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Administration > Short-term Disability Plan
Short-term Disability Plan
Short-term Disability benefits are self-funded by the Company and are administered by:
Hartford Life
P.O. Box 2999
Hartford, CT 06104
Request for Review
To request a review of a denial of a Short term Disability claim, follow these steps:
Step One: Appeal to Claims Administrator
Hartford Life
Attn: Disability Claim Appeal Unit
Business Management Services—B2E
P.O. Box 2999
Hartford, CT 06104
If your claim is wholly or partially denied, you will be notified of the decision within 45 days after the Claim Administrator's receipt of your claim. Under special circumstances, the notice period may be extended for 30 days.
If an extension is required, you will be notified of the special circumstances involved and the date by which the Claims Administrator expects to render a final decision. If the Claims Administrator determines that a decision cannot be made within the original 30-day extension, the notice period may be extended for another 30 days. If a second 30-day extension is required, you will be notified of the special circumstances involved and the date by which the Claims Administrator expects to make a decision. If the extension of time is required because you failed to provide information necessary to decide the claim, the notice of extension will describe the additional required information and you will be allowed at least 45 days from receipt of the notice of extension to provide the specified information.
If your claim is denied, the Claims Administrator will provide you with a written or electronic notification of any adverse benefit determination. The notice will:
  • Provide the specific reason(s) for the denial
  • Refer to the specific plan provisions on which the denial is based
  • Describe any additional information necessary for you to complete your claim and explain why such information is necessary
  • Describe the plan's review procedure and time limits that apply to your right to appeal, including your right to bring a civil action under Federal law following an adverse benefit determination on review
  • If the plan relied on a specific internal rule or guideline to make the adverse determination, provide (1) an explanation of the rule or guideline, or (2) a statement that a specific rule or guideline was relied upon and that a copy of the rule will be provided to you free of charge upon request.
  • Within 180 days after you receive a notice of the decision on your claim, you or your authorized representative may request a review of a denied claim by submitting a written request for review to the Employee Benefits Administration Committee (EBAC).
Step Two: Appeal to the Employee Benefit Administration Committee (EBAC)
  • Your appeal must be sent in writing to:
The Employee Benefits Administration Committee
Diageo N.A., Inc.
801 Main Avenue
Norwalk, CT 06851
  • You or your authorized representative may review any relevant documents, and submit additional information as may be appropriate. You may also submit, in writing, the reasons that you think your claim should not be denied including the reasons you believe you are entitled to benefits, together with any other supporting documents.
  • Within 60 days after the date of your appeal is received, the EBAC will review the appeal. It will review all documents and information submitted and may request additional information and/or documents from Diageo NA personnel, its benefits providers, legal counsel, or other individuals relevant to the appeal. The Committee will send its decision, in writing, to the person requesting the review, including the specific reasons for the decision and references to the plan provisions on which it is based.
  • If special circumstances require more than 60 days to review your appeal, the total review time may be extended to 120 days. If you do not receive a final decision within 120 days of your appeal, you may consider your appeal denied.
 
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