CLAIMS PROCEDURES

If you do not receive the benefits you expected or if your application for benefits is denied, you may file a claim for benefits with the Retirement Fund. You can file a claim by writing a letter to the following address: YMCA Retirement Fund, Attn: Claims Review Panel, 140 Broadway, New York, NY 10005.

If you file a claim for benefits and your claim is denied, you will receive a written determination from the Claims Review Panel of the Retirement Fund. If you wish to appeal the decision, you may do so in writing to the Board’s Benefits and Operations Committee. The Benefits and Opera­tions Committee will review your appeal and notify you in writing of their decision regarding the claim. If your claim is for disability retirement benefits, separate procedures apply and your claim will be processed by the Disability Administrator, an insurance carrier.

For full details of our claims procedures, please see below.

CLAIMS PROCEDURES FOR THE YMCA RETIREMENT FUND RETIREMENT PLAN AND THE YMCA RETIREMENT FUND TAX-DEFERRED SAVINGS PLAN

Set forth below are claims procedures with respect to the YMCA Retirement Fund Retirement Plan (“Retirement Plan”) and the YMCA Retire­ment Fund Tax-Deferred Savings Plan (“Savings Plan”) (collectively, the “Plan”), sponsored by the YMCA Retirement Fund (“Fund”). There are separate procedures for general claims and for disability claims.

General claims will initially be reviewed by the Claims Review Panel, which is made up of members of the YMCA Retirement Fund Manage­ment who have been appointed by the President. Appeals of the Claims Review Panel’s determination will be heard by the Benefits and Opera­tions Committee, which is comprised of members of the YMCA Retirement Fund Board of Trustees.

Disability claims will be reviewed by the Disability Administrator, the insurer selected by the YMCA Retirement Fund. The Board of Trustees, or its delegate, has the exclusive right to interpret the Plan, and its decisions are conclusive and binding upon all parties.

Beginning July 1, 2006, the Retirement Plan, but not the Savings Plan, became subject to the Employee Retirement Income Security Act of 1974, as amended (“ERISA”). The below claims procedures are intended to comply with ERISA §503 and ERISA Regulations §2560.503-1(a)­(i). The following claims procedures are effective for Retirement Plan benefit claims filed on or after July 1, 2006.

GENERAL CLAIMS PROCEDURES

The Board and Fund Management will endeavor to administer the Plan fairly and consistently and to pay all benefits that Participants or benefi­ciaries are properly entitled to receive. To this end, the Claims Review Panel and the Benefits and Operations Committee will apply administra­tive processes and safeguards designed to ensure that (1) benefit claim determinations are made in accordance with the Plan documents; and (2) plan provisions are applied consistently with respect to similarly situated individuals.

How Do You Bring a Claim?

You, your beneficiary or anybody authorized to act on your behalf, have the right to bring a claim for benefits. If for any reason you wish to file such a benefits claim, it must be made in writing to the Claims Review Panel, which will review claims. You may mail your benefits claims to the following address: YMCA Retirement Fund, Attn: Claims Review Panel, 140 Broadway, New York, NY 10005.

How Will You Know When Your Claim is Determined?

If your claim is approved, you will receive benefits and a notification from a representative of the Fund that your claim is approved.

The Claims Review Panel will notify you in writing within 90 days after receiving the claim if it makes an “adverse benefit determination.” The term “adverse benefit determination” includes any of the following: a denial, reduction, or termination of a benefit.

If special circumstances warrant extension of the 90-day processing period, the Claims Review Panel will notify you within the initial 90-day period and indicate the date that the benefit determination will be rendered. Extensions cannot be longer than 90 days after the end of the initial 90-day period beginning when the claim is filed. You may also agree to a further extension of the time period within which the Claims Review Panel must decide the claim.

Notice that your claim is denied will include: (1) the specific reason or reasons for the denial; (2) the specific Plan provisions or documents that the denial is based on; (3) a description of additional material or information that you must provide to assert the claim and an explanation as to why you must do so; (4) a description of the Plan’s review procedures and relevant time limits; (5) a statement of your right to appeal the Claims Review Panel’s decision within 60 days of the “adverse benefit determination” to the Benefits and Operations Committee. You will be notified of the Claims Review Panel’s decision as soon as possible, but no later than five (5) days after the benefit determination.

What Are Your Rights if Your Claim is Denied?

1. After receipt of a notice denying a claim for benefits, you may appeal the Claims Review Panel’s decision to the Benefits and Operations Committee. In order to do so, you must submit a written request for review to the Benefits and Operations Committee within 60 days af­ter the date that the denial is received. You may also submit written comments, documents, records and other information related to the claim for benefits in the appeal. In addition, after receipt of a notice denying a claim for benefits, you have a right, upon request and free of charge, to review and receive copies of all documents, records and other information relevant to the claim for benefits. A document, record or other information is "relevant" for this purpose if: (1) it was relied upon in making the benefit determination; (2) it was submit­ted, considered or generated in the course of making the benefit determination (even if it was not relied upon in making the benefit de­termination); and (3) it demonstrates compliance with the administrative processes and safeguards in making the benefit determination.
2. Upon receipt of an appeal, the Benefits and Operations Committee will examine your claim, along with all comments, documents, re­cords and other information that you submit relating to the claim, regardless of whether it was submitted or considered in the initial bene­fit determination. The Benefits and Operations Committee must then make a benefit determination no later than the date of the Benefits and Operations Committee quarterly meeting that follows the Fund’s receipt of a request for a review. If a request for review is filed within 30 days before the meeting date, then the benefit determination may be made no later than the date of the second meeting follow­ing the Fund’s receipt of the request for review. If special circumstances (such as the need to hold a hearing) as determined by the Benefits and Operations Committee require a further extension of time for processing, a benefit determination will be made not later than the third meeting of the Benefits and Operations Committee following the Fund's receipt of the request for review. If an extension is needed, you will be provided with written notice of the extension, describing the special circumstances and the date as of which the benefit determination will be made, prior to the commencement of the extension. You may also agree to a further extension of the time period within which the Benefits and Operations Committee must decide the claim. You will be notified of the Benefits and Operations Committee decision concerning your appeal as soon as possible, but no later than five (5) days after the benefit determination.
3. The Benefits and Operations Committee’s final decision will be in writing. If your claim on appeal is approved, you will receive benefits and a notification from the Benefits and Operations Committee that your claim is approved. If your appeal is denied, the notice must in­clude: (1) the specific reason or reasons for the denial; (2) the specific plan provision on which the determination was based; (3) a statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the your claim for benefit, and (4) a statement that you have the right to bring a civil action under ER­ISA § 502(a) following a denial of your appeal by the Benefits and Operations Committee. See paragraph (a) above for a description of what information is "relevant."
4. You are prohibited from filing a lawsuit concerning your benefit claim until you have exhausted the claim procedures described above. This provision is enforceable under ERISA with respect to Retirement Plan benefit claims.

Contact Information for General Claims:

Claim requests may be submitted to the Claims Review Panel at the below address:

YMCA Retirement Fund
140 Broadway, 28th Floor
New York, NY 10005-1197
Attention: Claims Review Panel

Facsimile: 646-458-2550

Appeal requests may be submitted to the Benefits Committee at the below address:

YMCA Retirement Fund
140 Broadway, 28th Floor
New York, NY 10005-1197
Attention: Benefits and Operations Committee

Facsimile: 646-458-2550

DISABILITY RETIREMENT CLAIMS PROCEDURES

How Do You Bring a Disability Retirement Claim?

The Fund has retained an insurance company specializing in disability benefits to act as the claims fiduciary and assist in processing disability claims ("the Disability Administrator").

You or anyone authorized to act on your behalf has the right to file a claim for disability retirement benefits with the Disability Administrator. If for any reason you wish to file a claim for disability retirement benefits, it must be made in writing to the Disability Administrator on the disability forms provided by the YMCA Retirement Fund. (You can obtain the disability forms by calling the Retirement Fund Customer Service Department.)

How Will You Know When Your Disability Retirement Claim is Determined?

If your claim is approved you will receive written notification from the Disability Administrator. Alternatively, if the Disability Administrator makes an “adverse benefit determination,” you will receive written or electronic notification within 45 days of the decision. The term “adverse benefit determination” means any of the following: a denial, reduction, or termination of, or a failure to provide or make a payment (in whole or in part) for a disability retirement benefit.

If it is determined that special circumstances warrant extension of the 45 day processing period, the Disability Administrator will notify you dur­ing the initial 45 day period and advise you of the expected benefit determination date. The initial extension of time cannot be longer than 30 days after the end of the initial 45 day processing period.

If the Disability Administrator determines that a decision cannot be made before the end of the initial 30 day extension period, then the period for making the decision may be extended for an additional 30 days. Both the initial 30 day extension and any subsequent 30 day extension must be necessary (as determined by the Disability Administrator within its discretion) due to matters beyond the control of the Disability Administrator, the Fund or the Retirement Plan.

The Disability Administrator will notify you of the need for a 30 day extension of the processing period before the expiration of the initial 45 day processing period and/or the initial 30 day extension. The notice will specifically explain the standards on which entitlement to a benefit is based, the unresolved issues that prevented deciding the disability retirement claim, and the additional information needed to resolve those issues. You will be given at least 45 days to provide the information or to submit to a requested examination.

If an extension occurs because you did not submit information, the period for making the benefit determination will be extended from the date that the Disability Administrator sent the extension notice to you until the date that the Disability Administrator receives your response to the request for additional information or the date the extension period ends, whichever is earlier.

Notice that a disability retirement claim is denied will include: (1) the specific reason or reasons for the denial; (2) the specific Retirement Plan provision(s) or document(s) upon which the denial is based; (3) a description of any additional necessary material or information that you must provide to perfect the claim and an explanation as to why such material or information is necessary; (4) an explanation of any scientific or clini­cal judgment relied upon to decide the claim or a statement that such an explanation will be provided free of charge; (5) any internal rule, guideline, protocol, or other similar criterion relied upon to make the adverse benefit determination or a statement that the rule, guideline, pro­tocol or other similar criterion was relied upon and that you may receive a free copy of it upon request; (6) a description or copy of these proce­dures and relevant time limits; (7) a statement that you have a right to appeal the Disability Administrator’s decision; and (8) a statement of your right to bring a civil action under ERISA following a denial of your appeal.

What Are Your Rights if Your Disability Retirement Claim is Denied?

1. After receipt of a notice denying a claim for disability retirement benefits (or failure to receive notice that a claim was denied or approved within the applicable time limits, which is considered a denial), you may appeal the Disability Administrator’s decision.
2. In order to appeal, you must submit a written request for review to the Disability Administrator within one hundred and eighty (180) days after you receive the denial notice. You may also submit written comments, documents, records and other information related to the dis­ability claim in the appeal. In addition, after receipt of a denial notice, you have the right, upon request and free of charge, to review and receive copies of all documents, records and other information relevant to the disability claim. A document, record or other information is “relevant” for this purpose if: (1) it was relied upon in making the benefit determination; (2) it was submitted, considered or generated in the course of making the benefit determination (even if it was not relied upon in making the benefit determination); and (3) it demon­strates compliance with the administrative processes and safeguards in making the benefit determination.
3. The disability claim for will be reviewed anew on appeal. No deference will be given to the original denial. The review will be conducted by the Disability Administrator’s review committee that is separate from (and not subordinate to) the Disability Administrator reviewing body that denied your original disability claim. If the decision is based in whole or in part on a medical judgment, including determina­tions with regard to whether a particular treatment, drug or other item is experimental, investigational, or not medically necessary or ap­propriate, then the review will include consultation with a health care professional who has appropriate training and experience in the field of medicine involved, and who has not consulted with respect to (and is not subordinate to someone who has consulted with re­spect to) the original denial. Upon your request, any medical, or vocational experts consulted in connection with the disability retirement claim will be identified, without regard to whether their advice was relied upon in making the determination.
4. Upon receipt of an appeal, the Disability Administrator will review the disability retirement claim anew, along with all comments, docu­ments, records and other information submitted by you relating to the claim, regardless of whether such items were submitted or con­sidered in the initial benefit determination. The Disability Administrator must then issue a final decision within 45 days after the date that you filed an appeal in accordance with these procedures. The clock begins running on the date that you properly file a written appeal, regardless of whether you included all of the information necessary to make a benefit determination on your appeal. The Disability Ad­ministrator has discretion to extend this period because of a lack of information necessary to make a decision. If the Disability Adminis­trator determines that special circumstances require an extension of the 45 day period, the Disability Administrator must notify you in writing before the end of the initial 45 day period, indicating the special circumstances warranting an extension for processing the appeal and the expected date of the benefit determination. The extension may not be more than 45 days after the end of the initial 45 day pe­riod. If an extension occurs because of your failure to submit needed information, the period for making the benefit determination on re­view will be extended from the date the Disability Administrator sent the extension notice to you until the date the Disability Administrator receives your response to the request for additional information or the date the extension period ends, whichever is earlier.
5. The Disability Administrator will provide you with written or electronic notification of its final decision. If your appeal is approved, you will receive benefits or a short letter from the Disability Administrator advising you of the approval. If your appeal is denied, the denial notice will include: (1) the specific reason or reasons for the denial; (2) the specific Retirement Plan provision(s) or document(s) upon which the denial is based; (3) a statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the claim for benefits; (4) a statement that you have the right to bring a civil ac­tion under ERISA; (5) a statement that a specific internal rule, guideline, protocol or other similar criterion was relied upon in making the adverse benefit determination and that, upon request, a copy of the specific internal rule, guideline, protocol or similar criterion will be provided to you free of charge; and (6) if the adverse benefit determination is based upon a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the determination, applying the terms of the Re­tirement Plan to your medical circumstances, or a statement that such explanation will be provided free of charge upon request.
6. A document, record or other information is “relevant” for this purpose if: (1) it was relied upon in making the benefit determination; (2) it was submitted, considered or generated in the course of making the benefit determination (even if it was not relied upon in making the benefit determination); and (3) it demonstrates compliance with the administrative processes and safeguards in making the benefit de­termination.
7. You are prohibited from filing a lawsuit concerning your disability claim until you have exhausted the claim procedures described above. This provision shall be enforceable under ERISA beginning July 1, 2006 with respect to Retirement Plan disability claims.

Contact Information for Disability Retirement Claims:

Disability claim forms may be obtained from the YMCA Retirement Fund (Telephone number 1-800-738-9622) and submitted to the Disability Administrator at the address listed below:

Liberty Life Assurance Company of Boston
Disability Claims
P.O. Box 1525
Dover, NH 03821-0268
Facsimile: 603-743-6422

Disability retirement appeal requests should be submitted to the Disability Administrator at the below address:

Liberty Life Assurance Company of Boston
Disability Claims
P.O. Box 1525
Dover, NH 03821-0268
Facsimile: 603-743-6422

Compliance with Applicable Laws:

The above claims procedures are intended to comply with ERISA § 503 and the U.S. Department of Labor Regulation § 2560.503-1 and shall be construed, interpreted and applied in accordance with such Section. Electronic notifications with respect to benefit claims will be made in compliance with applicable law.

Additional Information

If you have any questions about the Retirement Plan which are not answered by this summary, please contact the plan administrator at 1 (800) RET-YMCA, Monday through Friday 8:30am – 6:00pm (EST). You should also review the summary of your legal rights under the federal pension law which appears in Appendix A of the Retirement Plan.