HomeMy WebLinkAbout10-02-2000 City of Auburn Law Enforcement Officers and Firsfighters Disability Board
Monday, October 2, 2000 - 10:00 AM - Conference Room I
MINUTES
I. CALL TO ORDER
Chair Kelly called the meeting to order at 10:00 AM in Room 1 located in Auburn
City Hall, 25 West Main Street, Auburn, WA. Members present included: Chair
Jim Kelly, Chair Pro Tem Bud Larson, Member Pete Lewis and Member Russ
Vandver. Member Jeanne Barber was excused. Others present included:
Mayor Charles A. Booth, Associate City Attorney Karen Gulliver, Finance
Director Diane L. Supler, and Board Secretary Danielle Daskam.
II. APPROVAL OF MINUTES
A. Minutes of the September 5, 2000 LEOFF Board Meeting
Motion by Member Lewis, second by Member Larson to approve the
September 5, 2000 LEOFF Board minutes as distributed.
MOTION CARRIED UNANIMOUSLY. 4-0.
III. UNFINISHED BUSINESS
A. Pending Disability Leave/Retirement Applications
There was no pending disability leave/retirement application.
B. Claims
1. John Wickstrom
On July 5, 2000, the Board tabled the following claims pending the
receipt of additional documentation supporting the medical
necessity of the medical service. Mr. Wickstrom's claims were
tabled on August 7, 2000 and September 5, 2000. Mr. Wickstrom
submitted a letter dated September 5, 2000 in response to the
Board's request for additional information.
a. Regence Explanation of Benefits Claim No. 0012610554900.
processed on June 7, 2000 for medical services received on
April 27, 2000 in the amount of $8.16.
LEOFF Board Minutes
October 2, 2000
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 2, 2000 - 10:00 AM - Conference Room 1
b. Regence Explanation of Benefits Claim No. 0005934358500
processed on March 27, 2000 for medical services received
on February 21, 2000 in the amount of $15.00.
Chair Kelly acknowledged receipt of Mr. Wickstrom's letter dated
September 5, 2000. Board members reviewed Mr. Wickstrom's
letter.
Motion by Member Vandver, second by Member Lewis to deny
Claim No. 0012610554900 for medical services received on April
27, 2000 in the amount of $8.16.
MOTION CARRIED UNANIMOUSLY. 4-0.
Motion by Member Lewis, second by Member Vandver to approve
Claim No. 0005934358500 processed on March 27, 2000 for
medical services received on February 21, 2000 in the amount of
$15.00.
MOTION CARRIED UNANIMOUSLY. 4-0.
2. Ron Mauel
On September 5, 2000, the LEOFF Board tabled Mr. Mauel's
request for reimbursement of pharmacy expenses in the amount of
$7.00 pending the receipt of the pharmacy prescription receipt. No
new information was received since the last meeting.
a. Pharmacy expense in the amount of $7.00 sold on July 19,
2000.
Motion by Member Vandver, second by member Lewis to table Mr.
Mauel's claim for an additional month.
MOTION CARRIED UNANIMOUSLY. 4-0.
3. James Monnett
On September 5, 2000, the LEOFF Board tabled Mr. Monnett's
claim pending the receipt of additional documentation establishing
the medical necessity of the medical service. No new information
was received.
LEOFF Board Minutes
October 2, 2000
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 2, 2000 - t0:00 AM - Conference Room I
a. Regence Explanation of Benefits Claim No. 0016400479300
processed on June 21, 2000 for medical services received
on June 2, 2000 in the amount of $250.00.
Chair Kelly reported he spoke with Mr. Monnett on the telephone
recently regarding his outstanding claim. According to Mr.
Monnett, he has worn orthotics for approximately twenty years.
Chair Kelly advised Mr. Monnett that additional documentation is
required to support Mr. Monnett's claim.
Motion by Member Vandver, second by Member Lewis to table Mr.
Monnett's claim for an additional month pending the receipt of
additional documentation.
MOTION CARRIED UNANIMOUSLY. 4-0.
4. Richard Huseby
On September 5, 2000, the LEOFF Board tabled Mr. Huseby's
claim pending the receipt of additional documentation regarding
whether the hearing device was already under warranty, whether
the repairs performed were warranty work, and whether the repairs
include a one-year warranty.
a. Request for reimbursement of hearing aid repair expenses in
the amount of $121.97.
Secretary Daskam distributed documentation received from Mr.
Huseby today consisting of a copy of a warranty card. Member
Vandver reported he spoke with Mr. Huseby. Mr. Huseby indicated
that the warranty on his hearing aid had expired prior to the
necessary repairs. The card represents a warranty on the repairs.
Motion by Member Lewis, second by Member Vandver to approve
Mr. Huseby's claim for hearing aid repairs in the amount of
$121.97.
MOTION CARRIED UNANIMOUSLY. 4-0.
LEOFF Board Minutes
October 2, 2000
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 2, 2000 - 10:00 AM - Conference Room 1
5. R.K. Calkins
On September 5, 2000, the LEOFF Board tabled Mr. Calkins' claim
pending the receipt of explanation of benefits documentation from
Medicare and Regence. No new information was received.
a. Request for reimbursement of chiropractic services received
on August 2, 2000 in the amount of $50.00.
Motion by Member Vandver, second by Member Lewis to table Mr.
Calkins' claim for an additional month.
MOTION CARRIED UNANIMOUSLY. 4-0.
C. Appeals
1. Mick Crawford
a. On August 11, 2000, Mr. Crawford filed a request for
reconsideration of the Board's rejection of pharmacy
expenses in the amount of $14.00 because the date
processed fell outside the ninety (90) day limitation for filing
claims.
On September 5, 2000, the LEOFF Board tabled Mr.
Crawford's request for reconsideration.
Associate City Attorney Gulliver reported on her research
related to applying a timeline for submission of claims for
eligible medical expenses under the LEOFF laws. She
noted the LEOFF Board has had a policy for several years
requiring claims submission within ninety days of the date
processed/paid 'by the insurance carrier. It was her
understanding that the Board established the policy to
ensure submission of claims within a timely manner. In Ms.
Gulliver's opinion, the LEOFF Board has the discretion to
establish a policy and set a timeline for submission of
claims.
Chair Kelly questioned whether the' Board can deny benefits
if a member does not follow Board policy and the failure to
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October 2, 2000
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 2, 2000 - 10:00 AM - Conference Room 1
follow Board policy results in a denial of benefits. He also
questioned whether past Board practices impact the current
Board's application of the policy.
Associate City Attorney Gulliver responded that the policy
has been in place for several years. Although past Boards
did not strictly apply the policy, the current Board has
applied the policy consistently. She. stressed that policies
must be applied equally to everyone or to no one.
Finance Director Supler added that the claims submitted
outside the ninety day limit could be viewed as "disqualified"
claims since the claim was not submitted in accordance with
adopted Board policies and procedures. She also stressed
the need for a timeline in submitting claims from a budget
management standpoint.
Member Lewis inquired whether there is any other LEOFF
Board in the state of Washington that has a policy requiring
submission of claims within a certain timeline.
Motion by Member Lewis, second by Member Vandver to
table Mr. Crawford's request for reconsideration for an
additional month.
MOTION CARRIED UNANIMOUSLY. 4-0.
IV. NEW BUSINESS
A. Disability Leave/Retirement Applications
There was no new application for disability leave/retirement.
B. Appeals
There was no new request for reconsideration.
C. Medical Claims
1. Bruce Caldwell
LEOFF Board Minutes
October 2, 2000
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 2, 2000 - 10:00 AM - Conference Room 1
a. Regence Explanation of Benefits Claim No. 0018510892000
processed on June 14, 2000 for medical services received
on May 31, 2000 in the amount of $16.87;
and Regence Explanation of Benefits Claim No.
0017531320800 processed on July 12, 2000 for medical
services received on June 22, 2000 in the amount of $42.17.
LEOFF Board members reviewed Mr. Caldwell's claims. Chair
Kelly noted that Mr. Caldwell's Claim for Payment form reflects the
amount submitted to LEOFF as $109.62. However, the supporting
documents in the amount of $16.87 and $42.17 total $59.04.
Motion by Member Lewis, second by Member Vandver to approve
Mr. Caldwell's claim in the total amount of $59.04.
MOTION CARRIED UNANIMOUSLY. 4-0.
2. Murray Board
a. Request for reimbursement of pharmacy expenses in the
amount of $88.68.
Board members reviewed Mr. Board's claim for reimbursement of
pharmacy expenses. Chair Kelly noted that several of the
pharmacy expenses were processed beyond the ninety day limit for
filing claims.
Motion by Member Larson, second by Member Lewis to approve
reimbursement of pharmacy expenses within the ninety day limit for
filing claims in the total amount of $25.00.
MOTION CARRIED UNANIMOUSLY. 4-0.
3. Edward Wolters
a. Request for reimbursement of pharmacy expenses in the
amount of $51.79.
b. Request for reimbursement of hearing aid repair expenses in
the amount of $75.00.
LEOFF Board Minutes
October 2, 2000
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 2, 2000 - 10:00 AM - Conference Room 1
Board members reviewed Mr. Wolters' claim for payment. Chair
Kelly noted that some of Mr. Wolters' pharmacy expenses are
beyond the ninety day limit for filing claims.
Motion by Member Lewis, second by Member Vandver to approve
reimbursement of pharmacy expenses within the ninety day limit for
claims in the amount of $36.79 and hearing aid repairs in the
amount of $75.00 for a total reimbursement of $111.79.
MOTION CARRIED UNANIMOUSLY. 4-0.
4. Ray H. Ogden, Sr
a) Request for reimbursement of pharmacy expenses in the
amount of $213.00.
Board members reviewed Mr. Odgen's claim for reimbursement of
pharmacy expenses. Chair Kelly noted that $109.00 of the
pharmacy expenses are within the ninety day limit for filing claims.
The remaining pharmacy expenses are outside the ninety day limit
for filing claims.
Motion by Member Larson, second by Member Vandver to approve
reimbursement of pharmacy expenses within the ninety day limit for
filing claims in the amount of $109.00.
MOTION CARRIED UNANIMOUSLY. 4-0.
5. Richard Huseby
Request for reimbursement of corrective lenses expenses in the
amount of $79.00.
Board Secretary Daskam presented Mr. Huseby's claim as an
agenda modification.
Board members reviewed Mr. Huseby's claim, including a letter
dated September 19, 2000 from James A. Lombardo, Optometric
Physician.
LEOFF Board Minutes
October 2, 2000
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 2, 2000 - t0:00 AM - Conference Room I
Motion by Member Lewis, second by Member Vandver to approve
Mr. Huseby's claim for reimbursement of corrective lenses expense
in the amount of $79.00.
MOTION CARRIED UNANIMOUSLY. 4-0.
6. Doris Gall Darough
Regence Explanation of Benefits Claim No. 0022400984300
processed on September 6, 2000 for chiropractic services received
on July 29, 2000 in the amount of $15.00.
Board Secretary Daskam presented Ms. Darough's claim as an
agenda modification.
Motion by Member Vandver, second by Member Lewis to approve
Ms. Darough's claim in the amount of $15.00.
MOTION CARRIED UNANIMOUSLY. 4-0.
7. Ernest Miller
Regence Explanation of Benefits Claim No. 0024133999700
processed on September 4, 2000 for chiropractic services received
on August 2 and 16, 2000 in the total amount of $24.00.
Board Secretary Daskam presented Mr. Miller's claim as an
agenda modification.
Motion by Member Vandver, second by Member Larson to approve
Mr. Miller's claim in the amount of $24.00.
MOTION CARRIED UNANIMOUSLY. 4-0.
D. Correspondence
1. Letter dated September 8, 2000 to LEOFF Board Secretary from
Department of Retirement Systems.
Board members reviewed the correspondence from the
Department of Retirement Systems regarding a retired LEOFF
member. The letter was advisory only and reported that the
Department of Retirement Systems received an anonymous
LEOFF Board Minutes
October 2, 2000
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, October 2, 2000 - 10:00 AM - Conference Room 1
complaint that the retiree was working in a labor intensive
profession. The LEOFF member retired in 1982 and is over the
age of 49-1/2 years. No action by the Board was necessary.
E. Fire Department LEOFF Board Representative Election
According to LEOFF Board Policy and Procedure, 1.05, Elections, the
LEOFF Board Secretary is to prepare and mail forms for nomination of
law enforcement or firefighter representative to each active and retired law
enforcement or fire fighter personnel for a two year term. Fire
Representative Russ Vandver's term expires on December 31, 2000.
Board members reviewed the election schedule. There were no
comments.
V. ADJOURNMENT
There being no further business to come before the Board, the meeting
adjourned at 10:50 AM.
Approved this ~ ~ day of November, 2000.
LEOFF Board Minutes
October 2, 2000
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