BENEFITS DENIED
Some benefits are denied, either because of improper filing or because your benefit claim was not covered, or because of ineligibility for the benefits. There is a two-level appeals procedure to handle these situations.
1. Formerly protest the decision of the Plan denying your benefit. Write a letter to the appropriate Plan Administrator of the DC 37 Health and Security Plan or the DC 37 Education Fund; or the MELS Chief Counsel at 125 Barclay Street, New York, New York 10007, saying what your protest is, and why you think the denial is wrong. Add any other information that might help. This protest must be filed within 60 days from receipt of the rejection notice.
2. The appropriate Administrator or the MELS Chief Counsel will review your case and either uphold the decision of the Plan or grant your appeal protest. In either case, the decision will be forwarded to you in writing.
3. If the Administrator or the MELS Chief Counsel decides against you, and you wish to continue the appeal, do so by writing to the appropriate Appeals Committee of the Board of Trustees (Board of Trustees DC 37 Health and Security Plan, Board of trustees DC 37 Education Fund or the MELS Advisory Committee), at 125 Barclay St., New York, New York 10007. Give all the information and add anything new that might help your case. Write this letter within 14 days after receiving the written decision from the Administrator or Chief Counsel denying your protest.
4. The Appeals Committee will review the entire record of your appeal and what happened to it. They will make a final decision, which must be sent to you in writing.
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