78 • If the determination was based on the absence of medical necessity, or because the treatment was experimental or investigational, or other similar exclus ion, you will receive an explanation of the scientific or clinical judgment for the determination applying the terms of the Plan to your claim, or a statement that it is available upon request at no charge. • If the adverse benefit determination involves urg ent care, a statement of the expedited review process applicable to such claims. An adverse determination involving urgent care may be provided orally, provided written notification is provided not later than three calendar days after the oral notification . If a Pre - Service claim is approved, you will receive written (or electronic, as applicable) notice within fifteen (15) days of the appropriate Claims Administrator’s receipt of the claim. Notice of Approval of an Urgent Care Claim will be provided in wri ting (or electronically, as applicable) to you and your health care professional within the applicable timeframe after the Claims Administrator’s receipt of the claim. Internal Appeals for Health Claims A. First Level Appeal • Medical Benefits Appeal If you d isagree with Cigna’s decision on any of your claims for medical benefits, you may submit an appeal to Cigna. Your request for appeal review must be made in writing within 180 days of receipt of your denial notice, and should be mailed to the Cigna Appeals Unit, P.O. Box 188011, Chattanooga, TN 37422 - 8011 . You should state the reason why you feel your appeal should be approved and include any information supporting your appeal. Your appeal will be reviewed by someone at Cigna not involved in the initial decision. Note: You must first file your internal appea l with Cigna as you initiate the Appeals process. First level appeals received more than 180 days after receipt of the notice of the claim denial or adverse determination will be denied as untimely. Cigna will respond in writing to your appeal no later th an 15 calendar days (for pre - service claims) or 30 calendar days (for post - service claims) after the appeal is received. In ruling on such first level appeals, Cigna serves in the capacity of a named fiduciary under ERISA. • Eligibility Appeal If you are a ppealing an adverse determination relating to eligibility to the Board of Trustees, your appeal must be made to the Board of Trustees in writing within 180 days after receipt of the de nial notice. Appeals received more than 180 days after receipt of the n otice will be denied as untimely. If you file an appeal with the Board of Trustees, you will be deemed to authorize the Fund to obtain information relevant to your claim. Mail your written appeal directly to the Board of Trustees, National IAM Benefit Tr ust Fund, 99 Street, SE, Suite 600, Washington, D.C. 20003. T he Board of Trustees will make a determination at the next scheduled meeting of the Board of Trustees following the Plan’s receipt of a request for review, unless the request for review is file d within 30 calendar days preceding the date of such meeting. In such case, a benefit determination may be made no later than the date of the second meeting following the Plan’s receipt of a request for review. If special circumstances require a further extension of time, a determination will be rendered not later than the third meeting of the Board of Trustees following the Plan’s receipt of the request for review. If such an extension of time for review is required because of special circumstanc es, the Board of Trustees will notify the claimant in writing of the extension, describing the special circumstances and the date as of which the benefit determination will be made, prior to the commencement of the extension. Notice of the benefit determin ation and review by the Board of Trustees will be made as soon as possible, but not later than five calendar days after the benefit determination is made.