101 is required, you will be notified of the extension and the reasons for it prior to the commencement of the extension. In deciding an appeal of a benefit determination that was based, in whole or in part, on a medical judgment (including determinations about whether a particular treatment, drug, or other item is experimental, investigational, or not Medically Necessary or appropriate), the reviewer will consult with a health care professional who has appropriate training and expertise in the particular field of medicine, and who was not consulted in connection with the original determination. You will also be provided, upon request, with the identity of any medical or vocational experts whose advice was obtained at any level of the claims and appeals process, without regard to whether that advice was relied on. If you submit an appeal with the Board of Trustee, any applicable statute of limitations will be delayed while the appeal is pending. The filing of a claim will have no effect on your rights to any other benefits under the Plan. No fees or costs are imposed upon you as part of the appeal to the Board of Trustees. The decision to submit an appeal to the Board of Trustees will have no effect upon your rights to any other benefits under the Plan. If you choose to appeal to the Board of Trustees following an adverse determination at the first level of appeal, you must do so in writing, and you should send the following information: • The specific reason(s) for the appeal; • Copies of all past correspondence with the Fund, including any Explanation of Benefits (EOB’s); • Copies of the first level adverse appeal determination made by the Claims Administrator; and • Any applicable information that you have not yet sent to the Fund Office. • 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: Board of Trustees National IAM Benefit Trust Fund 99 M Street, SE, Suite 600 Washington, DC 20003 The Board of Trustees will review your appeal. They will evaluate your claim within the timeframes described above. You will be notified of the Board of Trustees decision on your appeal within 15 calendar days after the date your appeal is reviewed. Prescription Drug Benefit Claims There are separate procedures for making claims for the Prescription Drug Benefit, including a special procedure to fill prescriptions for Specialty Medications. You do not have to complete a written claim form if you have a CVS Caremark prescription card and use a participating pharmacy. If any claim for a prescription drug benefit is denied, you have the right to appeal by following the procedures explained below. You may get your general prescriptions filled at any participating pharmacy by presenting your CVS Caremark prescription card to the pharmacist. However, if you use a non-participating pharmacy that does not accept your CVS Caremark card, you must first pay the pharmacist and then seek reimbursement by filing a written claim with CVS Caremark.