WAC 182-16-032   How can a decision made by the PEBB program regarding eligibility, enrollment, or premium payments; or a decision made by an employer group regarding life insurance or long-term disability insurance be appealed?  (1) An eligibility, enrollment, or premium payment decision made by the PEBB program may be appealed by submitting a notice of appeal to the PEBB appeals committee.

     (2) An eligibility or enrollment decision made by an employer group regarding life insurance or long-term disability insurance may be appealed by submitting a notice of appeal to the PEBB appeals committee.

     (3) The contents of the notice of appeal are to be provided in accordance with WAC 182-16-040.

     (4) The notice of appeal from an employee or employee's dependent must be received by the PEBB appeals manager within thirty days of the date of the denial notice.

     (5) The notice of appeal from a retiree, self-pay enrollee, or dependent of a retiree or self-pay enrollee must be received by the PEBB appeals manager within sixty days of the date of the denial notice.

     (6) The PEBB appeals manager shall notify the appellant in writing when the notice of appeal has been received.

     (7) The PEBB appeals committee shall render a written decision within thirty days of receiving the notice of appeal. The written decision shall be sent to the appellant.

     (8) Any appellant who disagrees with the decisions of the PEBB appeals committee may request an administrative hearing, as described in WAC 182-16-050.



[Statutory Authority: RCW 41.05.160 and 2011 c 8. 11-22-036 (Order 11-02), § 182-16-032, filed 10/26/11, effective 1/1/12. Statutory Authority: RCW 41.05.160. 10-20-147 (Order 10-02), § 182-16-032, filed 10/6/10, effective 1/1/11; 09-23-102 (Order 09-02), § 182-16-032, filed 11/17/09, effective 1/1/10; 08-20-128 (Order 08-03), § 182-16-032, filed 10/1/08, effective 1/1/09.]