WAC 182-12-207   When can a retiree or eligible dependent's insurance coverage be canceled by HCA?  A retiree or eligible dependent's insurance coverage can be canceled by HCA for the following reasons:

     (1) Failure to comply with the PEBB program's procedural requirements, including failure to provide information or documentation requested by the due date in written requests from the PEBB program;

     (2) Knowingly providing false information;

     (3) Failure to pay the premium when due or an underpayment of premium;

     (4) Misconduct. If a retiree's insurance coverage is canceled for misconduct, insurance coverage will not be reinstated at a later date. Examples of such termination include, but are not limited to the following:

     (a) Fraud, intentional misrepresentation or withholding of information the subscriber knew or should have known was material or necessary to accurately determine eligibility or the correct premium; or

     (b) Abusive or threatening conduct repeatedly directed to an HCA employee, a health plan or other HCA contracted vendor providing insurance coverage on behalf of the HCA, its employees, or other persons.

     If a retiree's insurance coverage is canceled by HCA for the above reasons, insurance coverage for all of the retiree's eligible dependents is also canceled.



[Statutory Authority: RCW 41.05.160. 09-23-102 (Order 09-02), § 182-12-207, filed 11/17/09, effective 1/1/10; 07-20-129 (Order 07-01), § 182-12-207, filed 10/3/07, effective 11/3/07.]