HomeMy WebLinkAbout05-04-2004
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, May 4,2004 -10:00 AM - Conference Room 1
MINUTES
I. CALL TO ORDER
Chair Jim Kelly called the meeting to order at 10:00 a.m. in Conference Room 1
located at City Hall, 25 West Main Street, Auburn, Washington. The following
Board members were present: Chair Kelly, Chair Pro Tem Bud Larson, Member
Bill Peloza, Member Roger Thordarson, and Member Russ Vandver. Board
Secretary Danielle Daskam was also present.
II. APPROVAL OF MINUTES
A. Minutes of the April 6, 2004 LEOFF Board Meetinq
Motion by Chair Pro Tem Larson, second by Member Thordarson to
approve the April 6, 2004 minutes as distributed.
MOTION CARRIED UNANIMOUSLY. 5-0.
III. UNFINISHED BUSINESS
A. Pendinq Disabilitv Leave/Retirement Applications
There was no pending disability leave/retirement applications.
B. Claims
1. Rudv Peden
a. Regence Explanation of Benefits Claim No. 0332933201200
processed on December 9, 2003 for medical services
received on October 22,2003 in the amount of $144.00.
On April 6, 2004, the Board tabled Mr. Peden's claim
pending receipt of additional information including an
explanation for delay in submitting the claim beyond the 90-
day claim period, a description of the medical services
received, and information attesting to the medical necessity
of the medical services received. No new information was
received.
Motion by Vice Chair Larson, second by Member Vandver to
table Mr. Peden's claim until the next regular meeting.
MOTION CARRIED UNANIMOUSLY. 5-0.
LEOFF Board Minutes
May 4, 2004
Page 1
City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, May 4,2004 -10:00 AM - Conference Room 1
At the recommendation of Member Peloza, Chair Kelly
instructed the Board Secretary to include a statement on
future agendas that a letter has been sent to the claimant on
behalf of the Board advising of the Board's action.
2. Victor Shivelv
a. Request for reimbursement of dental and oral surgery
services received in February 2004 in the amount of
$1,489.30.
On April 6, 2004, the Board tabled Mr. Shively's claim
pending the receipt of an insurance explanation of benefits
statement. Mr. Shively submitted additional Information for
his claim after the Board agenda packet was distributed,
therefore, the materials were distributed during the meeting.
The Board members reviewed Mr. Shively's May 2, 2004
correspondence and Washington Dental Service
Explanation of Benefits statements.
Motion by Member Peloza, second by Member Vandver to
approve reimbursement of expenses in the amount of
$2,188.30 based on the Washington Dental Service
Explanation of Benefits statements.
MOTION CARRIED UNANIMOUSLY. 5-0.
b. Request for reimbursement of $680.00 for dental services
received by Mr. Shively.
On April 6, 2004, the Board tabled Mr. Shively's claim
pending the receipt of clarification of the document
information and receipt of an insurance explanation of
benefits statement. See Item III.B.2.a above for action on
this claim.
IV. NEW BUSINESS
A. Disabilitv Leave/Retirement Applications
No new application for disability leave/retirement was received.
B. Appeals
No appeal was filed.
LEOFF Board Minutes
May 4, 2004
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, May 4,2004 -10:00 AM - Conference Room 1
C. Medical/HearinqNision Claims
1. Martin Eric Bearscove
a. Regence Explanation of Benefits Claim No. 0406895022200
processed on March 17, 2004 and Medicare statement of
benefits claim no. 04058804816000 processed on April 1,
2004 for medical devices in the amount of $270.00.
Board members reviewed the Medicare and Regence
Explanation of Benefits Statements denying coverage for the
medical devices and a prescription for the medical devices
from Mr. Bearscove's provider.
Motion by Chair Pro Tem Larson, second by Member
Thordarson to approve reimbursement for the medical
devices in the amount of $270.00.
MOTION CARRIED UNANIMOUSLY. 5-0.
2. Don Webb
a. Request for reimbursement of lenses and frames in the total
amount of $233.65. Mr. Webb has not received
reimbursement for lenses or frames within the last year.
Motion by Member Thordarson, second by Chair Pro Tem
Larson to approve reimbursement in the amount of $200.00
in accordance with Board policy.
MOTION CARRIED UNANIMOUSLY. 5-0.
3. John Baker
a. Request for reimbursement of lenses and frames in the total
amount of $196.13. Mr. Baker has not received
reimbursement for lenses or frames within the last year.
Motion by Member Peloza, second by Member Vandver to
approve reimbursement in the amount of $196.13 in
accordance with Board policy.
MOTION CARRIED UNANIMOUSLY. 5-0.
LEOFF Board Minutes
May 4, 2004
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Tuesday, May 4,2004 -10:00 AM - Conference Room 1
4. William Pitzl
a. Request for reimbursement of lenses and frames in the total
amount of $455.00. Mr. Pitzl has not received
reimbursement for lenses or frames within the last year.
Motion by Member Peloza, second by Chair Pro Tem Larson
to approve reimbursement in the amount of $200.00 in
accordance with Board policy.
MOTION CARRIED UNANIMOUSLY. 5-0.
5. Rav Oqden
Request for pre-approval for the purchase one hearing aid from
Costco Hearing Aid Center in the amount of $899.00. Mr. Ogden's
request was added to the agenda.
Motion by Chair Pro Tem Larson, second by Member Vandver to
approve the purchase of one hearing aid in the amount of $899.00
for Mr. Ogden.
MOTION CARRIED UNANIMOUSLY. 5-0.
D. Correspondence
Chair Kelly acknowledged the following correspondence as informational
only:
1. April 27, 2004 e-mail from Department of Retirement Systems
Rules Coordinator regarding possible rule-making (Chapter 4, Laws
of 2004 [HB 2418]).
E. Discussion
Chair Kelly reminded the Board members that he will be unable to attend
the June 1, 2004 Board meeting.
V. ADJOURNMENT
There being no further business to come before the Board, the meeting
adjourned at 10:26 a.m.
51--
APPROVED THIS / DAY OF JUNE, 2004.
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Danielle Daskam, Secretary
LEOFF Board Minutes
May 4, 2004
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