MMC Benefits Handbook
How the Benefits Handbook Is Used
Claims Administrators (or Account Administrator or Plan Administrator, as applicable)
The Claims Administrator (or Account Administrator or Plan Administrator, as applicable) for each plan described in the Benefits Handbook uses the description of the applicable plan in the Benefits Handbook to make determinations on claims for benefits under the plan and processes the claims. (Should any plan provision described become invalid or unenforceable, it will not affect the validity or enforceability of any other plan provision.) When necessary, the Claims Administrators (or Account Administrators or Plan Administrator, as applicable) may also refer to their internal guidelines and other formal documents such as insurance policies, certificates of insurance, and benefits summaries in making claims/benefits determinations. Such other documents are available to you upon request without any cost. The Claims Administrator or Account Administrator or Plan Administrator, as applicable, has full discretion and authority to make all such claims/benefits determinations.
Unless the Plan Administrator has delegated such authority to a Claims Administrator or Account Administrator, the Plan Administrator shall have complete authority to interpret and construe the provisions of the plans, make findings of fact, correct errors, and supply omissions. All decisions and interpretations of the Plan Administrator made pursuant to the plan shall be final, conclusive, and binding on all persons and may not be overturned unless found by a court to be arbitrary and capricious.
Conflicts in Terms
Unless otherwise noted, for a self-insured benefit, if there is a conflict between a specific provision under the Benefits Handbook and a benefit booklet/summary, the Benefits Handbook controls. For fully insured benefits, the terms of the certificate of insurance/evidence of coverage or insurance policy will control when describing specific benefits that are covered or insurance-related terms.
Headings, Navigation Menus, Tables of Contents, Etc.
Note that the various headings and sub-headings in the Benefits Handbook (which produce the website navigation menus and the tables of contents in the printed version) are provided for your convenience and in no way define, limit, or otherwise describe the scope or intent of the plans.