File #: 24-0159    Version: 1
Type: decision Status: Passed
File created: 2/8/2024 In control: LEOFF I Disability Board
Agenda date: 2/12/2024 Final action: 2/12/2024
Title: Approval of Case #24-3 Dental Request
Attachments: 1. Case 24-3


Approval of Case #24-3 Dental Request




Whether to approve payment in the amount of $2,436.50 for a dental implant.


Staff Contact:

Debbi Hufana, HR Analyst, Human Resources, 360.753.8149



LEOFF 1 member is requesting reimbursement in the amount of $2,436.50 for a dental implant.  The total for this procedure is $2,548.00 and insurance paid $111.50 of this. This work has been completed and the member did not present this to the board for preapproval as required by the LEOFF policy.  The attached documents include services on additional teeth under the board approval threshold which have been reimbursed to the member.  There will likely be additional expenses for this implant for a crown to complete the work.  This is not in accordance with LEOFF policy as the member did not submit the request for prior approval.



Application for payment of services and supporting documents


Section III Procedures to Receive Benefits, H.