PDFWAC 182-32-2040

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 school employees benefits board (SEBB) wellness incentive program contracted vendor.
(2) Any subscriber who disagrees with a decision in response to an appeal filed with the SEBB wellness incentive program contracted vendor may appeal the decision by submitting a request for a brief adjudicative proceeding to the SEBB appeals unit.
(a) The request for a brief adjudicative proceeding from a current or former employee must be received by the SEBB appeals unit no later than thirty days after the date of the denial notice. The contents of the request for a brief adjudicative proceeding are to be provided as described in WAC 182-32-2070.
(b) The request for a brief adjudicative proceeding from a self-pay subscriber must be received by the SEBB appeals unit no later than sixty days after the date of the denial notice. The contents of the request for a brief adjudicative proceeding are to be provided as described in WAC 182-32-2070.
(3) The SEBB appeals unit shall 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 adjudicative proceeding of a decision made under subsection (1) of this section within thirty days by following the process in WAC 182-32-2020(2), the decision of the SEBB wellness incentive program contracted vendor becomes the authority's final decision.
[Statutory Authority: RCW 41.05.021, 41.05.160, 2017 3rd sp.s. c 13, 2018 c 260, and SEBB policy resolutions. WSR 19-14-093 (Admin #2019-01), § 182-32-2040, filed 7/1/19, effective 8/1/19.]