Appeals and reporting tightened in proposed OJI plan; trustees get 10/30-day windows

The consultant said the proposed OJI rewrite tightens dispute-resolution timelines and formalizes who manages appeals. Under the draft, an injured employee may request an informal dispute meeting with plan management in writing within 10 calendar days; if unsatisfied, they may request a formal appeal to the Self Insurance Board in writing within 30 calendar days of the informal meeting. "There's a request deadline. So the meeting must be requested in writing within 10 calendar days," the consultant said.

Trustees also heard that the plan manager (claims manager/"Kim") will be the primary contact for scheduling and that the plan narrows the informal meeting to the issues specified in the written request to prevent open-ended rehearings. The board discussed keeping firm deadlines while preserving limited discretionary authority for risk management in certain benefit decisions.