible Retirement Plan is an individual retirement account or individual retirement annuity.

10.4.4 Direct Rollover.
A Direct Rollover is a payment by the Plan to the Eligible Retirement Plan specified by the Employee or surviving spouse.

10.4.5 Limit on Distributions.
An Employee or surviving spouse may split an Eligible Rollover Distribution which is greater than $500, by receiving a portion as a Direct Rollover and receiving direct payment of the balance, provided that the amount to be distributed as a Direct Rollover must be at least $500. Only one Direct Rollover shall be allowed with respect to each distribution.

10.4.6 Acceptance of Rollover Distributions.
The Plan shall not accept rollover distributions, except for Participants electing the Pension Enhancement Option under Article 10.5.

10.5 Pension Enhancement Option

At the election of the Employee, the Plan may accept transfer of all or part of a lump sum distribution, but not less than $10,000 from the Employee’s account in the Amended Carpenters of Western Washington Individual Account Pension Plan (“Individual Account Plan”) for the purpose of providing additional monthly retirement income from this Plan. The Plan shall not accept a transfer before the Employee’s retirement under this Plan, provided that if the Employee retires on a Disability Retirement, the Plan shall not accept a transfer until the Employee reaches his Normal Retirement Date.

The amount of the additional monthly retirement income shall be calculated using the Plan’s then current actuarial assumptions used for funding, paid in the same form of retirement benefit elected by the Employee at retirement. Any supplemental benefits and increases approved by the Trustees shall be applied to the additional monthly retirement income.

If monthly benefits terminate under the form of retirement benefit elected by the Employee before the Plan pays out (in additional monthly benefits) the total transferred amount, the balance of the transferred amount shall be paid in a lump sum to the Employee’s surviving designated beneficiary. If there is no surviving designated beneficiary, the balance of the transferred amount shall be forfeited.