HomeMy WebLinkAbout10-01-2001 City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 1, 2001 - 10:00 AM- Conference Room I
MINUTES
I. CALL TO ORDER
Chair Jim Kelly called the October 1, 2001 LEOFF Board meeting to order at
10:00 AM in Room I located at Auburn City Hall, 25 West Main Street, Auburn,
WA, 98001. Members present included: Chair Jim Kelly, Chair Pro Tem Bud
Larson and Member Stacey Brothers. Members Jeanne Barber and Russ
Vandver were excused. Others present included Mayor Charles Booth,
Associate City Attorney Karen Gulliver, and Board Secretary Danielle Daskam.
II. APPROVAL OF MINUTES
A. Minutes of the September 4. 2001 LEOFF Board Meeting
Motion by Chair Pro Tem Larson, second by Member Brothers to approve
the September 4, 2001 LEOFF Board minutes as distributed.
MOTION CARRIED UNANIMOUSLY. 3-0.
B. Minutes of the September 24, 2001 Special LFOFF Board Meeting
Motion by Chair Pro Tem Larson, second by Member Brothers to approve
the September 24, 2001 LEOFF Board minutes as distributed.
MOTION CARRIED UNANIMOUSLY. 3-0.
III. UNFINISHED BUSINESS
A. Pending Disability Leave/Retirement Applications
There was no pending disability leave/retirement application.
B. Claims
1. Ronald L. Cude
a. Request for reimbursement of medical services received on
March 9, 2001 in the amount of $202.47.
b. Request for reimbursement of medical services received in
March, April and May 2001 in the amount of $354.79.
LEOFF Board Minutes
October 1, 2001
Page 1
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 1, 2001 - 10:00 AM - Conference Room I
On August 6, 2001, the Board tabled Mr. Cude's claim
pending the receipt of the required insurance explanation of
benefits statements. On September 4, 2001 the Board
received Medicare and Regence Explanation of Benefits
Statements from Mr. Cude in support of his claim.
On September 4, 2001, Board members noted the Medicare
and Regence Explanation of Benefits Statement referenced
different service dates and others noted a message code
that "payment was made to the provider on assigned
charge-patient is not responsible for balance."
At the request of the Board, Beverly Lakey, a Benefits
Specialist with the Association of Washington Cities Benefit
Trust, reviewed the documents submitted by Mr. Cude.
According to Ms. Lakey, Mr. Cude's claim in the amount of
$354.79 for services received on March 8, 2001 from Dr.
Gilbert was submitted with a Regence Explanation of
Benefits but not the related Medicare Explanation of Benefits
Statement. She reported that it appears there is no balance
as the provider accepted assignment. With regard to the
claim in the amount of $202.47 for services received on
March 9, 2001, Mr. Cude submitted the Medicare
Explanation of Benefits, but not the related Regence
Explanation of Benefits Statements.
Motion by Member Brothers, second by Chair Pro Tem
Larson to table Mr. Cude's claim in the amount of $354.79
pending receipt of the Medicare Explanation of Benefits
Statement for services received on March 8, 2001.
MOTION CARRIED UNANIMOUSLY. 3-0.
Motion by Member Brothers, second by Chair Pro Tem
Larson to table Mr. Cude's claim in the amount of $202.47
pending receipt of the Regence Explanation of Benefits
Statement for services received on March 9, 2001.
MOTION CARRIED UNANIMOUSLY. 3-0.
LEOFF Board Minutes
October 1, 2001
Page 2
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 1, 2001 - 10:00 AM - Conference Room 1
C. Appeals
1. James Fisk
In a letter received August 27, 2001, Mr. James Fisk filed a request
for reconsideration of the August 6, 2001 LEOFF Board action
denying his claim that was beyond the ninety (90) day limitation for
filing claims. On September 4, 2001, the LEOFF Board scheduled
today's meeting for hearing Mr. Fisk's appeal.
Mr. Fisk was not in attendance at the meeting.
Motion by Member Brothers, second by Chair Pro Tem Larson to
postpone Mr. Fisk's appeal until the end of today's agenda.
MOTION CARRIED UNANIMOUSLY. 3-0.
Following Item IV.E.1 of these minutes and finding that Mr. Fisk
was not in attendance, Chair Pro Tem Larson moved and Member
Brothers seconded to deny Mr. Fisk's appeal.
MOTION CARRIED UNANIMOUSLY. 3-0.
IV. NEW BUSINESS
A. Disability l eave/Retirement Applications
There was no new application for disability leave/retirement.
B. Appeals
There were no new requests for reconsideration.
C. Medical Claims
1. Gerry E. Fuller
a. Request for reimbursement of lens expenses in the amount
of $37.00.
Board members reviewed Mr. Fuller's Eye Exam and
Corrective Lenses Worksheet and LEOFF Board Policy
9.02.
LEOFF Board Minutes
October 1, 2001
Page 3
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October I, 2001 - 10:00 AM - Conference Room 1
Motion by Chair Pro Tem Larson, second by Member
Brothers to deny Mr. Fuller's claim in the amount of $37.00
as it is in excess of the amount allowed under LEOFF Board
Policy 9.02.
MOTION CARRIED UNANIMOUSLY. 3-0.
b. Regence Explanation of Benefits Claim No. 0122720633000
processed on August 27, 2001 for services received on
August 6, 2001 in the amount of $53.36.
Motion by Member Brothers, second by Chair Pro Tem
Larson to approve Mr. Fuller's claim in the amount of
$53.36.
MOTION CARRIED UNANIMOUSLY. 3-0.
2. Stan Laatsch
Request for reimbursement of lense expenses incurred on June 2,
2001 in the amount of $93.00.
LEOFF Board members reviewed Mr. Laatsch's claim noting that
his claim includes a service worksheet from Kosnoski Eye
Associates and a letter from the treating doctor, Paul Chous,
addressed to Vision Service Plan. The claim was not accompanied
by a LEOFF Corrective Eye Exam and Lenses Worksheet or proof
of payment from Vision Service Plan.
Motion by Chair Pro Tem Larson, second by Member Brothers to
table Mr. Laatsch's claim pending the receipt of additional
information.
MOTION CARRIED UNANIMOUSLY. 3-0.
3. Ray M. Nixon
a. Request for reimbursement of lense expenses incurred July
2, 2001 and processed by VSP insurance on September 4,
2001 in the amount of $130.00.
LEOFF Board Minutes
October 1, 2001
Page 4
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 1, 2001 - 10:00 AM - Conference Room 1
Board members reviewed Mr. Nixon's claim, including an
Eye Exam and Corrective Lenses Worksheet, a Vision
Service Plan Vision Care Benefit Reimbursement form, and
a receipt from WalMart Vision Center.
Motion by Member Brothers, second by Chair Pro Tem
Larson to approve reimbursement of lense expenses for Mr.
Nixon in the amount of $130.00.
MOTION CARRIED UNANIMOUSLY. 3-0.
b. Request to purchase hearing aids from other than the
LEOFF Board hearing aid provider in the total amount of
$5,640.00.
Chair Kelly acknowledged receipt of a letter and audiogram
from Powers Hearing Rehabilitation Center for the provision
of hearing aids for Mr. Nixon in the amount of $5,640.
Motion by Chair Pro Tem Larson, second by Member
Brothers to table Mr. Nixon's claim for hearing aids and
request the Costco Hearing Aid Center provide information
on the cost of equivalent hearing aids.
MOTION CARRIED UNANIMOUSLY. 3-0.
D. Correspondence
1. E-mail addressed to Jim Kelly from Patricia Djarf dated September
25, 2001.
Chair Kelly reported that he received an e-mail from retired Police
Specialist Patricia Djarf, in which Ms. Djarf explains that she is
working with Medicare and Regence to correct her Medicare record
which mistakenly shows that Medicare is secondary to the
Regence insurance. Neither insurance has paid her claims
claiming that the other is the primary insurance carrier. The
purpose of her e-mail is to forewarn the Board that her claims may
be delayed and not submitted within the ninety-day limit.
Board members agreed no action is required at this time.
LEOFF Board Minutes
October 1, 2001
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 1, 2001 - 10:00 AM - Conference Room 1
E. Discussion
1. LEOFF Board Policies and Procedures
Chair Kelly requested the Board review the LEOFF Policy and
Procedure Manual and bring forward any proposed amendments
for discussion at the next meeting. Chair Kelly suggested the
following areas for future discussion: a policy relating to laser eye
surgery; possible amendments to Section 9.02, Medical Claims for
Corrective Lenses; and possible amendment of Section 9.01(I)
which provides for the time limit for filing claims.
Chair Kelly requested the Board Secretary obtain corrective lense
and frame policies from other LEOFF Boards and a copy of the
Vision Service Plan benefit schedule for review at the next Board
meeting.
Chair Kelly also requested the Board Secretary obtain copies of
other LEOFF Boards' laser eye surgery policies for discussion at
the next Board meeting.
V. ADJOURNMENT
There being no further business to come before the LEOFF Board, the meeting
adjourned at 10:36 AM.
APPROVED THE ~ ' DAY OF NOVEMBER, 2001.
~m~<elly, Chair B Secretary
LEOFF Board Minutes
October 1, 2001
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