(d) Calculating Time Periods. For purposes of Section 1.1, the period of time within which a benefit determination is required to be made will begin at the time a claim is filed in accordance with this claims procedure, without regard to whether all the information necessary to make a benefit determination accompanies the filing.
Section 1.2 Claims Review Procedure.
(a) Appeal of Adverse Benefit Determination. If a Claimant wants to request a review of an adverse benefit determination, the Claimant must, within 60 days following receipt of a notification of an adverse benefit determination issued under Section 1.1, appeal in writing to the Plan Administrator. In conducting a review requested pursuant to this Section 1.2, the Plan Administrator must allow the Claimant the opportunity to submit written comments, documents, records, and other information relating to the claim, and the Plan Administrator will take into account all comments, documents, records, and other information submitted by the Claimant relating to the claim, regardless of whether such information was submitted or considered in making the initial benefit determination under Section 1.1. Upon request and free of charge, the Claimant will be provided reasonable access to, and copies of, all documents, records and other information “relevant” to the Claimant’s claim for benefits, provided that a document, record or other information will be considered “relevant” to a claim if such document, record or other information:
(1) was relied upon in making the benefit determination;
(2) was submitted, considered, or generated in the course of making the benefit determination, without regard to whether such document, record, or other information was relied upon in making the benefit determination; or
(3) demonstrates compliance with the administrative processes and safeguards in making the benefit determination.
(b) Content and Notice of Benefit Determination. To the extent that an adverse benefit determination (a denial) is made on review with respect to a claim, the Plan Administrator will notify the Claimant by providing a written or electronic notice (an electronic notice must comply with 29 CFR § 2520.104b-1(c)(1)(i), (iii), and (iv)) within the applicable period prescribed by this Section 1.2 that sets forth:
(1) The specific reason for the adverse determination;
(2) A reference to the specific Plan provisions on which the determination was 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; and
(4) A statement of the Claimant’s right to bring a civil action in court under Section 502(a) of ERISA.