Claims Relating to Eligibility
If you have a claim relating to your length of service, status, or membership in the Postretirement Life Insurance Plan that has been denied by Metropolitan Life Insurance Company, you will receive written notice of the denial within 90 days of receipt of the initial claim unless, due to special circumstances, an additional 90 days is required. Such notification will include:
  • the specific reason(s) for the denial of the claim;
  • a reference to the Plan provision(s) which apply to the denial;
  • a description of any additional material or information necessary for a participant or beneficiary to perfect the claim and an explanation of why such material or information is necessary;
  • a description of the Plan's review procedures and the time limits applicable to such procedures; and
  • a statement of the participant's or beneficiary's right to bring a civil action under section 502(a) of ERISA following an adverse benefit determination on review.
Appeals
If you are not satisfied with Metropolitan Life Insurance Company's decision regarding your length of service, status or membership in the Plan, you may submit a written appeal to the Employee Benefit Appeals Committee (EBAC).
Send your appeal to:
Pacific Gas and Electric Company
Benefits Department
EBAC Appeals
1850 Gateway Boulevard, 7th Floor
Concord, CA 94520
Your appeal to EBAC must be received within 90 days of your receipt of the denial of your claim by Metropolitan Life Insurance Company.
No special form or format is required in submitting a written appeal; you may submit written comments, documents, records and other information relating to your claim. You may also request, free of charge, access to, or copies of, all documents, records and other information relevant to your claim for benefits. The review of your appeal will take into account all comments, documents, records and other information submitted by you relating to your claim, without regard to whether such information was submitted or considered at the initial benefit determination. Please note, however, that it is the obligation of EBAC to administer the Plan fairly, consistently, and in accordance with the provisions of the Plan.
If EBAC denies your appeal, you will receive a written response which will include:
  • the reason(s) for the denial of the claim;
  • a reference to the Plan provision(s) which apply to the denial;
  • 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 your claim for benefits;
  • an explanation of any voluntary appeal procedures and your right to obtain information about such procedures; and
  • a statement of your right to bring an action under section 502(a) of ERISA.
You will receive a final ruling from EBAC within 60 days of EBAC's receipt of your appeal unless, due to special circumstances, EBAC requires additional time to respond, up to another 60 days.
You may bring an action under section 502(a) of ERISA only after you have exhausted all levels of review on appeal.