DISABILITY

Filing a Claim

To apply for Valassis Disability Plan benefits, follow these steps:

• Notify your supervisor as soon as you know you will be absent from work because of an illness or injury.
  
  
• Keep your supervisor informed of your progress.
  
  
• If your disability is expected to last for more than 15 days, contact your Human Resources Representative or the Associate Resource Center (ARC) at 877-238-6847. You will then be instructed to call Sun at 1-800-247-6875 or https://www.sunlife-usa.net/claims/claimsOnline/index.cfm to file a claim.

• You should make sure that your doctor has a medical authorization on file. This form allows your doctor to discuss your progress with the disability carrier to help process claims and get you back to work as soon as you are healthy.

The Sun Life's program brochure is available here.

If you are applying for LTD benefits, Sun Life will help you to file the necessary claim forms.

You will receive a written decision on your claim within a reasonable time after Sun Life receives your claim. If you do not receive a decision within 45 days after they receive your claim, you may immediately request a review as though your claim had been denied.

Once the benefits have been approved, Sun Life will periodically review your medical condition. Insurance representatives will also work with you to help you return to work through a rehabilitation program. While you are receiving Valassis Disability Plan benefits, your claim will be paid according to policy provisions.

Sun Life may require periodic proof of the continuation of total disability from your physician or may require you to be examined by a physician of its choice. If an examination is required, Sun Life will pay for the cost of such an exam.

If Your Claim Is Denied
In the event that your claim is denied, either in full or in part, the Plan Administrator will notify you in writing within 45 days after your claim form was filed. Under special circumstances, the Plan Administrator is allowed two additional periods of 30 days each (105 days in total) within which to notify you of its decision. If such an extension is required, you will receive a written notice indicating the reason for the delay and the date you may expect a final decision. If extra time is required to make a decision because you need to submit additional information, you will have 45 days to submit that information. If you deliver that information within the 45 days, the 30-day extension period will start when your additional information is received. If your claim is denied, the notice of denial shall include:

• The specific reason or reasons for denial with reference to those plan provisions on which the denial is based;

• A description of any additional material or information necessary to complete or perfect the claim and an explanation of why that material or information is necessary;

• A description of plan procedures and time limits for appealing the decision;

• The disclosure of any internal rule or guideline that was relied on in making the decision; and

• A statement letting you know that you have the right to sue in federal court, following the denial of your claim on appeal.

Please note that if the Plan Administrator does not respond to your claim within the time limits set forth above, you should assume that your claim has been denied and you should begin the appeal process at that time.

Appealing a Denied Claim
You, or your authorized representative, may appeal a denied claim within 180 days after you receive the Plan Administrator's notice of denial. You have a right to:

• Submit a request for review in writing to the Plan Administrator;

• Review or make copies of all relevant documents upon request and free of charge; and

• Submit written comments, documents or other information in support of your appeal.

The appeal will not take into account the original decision, and it will be conducted by a different person from the person who made the original decision. In addition, the person reviewing your appeal will not report to the person who made the initial decision. The review will take into account any new information, even if that information wasn't available for the initial decision. If the appeal is denied based on a medical judgment, the reviewer will consult with a health professional who has appropriate training and experience. A final decision on the review shall be made not later than 45 days following receipt of the written request for review, unless special circumstances require more time for processing. If additional time is needed, you will be notified of the need for additional time and why, but the extension cannot be more than 45 days.

The person reviewing your appeal may require additional documents from you. If more information is requested from you, you will have 45 days to deliver it. If you deliver the information within this time period, then the 45-day extension for the review will begin when your additional information is received.

The final decision on your appeal shall be furnished in writing and shall include the reasons for the decision with reference, again, to those Plan provisions upon which the final decision is based. You will receive access to the documents and information relevant to the determination or copies of these documents without charge. The decision will also list any internal rule or guideline that was used in making the decision, as well as a statement describing your right to bring a civil suit under federal law. The decision on your appeal will also state that there may be other voluntary ways to settle your dispute, such as mediation, and will advise you who to contact to find out about those methods.