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File #: 21-0162    Version: 1
Type: decision Status: Passed
File created: 2/3/2021 In control: LEOFF I Disability Board
Agenda date: 2/8/2021 Final action: 2/8/2021
Title: Approval of Case 21-1 Dental Request
Attachments: 1. Request


Approval of Case 21-1 Dental Request




Whether to approve payment for dental implant for retired LEOFF 1 member in the amount of $2,340.00


Staff Contact:

Debbi Hufana, HR Analyst, Human Resources, 360.753.8149



The board must decide whether or not to approve the request for a dental implant for the member in the amount of $2,340.00.


The member had this dental work done and originally requested reimbursement in the amount of $600.00 as they were not aware the board could approve dental work over the amount of $600.00.  Once the member became aware of this, they are requesting the full amount paid of $2,340.00.  I made the member aware for future dental work over the amount of $600.00 the proper procedure is to submit the application for payment of services and the treatment plan to the board for approval prior to having the work done.



Application for payment of services

Treatment plan

Statement of account


Section III Procedures to Receive Benefits, H. Dental Benefits