13 PLAN ADMINISTRATION The Plan Administrator shall be responsible for the general administration of the Plan , including the H ealth Benefit P rograms referenced above , and shall be the “Plan A dministrator” and “named fiduciary” within the meaning o f ERISA under the Plan and the Benefit P rograms (except to the extent another person or entity is specifically d esignated ; ) p rovid ed, however, for Fully Insured Benefit P rograms, unless specifically provided otherwi se in the Governing D ocuments, the Insurer shall be the “named fiduciary,” and claims fiduciary responsible for administering and determining benefits unde r such Benefit P rogram, and shall have full authority and discretion to interpret the terms of the Benefit P rogram for those purposes. With resp ect to the Plan , including the Welfare Benefit P rograms identified in this document , the Plan Administrator shall have, without limitation, the following discretionary authority, duties and powers: 1) To make and enforce such rules and regulations as it deems necessary or proper for the efficient administration of the Plan , including the establishment of any claims procedures that may be required by applicable provisions of law; 2) Except to the extent reserved to the Insurer w ith respect to a F ully Insured Benefit P rogram, to interpret the provisions of the Plan , make findings of fact, and correct errors in, supply omissions from, and resolve inconsistencies or ambiguities in the language of the Plan , and to decide all claims and appeals arising under the Plan ; 3) To decide all questions concerning the Plan and the eligibility of any person to participate in the Plan ; 4) To appoint such agents, counsel, accountants, consultants and other persons as may be required to assist in administering the Plan ; and 5) To allocate and delegate its fiduciary and administrative responsibilities under the Plan and to designate other persons to carry out any of its responsibilities under the Plan , any such allocation, delegation, or designation to be in writing. Without limitation, the Plan Administrator may designate other organizations or persons (who also may be employed by an Employer) to carry out the following: a. pursuant to an administrative services or claims administration agreement, the responsibility fo r administering and managing a Welfare Benefit P rogram or p rograms, including the processing and payment of claims under the Welfare Benefit Program and the recordkeeping related thereto; b. the responsibility to prepare, report, file and disclose any forms, documents and other information required to be reported and filed by law with any government agency or to be prepared and disclosed to Employees, Participants or other persons entitled to disclosure u nder the Benefit P rograms; and c. the responsibility to review cla ims or claim denials under the Benefit P rograms, including discretionary authority to act as claims fiduciary to determine adverse claims determinations within the meaning of Department of Labor Regulation § 2560.503 - 1.
2026 Benefits Guide by Snellings Walters Page 60 Page 62