HomeMy WebLinkAbout02-02-2016 Minutes City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, February 2, 2016 - 70:00 AM — Council Conference Room
MINUTES
I. CALL TO ORDER
Chair Jim Kelly called the meeting to order at 10:00 a.m. in the Council
Conference Room located on the first floor of Auburn City Hall, 25 West Main
Street in Aubu�n. Members present included Chair Kelly, Chair Pro Tem Bill
Petersen, Member Yolanda Trout, Member Claude DaCorsi, and Member-at-
large Kurt Vogel. Also present were Board Attorney Doug Ruth and Board
Secretary Danielle Daskam. LEOFF 1 Fire retiree Mick Crawford was also in
attendance.
II. AGENDA MODIFICATIONS
There was no change to the agenda.
III. APPROVAL OF MINUTES
A. Minutes of the Januarv 5. 2016 LEOFF Board Meetinq
Motion by Chair Pro Tem Petersen, second by Member Trout to approve
the January 5, 2016 minutes as distributed.
MOTION CARRIED UNANIMOUSLY. 5-0
IV. UNFINISHED BUSINESS
A. Pendina Disabilitv Leave/Retirement Aqplications
There was no pending disability leave/retirement application.
B. Pendina Medical/HearinqNision/Dental Claims
1. Murrav Board
Request for reimbursement of dental expenses in the amount of
$984 for services received on December 2, 2015.
'MURRAY BOARD $1,200.00 IBALANCE I,
i2015 _ i $1,200.00_i
i - - --- �
June 2, 2015 5267.001 5933.00 i
I i � I
On January 5, 2016, the LEOFF Board tabled the claim pending
clarification on whether the services provided were eligible under
medical insurance. See fhe enclosed email from the Association of
LEOFF Board Minutes
February 2, 2016
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, February 2, 2016 - 10:00 AM — Council Conference Room
Washington Cities Benefits Representative, which explains 4hat
insurance covers only surgery and related services to the surgery
for Mr. Board's condition; insurance does not cover other
treatment.
Motion by Chair Pro Tem Petersen, second by Member Vogel to
approve the claim in the amount of $933.00, which is the balance
of Mr. Board's 2015 derital benefit.
MOTION CARRIED UNANIMOUSLY. 5-0
2. Cali Ann Edwards
Request for reimbursement of equipment in fhe amount of
$20,077.35.
On January 5, 2016, the LEOFF Board tabled Ms. Edwards' claim
pending receipt of addifional information regarding the medical
necessity of the equipment and whether the claims were submitted
to Medicare/insurance. No new information was received.
V. NEW BUSINESS
A. Disabilitv Leave/Retirement Applications
No application for disability leave/retirement was received.
B. Appeals/Requests for Reconsideration
No request for reconsideration was received.
C. Medical/HearinqNision/Dental Claims
1. Dave Schuur
Request for approval/reimbursement of long-term care expenses
for the month of Jarivary 2016 in the amount of $4,253.20
($137.20/day).
Motion by Chair Pro Tem Petersen, second by member Trout to
approve the claim in the amount of $4,253.20.
MOTION CARRIED UNANIMOUSLY. 5-0
2. Theodore Lindback
Request for reimbursement of dental expenses in the amount of
$99.75 for services received on January 18, 2016. Mr. Lindback
has not received dental expense reimbursement in 2016.
LEOFF Boarii Minutes
February 2, 2016
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, February 2, 2016 - 10:00 AM — Council Conference Room
Motion by Chair Pro Tem Petersen, second by Member Vogel to
approve the claim in the amount of $99.75.
MOTION CARRIED UNANIMOUSLY. 5-0
3. Michael Darbv
Request for reimbursement of dental expenses in the amount of
$189.00 for services received on January 13, 2016. Mr. Darby has
not received dental expense reimbursement in 2016.
Motion by Member Vogel, second by Chair Pro Tem Petersen to
approve the claim in the amount of $189.00.
MOTION CARRIED UNANIMOUSLY. 5-0
D. Other Discussion
1. Policv and Procedure Manual Uodate
Board Attorney Ruth reviewed his memo to the Board dated
January 28, 2016 regarding LEOFF Board Policy Manual 2016
Changes. Attorney Ruth stated he reviewed the current Policies
and Procedures for conformance with current statutes and case
law. In 2013, the State Legislature revised RCW 41.26.110 to
address a potential dilemma in electing LEOFF board members.
The new law provides the authority for LEOFF 1 law enforcement
officers and fire fighters to elect a second representative if no Plan
1 fire fighters or law enforcement officers are eligible to vote.
Attorney Ruth suggested amending Section 1.01 Membership to
add a new paragraph E:
Section 1.01 Membership.....
E. If there are either no fire fiqhters or no law
enforcement officers uhder the iurisdiction of the board
eliqible to vote, the eliqible officers or fire fiqhters shall elect
a second eliqible emalovee reoresentative.
Board Attorney Ruth also suggested the following changes to
Section 9.02 relating to vision services. The proposed
amendments eliminate an ambiguity in the policy language that
addresses vision benefits in Section 9.02(C) and the revisions to
Section 9.02(C) and the reimbursement worksheets intend to clarify
the provisions. Additionally, revisions are proposed to remove
LEOFF Board Minutes
February 2, 2016
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City of Auburn Law Enforcement Office's and Firefighters Disability Board
Tuesday, February 2, 2016 - 10:00 AM — Council Conference Room
archaic language and combine worksheets for retirees and active
members into one worksheet.
Upon further discussion by the Board, the following amendments
were recommended including the proposed changes to the claims
worksheets:
Section 9.02 Medical Claims for Corrective Lenses and Frames
A. Active LEOFF 1 Members
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rtie I C/1CC c.,�..a �.,. ..,...�.,+e..,.,,... The LEOFF Board wlll
reimburse up to the amounts described below. The
reimbursement rates apply after all insurance coverages have
been applied. Any balance due after the LEOFF Board
reimbursement is the responsibility of the LEOFF I member. To
receive reimbursement, fhe member shall forward a coav of anv
insurance Exqlanation of_Benefits Statement toqether with a
completed Corrective Lenses and Frames Worksheet to the
LEOFF Board for consideration.
B. Retired LEOFF I Members
Eye examinations for retired LEOFF I members are to be
charged to the City-contracted plan . The
retired LEOFF I member may purchase from the optician or
ophthalmologist of his or her choice.
The member shall s�ieald forward a completed Corrective
Lenses and Frames Worksheet to the LEOFF Board for
consideration for any lenses and frames expense. The LEOFF
Board will reimburse up to the amounts described below. The
reimbursement rates apply after all, if any, insurance coverages
have been applied. Any balance due after the LEOFF Board
reimbursement is the responsibility of the LEOFF I member.
C. Vision Benefits
Payments for eyeglasses and contact lenses, plus the
reasonable costs of necessary eye examination services of a
LEOFF Board Minutes
February 2, 2016
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, February 2, 2016 - 10:00 AM — Council Conference Room
licensed ophthalmologist or optometrist, will be approved
pursuant to the authority granted to the Board under RCW
41.26.150, if eyeglas.ses are prescribed by an ophthalmologist
or optometrist:.
The Board will approve payment either for one pair of
eyeglasses or for contact lenses, at the member's option, or as
prescribed, to correct vision when required for a new
prescription in accordance with the following schedule:
1. Evealass Lenses and Frames: $270.00 maximum per single
set of frames and pair of lenses not more than once every
twelve (12) consecutive months. Lenses covered include
single vision, bifocal, trifocal and progressive lenses.
2. Second Pair: A second pair of monofocal (i.e. computer)
glasses shall be approved only if prescribed by a
ophthalmologist or licensed optometrist. The maximum cost
of the second pair shall not exceed $270.00 per single set of
frames and pair of lenses not more than once in a twenty-
four (24) consecutive months.
3. Contact Lenses: Not to exceed $250 maximum during any
twelve (12) month period including disposable contact
lenses.
4. Replacement: Claims for replacement pair of eyeglass
frames and/or lenses or contacts will be allowed if proof of
damage is provided and shown to have been incurred in the
performance of a member's fire or law enforcement duties.
Only one replacement pair per year, due to accidental
damage, will be allowed, not to exceed the amount allowable
above.
5. Additional/S�are Pair: No reimbursement will be made for a
spare pair of glasses or contact lenses. (Rev. 5/2008)
D. Corrective Vision.Surqerv
The Board will reimburse the member the amount of $1,000 per
eye for corrective vision surgery. If a member is reimbursed the
$1,000 per eye for the surgery, he or she will not be reimbursed
for eyeglasses or contact lenses during the subsequent two
calendar years, unless eyeglasses or contact lenses are
medically necessary. (Rev. 7/2012)
LEOFF Board Minutes
February 2, 2016
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, February 2, 2016 - 10:00 AM — Council Conference Room
Upon discussion of LEOFF 1 Fire retiree Mick Crawford's
suggested policy revisions, it was consensus of the Board not to
amend Sections 9.09, 9.02B, 9.03 or 9.01(A)(1) at this time.
It was consensus of the Board members to amend Sections 9.01(I)
and (J) to allow LEOFF 1 members to submit claims for payment
for office co-pays within 12 months and to allow payment of the
claim with the approval of the LEOFF 1 representative to the Board
rather than require full LEOFF Board review and approval prior to
payment to the LEOFF 1 member.
Chair Kelly brought forward a discussion of coverage limits for
vision, dental, and hearing aids that are currently in the LEOFF
Policies and Procedures. Chair Pro Tem offered to submit a
comparison of benefits obtained from last year's LEOFF
conference. Each year, the organizers of the LEOFF Conference
prepare a comparison of other jurisdiction's policies and benefits
provided under their policies.
2. Mick Crawford
(For clarification of these minutes, Mr. Crawford's comments were
received immediately following approval of the minutes.)
LEOFF 1 Fire Captain retiree Mick Crawford addressed the Board
regarding his eligibility for Social Security and Medicare Parts A, B
and C. Mr. Crawford reported he received a letter from the City's
Human Resources Director advising that anyone over the age of 65
can purchase Medicare Part B. Mr. Crawford stated the LEOFF
Policies state that the amount the Board is obligated to pay for his
medical services will be reduced any amount received or eligible to
be received by another insurance company or under Medicare. Mr.
Crawforc! confended he is not eligible for Medicare Parts A, B or C.
He stated he applied twice for Meclicare and received two rejection
letters from Social Security.
Mr. Crawfortl questioned the authority under which the City is
requiring him to purchase Medicare Part B, even though he is not
eligible for Medicare. And, additionally, if there is authority to
require him to purchase Medicare Part B, why not Part A.
Board Attorney Ruth stated the policies reference the requirement
to enroll in Medicare Part B in a couple sections of the policies and
procedures and references RCW 41.26.152; however, he will need
to perform additional research on the question.
LEOFF Board Minutes
February 2, 2016
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City of Auburn Law Enforcement Offcers and Firefighters Disability Board
Tuesday, February 2, 2016 - 10:00 AM — Council Conference Room
Chair Pro Tem Petersen added that Social Security and Medicare
are separate issues. Chair Pro Tem Petersen stated he believes it
is Ehe state LEOFF statute that requires members to subscribe to
Medicare Part B.
Chair Kelly questioned whether the scenario is isolated to retiree
Mick Crawford or are other fire members affected.
Mr. Crawford proposed changes to the current policies and
procedures to eliminate prior approval for an eye examination and
hearing exam.
Mr. Crawford also proposed extending the 90 day period that
medical claims must be submitted.
Mr. Crawford also advised the Board that the new insurance,
Premera, is requiring him to obtain a primary physician and a
referral to his heart doctor, which he has been a patient of for over
seven years. Mr. Crawford also expressed frustration that the new
insurance is requiring changes in how some of his drugs are
dispensed.
Chair Kelly reques4ed Mr. Crawford work with the City's Human
Resources Department to rectify any medical insurance coverage
issues he is experiencing.
VI. ADJOURNMENT
There being no further business to come before the Board, the meeting
adjourned at 10:47.
APPROVED this 2nd day of March, 2016.
A/w�rc.a �E� ���k� /
JIM I:ELLY, CHAIR Danielle Daskam, Board Secretary
LEOFF Board Minutes
February 2, 2016
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