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(ii) provide that, in deciding an appeal of any adverse benefit determination that is <br />based in whole or in part on a medical judgment, including determinations with <br />regard to whether a particular treatment, drug, or other item is experimental, <br />investigational, or not medically necessary or appropriate, the appropriate named <br />fiduciary shall consult with a health care professional who has appropriate training <br />and experience in the field of inedicine involved in the medical judgment; <br />(iii) provide for the identification of inedical or vocational experts whose advice was <br />obtained on behalf of the Plan in connection with a claimant's adverse benefit <br />determination, without regard to whether the advice was relied upon in making <br />the benefit determination; <br />(iv) provide that the health care professional engaged for purposes of a consultation <br />under this section shall be an individual who is neither an individual who was <br />consulted in connection with the adverse benefit determination that is the subject <br />of the appeal, nor the subordinate of any such individual; and <br />The Plan administrator shall notify the claimant of the Plan's benefit determination on <br />review. In the case of a post-service claim, the Plan administrator will notify the claimant of the <br />Plan's benefit determination on review within a reasonable period of time, not later than 60 days <br />after receipt by the Plan of the claimant's request for review of an adverse benefit determination. <br />Nothing in this section shall be construed to supersede any provision of State law that <br />regulates insurance, except to the extent that such law prevents the application of a requirement <br />of this section. <br />45 City of Roseville MPD <br />