Wash. Admin. Code § 182-16-2040

Current through Register Vol. 24-12, June 15, 2024
Section 182-16-2040 - How can a subscriber appeal a decision regarding the administration of wellness incentive program requirements?
(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.

Wash. Admin. Code § 182-16-2040

Adopted by WSR 18-22-033, Filed 10/29/2018, effective 1/1/2019
Amended by WSR 19-17-073, Filed 8/20/2019, effective 1/1/2020
Amended by WSR 20-16-062, Filed 7/28/2020, effective 1/1/2021