Berkeley Municipal Code Art. 7 Administration

The administration of the plan shall be under the supervision of the administrator. It shall be a principal duty of the administrator to see that the plan is carried out, in accordance with its terms, for the exclusive benefit of persons entitled to participate in the plan without discrimination among them. The administrator will have the full power to administer the plan in all of its details, subject to applicable requirements of law. For this purpose, the administrator’s powers will include, but will not be limited to, the following authority, in addition to all other powers provided by this plan:

A. 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;

B. To interpret the plan, its interpretation thereof in good faith to be final and conclusive on all persons claiming benefits under the plan;

C. To decide all questions concerning the plan and the eligibility of any person to participate in the plan;

D. To appoint such agents, counsel, accountants, consultants and other persons as may be required to assist in the administration of the plan;

E. To allocate and delegate its 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 by written instrument and in accordance with applicable requirements of law.

F. To determine a claims procedure under which participants may apply for reimbursement of dependent care expenses; and

G. To determine the eligibility of dependent care expenses for reimbursement under this plan. (Ord. 5851-NS § 1 (part), 1988)

The administrator will make available to each participant such of its records under the plan as pertain to them, for examination at reasonable times during normal business hours. (Ord. 5851-NS § 1 (part), 1988)

In administering the plan, the administrator shall be entitled to the extent permitted by law to rely conclusively on all tables, valuations, certificates, opinions and reports which are furnished by accountants, counsel, or other experts employed or engaged by the administrator. (Ord. 5851-NS § 1 (part), 1988)

The City agrees to indemnify and to defend to the fullest extent permitted by law any employee serving as administrator (including any employee or former employee who formerly served as such) against all liabilities, damages, costs and expenses (including attorney’s fees and amounts paid in settlement of any claims approved by the City) occasioned by an act or an omission to act in connection with the plan, if such act or omission is in good faith. (Ord. 5851-NS § 1 (part), 1988)

Any person whose claim for benefits under the plan has been denied in whole or in part shall receive a notice from the administrator setting forth the specific reasons for such denial, specific references to the plan provisions on which the denial was based and an explanation of the procedure for review of the denial. Such person, or such person’s duly authorized representative, may appeal to the administrator for a review of the denial by sending to the administrator a written request for review within sixty days after receiving notice of the denial. The administrator shall give the claimant the opportunity to review pertinent documents in preparing such request. The request for review shall set forth all grounds on which it is based, together with supporting facts and evidence which the claimant deems pertinent. The administrator may require the claimant to submit such additional facts, documents or other material as it deems necessary or advisable in making its review of the denial. Within sixty days after the receipt of the request for review, the administrator shall communicate its decision to the claimant in writing (unless there has been an extension of up to sixty days due to special circumstances, provided the delay and the special circumstances occasioning it are communicated to the claimant within the first sixty day period), and if the administrator confirms the denial, in whole or in part, the communication shall set forth the reasons for the decision and specific references to the plan provisions on which the decision is based. (Ord. 5851-NS § 1 (part), 1988)

If any person to whom any payment shall be due under the plan shall be a minor, or shall be or become in the judgment of the administrator, physically or mentally incompetent, the administrator shall have the right to determine to whom such payments shall be made for the benefit of such person. Written receipt of the person to whom any such payment is made shall be a complete discharge of the obligation for any sum paid. (Ord. 5851-NS § 1 (part), 1988)