· | Applicable restrictions, limitations, and exclusions; |
· | The procedure for filing a claim for benefits; |
· | The procedure for requesting an adjudication of disputes or appeals arising from beneficiaries regarding the payment or denial of any claim for benefits; and |
· | A schedule of any direct monetary contributions toward the program financing required by the employee. |
Legal Reference: | WAC 200-110-060 (Applies only if the Trust self-insures any Trust benefits.) Standards for operations—Standards for management—Disclosures |
Patient Protection and Affordable Care Act of 2010, as amended by the Health care and Education Reconciliation Act of 2010, and its implementing regulations |
Adopted: | ||
August 29, 2005 | ||
Revised: | ||
January 24, 2011 | ||
Revised: | ||
October 16, 2013 | ||