16 CSR 50-1.020 - Appeal Process
PURPOSE: This rule establishes formal procedures for appeals to the board of directors.
(1) Members, beneficiaries and surviving
spouses may request review by the board of directors of decisions by the board
or its designee concerning eligibility for and the amount of benefits, service,
contributions, refunds and membership.
(2) Requests.
(A) The request for review must be stated in
writing, addressed to the plan administrator. The request must state what
decision the board is being asked to review, and what action the board is being
asked to take.
(B) The request must
be made within sixty (60) days after the administrative decision has been
mailed or otherwise communicated to the party making the request for
review.
(3) The review
will be conducted at the next regularly scheduled meeting of the board of
directors which is at least thirty (30) days after the request for review is
received. The party requesting review (the appellant) will be notified in
writing of the date the board will conduct the review. All reviews will be
conducted in Jefferson City, Missouri.
(4) The plan administrator will prepare
background material for the board, which will include documentation necessary
for the board to review the decision. The background material will be provided
to the appellant at the same time that it is provided to the board. Any
requirements of law prohibiting reproduction or distribution of material will
be observed.
(5) Reviews.
(A) Reviews will be held on an informal basis
and no formal rules of evidence will be applied.
(B) The appellant may present additional
documentation and testimony for the board to consider. Attendance by the
appellant is not required, however, and the appellant may submit the additional
information without being present at the meeting. Nonappearance by the
appellant at the meeting will not adversely affect the board's consideration of
the request.
(C) The appellant is
encouraged to provide any documentation at least one (1) week prior to the
meeting so it can be distributed to the board before the meeting.
(6) The appellant may be
represented by counsel at the review. The appellant may present witnesses to
the board who can provide information to the board. The chair retains
discretion to limit the number of witnesses appearing before the board. The
chair also retains discretion to require testimony to be limited only to the
subject of the request for review.
(7) The board will consider the background
material, the appellant's information and any relevant legal materials, and
make its decision no later than the next regularly scheduled meeting.
(8) The decision of the board will be
communicated to the appellant in writing by its legal counsel.
(9) Any party adversely affected by the
decision may seek judicial review under the provisions of Chapter 536,
RSMo.
Notes
*Original authority: 50.1032, RSMo 1995.
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