File #: 21-0711    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 21-6 Dental Request
Attachments: 1. Request

Title

Approval of Case 21-6 Dental Request

 

Report

Issue:

Whether to approve payment for dental work in the amount of Option #1 $3,027.00 or Option #2 $6,932.00

 

Staff Contact:

Debbi Hufana, HR Analyst, Human Resources, 360.753.8149

 

Background:

LEOFF 1 member is requesting board approval for dental work.  Member has presented two options from provider.  Option #1 is for 1 crown & build-up and 3 filings.  Option #2 is for 4 crowns & build up.  As noted on the application for payment of services, Option #2 is the preferred option.

 

Attachments:

Application for Payment of Services

Option #1

Option #2

 

Reference:
Section III Procedures to Receive Benefits