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Home My WebLink About07-05-2005 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 5,2005 -10:00 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 at Auburn City Hall, 25 West Main Street in Auburn. Chair Kelly and the following Board members were present: Chair Pro Tem Bud Larson (member-at-Iarge), Member Bill Peloza, and Member Roger Thordarson. Member Russ Vandver was excused. Also present was Deputy City Clerk Cathy Richardson. II. APPROVAL OF MINUTES A. Minutes of the June 7, 2005 LEOFF Board Meetinq Motion by Chair Pro Tem Larson, second by Member Thordarson to approve the June 7, 2005 minutes as distributed. MOTION CARRIED UNANIMOUSLY. 4-0. III. UNFINISHED BUSINESS A. Pendinq Disabilitv Leave/Retirement Applications There was no pending disability leave/retirement application. B. Medical/HearinoNision Claims 1. Ed Henderson Request for reimbursement of (Medicare) claim #11-05025-241- 830 (no Regence EOB submitted) for medical services received on January 21, 2005 and processed by Medicare on February 11, 2005 in the amount of $23.30. Mr. Henderson's claim was tabled on April 5, May 3, and June 7, 2005, pending the receipt of the Regence Explanation of Benefits statement. To date, no response has been received. Motion by Chair Pro Tem Larson, second by Member Thordarson to deny Mr. Henderson's claim for medical services due to lack of response by the claimant to the Board's request for the Regence Explanation of Benefits statement. MOTION CARRIED UNANIMOUSLY. 4-0. LEOFF Board Minutes July 5, 2005 Page 1 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 5,2005 -10:00 AM - Council Conference Room 2. John T. Calkins Request for reimbursement of Regence Claim #0500432571900 for medical services received on December 8, 2004 and processed by Regence on January 21, 2005 in the amount of $274.00. On April 5, May 3, and June 7, 2005, the Board tabled Mr. Calkins' claim. Previously, the Board had requested Mr. Calkins have his physician resubmit the claim to Regence with supporting medical data that medical services received were non-routine/preventative. To date, no further information has been received. Motion by Chair Pro Tem Larson, second by Member Thordarson to deny Mr. Calkins' claim for medical services due to lack of response by the claimant to the Board's request for Mr. Calkins to follow-up with his physician to re-bill Regence with supporting medical data that medical services received were non- routine/preventative. MOTION CARRIED UNANIMOUSLY. 4-0. 3. Fred Fisher Claim for payment in the amount of $117.54 for medical services received on October 18, 2004. On June 7, 2005, the LEOFF Board tabled Mr. Fisher's claim pending the receipt of the Regence Explanation of Benefits Statement. To date no response has been received. Motion by Chair Pro Tem Larson, second by Member Thordarson to table Mr. Fisher's claim pending the receipt of the Regence Explanation of Benefits Statement MOTION CARRIED UNANIMOUSLY. 4-0. 4. Rav Oqden Claim for reimbursement of vision expenses in the amount of $377.00. Mr. Ogden's last reimbursement for vision expenses were approved on July 6, 2004 in the amount of $200.00 for a claim received June 10, 2004 for services received on February 11, 2004. On June 7, 2005, the LEOFF Board tabled Mr. Ogden's claim pending further research to determine whether the claim had been LEOFF Board Minutes July 5, 2005 Page 2 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 5, 2005 - 10:00 AM - Council Conference Room previously paid. LEOFF Board records indicate that on July 6, 2004, the LEOFF Board approved $200.00 towards the same expenses. Motion by Chair Pro Tem Larson, second by Member Thordarson to deny the Mr. Ogden's claim for vision expenses due to prior payment to Mr. Ogden in the amount of $200.00 towards the same claim for vision .expenses. MOTION CARRIED UNANIMOUSLY. 4-0. IV. NEW BUSINESS A. Disabilitv Leave/Retirement Applications There was no new disability leave/retirement application. B. Appeals/Requests for Reconsideration No appeal or request for reconsideration was filed. C. Medical/HearinqNision Claims 1. Bruce Caldwell Claim for Regence Explanation of Benefits Statement #0513832376500 for medical services received on May 10, 2005 and processed by insurance on June 1, 2005 in the amount of $70.19. Motion by Member Peloza, second by Member Thordarson to approve the claim in the amount of $70.19. MOTION CARRIED UNANIMOUSLY. 4-0. 2. Roqer Lee Claim for reimbursement of lenses and frames in the amount of $290.00. (Mr. Lee has not received reimbursement for vision expenses in the past year.) Motion by Member Peloza, second by Chair Pro Tem Larson to approve the claim in the amount of $200.00 per Section 9.02 relating to claims for corrective lenses and frames. MOTION CARRIED UNANIMOUSLY. 4-0. D. Discussion LEOFF Board Minutes July 5, 2005 Page 3 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 5,2005 - 10:00 AM - Council Conference Room 1. Policy and Procedure Amendment - Medical Claims Procedure Pursuant to discussion at the June 7, 2005 LEOFF Board meeting regarding guidelines for incomplete claims submitted by LEOFF members, the following proposed amendment to Section 9.01 (I) was submitted by Chair Kelly for consideration by the Board: LEOFF Board Minutes July 5, 2005 Page 4 I. All claims, except prescription claims, shall be submitted to the Board within ninety (90) days of date processed/paid by the insurance documentation. The Board will review the submitted claim at the next full Board meetino. If all documentation is submitted properly the Board will consider reimbursement of expenses. However. if for any reason, the claim for payment/reimbursement is insufficient, at the discretion of the Board. it may table the claim until the next meetinq or until receipt of the requested documentation. The claim may be tabled for three consecutive Board meetinqs. If, after three (3) Board meetinqs the Claimant has not provided the Board with the requested documentation, the claim for payment/reimbursement may be denied pendinq receipt of the requested information. Failure to comply may result in rejection of the claim. Member Peloza referred to the proposed Policy and Procedure Amendment and suggested amending the guidelines by striking a portion of the last three lines of the paragraph as follows: I. All claims, except prescription claims, shall be submitted to the Board within ninety (90) days of date processed/paid by the insurance documentation. The Board will review the submitted claim at the next full Board meetinq. If all documentation is submitted properly the Board will consider reimbursement of expenses. However, if for any reason, the claim for payment/reimbursement is insufficient. at the discretion of the Board, it may table the claim until the next meetino or until receipt of the requested documentation. The claim may be tabled for three consecutive Board meetinqs. If, after three (3) Board meetinqs the Claimant has not provided the Board with the requested documentation. the claim for payment/reimbursement may bo doniod pondino City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, July 5,2005 - 10:00 AM - Council Conference Room recoipt of tho roquostod information. F3ilure to comply ~result in rejection of the claim. Board Members concurred with the proposed amendment pending review by Board Attorney Joseph Beck. 2. New Medicare Part D Voluntary Prescription Druq Coveraqe Board Members briefly reviewed correspondence from Association of Washington Cities (AWC) regarding the new Medicare Part D Voluntary Prescription Drug Program. Member Peloza requested a presentation from the City's Human Resources Department related to the impacts of the new Medicare Part D Voluntary Prescription Drug Program to LEOFF members. Board Members concurred. 3. Continued Discussion from June 7, 2005 Meetinq Reqardino Annual Eye Examinations Discussion regarding annual eye examinations was postponed until August 2, 2005. V. ADJOURNMENT There being no further business adjourned at 10:22 a.m. APPROVED THE ). d DAY OF to come before the Board, the meeting {~~(~ () ,2005. ~~ \4-~ Ji Kelly, Chair \ ., , ( Cathy R hardson, Deputy City Clerk LEOFF Board Minutes July 5, 2005 Page 5