Health Insurance Appeals Board

Hears appeals regarding the decisions of the employee health plan administrator. The City Council makes two appointments to this seven member board. Both must have substantive professional experience in benefits administration for a large organization. The length of terms is three years, with openings occurring in February.

Members & Terms:

David Smith - Term Ending February 16, 2013
Vacant - Term Ending February 16, 2014

Establishing Legislation:

Sec. 19-114. Health insurance appeals board.

There shall be health insurance appeals board to hear appeals regarding the decisions of the employee health plan administrator.

(1) Composition of the board. The board shall consist of:

(a) Two (2) management representatives appointed by the city manager;

(b) Two (2) classified employee representatives elected at large by a majority vote of all city employees;

(c) Two (2) citizen members with substantive professional experience in benefits administration for a large organization, to be appointed by the city council; and

(d) The administrator, who is the director of human resources, shall serve as chair, with voting power only in case of a tie.

Board members shall serve staggered three-year terms, except the administrator, who will serve continuously. In the case of employee representatives, the employee receiving the most votes will serve a three-year initial term; and the one receiving the next highest number of votes will have a two-year initial term.

(2) Meetings; quorum; attendance; vacancies. The board shall hold such meetings as may be required for the transaction of business by the board. A quorum for the transaction of business at such meeting shall be a majority of the duly-appointed and acting members of the board.

(3) Powers and duties.

(a) The board shall hear appeals from the decisions of the administrator in accordance with the provisions of this article, and such additional rules as it shall adopt.

(b) Records of hearings before the board shall be kept by the board's secretary.

(c) The board shall have exclusive original jurisdiction to receive, hear, determine and rule upon all appeals from decisions of the administrator for benefits from the fund. The decision of the board shall be in writing, and the board may take and preserve the evidence on any disputed claim, and such evidence, records, findings and decisions of the board shall be subject to judicial review.

(d) The board shall have the power to prescribe rules and regulations, not inconsistent with state laws or this article, to govern and control the hearing, consideration and disposition of all appeals.

(Ord. No. 11335, § 2, 1-5-87; Ord. No. 1223, § 1, 4-17-89; Ord. No. 12276, § 1, 7-5-89; Ord. No. 12311, § 1, 8-7-89; Ord. No. 12474, § 1, 1-8-90; Ord. No. 15754, § 1, 9-21-98; Ord. No. 17658, § 1, 4-21-03)