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As Amended and Effective on January 1, 1988
Sponsored by The International Foundation of Employee
Benefit Plans
Reproduced with permission of the American
Arbitration Association
335 Madison Avenue, Floor 10, New York, NY 10017-4605
Phone 212-716-5800.
The American Arbitration Association
To facilitate the arbitration process, in accordance with
applicable laws, the American Arbitration Association (AAA) is available to
administer arbitration cases under various specialized rules.
The AAA is a public-service, not-for-profit organization
offering a broad range of dispute resolution services to business executives,
attorneys, individuals, trade associations, unions, management, consumers,
families, communities, and all levels of government. Services are available
through AAA head quarters in New York City and through offices located in major
cities throughout the United States. Hearings may be held at locations
convenient for the parties and are not limited to cities with AAA offices. In
addition, the AAA serves as a center for education and training, issues
specialized publications, and conducts research on all forms of out-of-court
dispute settlement.
It welcomes this latest opportunity to make its services
available to employee benefit plans by issuing these rules in cooperation with
the International Foundation of Employee Benefit Plans.
The AAA maintains throughout the United States panels of
arbitrators that include experts in all industries and professions. By arranging
for arbitration under these rules, parties may obtain the services of
arbitrators who are familiar with employee benefit plans.
The Association does not act as arbitrator. Its function
is to administer arbitrations in accordance with the agreements of parties and
to maintain panels from which arbitrators may be chosen by them. Once
designated, the arbitrator decides the issues and the award is final and
binding.
Inquiries about these rules may be addressed to the
International Foundation of Employee Benefit Plans, 18700 West Bluemound Road.
P.O. Box 69, Brookfield, WI 53008-0069 the telephone number is (414)
786-6701 or to any office of the AAA.
The International Foundation of Employee Benefit Plans
The Foundation was organized in 1994 and has grown and
developed steadily over the years to become the largest educational organization
in the employee-benefit field. Total membership includes some 23,000 individuals
representing 6,800 corporations, trust funds, public-employee groups, and
professional adversory firms.
Jointly administered labor-management employee-benefit
trust funds grew from the Taft-Hartley Act of 1947 and exist to provide
employees and their families and dependents with pensions upon retirement. They
are administered by boards of trustees on which labor and management are equally
represented. The boards receive contributions and distribute funds to employees
in the form of benefits, in accordance with provisions of collective-bargaining
and trust agreements and law. As such, the operation of employee-benefit trust
funds is an area of legal complexity.
These Rules
The Employee Retirement Income Security Act of 1974 (ERISA)
requires that all private pension and welfare plans establish a procedure to
"afford a reasonable opportunity to any participant whose claim for
benefits has been denied for a full and fair review. . . of the decision denying
the claim."
Many employee welfare and pension plans currently provide
for arbitration of benefit-claim disputes in their collective bargaining
agreements. For those plans that do not, the International Foundation of
Employee Benefit Plans has developed these rules in cooperation with the
American Arbitration Association.
Plan administrators may employ the rules so that
arbitration is required for all claims or they may provide that arbitration is
optional for the plan, the claimant, or both. If it is decided that arbitration
will be the required procedure to resolve all benefit-claim disputes, the
following clause may be made a part of the plan.
Any controversy or claim made on or after [the effective
date] arising from or relating to a claim for benefits payable by this plan
shall* be settled by arbitration administered by the American Arbitration
Association under its Employee Benefit Plan Claims Arbitration Rules,
incorporated by reference herein. The decision of the arbitrator shall be
final and binding and judgment on the award may be entered in any court having
jurisdiction.
* Options
(a) To make arbitration optional to the claimant, insert
after "shall"" at the option of the claimant".
(b) To make arbitration optional to the plan, insert after
"shall" "at the option of the Trustees".
(c) To make arbitration optional to the plan and the
claimant, insert after "shall" "upon the joint submission of the
Board of Trustees and the claimant".
1. The Agreement of the Parties
The parties shall be deemed to have made these rules a
part of their arbitration agreement whenever, in a Submission or document of a
pension or welfare plan (as defined in the Employee Retirement Income Security
Act of 1974), they have provided for arbitration by the American Arbitration
Association (hereinafter the AAA) or under its rules. These rules shall apply in
the form obtaining when the arbitration is initialed.
2. The Name of the Tribunal
Any tribunal constituted by the parties under these rules
shall be called the Employee Benefit Plan Claims Arbitration Tribunal.
3. The Administrator
When arbitration is provided for under these rules and an
arbitration is instituted thereunder, the AAA is authorized to administer the
arbitration. The authority and obligations of the administrator are provided in
these rules.
4. Delegation of Duties
The duties of the AAA may be carried out through such
representatives or committees as the AAA may direct.
5. The National Panel of Arbitrators
The AAA shall establish and maintain a National Panel of
Employee Benefit Plan Claims Arbitrators and shall nominate arbitrators
therefrom, as hereinafter provided.
6. The Office of the Tribunal
The general office of a tribunal is the headquarters of
the AAA, which may, however, assign the administration of an arbitration to any
of its regional offices.
7.
Initiation under an Arbitration Provision in a Benefit Plan
Any plan participant or beneficiary whose claim for
benefits has been denied, in whole or in part, may initiate an arbitration under
these rules by writing to any AAA office.
The request for arbitration should briefly outline the
nature of the claim. The request must be accompanied by a copy of the Denial of
Claim where available and by a filing fee of $150.
Upon receipt by the AAA of the request for arbitration
(demand) and the appropriate filing fee, the AAA shall send to the plan written
notice that arbitration has been requested. The notice shall state the name of
the applicant and the file number set forth on the Denial of Claim where
available. Upon receipt of written notice from the AAA, the plan shall send $350
to the AAA for its share of the filing fee.
8. Initiation under a Submission
An arbitration under these rules may, in the absence of an
arbitration provision in the plan, be initiated by filing at any regional office
of the AAA two copies of a written agreement to arbitrate under these rules
(submission), signed by the parties and setting forth the nature of the dispute
and the remedy sought, together with the appropriate filing fee as provided in Section
7.
9. Initiation and Filing Fees in Special Circumstances
In the event of extreme hardship on the part of any party,
the AAA may defer or reduce the filing fee.
10. Other Fees and Expenses
A fee of $50 is payable by each party for each second or
subsequent hearing that is either clerked by the AAA or held in a hearing room
provided by the AAA.
Other expenses of the arbitration, including required
traveling and other expenses of the arbitrator and of AAA representatives and
the expenses of any witness and the cost of any proof produced at the direct
request of the arbitrator, shall be borne equally by the parties, unless they
agree otherwise or unless the arbitrator in the award assesses such expenses or
any part thereof against any specified party or parties.
A fee of $50 for an adjournment of any scheduled hearing
is payable by the party causing same. If the adjournment is mutually requested
by the parties, the fee shall be borne equally.
11. The Arbitrator's Fee
Unless mutually agreed otherwise, the arbitrator shall be
compensated at an agreed per diem for each hearing or other conference,
for the making of the award, and for the preparation of the accompanying
statement of reasons for the award. Any arrangement for the compensation of the
arbitrator shall be made through the AAA and not directly by the arbitrator. In
the absence of agreement between the parties, an appropriate per diem
will be established by the AAA.
12. Grouping of Claims for Hearing
Claims involving common issues of fact against the same
plan may be scheduled for hearing before the same arbitrator whenever the
parties and the arbitrator so agree.
13. Locale of Hearing
Unless the parties otherwise agree, a hearing shall be
held at the AAA regional office closest to the administrative headquarters of
the plan. If that office is more than 200 miles from the principal residence of
the claimant, the hearing shall be held in either the AAA regional office or the
city of the US District Court nearest to the place of the participant's covered
employment under the plan or, if the participant is no longer employed, the
place of last covered employment. In cases of undue hardship, the AAA shall have
the final power to determine the locale of the hearing.
14. Number of Arbitrators
Unless mutually agreed otherwise by the parties, the
dispute shall be heard and determined by one neutral arbitrator.
15. Appointment from the Panel
The arbitrator shall be appointed in the following manner:
immediately after the filing of the demand or submission, the AAA shall submit
simultaneously to each party an identical list of names of persons chosen from
the National Panel of Employee Benefit Plan Claims Arbitrators. Each party shall
have seven business days from the mailing date within which to strike any name
on the list, number the remaining names to indicate the order of preference, and
return the list to the AAA. If a party does not return the list within the time
specified, all persons named therein shall be deemed acceptable. From among the
persons who have been approved on both lists, and in accordance with the
designated order of mutual preference, the AAA shall invite the acceptance of an
arbitrator to serve. If the parties fail to agree upon any of the persons named,
if those named decline or are unable to act, or if for any other reason the
appointment cannot be made from the submitted lists, the administrator shall
have the power to make the appointment from among the other members of this
panel without the submission of any additional list.
16. Qualifications of the Arbitrator
No person with a personal, financial, or other interest in
the outcome of the arbitration shall serve as arbitrator in any arbitration. An
arbitrator shall disclose to the AAA any circumstance likely to create a
presumption of bias that might disqualify that person from serving as an
impartial arbitrator. Upon receipt of such information, the AAA shall
immediately disclose it to the parties. If a party challenges an arbitrator, the
AAA shall determine whether the arbitrator should be disqualified and shall
inform the parties of its decision, which shall be conclusive. If an arbitrator
should resign, be disqualified, or be otherwise unable to perform the duties of
office, the AAA shall appoint another arbitrator to the case.
17. Oaths
Before proceeding with the performance of arbitral duties,
the arbitrator shall take an oath of office. The arbitrator has discretion to
require witnesses to testify under oath if requested by either party or if the
law so requires.
18. Conciliation
At the hearing, the arbitrator shall, if the parties
agree, attempt to conciliate the dispute. If the dispute is not resolved, the
arbitrator shall retain jurisdiction to hear and decide the dispute.
19. Time and Place
The arbitrator shall fix the time and place within the
determined locale for each hearing. The AAA shall mail to each party notice
thereof at least ten days in advance, unless the parties by mutual agreement
waive such notice or modify the terms thereof.
20. Hearing on Documents Only
The parties may agree in writing to waive an oral
arbitration hearing. Any hearing on documents only shall be conducted pursuant
to these rules and the administrative filing fee as provided in Section
7 shall apply.
21. Adjournments
A. request for an adjournment shall be made in writing to
the AAA. The arbitrator may for good cause shown adjourn the hearing upon the
request of a party or upon his or her own initiative, and shall adjourn when all
of the parties agree thereto.
22. Representation by Counsel
Any party may be represented by counsel or any other
person designated by the party in writing to the AAA.
23. Stenographic Records
Any party wishing a stenographic record shall make
arrangements directly with a stenographer and shall notify the other parties of
such arrangements in advance of the hearing. The requesting party or parties
shall pay the cost of such record.
24. Interpreters
Any party wishing an interpreter shall make all
arrangements directly with an interpreter and shall assume the costs of such
service.
25. Attendance at Hearings
Persons having a direct interest in the arbitration are
entitled to attend hearings. It shall be discretionary with the arbitrator to
determine the propriety of the attendance of any other person.
26. Evidence
The parties may offer such evidence as they desire and
shall produce such additional evidence as the arbitrator may deem necessary to a
determination of the dispute. The arbitrator shall be the judge of the relevance
and materiality of the evidence offered and strict conformity to legal rules of
evidence shall not be necessary. Documents, affidavits, memoranda, and other
written material offered by the parties may be considered by the arbitrator.
When authorized by law, the arbitrator may subpoena witnesses or documents upon
his or her own initiative or upon the request any party.
27. Arbitration in the Absence of a Party
The arbitration may proceed in the absence of any party
who, after due notice, fails to be present or fails to obtain an adjournment. An
award shall not be made solely on the default of that party. The arbitrator
shall require the other party to submit such evidence as may be required for the
making of an award.
28. Closing of Hearings
The arbitrator shall specifically inquire of all parties
whether they have any further proofs to offer or witnesses to be heard. Upon
receiving negative replies or if satisfied that the record is complete, the
arbitrator shall declare the hearings closed and a minute thereof shall be
recorded. If briefs are to be filed, the hearings shall be declared closed as of
the final date set by the arbitrator for the receipt of briefs. If documents are
to be filed as provided for in Section 26 and the
date set for their receipt is later than that set for the receipt of briefs, the
later date shall be the date of closing the hearings. The time limit within
which the arbitrator is required to make the award shall commence to run, in the
absence of another agreement by the parties, upon the closing of the hearings.
29. Reopening of Hearings
The hearings may be reopened on the motion of the
arbitrator or upon application of a party at any time before the award is made.
If the reopening of the hearings would prevent the making of the award within
the specific time agreed upon by the parties in the document out of which the
controversy has arisen, the matter may not be reopened unless the parties agree
upon the extension of that time. When no specific date is fixed in the document,
the arbitrator may reopen the hearings, and shall have thirty days from the
closing of the reopened hearings within which to make an award.
30. Time of the Award
Unless otherwise agreed to by the parties, the award shall
be made promptly and no later than thirty days from the date of closing the
hearings or, if the hearing has been on documents only, from the date of
transmittal of the final statements and proofs to the arbitrator.
31. Form and Scope of the Award
The award shall be in writing and accompanied by a brief
statement of the reasons for the decision.
The arbitrator may, in the award, assess administrative
filing fees, costs, expenses, arbitrator compensation, and reasonable
attorney fees in favor of any party. If any fees or expenses are due the
AAA, the arbitrator shall, in the award, assess them in favor of the AAA.
32. Delivery of the Award to Parties
The parties shall accept as legal delivery of the award
the placing of the award or a true copy thereof in the mail, addressed to the
parties or their designated representatives at the last known address, or any
other form of service permitted by law.
33. Applications to Court and Exclusion of Liability
(a) No judicial proceeding by a party relating to the
subject matter of the arbitration shall be deemed a waiver of the party's right
to arbitrate.
(b) Neither the AAA nor any arbitrator in a proceeding
under these rules is a necessary party in judicial proceedings relating to the
arbitration.
(c) Parties to these rules shall be deemed to have
consented that judgment upon the award rendered by the arbitrator(s) may be
entered in any federal or state court having jurisdiction thereof.
(d) Neither the AAA nor any arbitrator shall be liable to
any party for any act or omission in connection with any arbitration conducted
under these rules.
34. Communication with Arbitrator and Serving of Notice
(a) There shall be no communication between the parties
and a neutral arbitrator other than at oral hearings. Any other oral or written
communication from the parties to the arbitrator shall be directed to the AAA
for transmittal to the arbitrator.
(b) Each party to an agreement that provides for
arbitration under these rules shall be deemed to have consented that any paper,
notice, or process necessary or proper for the initiation or continuation of an
arbitration under these rules; for any court action in connection therewith; or
for the entry of judgment on any award made thereunder may be served upon the
party by mail addressed to the party or its attorney at the last known address
or by personal service, within or without the state wherein the arbitration is
to be held (whether such party be within or without the United States of
America), provided that a reasonable opportunity to be heard with regard thereto
has been granted to that party.
35. Waiver of Rules
Any party who proceeds with the arbitration after
knowledge that any provision or requirement of these rules has not been complied
with and who fails to state any objection thereto in writing shall be deemed to
have waived the right to object.
36. Deposits
The AAA may require the parties to deposit in advance such
sums of money as it deems necessary to defray the expense of the arbitration,
including the arbitrator's fee, if any, and shall render an accounting to the
parties and return any unexpended balance.
37. Interpretation and Application of Rules
The arbitrator shall interpret and apply these rules
insofar as they relate to the powers and duties of the arbitrator. All other
rules shall be interpreted and applied by the AAA. Administrative Fees
Initial Administrative Fee
The initial administrative fee is $500 due and payable at
the time of filing ($150 by the filing party and $350 by the plan).
Additional-Hearing Fees
A fee of $50 is payable for each second or subsequent
hearing that is clerked by the AAA or held in a hearing room provided by the
AAA.
Adjournment Fees
A fee of $50 is payable for an adjournment of any
scheduled hearing.
Overtime
A fee of $10 per hour is payable for hearings held on
Saturdays, legal holidays, or after 6 p.m. on weekdays, provided that these
hearings are either clerked by the AAA or held in a hearing room provided by the
AAA.
Refund Schedule
If the AAA is notified that the matter has been settled or
withdrawn before the original due date for the return of the first list, all of
the fee in excess of $150 will be refunded; otherwise, no refund will be made.
©1998 American Arbitration Association.
All Rights Reserved.
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