Section 182-16-2030 - [Effective 1/1/2025] Appealing a public employees benefits board (PEBB) program decision regarding eligibility, enrollment, premium payments, premium surcharges, a PEBB wellness incentive, or certain decisions made by an employer group(1) A decision made by the public employees benefits board (PEBB) program regarding eligibility, enrollment, premium payments, premium surcharges, or a PEBB wellness incentive, may be appealed by submitting a request to the PEBB appeals unit for a brief adjudicative proceeding to be conducted by the authority.(2) A decision made by a PEBB participating employer group regarding life insurance, LTD insurance, eligibility to participate in the PEBB wellness incentive program, or eligibility to receive a PEBB wellness incentive, may be appealed by submitting a request to the PEBB appeals unit for a brief adjudicative proceeding to be conducted by the authority.(3) The contents of the request for a brief adjudicative proceeding are to be provided as described in WAC 182-16-2070.(4) The request for a brief adjudicative proceeding from a current or former employee or employee's dependent must be received by the PEBB appeals unit no later than 30 days after the date of the denial notice.(5) The request for a brief adjudicative proceeding from a retiree, a continuation coverage enrollee, a retired employee or retired school employee continuing PEBB health plan coverage when their employer group ceases participation, a survivor, or their dependent must be received by the PEBB appeals unit no later than 60 days after the date of the denial notice.(6) The PEBB appeals unit must notify the appellant in writing when the request for a brief adjudicative proceeding has been received.(7) The brief adjudicative proceeding will be conducted by a presiding officer designated by the director.(8) Failing to timely request a brief adjudicative proceeding will result in the prior PEBB program decision becoming the authority's final order without further action.Wash. Admin. Code § 182-16-2030
Adopted by WSR 18-22-033, Filed 10/29/2018, effective 1/1/2019Amended by WSR 19-17-073, Filed 8/20/2019, effective 1/1/2020Amended by WSR 20-16-062, Filed 7/28/2020, effective 1/1/2021Amended by WSR 24-18-076, Filed 8/29/2024, effective 1/1/2025