reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2010 - Appealing a decision regarding school employees benefits board (SEBB) eligibility, enrollment, premium payments, premium surcharges, a wellness incentive, or the administration of benefits

Current through Register Vol. 24-14, July 15, 2024
(1) Any current or former school employee of
				  a school employees benefits board (SEBB) organization or their dependent
				  aggrieved by a decision made by the SEBB organization with regard to SEBB
				  eligibility, enrollment, or premium surcharges may appeal that decision to the
				  SEBB organization by the process described in WAC
				  182-32-2020.
Note:
Eligibility decisions address whether a subscriber
								or a subscriber's dependent is entitled to SEBB benefits, as described in SEBB
								rules and policies. Enrollment decisions address the application for SEBB
								benefits as described in SEBB rules and policies including, but not limited to,
								the submission of proper documentation and meeting enrollment
								deadlines.
(2) Any subscriber or dependent aggrieved by
				  a decision made by the SEBB program with regard to SEBB eligibility,
				  enrollment, premium payments, premium surcharges, eligibility to participate in
				  the SEBB wellness incentive program, or eligibility to receive the SEBB
				  wellness incentive, may appeal that decision to the SEBB appeals unit by the
				  process described in WAC
				  182-32-2030.
(3) Any enrollee aggrieved by a decision
				  regarding the administration of SEBB medical, dental, and vision, life
				  insurance, accidental death and dismemberment (AD&D) insurance, or
				  long-term disability insurance, may appeal that decision by following the
				  appeal provisions of those plans, with the exception of:
(a) Enrollment decisions;
(b) Premium payment decisions other than life
				  insurance or AD&D insurance premium payment decisions; and
(c) Eligibility decisions.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2020 - Appealing a decision made by a school employees benefits board (SEBB) organization about eligibility, premium surcharges, or enrollment in benefits

Current through Register Vol. 24-14, July 15, 2024
(1) An eligibility,
				  premium surcharges, or enrollment decision made by a school employees benefits
				  board (SEBB) organization may be appealed by submitting a written request for
				  administrative review to the SEBB organization. The SEBB organization must
				  receive the request for administrative review no later than thirty days after
				  the date of the denial notice. The contents of the request for administrative
				  review are to be provided as described in WAC
				  182-32-2070.
(a) Upon receiving the request for
				  administrative review, the SEBB organization must perform a complete review of
				  the denial by one or more staff who did not take part in the decision resulting
				  in the denial.
(b) The SEBB
				  organization must render a written decision within thirty days of receiving the
				  written request for administrative review. The written decision must be sent to
				  the school employee or school employee's dependent who submitted the request
				  for administrative review and must include a description of the appeal rights.
				  The SEBB organization must also send a copy of the SEBB organization's written
				  decision to the SEBB organization's administrator (or designee) and to the SEBB
				  appeals unit. If the SEBB organization fails to render a written decision
				  within thirty days of receiving the written request for administrative review,
				  the request for administrative review may be considered denied as of the
				  thirty-first day and the original underlying SEBB organization decision may be
				  appealed to the SEBB appeals unit by following the process in this
				  section.
(c) The SEBB organization
				  may reverse eligibility, premium surcharges, or enrollment decisions as
				  permitted by WAC
				  182-30-060.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2030 - Appealing a school employees benefits board (SEBB) program decision regarding eligibility, enrollment, premium payments, premium surcharges, and a SEBB wellness incentive

Current through Register Vol. 24-14, July 15, 2024
(1) A decision made
				  by the school employees benefits board (SEBB) program regarding eligibility,
				  enrollment, premium payments, premium surcharges, or a SEBB wellness incentive
				  may be appealed by submitting a request to the SEBB appeals unit for a brief
				  adjudicative proceeding to be conducted by the authority.
(2) The contents of the request for a brief
				  adjudicative proceeding are to be provided as described in WAC
				  182-32-2070.
(3) The request for a brief adjudicative
				  proceeding from a current or former school employee or school employee's
				  dependent must be received by the SEBB appeals unit no later than thirty days
				  after the date of the denial notice.
(4) The request for a brief adjudicative
				  proceeding from a self-pay enrollee or dependent of self-pay enrollee must be
				  received by the SEBB appeals unit no later than sixty days after the date of
				  the denial notice.
(5) The SEBB
				  appeals unit must notify the appellant in writing when the request for a brief
				  adjudicative proceeding has been received.
(6) The brief adjudicative proceeding will be
				  conducted by a presiding officer designated by the director.
(7) Failing to timely request a brief
				  adjudicative proceeding will result in the prior SEBB program decision becoming
				  the authority's final order without further action.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2040 - How can a subscriber appeal a decision regarding the administration of wellness incentive program requirements?

Current through Register Vol. 24-14, July 15, 2024
(1)
				  Any subscriber aggrieved by a decision regarding the completion of the wellness
				  incentive program requirements, or request for a reasonable alternative to a
				  wellness incentive program requirement, may appeal that decision to the school
				  employees benefits board (SEBB) wellness incentive program contracted
				  vendor.
(2) Any subscriber who
				  disagrees with a decision in response to an appeal filed with the SEBB wellness
				  incentive program contracted vendor may appeal the decision by submitting a
				  request for a brief adjudicative proceeding to the SEBB appeals unit.
(a) The request for a brief adjudicative
				  proceeding from a current or former school employee must be received by the
				  SEBB appeals unit no later than thirty days after the date of the denial
				  notice. The contents of the request for a brief adju-dicative proceeding are to
				  be provided as described in WAC
				  182-32-2070.
(b) The request for a brief adjudicative
				  proceeding from a self-pay subscriber must be received by the SEBB appeals unit
				  no later than sixty days after the date of the denial notice. The contents of
				  the request for a brief adjudicative proceeding are to be provided as described
				  in WAC
				  182-32-2070.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2050 - How can a school employee appeal a decision regarding the administration of benefits offered under the salary reduction plan?

Current through Register Vol. 24-14, July 15, 2024
(1) Any school
				  employee who disagrees with a decision that denies eligibility for, or
				  enrollment in, a benefit offered under the salary reduction plan may appeal
				  that decision by submitting a written request for administrative review to
				  their school employees benefits board (SEBB) organization. The SEBB
				  organization must receive the written request for administrative review no
				  later than 30 days after the date of the decision resulting in denial. The
				  contents of the written request for administrative review are to be provided as
				  described in WAC
				  182-32-2070.
(a) Upon receiving the written request for
				  administrative review, the SEBB organization must perform a complete review of
				  the denial by one or more staff who did not take part in the decision resulting
				  in the denial.
(b) The SEBB
				  organization must render a written decision within 30 days of receiving the
				  written request for administrative review. The written decision must be sent to
				  the school employee who submitted the written request for review and must
				  include a description of appeal rights. The SEBB organization must also send a
				  copy of the SEBB organization's written decision to the SEBB organization's
				  administrator (or designee) and to the SEBB appeals unit. If the SEBB
				  organization fails to render a written decision within 30 days of receiving the
				  written request for administrative review, the request for administrative
				  review may be considered denied as of the 31st day and the original underlying
				  SEBB organization decision may be appealed to the SEBB appeals unit by
				  following the process in this section.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2070 - What should a written request for administrative review and a request for brief adjudicative proceeding contain?

Current through Register Vol. 24-14, July 15, 2024
A written request for administrative review of the school
					 employees benefits board (SEBB) organization's decision and a request for brief
					 adjudicative proceeding should contain:
(1) The name and mailing address of the party
				  requesting an administrative review or the brief adjudicative
				  proceeding;
(2) The name and
				  mailing address of the appealing party's representative, if any;
(3) Documentation, or reference to
				  documentation, of decisions previously rendered through the appeal process, if
				  any;
(4) A statement identifying
				  the specific portion of the decision being appealed and clarifying what is
				  believed to be unlawful or in error;
(5) A statement of facts in support of the
				  appealing party's position;
(6) Any
				  information or documentation that the appealing party would like
				  considered;
(7) The type of relief
				  sought; and
(8) The signature of
				  the appealing party or the appealing party's representative.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2080 - Who can appeal or represent a party in a brief adjudicative proceeding?

Current through Register Vol. 24-14, July 15, 2024
(1) The appellant
				  may act as their own representative or may choose to be represented by another
				  person, except that employees of the health care authority (HCA) or HCA's
				  authorized agents may not represent an appellant, unless approved by a
				  presiding officer or reviewing officer.
(2) If the appellant is represented by a
				  person who is not an attorney admitted to practice in Washington state, the
				  representative must provide the presiding officer and other parties with the
				  representative's name, address, and telephone number. In cases involving
				  confidential information, the nonattorney representative must provide the
				  school employees benefits board (SEBB) appeals unit and other parties with a
				  signed, written consent permitting release to the nonat-torney representative
				  of the appellant's health information protected by state or federal
				  law.
(3) An attorney admitted to
				  practice law in Washington state representing the appellant must file a written
				  notice of appearance containing the attorney's name, address, and telephone
				  number with the presiding officer's office and serve all parties with the
				  notice. In cases involving confidential information, the attorney must provide
				  the SEBB appeals unit and other parties with a signed, written consent
				  permitting release to the attorney of the appellant's health information
				  protected by state or federal law. If the appellant's attorney representative
				  no longer represents the appellant, then the attorney must file a written
				  notice of withdrawal of representation with the presiding officer or reviewing
				  officer or officer's office and serve all parties with the notice.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2085 - Continuances

Current through Register Vol. 24-14, July 15, 2024
The presiding officer, reviewing officer or officers may
					 grant, in their sole discretion, a request for a continuance on motion of the
					 appellant, the authority, or on their own. The continuance may be up to 30
					 calendar days.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2090 - Initial order

Current through Register Vol. 24-14, July 15, 2024
Unless a continuance has been granted, within ten days
					 after the school employees benefits board (SEBB) appeals unit receives a
					 request for a brief adjudicative proceeding, the presiding officer must render
					 a written initial order that addresses the issue or issues raised by the
					 appellant in their appeal. The presiding officer must serve a copy of the
					 initial order on all parties and the initial order must contain information on
					 how the appellant may request review of the initial order.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2100 - How to request a review of an initial order resulting from a brief adjudicative proceeding

Current through Register Vol. 24-14, July 15, 2024
(1) Both the
				  appellant and the authority may request review of an initial order. An
				  appellant who has received an initial order upholding a school employees
				  benefits board (SEBB) organization decision, SEBB program decision, or a
				  decision made by a SEBB program contracted vendor, may request review of the
				  initial order by the authority. The appellant may request review of the initial
				  order by filing a written request or making an oral request with the SEBB
				  appeals unit within 21 days after service of the initial order. The written or
				  oral request for review of the initial order must be made by using the contact
				  information included in the initial order. If the appellant fails to request
				  review of the initial order within 21 days, the initial order becomes the
				  authority's final order without further action.
(2) Upon timely request by the appellant, a
				  review of an initial order will be performed by one or more reviewing officers
				  designated by the director of the authority.
(3) If the appellant has not requested
				  review, the authority may review an order resulting from a brief adjudicative
				  proceeding on its own, and without notice to the parties, but it may not take
				  action on review less favorable to any party than the initial order without
				  giving that party notice and an opportunity to explain that party's view of the
				  matter.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2105 - Withdrawing the request for a brief adjudicative proceeding or review of an initial order

Current through Register Vol. 24-14, July 15, 2024
(1) The appellant
				  may withdraw the request for a brief adjudicative proceeding or review of an
				  initial order for any reason, and at any time, by contacting the school
				  employees benefits board (SEBB) appeals unit. The SEBB appeals unit will
				  present the withdrawal request to the presiding officer or reviewing officer or
				  officers.
(2) The request for
				  withdrawal must be made in writing.
(3) After a withdrawal request is received,
				  the presiding officer or reviewing officer or officers must enter and serve a
				  written order dismissing the brief adjudicative proceeding or review of an
				  initial order.
(4) If an appellant
				  withdraws a request for a brief adjudicative proceeding or review of an initial
				  order, the appellant may not reinstate the request for a brief adjudicative
				  proceeding or review of an initial order unless time remains on their original
				  appeal period.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2110 - Final order

Current through Register Vol. 24-14, July 15, 2024
(1) A final order
				  issued by the reviewing officer or officers will be in writing and include a
				  brief statement of the reasons for the decision.
(2) The final order must be served within 20
				  days of the date of the initial order or of the date the request for review of
				  the initial order was received by the SEBB appeals unit, whichever is
				  later.
(3) The final order will
				  include a notice that reconsideration and judicial review may be
				  available.
(4) A request for review
				  of the initial order is deemed denied if the authority does not issue a final
				  order within 20 days after the request for review of the initial order is
				  filed.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2120 - Request for reconsideration

Current through Register Vol. 24-14, July 15, 2024
(1) A request for
				  reconsideration asks the reviewing officer or officers to reconsider the final
				  order because the party believes the reviewing officer or officers made a
				  mistake of law, mistake of fact, or clerical error.
(2) A request for reconsideration must state
				  in writing why the party wants the final order to be reconsidered.
(3) Requests for reconsideration must be
				  filed with the reviewing officer or officers who entered the final
				  order.
(4) If a party files a
				  request for reconsideration:
(a) The reviewing
				  officer or officers must receive the request for reconsideration on or before
				  the tenth business day after the service date of the final order;
(b) The party filing the request must send
				  copies of the request to all other parties; and
(c) Within five business days of receiving a
				  request for reconsideration, the reviewing officer or officers must serve to
				  all parties a notice that provides the date the request for reconsideration was
				  received.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2130 - Judicial review of final order

Current through Register Vol. 24-14, July 15, 2024
(1)
				  Judicial review is the process of appealing a final order to a court.
(2) The appellant may appeal a final order by
				  filing a written petition for judicial review that meets the requirements of
				  RCW
				  34.05.510 through
				  34.05.598.
				  Neither the school employees benefits board (SEBB) program nor a SEBB
				  organization may request judicial review.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2135 - Petitions for judicial review-Service on the authority

Current through Register Vol. 24-14, July 15, 2024
Delivery pursuant to
					 RCW
					 34.05.542(4) shall be deemed
					 to have been made when a copy of the petition for judicial review has been
					 received by the school employees benefits board (SEBB) appeals unit at Cherry
					 Street Plaza, 626 8th Avenue S.E., Olympia, WA 98501 or received by mail at the
					 SEBB appeals unit, P.O. Box 45504, Olympia, WA 98504-5504.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2140 - Presiding officer-Designation and authority

Current through Register Vol. 24-14, July 15, 2024
The designation of a presiding officer must be consistent
					 with the requirements of
					 RCW
					 34.05.485 and the presiding officer must not
					 have personally participated in the decision made by the school employees
					 benefits board (SEBB) organization or SEBB program.
(1) The presiding officer will decide the
				  issue based on the information provided by the parties during the presiding
				  officer's review of the appeal.
(2)
				  A presiding officer is limited to those powers granted by the state
				  constitution, statutes, rules, or applicable case law.
(3) A presiding officer may not decide that a
				  rule is invalid or unenforceable.
(4) In addition to the record, the presiding
				  officer may employ the authority's expertise as a basis for the
				  decision.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2150 - Reviewing officer or officers-Designation and authority

Current through Register Vol. 24-14, July 15, 2024
(1) The designation
				  of a reviewing officer or officers must be consistent with the requirements of
				  RCW
				  34.05.491 and the reviewing officer or
				  officers must not have personally participated in the decision made by the
				  school employees benefits board (SEBB) organization or SEBB program.
(2) The reviewing officer or officers must
				  review the initial order and the record to determine if the initial order was
				  correctly decided and make any inquiries necessary to ascertain whether the
				  proceeding must be converted to a formal administrative hearing.
(3) The reviewing officer or officers will
				  issue a final order that will either:
(a)
				  Affirm the initial order in whole or in part; or
(b) Reverse the initial order in whole or in
				  part; or
(c) Remand to the
				  presiding officer in whole or in part.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part II - BRIEF ADJUDICATIVE PROCEEDINGS › Section 182-32-2160 - Conversion of a brief adjudicative proceeding to a formal administrative hearing

Current through Register Vol. 24-14, July 15, 2024
(1) The presiding
				  officer or the reviewing officer or officers, in their sole discretion, may
				  convert a brief adjudicative proceeding to a formal administrative hearing at
				  any time before the final order is issued on motion by:
(a) The appellant;
(b) The representative of the
				  appellant;
(c) The authority;
				  or
(d) The presiding officer or
				  reviewing officer or officers.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3000 - Formal administrative hearings

Current through Register Vol. 24-14, July 15, 2024
(1)
				  When a brief adjudicative proceeding is converted to a formal administrative
				  hearing consistent with WAC
				  182-32-2160,
				  the director designates a hearing officer to conduct the formal administrative
				  hearing.
(2) Formal administrative
				  hearings are conducted consistent with the Administrative Procedure Act,
				  RCW
				  34.05.413 through 34-05-476.
(3) Part III describes the general rules and
				  procedures that apply to school employees benefits board (SEBB) benefits formal
				  administrative hearings.
(a) Part III
				  supplements the Administrative Procedure Act (APA), chapter 34.05 RCW, and the
				  model rules of procedure in chapter 10-08 WAC. The model rules of procedure
				  adopted by the chief administrative law judge pursuant to
				  RCW
				  34.05.250, as now or hereafter amended, are
				  hereby adopted for use by the authority in school employees benefits board
				  (SEBB) benefits formal administrative hearings. Other procedural rules adopted
				  in chapters 182-30, 182-31, and 182-32 WAC are supplementary to the model rules
				  of procedure.
(b) In the case of a
				  conflict between the model rules of procedure and Part III, the procedural
				  rules adopted in Part III must govern.
(c) If there is a conflict between Part III
				  and specific SEBB program rules, the specific SEBB program rules prevail. SEBB
				  program rules are found in chapters 182-30 and 182-31 WAC.
(d) Nothing in Part III is intended to affect
				  the constitutional rights of any person or to limit or change additional
				  requirements imposed by statute or other rule. Other laws or rules determine if
				  a hearing right exists, including the APA and program rules or laws.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3005 - Record-Formal administrative hearings

Current through Register Vol. 24-14, July 15, 2024
The record in a formal administrative hearing consists of
					 the official documentation of the hearing process. The record includes, but is
					 not limited to, recordings or transcripts, admitted exhibits, decisions,
					 briefs, notices, orders, and other filed documents.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3010 - Requirements to appear and represent a party in the formal administrative hearing process

Current through Register Vol. 24-14, July 15, 2024
(1) All parties
				  must provide the hearing officer and all other parties with their name,
				  address, and telephone number.
(2)
				  The appellant may act as their own representative or have another person
				  represent them, except that employees of the health care authority (HCA) or
				  HCA's authorized agents may not represent an appellant, unless approved by a
				  hearing officer.
(3) If the
				  appellant is represented by a person who is not an attorney admitted to
				  practice in Washington state, the representative must provide the hearing
				  officer and all other parties with the representative's name, address, and
				  telephone number. In cases involving confidential information, the non-attorney
				  representative must provide the HCA hearing representative with a signed,
				  written consent permitting release to the nonattorney representative of health
				  information protected by state or federal law.
(4) An attorney admitted to practice law in
				  Washington state, who wishes to represent the appellant, must file a written
				  notice of appearance containing the attorney's name, address, and telephone
				  number with the hearing officer's office and serve all parties with the notice.
				  In cases involving confidential information, the attorney representative must
				  provide the HCA hearing representative with a signed, written consent
				  permitting release to the attorney representative of the appellant's health
				  information protected by state or federal law. If the appellant's attorney
				  representative no longer represents the appellant, then the attorney must file
				  a written notice of withdrawal of representation with the hearing officer's
				  office and serve all parties with the notice.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3015 - Hearing officers-Assignment, motions of prejudice, and disqualification

Current through Register Vol. 24-14, July 15, 2024
(1)
Assignment:
A hearing officer will be assigned at least five business
				  days before a hearing. A party may ask which hearing officer is assigned to a
				  hearing by contacting the hearing officer's office listed on the notice of
				  hearing. If requested by a party, the hearing officer's office must send the
				  name of the assigned hearing officer to all parties, by electronic mail or in
				  writing, at least five business days before the scheduled hearing
				  date.
(2)
Motion of
				  prejudice:
Any party requesting a different hearing officer may file a
				  written motion of prejudice against the hearing officer assigned to the matter
				  before the hearing officer rules on a discretionary issue in the case, admits
				  evidence, or takes testimony.
(a) A motion of
				  prejudice must include a declaration stating that a party does not believe the
				  hearing officer can hear the case fairly. Service of copies of the motion must
				  also be made to all parties listed on the notice of hearing.
(b) Any party's first motion of prejudice
				  will be automatically granted. Any subsequent motion of prejudice made by a
				  party may be granted or denied at the discretion of the hearing officer no
				  later than seven days after receiving the motion.
(c) A party may make an oral motion of
				  prejudice at the beginning of a hearing before the hearing officer rules on a
				  discretionary issue in the matter, admits evidence, or takes testimony if:
(i) The hearing officer was not assigned at
				  least five business days before the date of the hearing; or
(ii) The hearing officer was changed within
				  five business days of the date of the hearing.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3030 - Authority of the hearing officer

Current through Register Vol. 24-14, July 15, 2024
(1)
				  A hearing officer must hear and decide the issues based on the evidence and
				  oral or written arguments presented during a formal administrative hearing and
				  admitted into the record.
(2) A
				  hearing officer has no inherent or common law powers, and is limited to those
				  powers granted by the state constitution, statutes, or rules.
(3) A hearing officer may not decide that a
				  rule is invalid or unenforceable. If the validity of a rule is raised during a
				  formal administrative hearing, the hearing officer may allow argument only to
				  preserve the record for judicial review.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3080 - Time requirements for service of notices made by the hearing officer

Current through Register Vol. 24-14, July 15, 2024
(1) The hearing
				  officer or their designee must serve a notice of a formal administrative
				  hearing to all parties and their representatives at least twenty-one calendar
				  days before the hearing date. The parties may agree to, but the hearing officer
				  cannot impose, a shorter notice period.
(2) If a prehearing conference or dispositive
				  motion hearing is scheduled, the hearing officer must serve a notice of the
				  prehearing conference or dispositive motion hearing to the parties and their
				  representatives at least seven business days before the date of the prehearing
				  conference or dispositive motion hearing except:
(a) The hearing officer may change any
				  scheduled formal administrative hearing into a prehearing conference or
				  dispositive motion hearing and provide less than seven business days' notice of
				  the prehearing conference or dispositive motion hearing; and
(b) The hearing officer may give less than
				  seven business days' notice if the only purpose of the prehearing conference is
				  to consider whether to grant a continuance.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3090 - Formal administrative hearing location

Current through Register Vol. 24-14, July 15, 2024
(1) A hearing officer must be present at all
				  hearings. Hearings may be held either in person or telephonically.
(a) A telephonic hearing is where all parties
				  and the hearing officer are present by telephone.
(b) An in-person hearing is where the
				  appellant appears face-to-face with the hearing officer. The other parties can
				  choose to appear either in person or by telephone, but cannot be ordered to
				  appear in person.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3100 - Rescheduling and continuances for formal administrative hearings

Current through Register Vol. 24-14, July 15, 2024
(1) Any party may
				  request the hearing officer to reschedule a formal administrative hearing if a
				  rule requires notice of a hearing and the amount of notice required was not
				  provided.
(a) The hearing officer must
				  reschedule the formal administrative hearing under circumstances identified in
				  this chapter if requested by any party.
(b) The parties may agree to shorten the
				  amount of notice required by any rule.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3110 - Prehearing conferences

Current through Register Vol. 24-14, July 15, 2024
(1) A
				  pre-hearing conference is a formal proceeding conducted on the record by a
				  hearing officer to prepare for a formal administrative hearing.
(a) The hearing officer must record a
				  prehearing conference using audio recording equipment.
(b) The hearing officer may conduct a
				  prehearing conference in person, by telephone conference call, or in any other
				  manner acceptable to the parties.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3120 - Dispositive motions

Current through Register Vol. 24-14, July 15, 2024
(1) A dispositive
				  motion could dispose of one or all the issues in a formal administrative
				  hearing, such as a motion to dismiss or motion for summary judgment.
(2) To request a dispositive motion hearing a
				  party must file a written dispositive motion with the hearing officer and serve
				  a copy of the motion to all other parties. The hearing officer may also set a
				  dispositive motion hearing, and request briefing from the parties, to address
				  any possible dispositive issues the hearing officer believes must be addressed
				  before the hearing.
(3) The
				  deadline to file a timely dispositive motion must be ten calendar days before
				  the scheduled hearing.
(4) Upon
				  receiving a dispositive motion, a hearing officer:
(a) Must convert the scheduled hearing to a
				  dispositive motion hearing when:
(i) The
				  dispositive motion is timely filed with the hearing officer at least ten
				  calendar days before the date of the hearing; and
(ii) The party filing the dispositive motion
				  has not previously filed a dispositive motion.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3130 - Subpoenas

Current through Register Vol. 24-14, July 15, 2024
(1) Hearing
				  officers, the health care authority (HCA) hearing representative, and attorneys
				  for the parties may prepare subpoenas as described in Washington state civil
				  rule 45, unless otherwise prohibited by law. Any party may request the hearing
				  officer prepare a subpoena on their behalf.
(2) The hearing officer may schedule a
				  prehearing conference to decide whether to issue a subpoena.
(3) If a party requests the hearing officer
				  prepare a subpoena on its behalf, the party is responsible for:
(a) Service of the subpoena; and
(b) Any costs associated with:
(i) Compliance with the subpoena;
				  and
(ii) Witness fees as described
				  in
				  RCW
				  34.05.446(7).
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3160 - Withdrawing a formal administrative hearing

Current through Register Vol. 24-14, July 15, 2024
(1) The appellant may withdraw a formal
				  administrative hearing for any reason, and at any time, by contacting the
				  health care authority (HCA) hearing representative who will coordinate the
				  withdrawal with the hearing officer.
(2) The request for withdrawal must generally
				  be made in writing. An oral withdrawal by the appellant is permitted during a
				  formal administrative hearing when both the hearing officer and HCA hearing
				  representative are present.
(3)
				  After a withdrawal request is received, the hearing officer must cancel any
				  scheduled hearings and enter and serve a written order dismissing the
				  case.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3170 - Office of administrative hearings-Initial or final order -Required information

Current through Register Vol. 24-14, July 15, 2024
(1)
Initial
				  order:
When the office of administrative hearings is holding a formal
				  administrative hearing on behalf of the authority, the hearing officer must
				  render a written initial order that addresses the issue or issues raised by the
				  appellant in their appeal. The hearing officer must serve a copy of the initial
				  order on all parties and the initial order must contain information on how the
				  appellant may request review of the initial order.
(2)
Final order:
The final order
				  will only be issued by the authority. After the reviewing officer or officers
				  receives a request for review, the reviewing officer or officers has 20
				  calendar days to enter and serve a final order to all parties unless the
				  reviewing officer serves notice allowing more time.
(3) In the written final order, the hearing
				  officer must:
(a) Identify the order as a
				  final order of the school employees benefits board (SEBB) program;
(b) List the name and docket number of the
				  case and the names of all parties and representatives;
(c) Enter findings of fact used to resolve
				  the dispute based on the evidence admitted in the record;
(d) Explain why evidence is, or is not,
				  credible when describing the weight given to evidence related to disputed
				  facts;
(e) State the law that
				  applies to the dispute;
(f) Apply
				  the law to the facts of the case in the conclusions of law;
(g) Discuss the reasons for the decision
				  based on the facts and the law;
(h)
				  State the result and remedy ordered; and
(i) Include any other information required by
				  law or program rules.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3175 - How to request a review of an initial order by the office of administrative hearings

Current through Register Vol. 24-14, July 15, 2024
(1) Both the
				  appellant and the authority may request review of an initial order. An
				  appellant who has received an initial order upholding a school employees
				  benefits board (SEBB) organization decision, a SEBB program decision, or a
				  decision made by a SEBB program contracted vendor, may request review of the
				  initial order by filing a written request or making an oral request with the
				  SEBB appeals unit within 20 days after service of the initial order. The
				  written or oral request for review of the initial order must be made by using
				  the contact information included in the initial order. If such review is
				  requested, the hearing officer or their des-ignee from the authority, shall
				  issue a final order in accordance with WAC
				  182-32-3030.
				  If the appellant fails to request review of the initial order within 20 days,
				  the initial order becomes the authority's final order without further
				  action.
(2) Upon timely request by
				  the appellant, a review of an initial order will be performed by one or more
				  reviewing officers designated by the director of the authority.
(3) If the appellant has not requested review
				  of the initial order, the authority may review an initial order issued by the
				  office of administrative hearings on its own, and without notice to the
				  parties, but it may not take action on review less favorable to any party than
				  the initial order without giving that party notice and an opportunity to
				  explain that party's view of the matter.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3180 - Request for reconsideration and response-Process

Current through Register Vol. 24-14, July 15, 2024
(1) A request for reconsideration asks the
				  hearing officer to reconsider the final order because the party believes the
				  hearing officer made a mistake of law, mistake of fact, or clerical
				  error.
(2) A request for
				  reconsideration must state in writing why the party wants the final order to be
				  reconsidered.
(3) Requests for
				  reconsideration must be filed with the hearing officer who entered the final
				  order.
(4) If a party files a
				  request for reconsideration:
(a) The hearing
				  officer must receive the request for reconsideration on or before the tenth
				  business day after the service date of the final order;
(b) The party filing the request must serve
				  copies of the request on all other parties on the same day the request is
				  served on the hearing officer; and
(c) Within five business days of receiving a
				  request for reconsideration, the hearing officer must serve to all parties a
				  notice that provides the date the request for reconsideration was
				  received.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3190 - Decisions on requests for reconsideration

Current through Register Vol. 24-14, July 15, 2024
(1) Unless the request for reconsideration is
				  denied as untimely filed under WAC
				  182-32-3180,
				  the same hearing officer who entered the final order, if reasonably available,
				  will also decide the request as well as any responses received.
(2) The decision on the request for
				  reconsideration must be in the form of a written order denying or granting the
				  request in whole or in part and if the request is granted issuing a new written
				  final order.
(3) If the hearing
				  officer does not send an order on the request for reconsideration within twenty
				  calendar days of the date of the notice described in WAC
				  182-32-3180(4)(c),
				  the request is deemed denied.
(4)
				  If any party files a request for reconsideration of the final order, the
				  reconsideration process must be completed before any judicial review may be
				  requested. However, the filing of a request for reconsideration is not required
				  before requesting judicial review.
(5) An order denying a request for
				  reconsideration is not subject to judicial review.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3200 - Judicial review of final order

Current through Register Vol. 24-14, July 15, 2024
(1)
				  Judicial review is the process of appealing a final order to a court.
(2) The appellant may appeal a final order by
				  filing a written petition for judicial review that meets the requirements of
				  RCW
				  34.05.510 through
				  34.05.598.
				  The school employees benefits board (SEBB) program may not request judicial
				  review.
(3) The appellant should
				  consult
				  RCW
				  34.05.510 through
				  34.05.598 for
				  further details and requirements of the judicial review process.
Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-32 - Appeals practices and procedures › Part III - FORMAL ADMINISTRATIVE HEARINGS › Section 182-32-3210 - Petitions for judicial review-Service on the authority

Current through Register Vol. 24-14, July 15, 2024
Delivery pursuant to
					 RCW
					 34.05.542(4) shall be deemed
					 to have been made when a copy of the petition for judicial review has been
					 received by the school employees benefits board (SEBB) appeals unit at Cherry
					 Street Plaza, 626 8th Avenue S.E., Olympia, WA 98501 or received by mail at the
					 SEBB appeals unit, P.O. Box 45504, Olympia, WA 98504-5504.