HomeMy WebLinkAbout01-07-2002 City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM -Conference Room I
MINUTES
I. CALL TO ORDER
Chair Jim Kelly called the meeting to order at 10:00 AM on Monday, January 7,
2002, in Room I located at Auburn City Hall, 25 West Main Street, Auburn, WA.
Chair Kelly and the following Board members were present: Chair Pre Tem Bud
Larson, Member Stacey Brothers, Member Gene Cerino and Member Russ
Vandver. Also present were: Associate City Attorney Karen Gulliver, LEOFF
retiree Alan Kosko, and Board Secretary Danielle Daskam.
II. APPROVAL OF MINUTES
A. Minutes of the December 31 2001 LEOFF Board Meetin~
Motion by Chair Pre Tem Larson, second by Member Brothers to approve
the December 3, 2001 LEOFF minutes as distributed.
MOTION CARRIED UNANIMOUSLY. 5-0.
III. UNFINISHED BUSINESS
A. Pendinq 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.
On October 1, November 5, and December 3, 2001, the
Board tabled Mr. Cude's claim in the amount of $202.47
pending the receipt of Regence Explanation of Benefits
Statement, and tabled the claim in the amount of $354.79
LEOFF Board Minutes
January 7, 2002
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City of Auburn Law Enforcement Officers and Fireflghters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room I
pending the receipt of Medicare Explanation of Benefits
Statement. No new information was received.
Motion by Chair Pro Tern Larson, second by Member
Brothers to deny Mr. Cude's claims.
MOTION CARRIED UNANIMOUSLY. 5-0.
2. Patricia Diarf
a. Request for reimbursement of lense expenses in the amount
of $10.00.
On November 5, 2001, the LEOFF Board tabled Ms. Djad's
claim pending the receipt of the date of service for her claim.
On December 3, 2001 the Board Secretary received
insurance documentation from Ms. Djarf indicating a date of
service of October 12, 2001.
Motion by Member Brothers, second by Member Vandver to
approve Ms. Djart's claim in the amount of $10.00.
MOTION CARRIED UNANIMOUSLY. 5-0.
3. Bill Petersen
a. Regence Explanation of Benefits Claim No. 0124110541800
processed on September 12, 2001 for services received on
August 1,2001 in the amount of $222.00.
On December 3, 2001, the LEOFF Board tabled Mr.
Petersen's claim pending the receipt of additional
information regarding the medical necessity of the services
received.
The Board reviewed a note dated December 18, 2001 from
Dr. Steven Rittenberg, a memo from Mr. Petersen received
December 7, 2001, and a MultiCare statement received
December 7, 2001 in response to the Board's request for
additional information.
LEOFF Board Minutes
January 7, 2002
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room 1
Motion by Member Vandver, second by Member Cerino to
approve Mr. Petersen's claim in the amount of $222.00.
MOTION CARRIED UNANIMOUSLY. 5-0.
4. Bruce Caldwell
a. Regence Explanation of Benefits Claim No. 0129032081900
processed on October 31, 2001 for services/equipment
received on October 12, 200 in the amount of $294.00.
On December 3, 2001, the LEOFF Board tabled Mr.
Caldwelrs claim pending the receipt of additional information
regarding his claim.
On December 31, 2001, the LEOFF Board Secretary
received a letter dated December 24, 2001 from Dr. Sandra
F. Reilly in response to the Board's request for additional
information.
Motion by Member Brothers, second by Member Cerino to
approve Mr. Caldwell's claim in the amount of $294.00.
MOTION CARRIED UNANIMOUSLY. 5-0.
Alan Kosko
a. Request for pre-approval of oral surgery expenses in the
amount of $9,825.00.
On December 3, 2001, the LEOFF Board tabled Mr. Kosko's
request pending the receipt of additional information
regarding potential insurance coverages.
On January 2, 2002, the LEOFF Board Secretary received a
treatment estimate from Dr. Ryning, DDS, and letter dated
December 27, 2001 from Dr. Woo with an updated cost
estimate for the oral surgery procedure in the amount of
$10,028.00.
LEOFF Boa~ Minutes
Janua~ 7,2002
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room I
Chair Kelly welcomed Mr. Kosko to the meeting.
Member Vandver noted that the oral surgery estimate from
Dr. Woo covers the services necessary to reconstruct the
jaw and make it ready to receive the false teeth or crowns.
Dr. Woo estimates that none of the oral surgery expenses
will be covered by insurance. The dentist expense to place
the false teeth or crowns is $806.00 per tooth with Mr.
Kosko's dental insurance paying fifty percent of the
expense.
Mr. Kosko briefly described the oral surgery and implant
procedure.
Chair Kelly recalled the Board's discussion at the last regular
meeting regarding the medical necessity of a dental
procedure. He referred the Board members to Section
8.02(A) and 8.02(D) of the Board Policies and Procedures.
Motion by Member Brothers, second by Member Vandver to
preapprove Mr. Kosko's implant surgery procedure in an
amount not to exceed $10,028.00 and process the dental
claim for the crowns separately.
MOTION CARRIED UNANIMOUSLY. 5-0.
Mr. Kosko was instructed to have the oral surgery and
dental claims processed through insurance and submit a
Claim for Payment to the LEOFF Board following receipt of
the insurance explanation of benefits statements.
Mr. Kosko expressed his gratitude for the opportunity to
have worked for the City of Auburn Fire Department.
6. Richard Huseby
Member Vandver presented a request from Richard Huseby
for replacement of his hearing aids. A copy of a January 4,
2002, letter addressed to Mr. Huseby from Audiologist
Donna Watts of Northwest Otolaryngology was presented to
the Board as an agenda modification. The letter included a
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Janua~ 7,2002
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room '1
recommendation to replace his six year old hearing aids for
two fully digital hearing aids for a total cost of $3,786.00.
Motion by Member Brothers, second by Member Cerino to
instruct the Board Secretary to submit the information to the
Board's hearing aid provider, Costco Hearing Aid Center, for
determination of their equivalent cost.
MOTION CARRIED UNANIMOUSLY. 5-0.
IV. NEW BUSINESS
A. Disability Leave/Retirement Applications
There was no new application for disability leave/retirement.
B. Appeals
No request for reconsideration was filed.
C. Medical Claims
1. Bruce Caldwell
a. Regence Explanation of Benefits Claim No. 0130432051800
processed on November 21, 2001 for services received on
October 29, 2001 in the amount of $150.00.
b. Regence Explanation of Benefits Claim No. 0131032080500
processed on November 21, 2001 for services received on
November 1, 2001 in the amount of $150.00.
c. Regence Explanation of Benefits Claim No. 0131634112600
processed on November 21, 2001 for services received on
November 5, 2001 in the amount of $300.00.
Chair Kelly noted that the services received by Mr. Caldwell
and submitted for payment by the Board were not covered
by contract according to the Regence Explanation of
Benefits statement.
Motion by Member Vandver, second by Chair Pro Tern
Larson to table Mr. Caldwell's claims pending receipt of
LEOFF Board Minutes
January 7, 2002
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room 1
additional information explaining the medical procedure or
care received.
MOTION CARRIED UNANIMOUSLY. 5-0.
2. Dave Schuur
a. Request for reimbursement of lense and frames expenses in
the amount of $15.43.
Chair Kelly noted that a Corrective Lense and Frames
Worksheet was not completed by Mr. Schuur.
Motion by Chair Pro Tem Larson, second by Member
Brothers to table Mr. Schuur's claim pending the receipt of
the vision care worksheet.
MOTION CARRIED UNANIMOUSLY. 5-0.
3. Raymond Sherman
a. Regence Explanation of Benefits Claim No. 0129932217000
processed on November 7, 2001 for services received on
October 22, 2001 in the amount of $45.00.
Motion by Member Cerino, second by Member Brothers to
approve Mr. Sherman's claim in the amount of $45.00.
MOTION CARRIED UNANIMOUSLY. 5-0.
D. Election of Chairperson and Chairperson Pro Tem
Section 1.05 of the LEOFF Board Polices and Procedures provides that at
the first meeting of each year, the members shall elect from among the
members, a member to serve as Chairperson and a member to serve as
Chairperson pro tempore.
For clarification of these minutes, the election of Chairperson and
Chairperson Pro Tem occurred immediately following Item II.A of these
minutes.
LEOFF Board Minutes
Janua~ 7,2002
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City of Auburn Law Enforcement Officers and Fireflghters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room 1
Motion by Member Brothers, second by Member Vandver to elect Jim
Kelly as Chairperson.
MOTION CARRIED UNANIMOUSLY. 5-0.
Motion by Member Brothers, second by Member Vandver to elect Bud
Larson as Chairperson Pro Tem.
MOTION CARRIED UNANIMOUSLY. 5-0.
E. Discussion
1. LEOFF Board Policies and Procedures
LEOFF Board to consider the following proposed amendments to
the LEOFF Board Policy and Procedure Manual:
Page 5, Section 1.11(E)(1), line 8 - Correct typographical error to
insert period -"._ During..."
Page 8, Section 2.04, first paragraph, line 6 - change "his" to
"his/her"
Page 13, Section 3.12, first paragraph, third line on page 13 -
change "his" to "his/her".
Page 13, Section 3.13, second line - delete the words "his/her".
Page 13, Section 3.14, first line - replace the period with a comma.
Page 25, Section 8.02(E) changed to read: The Board will
authorize the payment of the expense of an eye exam by aR
licensed optometrist or licensed ophthalmologist.
Page 27, Section 8.03, paragraph 8 changed to read: An
optometrist licensed under the provisions of Chapter 18.53 RCW o_r
an ophthalmologist licensed under Chapter 18.71 RCW.
Page 30, Section 9.01(I), first line changed to read: "All claims,
except prescription claims, shall be submitted to the Board within
ninety (90) days of .... "
LEOFF Board Minutes
Janua~ 7,2002
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room t
Page 30, Section 9.01, add a new Paragraph "J" to read:
"PrescriptiOn claims shall be submitted to the Board within twelw
(12) months from date of purchase. This policy shall apply to all
prescription claims purchased on or after January 1, 2002."
Page 30, Section 9.01 re-letter paragraphs J, K and L to
paragraphs K, L, and M, respectively.
Page 30, Section 9.02, change the title of the Section to: Medical
Claims for Corrective Lenses and Frames.
Page 30, Section 9.02, replace the existing Section 9.02 with the
following language:
Reimbursement rates for corrective lenses and frames are based
on the Board's designated corrective lenses and frames service
provider, Costco, and will be reviewed every two years. Any claim
submitted by a member who chooses not use the LEOFF Board
designated corrective lenses and frames service provider or lives
outside the service area may be limited to reimbursement up to
what the designated corrective lenses and frames service provider
would charge.
A. Lenses and Frames.
1. Active LEOFF 1 Members
Vision insurance coverage is provided for active
LEOFF 1 members through Vision Service Plan. If
any balance remains after Vision Service Plan, or any
other vision plan the LEOFF I member is enrolled in,
has paid its benefit, the member should forward a
copy of the Explanation of Benefits statement
together with a completed Corrective Lenses and
Frames Worksheet to the LEOFF Board for
consideration. The LEOFF Board may 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.
LEOFF Board Minutes
January 7, 2002
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room t
Single Vision $ 40.00
Bifocal $ 60.00
Tdfocal $ 80.00
Progressive $100. O0
Contacts (must be medically necessary):
Hard $ 40. O0/pair
Soft $15.00~six pack
Frames $ 90. O0
Corrective lenses will be eligible for reimbursement
every year (12 months). Frames will be eligible for
reimbursement every two years (24 months).
2. Retired LEOFF I Members
Eye examinations for retired LEOFF I members are to
be charqed to Regence BlueShield. The retired
LEOFF I member may purchase from the optician or
ophthalmologist of his or her choice.
The member should forward a completed Corrective
Lenses and Frames Worksheet to the LEOFF Board
for consideration for any lenses and frames expense.
The LEOFF Board may 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.
Single Vision $ 40.00
Bifocal $ 60.00
Tdfocal $ 80.00
Progressive $100. O0
Contacts (must be medically necessary):
Hard $ 40. O0/pair
Soft $15. O0/six pack
Frames $ 90. O0
LEOFF Board Minutes
Janua~ 7,2002
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room 1
Corrective lenses will be eli.qible for reimbursement
every year (12 months). Frames will be eli.qible for
reimbursement every two years (24 months).
Page 30, Section 9.02, create a new paragraph "B" entitled "Laser
Vision Correction" to read as follows:
"The Board will reimburse the member the amount of $700 per eye
for Radial Keratotomy (RK) surgery or laser eye sur.qery (LASIK
and RK). If a member is reimbursed the $700 per eye for the
surgery, he or she will not be reimbursed for eye.qlasses or contact
lenses durin.q the subsequent two calendar years, unless
eyeglasses or contact lenses are medically necessary."
Page 33, Section 9.05(A)(6), change the provision to read: "The
Board will not reimburse for home health care provided by an
individual who ordinarily resides in the member's home, or is a
member of the family of either the member or the member's
spouse, unless the individual is a licensed home health care
provider.
Appendix A and the manual's cover page will be amended to reflect
the current membership and member information.
Board members discussed the proposed amendments to the Board
Policies and Procedures Manual.
It was consensus of the Board to change the word "may" to "will"
contained in proposed Section 9.02, first paragraph, line 6;
proposed Section 9.02(A)(1) line 9; and proposed Section
9.02(A)(2) second paragraph, line 4.
Upon further discussion and recommendation by Attorney Gulliver,
it was Board consensus to approve the following changes to
Section 10.02, Formal Adoption, to read as follows:
"Revisions of the Board's policies and procedures
shall be adopted no later than the regularly scheduled
Board meeting in February of the year of review."
LEOFF Board Minutes
Janua~ 7,2002
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, January 7, 2002 - 10:00 AM - Conference Room I
Motion by Member Vandver, second by Member Brothers to adopt
the proposed revisions to the Board's policies and procedures as
modified today.
MOTION CARRIED UNANIMOUSLY. 5-0.
V. ADJOURNMENT
There being no further business to come before the Board, the meeting
adjourned at 10:48 AM.
APPROVED THIS ~ DAY OF FEBRUARY 2002.
Jir~ Kelly, Chair ~ Danielle Daskam, Secretary
LEOFF Board Minutes
January 7, 2002
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