Claims and Appeals Procedure

Submitting a Claim for Benefits

As a Plan participant, you do not have to file a claim for benefits, and neither does your beneficiary. However, if you feel your benefit has been incorrectly determined and you wish to request a review of that determination, you may file a written notice with the Plan Administrator.

The Plan Administrator has up to 90 days to evaluate and respond to your claim covered under TERISA, unless special circumstances require an extension of time. This extension will not exceed an additional 90 days (180 days total), and you will receive notice of such extension before the end of the initial 90-day period. This extension notice will state the circumstances requiring the extension of time and the date by which a decision is expected. You will be notified within the initial period of circumstances requiring the extension and the date by which the Plan Administrator expects to make a decision.

Filing an Appeal if Your Claim Is Denied

If your claim is denied, in whole or in part, you or your authorized representative can appeal and request a claim review within 60 days after receiving the denial notice.

You or your authorized representative may:

• Submit a written request for review of the denial;
• Have access to, and copies of, all documents relevant to the claim, free of charge;
• Submit documents, issues and comments in writing. These will be reviewed without regard to whether they were considered in the initial claim determination.

You will receive notification from the Plan Administrator of its decision within 60 days of receipt of your appeal, unless special circumstances require an extension. If special circumstances require an extension of time to process your appeal, you will receive notice prior to the end of the original period that the time for rendering a final decision has been extended — but not beyond 120 days from the receipt of your appeal. This notice will set out the circumstances requiring an extension of time and the date by which a decision is expected. Should you receive an adverse claim decision after exhausting your appeal rights, you have the right to seek judicial review. You must file an action in the Mashantucket Pequot Tribal Court under TERISA (Title XV, Mashantucket Pequot Tribal Law, accessible at www.mptnlaw.com) within one year after the date on which all administrative remedies are exhausted, that is, by the later of the date on which an adverse determination on review is issued or the last day on which a final decision should have been issued, or you will be forever prohibited from commencing such action.