Summary Plan Description SHORT TERM DISABILITY BENEFITS Effective 1 July 2013
SHORT TERM DISABILITY BENEFITS TABLE OF CONTENTS INTRODUCTION TO SHORT TERM DISABILITY BENEFITS 1 Plan Administration 1 Questions 1 HOW THE STD BENEFITS WORK 2 Who may participate? 2 How do I enroll? 3 When does my eligibility for STD benefits end? 3 What do STD benefits cost me? 3 Who is a doctor? 4 What is a health care professional? 4 Who determines if I am disabled? 4 What is Objective Medical Evidence? 4 What is a Medical Examination? 5 SUMMARY OF STD BENEFITS 6 How do I file a claim for STD benefits? 6 When do I receive my STD benefits? 6 When will my STD benefits begin? 6 What are my STD benefits? 7 How are STD benefits determined? 7 Will I still be eligible for STD benefits if I return to work on a part-time basis? 7 What is deducted from my STD benefits? 7 Will there be withholdings from my STD benefits? 8 What if my injury is caused by someone else? 8 Can my STD benefits be suspended? 9 When do my STD benefits end? 9 What if I receive an overpayment of STD benefits? 10 What if I die while I am receiving STD benefits? 10 Can my STD benefits be assigned, garnished, levied or transferred while I am on disability? 10 Can my STD benefits be paid to my representative or agent? 10 EXCLUSIONS 11 What is not covered? 11 CLAIMS AND APPEALS 12 Formal Claims Process First Level Review 12 Formal Appeals Process Second Level Review 13 Voluntary Appeal 14 How to File a Voluntary Appeal for an External Review 15 Preliminary Review 16 Referral to ERO 17 ERISA 17 Effective 07/01/2013 i Short Term Disability
INTRODUCTION TO SHORT TERM DISABILITY BENEFITS The Capital Group Companies, Inc. and its participating affiliates (the Company ) have contracted with Matrix Absence Management, Inc. to administer Short Term Disability (STD) benefits under The Health and Welfare Benefits Plan for Employees of the Capital Group Companies, Plan Number 501 ( the Plan ). For convenience, Matrix Absence Management, Inc. is referred to as Matrix or the Claim Administrator. STD benefits provide financial assistance for you by paying a portion of your income if you become sick or injured and cannot work. In some cases, you may receive STD benefits even if you work while you are disabled. Both work-related and off-the-job disabilities are covered. Certain types of disabilities may be excluded. The following pages explain how STD benefits work. Plan Administration These STD benefits are administered and governed at all times by the Plan. If any conflict should arise between the contents of this Summary Plan Description (SPD) and the Plan, or if any point is not covered in this SPD, the terms of the Plan will govern in all cases. You may review a copy of the Plan by contacting the Benefits Service Team. Currently, the Company intends to continue STD benefits as described in this SPD. It does, however, reserve the right to change, amend, or even terminate these benefits, in whole or in part, at any time. Questions If you have any questions after reviewing your SPD, you are encouraged to contact the Benefits Service Team. Effective 07/01/2013 1 Short Term Disability
HOW THE STD BENEFITS WORK These STD benefits are designed to assist you in meeting your reasonable income needs in the event you suffer a short-term disability and are unable to work. STD benefits work in combination with benefits you may receive from other sources such as Social Security or Workers Compensation to help provide an income while you are unable to perform your regular job. Benefits are calculated based on your earnings before you become disabled and on the amount of earnings you lose because of your disability. Who may participate? You may be eligible for STD benefits if you are a regular salaried full or part-time U.S.-based associate of The Capital Group Companies, Inc. or a participating affiliate and you are regularly scheduled to work 20 or more hours per week, and you are not a member of an excluded group listed below or a non-u.s.-based associate, unless separately provided benefit information specifically states that you are eligible to participate in this benefit. You will not be eligible for STD benefits under the Plan if you are: (i) an associate in the Core Investment Group (Senior Partner (SP) or Investment (I) job function codes only); (ii) an associate classified as temporary/hourly or hourly paid, or classified as short-term; (iii) an individual employed by the Company on a special or consulting basis under a written contract; (iv) a leased or temporary employee as deemed by the Company under certain provisions of the Internal Revenue Code; (v) an individual who is not considered to be, or classified for payroll purposes as, a common law employee of the Company including, but not limited to, individuals classified as independent contractors whose compensation is reflected by the issuance of a Form 1099; or (vi) an individual treated as a non-common law employee for payroll purposes, even if a court, tribunal, or administrative Effective 07/01/2013 2 Short Term Disability
agency determines that you are a common law employee. How do I enroll? When does my eligibility for STD benefits end? You do not need to enroll. When you satisfy the eligibility requirements, you are enrolled automatically as of that date. When any of the following occurs: You cease to be an eligible associate for a reason other than your disability. For example, if your scheduled work week is reduced to fewer than 20 hours per work or you are no longer employed with the Company; You begin an unpaid leave of absence; You begin receiving long term disability benefits; The date of your death; or The company discontinues STD benefits or terminates the Plan. What do STD benefits cost me? Your STD benefits are provided by the Company. For purposes of STD benefits, any of the following: You suffer an injury or illness (physical or mental) which prevents you from performing the primary duties of your job (or any reasonably related job); Your pregnancy prevents you from doing your job. Generally, if you are pregnant, you will be considered to be disabled without having to provide Objective Medical Evidence beginning two weeks before your estimated delivery date for a period not to exceed 90 consecutive calendar days ( 90-day period ). If you sustain a disability prior to giving birth that is pregnancy-related, the 90-day period of presumed disability will be reduced by any period of such pregnancy-related disability. Any disability during your pregnancy which is unrelated to the pregnancy will not reduce the 90-day presumed disability period. However, any period of disability, whether or not related to your pregnancy, will be subject to the normal STD rules and benefits limits set forth in the Plan. The 90-day period of presumed disability will not apply for any period after the death or stillbirth of a child. You contract or are exposed to a communicable disease (e.g., T.B., chickenpox) and your doctor (or a bona fide health official) states, in writing, the you must stay away from work; or You have been referred or recommended by a health care professional to undergo treatment for alcohol or drug Effective 07/01/2013 3 Short Term Disability
abuse. You must participate in an accredited residential program to qualify for benefits, or in an outpatient program for the treatment of drug or alcohol abuse which requires attendance for a minimum of five (5) days per week for a minimum of six (6) hours per day. You will not be considered disabled if you are doing work of any kind for pay or profit without first obtaining approval from the Claims Administrator. You will not be considered disabled if you turn down alternative employment offered by the Company that is within your capabilities and is comparable in status and pay to your regular job. Who is a doctor? What is a health care professional? Who determines if I am disabled? What is Objective Medical Evidence? A doctor, physician, surgeon, dentist, podiatrist, osteopathic or chiropractic practitioner, or psychologist who is duly licensed and acting within the scope of his or her practice. "Psychologist" means a licensed psychologist in the state of practice, with a doctorate degree in psychology and who either (1) has at least two years clinical experience in a recognized health setting, or (2) has met the standards of the National Register of the Health Service Providers in Psychology. For the purpose of disability related to normal pregnancy or childbirth, a midwife, nurse-midwife and a nurse practitioner duly licensed and acting within the scope of his or her practice, are considered to be doctors. The doctor may not be yourself, or a relative by blood, law or marriage or a domestic partner. A doctor or other health care professional licensed, accredited, or certified to perform specified health services consistent with State law. The Claims Administrator, based on Objective Medical Evidence, a certificate from your doctor, and any other information that may be relevant. Certificates from your doctor must contain (i) a diagnosis and diagnostic code prescribed in the International Classification of Diseases, or, where no diagnosis has yet been obtained, a detailed statement of symptoms, (ii) a statement of the medical facts within your doctor s knowledge, based on a physical examination and your documented medical history, (iii) your doctor s conclusion about your condition, and (iv) a statement of your doctor s opinion as to the expected duration of the disability. Objective Medical Evidence means a measurable abnormality which is evidenced by one or more standard medical diagnostic procedures such as laboratory tests, physical examination findings, X-rays, MRIs, EEGs, ECGs, CAT scans or similar tests that support the presence of a disability or Effective 07/01/2013 4 Short Term Disability
indicate a functional limitation. Objective Medical Evidence does not include your doctor s opinions based solely on the acceptance of subjective complaints like headache, fatigue, pain or nausea or other non-medical factors such as age, transportation or the local labor market. To be considered an abnormality, the test result must be clearly recognizable as out of the range of normal for a healthy population; the significance of the abnormality must be understood and accepted in the medical community. What is a Medical Examination? If you apply for benefits, the Claims Administrator may require that you submit to an examination by a doctor designated by the Claims Administrator, for his or her medical opinion as to whether you meet the eligibility requirements for disability benefits under the Plan. You may be subject to reexaminations from time to time while you are receiving benefits as directed by the Claims Administrator for the purpose of assisting the Claims Administrator in determining whether you continue to be eligible for such benefits. The doctor s fees and the expenses of such examination will be paid by the Plan. Effective 07/01/2013 5 Short Term Disability
SUMMARY OF STD BENEFITS How do I file a claim for STD benefits? You must notify the Claims Administrator of your claim as soon as is reasonably possible. Contact the Matrix Intake Center at 1-866-932-8045 or online at www.matrixeservices.com. Matrix will send you an information packet including a claim form. Fill out the form and return it to Matrix. You must return the required medical certification within 30 days after your first day of disability; otherwise, you may lose some or all of the STD benefits. In order to qualify for benefits, you may also be required to submit information from your doctor regarding your condition and the expected day you will return to work and any records on file in a hospital or from another company that may be relevant to your claim. If you fail to provide the requested information, benefits will not be paid for the period during which you fail to comply unless the Claims Administrator determines that your failure to comply was due to a reasonable cause. In no event will an application for benefits be accepted if filed more than 60 days after your first day of disability. When do I receive my STD benefits? When will my STD benefits begin? After you have submitted all the necessary information, your claim will be evaluated by the Claims Administrator. If it is approved, the amount of your benefit will be calculated and you will receive your payments through the normal payroll process. You will become eligible to receive STD benefits on your fifteenth (15 th ) consecutive calendar day of disability (provided you see a doctor at some point during that period). The start date of your disability will be determined by the Claims Administrator based on the objective medical evidence, certificate and other relevant information submitted by your doctor. A disability is deemed to be continuous if you return or are able to return to work for fourteen (14) consecutive calendar days or less and become disabled again due to the same or related cause or condition. If you return to work for more than fourteen (14) consecutive days and you become disabled again due to the same or a different cause or condition, a new 14-day waiting period will be applied. Effective 07/01/2013 6 Short Term Disability
What are my STD benefits? If you are disabled, the amount of your disability benefits will be determined by your cumulative length of employment with the Company as a full-time or part-time associate, as shown on the following schedule: Disability Duration Date of Disability 14 th day 0 to 12 Months 12 to 36 Months Length of Employment 36 to 60 Months 60 or more Months 0 0 0 0 15 th 180 th day 60% 70% 85% 100% How are STD benefits determined? Will I still be eligible for STD benefits if I return to work on a part-time basis? Partial weeks are paid at a daily rate that is 1/7 of your weekly benefit. STD benefits are based on your earnings. Earnings mean your daily base earnings in effect on the day immediately preceding your disability. Earnings do not include bonuses, overtime, or any other forms of additional compensation. However, if you are paid wholly or in part by commissions, your earnings will include commissions generated by your assigned territory on the date immediately preceding your disability. If you return to work for the Company on a part-time or modified schedule basis while eligible for disability benefits, you will receive your regular weekly benefit reduced by any income you earn from part-time employment and any other available benefits listed below in the What is deducted from my benefits? section. In no event will your combined income and STD benefits exceed your weekly earnings prior to becoming disabled. Generally, the duration of a part-time schedule is 30 calendar days. Each calendar day on a part-time or modified schedule basis will count as a full day of disability. What is deducted from my STD benefits? If you are eligible to receive any of the following income or benefits, they will be deducted from your STD benefits: (i) primary and dependent Social Security disability or retirement benefits (but not cost-of-living increases); (ii) benefits under any other plan, fund, or arrangement, by whatever name known, providing disability benefits pursuant to a compulsory act or law of any government; (iii) temporary or permanent disability payments (whether total or partial), vocational rehabilitation payments, and any other amounts awarded or allocated under workers compensation or a similar law; Effective 07/01/2013 7 Short Term Disability
(iv) benefits under a state disability plan (such as California SDI), or a Company plan providing disability benefits in place of a state plan; (v) benefits provided under any work loss provision in mandatory No-Fault automobile insurance; and (vi) benefits paid under a state leave program (such as California PFL or New Jersey FLI). If you are or might be entitled to any of the above benefits, your STD benefits, subject to appropriate reductions, will be paid to you upon receipt by the Claims Administrator of evidence that you have applied for such benefits. You may also be required to reimburse the Plan, for the amount of any payments made, immediately upon receipt of such benefits. If you do not apply for these benefits, your benefit will be reduced by the amount you would have received had you applied. Will there be withholdings from my STD benefits? What if my injury is caused by someone else? Your STD benefits will be subject to the same withholdings as your regular earnings. Appropriate taxes will be withheld from your payments and any contributions that you have elected to make to any medical, welfare or retirement plans. If your disability is the result of injury caused by someone else, you will receive STD benefits only if you agree to the following: 1. Reimburse the Plan, for the full amount of payments made under the terms of the Plan, immediately upon receipt of the proceeds of any settlement of, or judgment in, an action at law, arbitration, claim, or other proceeding to determine your rights of recovery arising out of your injury, net of your reasonable expenses in collecting such amount including reasonable attorney's fees, and net of any amounts which are allocated by terms of any judgment for the payment of unreimbursed medical expenses; you will execute and deliver all materials and papers and do whatever else is reasonably necessary to secure the rights of the Plan to reimbursement out of such proceeds, and you will do nothing to prejudice such rights; 2. Provide the Plan with a lien on the proceeds described in the preceding paragraph, to the extent of the full amount of payments made under the terms of the Plan; and 3. Provide the Plan with a credit against payments to be made in the nature under the Plan equal to the proceeds described above, less any amount paid to the Plan by way of reimbursement. Effective 07/01/2013 8 Short Term Disability
Can my STD benefits be suspended? Yes. Your STD benefits will be suspended if any of the following occurs: If you refuse to undergo a medical examination after the Claims Administrator has made a request that a doctor examine you at the Company s expense. If you fail to furnish written information about your disability within 30 days for the purpose of determining whether you are entitled to benefits following a written request by the Claims Administrator. If you leave your doctor s regular and continuous care and treatment, unless such regular and continuous care and treatment are not medically necessary, given the nature of your disability. If you refuse to follow or reject the treatment plan recommended by your doctor, unless you dispute the treatment plan in good faith and on the advice of another doctor. If you misstate or provide false information or materials to the Claims or Plan Administrator. Your STD benefits will be suspended as of the date of the examination (however, if the examination establishes that you are still disabled, your STD benefits will resume retroactive to the examination date). STD benefits will resume once you comply with these requirements. In no event will you be paid benefits for the period when you were out of compliance with the Plan. When do my STD benefits end? Your STD benefits will end on the date your disability ends. A disability is deemed to have ended if you return to work for at least one full day at your regular work schedule and do not become disabled again due to the same cause or condition within fourteen (14) consecutive calendar days of returning to work. If you begin a STD leave on or after July 1, 2013, your STD benefits will end on the date immediately following your 180 th cumulative calendar day of disability (including the waiting period) in any 12-month period. Your STD benefits will also end once you begin receiving long-term disability benefits, or on the date that your employment with the Company ends or your employment status changes so that you no longer meet eligibility requirements. However, if your disability ends before then (or if you die), your benefits will end as of that day. Effective 07/01/2013 9 Short Term Disability
What if I receive an overpayment of STD benefits? What if I die while I am receiving STD benefits? Can my STD benefits be assigned, garnished, levied or transferred while I am on disability? In the event you receive an overpayment of STD benefits, you will be required to repay such overpayment. The Plan Administrator will make reasonable arrangements with you or your legal representative(s) for the repayment to the Plan, including, but not limited to, the reduction of future benefits under the Plan or the reduction of future pay from the Company. In the event of your death, any STD payments due under this Plan as a result of your disability will be made to your beneficiary designated in your group life insurance policy or, if no such policy exists, to your spouse. If payments cannot be made under either of the above methods, payment will be made to your estate. To the extent permitted by law and except as provided in the What if my injury is caused by someone else? section, no STD benefit payable at any time under the Plan will be assignable or transferable, or subject to any lien, in whole or in part, either directly or by operation of law or otherwise, including, but not limited to, execution, levy, garnishment, attachment, pledge, bankruptcy, or in any other manner. No benefit payable under the Plan will be liable for, or be subject to, any of your obligations or liabilities. Can my STD benefits be paid to my representative or agent? In the event you are duly appointed a guardian, conservator, committee or other legal representative while you are entitled to any STD payment under the Plan, any such payment due may be made to the legal representative making such claim. The Plan will not be liable for any payments made, and the Claims Administrator and the Company will be discharged from any obligations. Effective 07/01/2013 10 Short Term Disability
EXCLUSIONS What is not covered? The Plan does not cover any of the following disabilities: your illness or injury was self-inflicted, including cosmetic surgery except for reconstructive surgery deemed necessary by a doctor as a result of your injury or illness; you became disabled because of your commission or your attempted commission of a felony or as a result of your engagement in an illegal occupation; you are injured in a war, insurrection or rebellion (unless you are traveling overseas on Company business when the injury is incurred), or your participation in a riot or service in the armed forces of any country or international authority; you are entitled to or are receiving unemployment benefits under any United States law or the law of any state; you are no longer under the regular and continuous care and treatment of a doctor, unless the Claims Administrator determines that your disability does not warrant such attention; your disability is not supported by Objective Medical Evidence; your disability results from a work-related injury or illness incurred as a result of your working for wages or profit with an employer other than the Company; or you are incarcerated (in jail or any other facility) as a result of a criminal conviction under a federal, state, municipal or foreign law or ordinance. Effective 07/01/2013 11 Short Term Disability
CLAIMS AND APPEALS Formal Claims Process First Level Review If the Claims Administrator determines that you are not eligible for STD benefits, and you are not satisfied with the Clams Administrator s decision, you may file a formal claim (first level review) within 180 days after receipt of the written decision. The formal claim must be in writing and sent to: Matrix Absence Management, Inc. Claims and Appeals Department 181 Metro Dr Ste 300 San Jose, CA 95110 Phone: (408) 360-8370; (800) 980-1006 Fax: (408) 360-9441 You will receive a written notice from the Claims Administrator within 45 days of receipt of the claim. If additional time is needed, the Claims Administrator can extend the timeframe up to 30 days. The Claims Administrator must tell you prior to the end of the first 45-day period that additional time is needed, explaining the special circumstances requiring an extension of time, any unresolved issues and additional information needed, and when the Claims Administrator expects to render a final decision. If more information is requested, you will have at least 45 days to provide it. The claim must then be decided no later than 30 days after you supply the additional information or the period of time given by the Plan to do so ends, whichever comes first. If your formal claim is denied, in whole or in part, the Claims Administrator must send you a written notice with a detailed explanation of why your claim was denied and a description of the appeals process. The Claims Administrator must include the Plan rules, guidelines, or exclusions used in the decision or provide you with instructions on how you can request a copy of the plan. Effective 07/01/2013 12 Short Term Disability
Formal Appeals Process Second Level Review If your formal claim is wholly or partially denied, you may ask to have the claim reviewed on appeal (second level review). To have the claim reviewed, you, or someone authorized to represent you, must make a written request for appeal to the Claims Administrator within 180 days after receiving notice of the formal claim denial. You may submit any documentation you feel will support your appeal and set forth the grounds and facts upon which the request for review is based. You may also state any issues or comments which you feel are pertinent to your claim. You or your representative may review documents pertinent to your claim. Upon receipt of a request for an appeal (second level review), the Claims Administrator will furnish a written decision within 45 days of receipt of your request. Arrangements will be made to have the claim reviewed fairly and fully. The review will be: 1. without deference to the initial claim denial; 2. of the entire file, including any new materials and arguments submitted since the initial denial; 3. rendered in consultation with a health care professional who has expertise in the field of medicine involved in the medical judgment, if the initial denial was made in consultation with a health care professional and the denial was based in whole or part on a medical judgment; and 4. rendered with the consultation of a health care professional who was not the individual consulted during the initial claim review that is the subject of the appeal, nor a subordinate of that individual, if the initial denial was made in consultation with a health care professional. Additional documents may be requested from you or your doctor as necessary during the review. If a decision cannot be reached within the 45 day period, you will be notified. In any event, a decision will be made within 90 days after receipt of the request for review. If it is determined that benefits or additional benefits are due, payment will be made promptly. Effective 07/01/2013 13 Short Term Disability
Formal Appeals Process Second Level Review (continued) If your appeal is denied on review, the Claims Administrator will furnish you with a written notice which will contain: 1. the specific reason or reasons for the denial; 2. references to pertinent Plan provisions on which the denial was based; 3. your entitlement to receive, upon request and free of charge, reasonable access to and copies of documents and other information relevant to the claim; 4. references to internal rules, guidelines, protocols or similar criterion which were relied upon in making the determination and, if not specifically set forth, your right to receive free of charge upon request copies of the rules, guidelines, protocols or other criterion which were relied upon; 5. if applicable, the identity of any medical or vocational professional(s) whose advice was obtained on behalf of the Plan in connection with the determination to deny benefits, whether or not the advice was relied upon in making the determination; and 6. your right to bring civil action under Section 502(a) of ERISA. Voluntary Appeal If you have completed all appeal processes, you may proceed with a voluntary appeal or pursue any available remedies under 502(a) of ERISA or under state law, as applicable. Subject to verification procedures that the Plan may establish, your Authorized Representative may act on your behalf in filing and pursuing a voluntary appeal. You or your Authorized Representative may pursue an external review. If you file a voluntary appeal to the Plan, any applicable statute of limitations will be tolled while the appeal is pending. The filing of a claim will have no effect on your rights to any other benefits under the Plan. However, the appeal is voluntary and you are not required to undertake it before pursuing legal action. Effective 07/01/2013 14 Short Term Disability
Voluntary Appeal (continued) How to File a Voluntary Appeal for an External Review You may submit your voluntary appeal in writing to Matrix at the address provided below: Matrix Absence Management, Inc. Claims and Appeals Department 181 Metro Dr Ste 300 San Jose CA 95110 Phone: (408) 360-8370; (800) 980-1006 Fax: (408) 360-9441 If you choose not to file for voluntary review, the Plan will not assert that you have failed to exhaust your administrative remedies because of that choice. You may file a voluntary appeal for External Review of any Adverse Benefit Determination or any Final Internal Adverse Benefit Determination that qualifies as set forth below. The Request for External Review Form must be submitted to Matrix within four (4) months following the date of a notice of an Adverse Benefit Determination or Final Internal Adverse Benefit Determination. If the last filing date falls on a Saturday, Sunday or Federal holiday, the last filing date is extended to the next day that is not a Saturday, Sunday or Federal holiday. You must include a copy of the notice and all other pertinent information that supports your request. If you file a voluntary appeal, any applicable statute of limitations will be tolled while the appeal is pending. The filing of a claim will have no effect on your rights to any other benefits under the Plan. However, the appeal is voluntary and you are not required to undertake it before pursuing legal action. The External Review process under this Plan gives you the opportunity to receive a review of an Adverse Benefit Determination (including a Final Internal Adverse Benefit Determination) conducted pursuant to applicable law. Your request will be eligible for External Review if the following are satisfied: Level one appeal has been exhausted; or The appeal relates to a rescission, defined as a cancellation or discontinuance of the benefit which has retroactive effect. Effective 07/01/2013 15 Short Term Disability
How to File a Voluntary Appeal for an External Review (continued) An Adverse Benefit Determination based upon your eligibility is not eligible for External Review. If the benefit denial is upheld by a level one appeal and it is determined that you are eligible for External Review, you will be informed in writing of the steps necessary to request an External Review. An independent review organization will refer the case for review by a neutral, independent clinical reviewer with appropriate expertise in the area in question. The decision of the independent external expert reviewer is binding on you, Matrix and the Plan unless otherwise allowed by law. Preliminary Review Within five (5) business days following the date of receipt of the request, Matrix must provide you with a preliminary review determining: the determination does not relate to eligibility; you have exhausted the internal appeals process (unless Deemed Exhaustion applies); and you have provided all paperwork necessary to complete the External Review. Within one (1) business day after completion of the preliminary review, Matrix will issue to you a notification in writing. If the request is complete but not eligible for External Review, the notification will include the reasons for its ineligibility and contact information for the Employee Benefits Security Administration (toll-free number 866-444- EBSA (3272)). If the request is not complete, the notification will describe the information or materials needed to make the request complete and Matrix must allow you to perfect the request for External Review within the four (4) month filing period or within the 48 hour period following the receipt of the notification, whichever is later. Effective 07/01/2013 16 Short Term Disability
Referral to ERO Matrix will assign an accredited Independent Review Organization/External Review Organization ( ERO ) as required under federal law, to conduct the External Review. The assigned ERO will: timely notify you in writing of the request s eligibility and acceptance for External Review; and, provide you with an opportunity, within ten (10) business days following the date of receipt, to submit additional information that the ERO must consider when conducting the External Review. Within one (1) business day after making the decision, the ERO will notify you, Matrix and the Plan. Upon receipt of a notice of a Final External Review Decision reversing the Adverse Benefit Determination or Final Internal Adverse Benefit Determination, the Plan will provide payment (including immediately authorizing or immediately paying benefits) for the claim. ERISA Your rights as a participant in the Plan are protected by the Employee Retirement Income Security Act of 1974, as amended (ERISA). See the Eligibility and Overview of Coverage Options section for details about your rights and the rights of Matrix, the Plan Administrator, The Capital Group Companies, Inc., and the Plan under the law. No action at Law or in Equity may be brought to recover under the Plan until the appeal rights herein provided have been exercised and the plan benefits in such appeal have been denied in whole or in part. No action at Law or in Equity may be brought in court on a claim for benefits under the Plan after 365 days following the decision on appeal (or 365 days following the expiration of the time to take an appeal if no appeal is taken). Effective 07/01/2013 17 Short Term Disability