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(a) If more than one coverage option is available through an employment-related group health plan, the employer shall provide the agency with information concerning the specific coverage provided by each option and the cost of the coverage for the children. Upon receipt of this information, the agency will contact both parents to determine which coverage option would be in the best interest of the children. The agency will select the coverage option that the agency determines will best meet the medical needs of the children at a reasonable cost. The agency will notify the employer of the coverage option selected.
(b) When the agency selects a coverage option under (a) of this section, the agency will send a notice to the parents of the selection. A parent may contest the selection by requesting an administrative review within 30 days after the date on which the notice is sent to the parents. The request must be in writing, state the specific reasons for the contest, and be accompanied by the documentation upon which the parent requesting the review intends to rely. The agency will conduct an administrative review within 20 days after it receives the request. The agency's administrative review is limited to whether
(1) the coverage option selected by the agency is available to the parent at a reasonable cost; or
(2) a coverage option other than the one selected by the agency would better meet the medical needs of the children at a reasonable cost.
(c) An administrative appeal is not available from the administrative review decision issued under (b) of this section, but the decision is final for the purpose of appeal to the superior court.
History: Eff. 11/30/2002, Register 164
Authority: AS 25.27.020
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Last modified 7/05/2006