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File #: 18-1179    Version: 1
Type: decision Status: Passed
File created: 12/4/2018 In control: LEOFF I Disability Board
Agenda date: 12/10/2018 Final action: 12/10/2018
Title: Case #15-18 Dental Request
Attachments: 1. 15-18 Dental Request

Title

Case #15-18 Dental Request

 

Report

Issue:

Whether or not to approve payment for one or two dental implants for LEOFF member and for what amount.

 

Staff Contact:

Debbi Hufana, General Government, Human Resources, 360.753.8149

 

Background:

The member is requesting preapproval from the board for dental work in the amount of $4,284.00.  The member had a broken tooth which was non restorable and was extracted.  The implants are recommended to replace the tooth which would allow for better food breakdown, digestion and continued health.  The cost of the procedure exceeds the allowable amount of $600/year for regular dental care.  This is in accordance with LEOFF l policies and procedures.  The LEOFF member has not completed this procedure yet.

 

 

Attachments:

Application for payment of services and provider treatment plan

 

 

Reference:
LEOFF Disability Board Policies and Procedures (2018) Section H, Dental Benefits