Laserfiche WebLink
O A <br /> IV . SERVICES TO BE PERFORMED BY JAG <br /> 4 . 1 Claims Services . JAG will provide the following claims administrative services for Plan <br /> Sponsor with respect to claims presented to JAG for payment during the term of this <br /> Agreement ( "Clallns ") : <br /> 4 . 1 . 1 Information . Provide information and assistance to Plan participants concerning claims <br /> for benefits under the Plan . Provide explanation of benefits for payments made and for <br /> denial of benefits . Provide claivn forms as needed . <br /> 4 . 1 . 2 Claims Processing. Receive and process Claims received after the Effective Date and pay <br /> or deny such Claims for benefits on the basis of IRS guidelines and in accordance with <br /> the terns of the Plan Document . <br /> 4 . 1 . 3 Debit Card Processing. Issue debit cards to participants , receive and process debit <br /> card transactions after the Effective Date , and approve or deny such transactions <br /> on the basis of IRS guidelines and in accordance with the terms of the Plan Document. <br /> 4 . 1 .4 Payment. Claims payments and debit card transactions will be made by JAG from an <br /> account ( "Account") established by JAG . JAG will prepare ch.ecics for such Account <br /> and will provide the Plan Sponsor with periodic listings of all checks issued . <br /> 4 . 1 . 5 Claiins Review Procedure . If a Plan participant files a written request to JAG for a review <br /> of any Claim or debit card transaction processed by JAG, the following procedure <br /> shall be implemented : <br /> (a) Initial Response by JAG . JAG will investigate the request and provide an <br /> appropriate written response to the participant within sixty (60) days after date of receipt <br /> of the request . Such response will include notification of a right of appeal to the Plan <br /> Sponsor. <br /> (b ) Appeals In the event a participant appeals to the Plan Sponsor, JAG will provide <br /> the Plan Sponsor with assistance and reconnnendations . It is understood and agreed that <br /> the Plan Sponsor is the final arbiter with respect to any and all benefits decisions. <br /> 4 . 1 . 6 Records Maintain records of coverage and claims histories of the Plan <br /> participants for up to seven (7) years if desired by Plan Sponsor. <br /> 4 . 1 . 7 Reports . Provide Plan Sponsor with management reports as mutually agreed upon by Plan <br /> Sponsor and JAG . <br /> Page 4 <br />