MMC Benefits Handbook
Authority over Benefit Determinations and Appeals
Health and Welfare Plans
The Claims Administrator or Plan Administrator, as applicable, has full discretion and authority to determine all claims for benefits under the Marsh & McLennan Companies Health & Welfare Benefits Program, Marsh & McLennan Companies Group Benefits Plan, and the Marsh & McLennan Companies Retiree Reimbursement Account. Claims concerning plan eligibility or enrollment, rather than payment of specific benefits, should be addressed to the Plan Administrator. Any action or determination in this review procedure will be final, conclusive, and binding on the Claims Administrators, the Plan Administrators, the Company, the plan participant or beneficiary and his or her legal representative, and the participant or beneficiary's family members and their legal representatives.
For plan years beginning on or after January 1, 2015, claims for reimbursement under the Health Care Flexible Spending Account Plan, Limited Purpose Health Care Flexible Spending Account Plan, or Dependent Care Flexible Spending Account must be for expenses incurred no later than December 31st and submitted no later than March 31st of the year following the Plan Year to which the expense was attributable.
The determination as to whether you should receive the pending health service is determined by you and your physician.
No legal action for benefits may be brought by any participant or beneficiary unless the plan's claim review procedure has been exhausted (that is, all appeals of adverse decisions have been made). Any such action (whether at law, in equity or otherwise) must be commenced within one year. This one-year period shall be computed from the earlier of (a) the date a final determination denying such benefit, in whole or in part, is issued under the plan's claim review procedure and (b) the date such individual's cause of action first accrued.
Tax-qualified Retirement and Savings Plans
The Plan Administrator of the Marsh & McLennan Companies 401(k) Savings and Investment Plan, the Marsh & McLennan Companies Retirement Plan, and the Marsh & McLennan Agency 401(k) Savings & Investment Plan use the claims procedure described in this section of the Benefits Handbook to make determinations on claims for benefits under the applicable retirement or savings plan. The Plan Administrator has full discretion and the maximum authority permitted by law to interpret the applicable plan and make all initial claims/benefits determinations.
No legal action for benefits may be brought by any participant or beneficiary unless the plan's claim review procedure has been exhausted (that is, all appeals of adverse decisions have been made). Any such action (whether at law, in equity or otherwise) must be commenced within one year. This one-year period shall be computed from the earlier of (a) the date a final determination denying such benefit, in whole or in part, is issued under the plan's claim review procedure and (b) the date such individual's cause of action first accrued.