File #: 24-0315    Version: 1
Type: decision Status: Passed
File created: 4/5/2024 In control: LEOFF I Disability Board
Agenda date: 4/8/2024 Final action: 4/8/2024
Title: Approval of Case #24-4 Dental Request
Attachments: 1. Case #24-4

Title

Approval of Case #24-4 Dental Request

 

Report

Issue:

Whether to approve payment for dental work in the amount of $4,897.00

 

Staff Contact:

Debbi Hufana, HR Analyst, Human Resources, 360.753.8149

 

Background:

Retired LEOFF 1 member is requesting approval for dental work in the amount of $4,897.00 for extractions, crown replacement and partial denture.  This request is in accordance with LEOFF Policies and Procedures.

 

Attachments:

Application for payment of services and treatment plan

 

Reference:
Section III Procedures to Receive Benefits