HomeMy WebLinkAbout10-02-2012 10/02/2012 City of Auburn Law Enforcement Officers and Fireflghters Disability Board
Tuesday, October 2, 2012 - 10:00 AM —Councii 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 Aubum.
Chair Kelly and the foilowing Board members were present: Bill Petersen, John
Holman, Wayne Osbome, and Kurt Vogel. Also present were Board Attomey
Steve Gross and Deputy City Clerk Shawn Campbell.
II. AGENDA MODIFICATIONS
A revised claim form was submitted by the Chair for discussion.
III. APPROVAL OF MINUTES
A. Minutes of the Seotember 4. 2012 LEOFF Board Meetinq
Motion by Member Holman, second by Member Vogel to approve the
September 4, 2012 minutes as distributed.
MOTION CARRIED UNANIMOUSLY 5-0
IV UNFINISHED BUSINESS
A. Pendina Disabilitv Leave/Retirement Aonlications
There was no pending disability leave/retirement application.
B. Pendina Medical/Hearin�sion Dental Claims
1 Ed Sluvs
Request for reimbursement of inedical services (medical device) in
the amount of$383.20.
On July 3, August 7 and September 4, 2012, the Board tabled Mr
Sluys' claim pending the receipt of additional information including
a statement of inedical necessity and the insurance explanation of
benefits statement. Nb addfional information was received.
Motion by Chair Pro Tem Petersen, second by Member Vogel to
deny the claim due to lack of response for additional information.
MOTION CARRIED UNANIMOUSLY 5-0
LEOFF Board Minutes
October 2,2012
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, October 2, 2012 -10:00 AM—Council Conference Room
2. Richard Husebv
Request for reimbursement of dental expenses in the amount of
$900 for services received on July 16, 2012. Mr Huseby has not
received dental expense reimbursement this year Mr Huseby
advised via a telephone conversation with the Board Secretary on
August 14, 2012, that he mistakenly believed that the maximum
dental reimbursement rate is $900 rather than $1,200. He wishes
to change his claim for payment to $1,200 in dental reimbursement
for a crown replacement. Mr Huseby submitted a detailed
description of his dental work.
Motion by Chair Pro Tem Petersen, second by Member Holman to
approve the claim in the amount of$1,200
MOTION CARRIED UNANIMOUSLY 5-0
V. NEW BUSINESS
A. Disabilitv Leave/Retirement An�lications
No application for disability leave/retirement was received.
B. Appeals/Reauests for Reconsideration
No request for reconsideration was received.
C. Medical/HearinaNision/Dental Claims
1 Monroe Shrooshire
Request for reimbursement of dental expenses in the amount of
$172.00 for services received on September 12, 2012.
MONROE SHROPSHIRE 2012 $1,20D.00 BALANCE
$1,200.00
April 3, 2012 $150.00 51,050.00
May 1, 2012 $15D.00 $900.00
July 3, 2012 $498.00 5402.00
Motion by Chair Pro Tem Petersen, second by Member Vogel to
approve the claim in the amount of$172.00.
MOTION CARRIED UNANIMOUSLY 5-0
2. Doris Daroucth
LEOFF Board Minutes
October 2, 2012
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, October 2, 2012 - 40:00 AM —Council Conference Room
Request for reimbursement of long term care costs for the month of
August 2012 in the amount of$2,684 91
Motion by Member Holman, second by Chair Pro Tem Petersen to
approve the claim in the amount of$2,684.91
MOTION CARRIED UNANMOUSLY 5-0
3. Doris Darouah
Request for reimbursement of inedical equipment in the amount of
$592.38 for expenses paid on September 6, 2012.
Motion by Chair Pro Tem Petersen, second by Member Holman to
table the claim pending receipt of information proving medical
necessity
MOTION CARRIED UNANIMOUSLY 5-0
4 Ron Loaan
a. Request for reimbursement of inedical expenses in the
amount of $169.29 for services received on January 26,
2012, insurance claim #2058798.
Motion by Chair Pro Tem Petersen, second by Member
Vogel to approve the claim in the amount of$169.29.
MOTION CARRIED UNANIMOUSLY 5-0
b. Request for reimbursement of inedical expenses in the
amount of $37 75 for services received on July 24, 2012,
insurance claim #2169641
Motion by Chair Pro Tem Petersen, second by Member
Vogel to approve the claim in the amount of$37 75.
MOTION CARRIED UNANIMOUSLY 5-0
c. Request for reimbursement of inedical expenses in the
amount of $458.77 for services received on August 7, 2012,
insurance claim #2182620.
Motion by Member Vogel, second by Chair Pro Tem
Petersen to approve the claim in the amount of$458.77
LEOFF Board Minutes
October 2, 2012
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City of Aubum Law Enforcement OfFcers and Firefighters Disability Board
Tuesday, October 2, 2072 - 70:00 AM —Council Conference Room
MOTION CARRIED UNANMOUSLY 5-0
d. Request for reimbursement of inedical expenses in the
amount of $793.00 for services received on July 24, 2012,
insurance claim #2174782.
Motion by Chair Pro Tem Petersen, second by Member
Vogel to approve the claim in the amount of$793.00.
MOTION CARRIED UNANIMOUSLY 5-0
e. Request for reimbursement of inedical expenses in the
amount of $139.82 for services received on July 21-24,
2012, insurance claim #2188546.
Motion by Chair Pro Tem Petersen, second by Member
Vogel to approve the claim in the amount of$139.82.
MOTION CARRIED UNANIMOUSLY 5-0
f Request for reimbursement of inedical expenses in the
amount of $20.00 for services received on July 21, 2012,
insurance claim #2197910.
Motion by Chair Pro Tem Petersen, second by Member
Vogel to approve the claim in the amount of$20.00.
MOTION CARRIED UNANIMOUSLY 5-0
D Discussion
1 Chair Kelly distributed a proposed and revised LEOFF 1 Claim for
Payment form. The information/instructions printed on the back of
the current form will be added to the new form. It was consensus
of the members to approve the form.
Board members recommended that a fill form be prepared and
available on the City's web site. It was recommended that the
Policy and Procedure Manual be made available on the City's web
site as well.
Chair Kelly will also review the vision claim forms for possible
revision.
LEOFF Board Minutes
October 2, 2012
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, October 2, 2012 = 70:00 AM—Council Conference Room
VI. ADJOURNMENT
There being no further business to come before the Board, the meeting
adjourned at 10:15 a.m.
APPROVED the�day of � �utt�-', 2012.
��� ��
Jim i Ily, Chair Da ielle Daskam, Board Secretary
LEOFF Board Minutes
October 2, 2012
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