Partial federal government shutdown
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
Find out how you can appeal a decision or denial by your employer or the Public Employees Benefits Board (PEBB) Program.
If you are a subscriber, dependent, or applicant for PEBB benefits, you may be able to file an appeal of a decision made by your employer or the PEBB Program. The rules for filing an appeal are in Chapter 182-16 WAC.
If you are seeking an appeal of a decision by a PEBB medical, dental, or vision plan, insurance carrier, or benefit administrator, see How can I appeal a decision made by a plan? For example, you would contact your health plan to appeal a denial of a medical claim.
The appeals process varies depending on your situation. Select your demographic to find the appeals process for your situation.
If your situation is: | Follow these instructions and submission deadlines |
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You disagree with a decision made by your employer and are requesting your employer's review about:
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Instructions: Complete Sections 1 through 3 of the PEBB Employee Request for Review/Notice of Appeal form and submit it to your payroll or benefits office. Deadline: Your payroll or benefits office must receive the form no later than 30 days after the date of the initial denial notice or decision you are appealing. |
You disagree with a review decision made by your employer and are now requesting the PEBB Appeals Unit review of your employer's decision. |
Instructions: Complete Section 6 and sign and date Section 8 of the PEBB Employee Request for Review/Notice of Appeal form and submit it to the PEBB Appeals Unit as directed on the form, use HCA Support, or follow these appeal rules. Deadline: The PEBB Appeals Unit must receive the form no later than 30 days after the date of your employer's written review decision date in Section 4. |
You disagree with a decision from the PEBB Program about:
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Instructions: Follow the instructions on the decision letter you received from the PEBB Program. |
If your situation is: | Follow these instructions and submission deadlines: |
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You disagree with a decision made by your employer about:
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Instructions: Contact your employer for information on how to appeal the decision or action. |
Disagree with a decision by your employer, a PEBB insurance carrier, or contracted vendor:
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Instructions: Complete Sections 1 through 3 of the PEBB Employee Request for Review/Notice of Appeal form and submit to the PEBB Appeals Unit as directed on the form, use HCA Support, or follow these appeal rules. Deadline: The PEBB Appeals Unit must receive the form no later than 30 days after the date of the denial notice or decision you are appealing |
If your situation is: | Follow these instructions and submission deadlines: |
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You disagree with a decision from the PEBB Program about:
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Instructions: Submit the Retiree/PEBB Continuation Coverage Notice of Appeal form to the PEBB Appeals Unit as instructed on the form, use HCA Support, or follow these appeal rules. Deadline: The PEBB Appeals Unit must receive your appeal no later than 60 days after the date of the denial notice or decision you are appealing |
Based on the group you belong to above, follow the instructions and submission deadlines for that type of appeal.
You can request review of the Presiding Officer’s Initial Order by following the instructions in the Initial Order's "How to request review of this Initial Order" section.
Once your request for review is received by the PEBB Appeals Unit, a decision will generally be mailed within 20 days. If you have questions call us at 1-800-351-6827.
If you are seeking a review of a decision by a PEBB medical, dental, or vision plan, insurance carrier, or benefit administrator, contact the plan to request information on how to appeal its decision. For example, you would contact your health plan to appeal a denial of a medical claim.
You must provide the PEBB Program with a copy of a valid power of attorney or a completed Authorization for Release of Information form naming your representative and authorizing him or her to access your medical records and exercise your rights under the federal Health Insurance Portability and Accountability Act (HIPAA) of 1996.
PEBB Appeals Unit
Phone: 1-800-351-6827
Fax: 1-360-763-4709
Mailing address:
PEBB Appeals Unit
Health Care Authority
PO Box 45504
Olympia, WA 98504-5504