Washington Administrative Code
Title 182 - Health Care Authority
PUBLIC EMPLOYEES BENEFITS BOARD (PEBB) PROGRAM
Chapter 182-16 - Appeals practice and procedure
Part II - BRIEF ADJUDICATIVE PROCEEDINGS
Section 182-16-2040 - How can a subscriber appeal a decision regarding the administration of wellness incentive program requirements?

Universal Citation: WA Admin Code 182-16-2040

Current through Register Vol. 24-18, September 15, 2024

(1) Any subscriber aggrieved by a decision regarding the completion of the wellness incentive program requirements, or request for a reasonable alternative to a wellness incentive program requirement, may appeal that decision to the public employees benefits board (PEBB) wellness incentive program contracted vendor.

(2) Any subscriber who disagrees with a decision in response to an appeal filed with the PEBB wellness incentive program contracted vendor may appeal the decision by submitting a request for a brief adjudicative proceeding to the PEBB appeals unit.

(a) The request for a brief adjudicative proceeding from a current or former employee must be received by the PEBB appeals unit no later than thirty days after the date of the denial notice. The contents of the request for a brief adjudica-tive proceeding are to be provided as described in WAC 182-16-2070.

(b) The request for a brief adjudicative proceeding from a retiree or self-pay subscriber must be received by the PEBB appeals unit no later than sixty days after the date of the denial notice. The contents of the request for a brief adjudica-tive proceeding are to be provided as described in WAC 182-16-2070.

(3) The PEBB appeals unit must notify the appellant in writing when the request for a brief adjudicative proceeding has been received.

(4) The brief adjudicative proceeding will be conducted by a presiding officer designated by the director.

(5) If a subscriber fails to timely request a brief adjudica-tive proceeding, the decision of the PEBB wellness incentive program contracted vendor becomes the authority's final order without further action.

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