1. COMPLIANCE AND RISK MANAGEMENT
    2. Claims and Appeals


    410

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    COMPLIANCE AND RISK MANAGEMENT

     

     





    Claims and Appeals

     

    Benefits under the Everett School Employee Benefit Trust (“Trust”) will be paid only if the Trustees of the Trust (“Trustees”) or their delegate decides, in their discretion, that participants and their dependents are entitled to them. Any person claiming a benefit, requesting an interpretation or ruling under a benefit plan offered through or by the Trust or requesting information under a benefit plan offered through or by the Trust shall follow the claims procedure established by the Trustees or any insurance carrier insuring Trust benefits. The claims procedure shall conform to the requirements of applicable Washington law.

     

    The Trustees will also establish procedures for claims audits, in compliance with Washington law.

     

     
    Cross References: Trust Procedure 410.1P  Claims Procedure
    Trust document Section 4.16


     

     
    Legal Reference: WAC 200-110-120  (Applies only if the Trust self-insures any Trust benefits.) Standards for claims management—Claims administration


     

     
    Adopted:
    January 1, 2004
    Revised:
    January 24, 2011
    Revised:
    October 16, 2013

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