File #: 21-0710    Version: 1
Type: decision Status: Passed
File created: 7/9/2021 In control: LEOFF I Disability Board
Agenda date: 7/12/2021 Final action: 7/12/2021
Title: Approval of Case 21-5 Dental Request
Attachments: 1. Request

Title

Approval of Case 21-5 Dental Request

 

Report

Issue:

Whether to approve payment for dental work for retired LEOFF 1 member in the amount of $1,912.00

 

Staff Contact:

Debbi Hufana, HR Analyst, Human Resources, 360.7536.8149

 

Background:

LEOFF 1 member is requesting reimbursement for dental work in the amount of $1,912.00 for cleaning and filings.  This request is brought to the board as the member has been reimbursed for previous dental work in 2021 up to the $2,000 annual amount.  This work has been completed.

 

Attachments:

Applications for payment of services (3)

Statement of Services Rendered (2)

 

Reference:
Section III Procedures to Receive Benefits