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HomeMy WebLinkAbout09-04-2001 City of Auburn Law Enforcement Officers and Firsfighters Disability Board Tuesday, September 4, 2001 - 10:00 AM - Conference Room 1 MINUTES I. CALL TO ORDER Chair Jim Kelly called the meeting to order at 10:00 AM in Room 1 located at Auburn City Hall, 25 West Main Street, Auburn, WA, 98001. Members present included: Chair Jim Kelly, Chair Pro Tem Bud Larson, Jeanne Barber, Stacey Brothers, and Russ Vandyer. Others present included: Mayor Charles Booth, Associate City Attorney Karen Gulliver, and Board Secretary Danielle Daskam. II. APPROVAL OF MINUTES A. Minutes of the August 6. ;>001 LFOFF Board Meeting Motion by Member Barber, second by Member Brothers to approve the August 6, 2001 minutes as distributed. MOTION CARRIED. 3-0. Chair Kelly and Member Vandver abstained due to their absence from the August 6, 2001 meeting. III. UNFINISHED BUSINESS A. Pending Disabilityleave/Retirement Applications 1. Harold F. Philbin Effective Date of Disability: April 1, 2001 Last Day of Service: March 31, 2001 On April 2, 2001, the LEOFF Board approved disability leave for Mr. Philbin effective April 1, 2001 with last day of service on March 31, 2001. On June 4, 2001, the Board waived the monthly physician's report, with the understanding that Mr. Philbin would be subject to review by the Board's physician at a time in the future. The Board's waiver of monthly physician reports was based on the May 2, 2001 letter from Ron Kuppersmith MD. On August 6, 2001, the Board directed Mr. Philbin to undergo an examination by the Board's physician. The examination was conducted August 20, 2001. LEOFF Board Minutes September 4, 2001 Page 1 City of Auburn Law Enforcement Officers and Firsfighters Disability Board Tuesday, September 4, 2001 - 10:00 AM - Conference Room 1 Mr. Philbin's six months disability leave will conclude on September 30, 2001. Chair Kelly reported that although Mr. Philbin was examined by the Board physician (OMAC) on August 20, 2001, the written physician's report was not yet available. Chair Kelly announced that a special board meeting will be called before the end of the month and upon receipt of the physician's report. Motion by Chair Pro Tem Larson, second by Member Brothers to continue Mr. Philbin's disability leave until the next special meeting of the Board. MOTION CARRIED UNANIMOUSLY. 5-0. B. Claims 1. John Wickstrom a. Request dated March 30, 2001 for reimbursement of lenses expense in the amount of $104.00. On May 7 and June 4, 2001, the LEOFF Board tabled Mr. Wickstrom's claim for reimbursement of lenses expense pending the receipt of information confirming that Mr. Wickstrom had submitted his claim to the insurance company, Vision Service Plan. On June 7, 2001, the LEOFF Board received the enclosed Eye Exam and Corrective Lenses Worksheet completed by his provider. On July 2 and August 6, 2001, the LEOFF Board tabled Mr. Wickstrom's claim to allow time for Chair Kelly to contact Mr. Wickstrom regarding his claim. Chair Kelly reported that he spoke with Mr. Wickstrom regarding his claim and explained to him that it appeared that insurance had already paid more than the $175.00 maximum benefit provided by LEOFF. Mr. Wickstrom LEOFF Board Minutes September 4, 2001 Page 2 City of Auburn Law Enforcement Officers and Firsfighters Disability Board Tuesday, September 4, 2001 - 10:00 AM - Conference Room I indicated to Chair Kelly that no new information would be submitted regarding his claim. Motion by Chair Pro Tem Larson, second by Member Barber to deny Mr. Wickstrom's claim in the amount of $104.00. MOTION CARRIED UNANIMOUSLY. 5-0. 2. John A. Baker a. Request for reimbursement of medical expenses incurred in March 2001 in the amount of $62.00. On July 2 and August 6, 2001, the Board tabled Mr. Baker's claim pending the receipt of the appropriate insurance Explanation of Benefits Statement(s). To date, no new information has been received. Motion by Member Vandver, second by Member Barber to deny Mr. Baker's claim due to insufficient information. MOTION CARRIED UNANIMOUSLY. 5-0. 3. Ronald L. Cude a. Request for reimbursement of medical services received on March 9, 2001 in the amount of $202.47. (No Explanation of Benefits Statement included.) b. Request for reimbursement of medical services received in March, April and May 2001 in the amount of $354.79. (No Explanation of Benefits Statement included.) On August 6, 2001, the Board tabled Mr. Cude's claim pending the receipt of the required insurance explanation of benefits statements. Chair Kelly noted that additional information was submitted by Mr. Cude after the publication of the agenda and is submitted as an agenda modification. LEOFF Board Minutes September 4, 2001 Page 3 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, September 4, 2001 - 10:00 AM - Conference Room 1 Board members reviewed the Medicare and Regence Explanation of Benefits Statements received from Mr. Cude. Board members noted the Medicare Explanation of Benefits Statement referenced a March 9, 2001 service date while the Regence Explanation of Benefits Statements reflect March 23, 2001, March 8, 2001, January 17, 2001 and January 22, 2001 service dates. Members also noted that the Regence Explanation of Benefits Statements include a message code that "payment was made to the provider on assigned charge-patient is not responsible for balance." Motion by Chair Pro Tem Larson, second by Member Barber to table Mr. Cude's claim and request the Association of Washington Cities Benefit Trust representative assist in clarifying Mr. Cude's claim and the Explanation of Benefits Statements. MOTION CARRIED UNANIMOUSLY. 5-0. IV. NEW BUSINESS A. Disability l eave/Retirement Applications There was no new application for disability leave/retirement. B. Appeals 1. James Fisk In a letter received August 27, 2001, Mr. James Fisk filed a request for reconsideration of the August 6, 2001 LEOFF Board action denying his claim that was beyond the ninety (90) day limitation for filing claims. Included in the agenda packet were the following: LEOFF Board Policy 9.07; Mr. Fisk's letter requesting reconsideration received by the LEOFF Board Secretary on August 27, 2001, a copy of the rejected claim; and an excerpt from the August 6, 2001 LEOFF Board minutes reflecting the Board's action on Mr. Fisk's claim. Board members reviewed Mr. Fisk's letter requesting reconsideration of his rejected claim. LEOFF Board Minutes September 4, 2001 Page 4 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, September 4, 2001 - 10:00 AM - Conference Room I Motion by Chair Pro Tem Larson, second by Member Brothers to set the next regular Board meeting of October 1, 2001, as the date for reconsideration of Mr. Fisk's claim. MOTION CARRIED UNANIMOUSLY. 5-0. C. Medical Claims 1. Fdward M. Wolters a. A request dated August 12, 2001 for authorization to purchase hearing aids from the Board's designated hearing aid provider in the amount of $1,899.00 each. Also enclosed is a letter dated August 21, 2001 from Shirley Haarhues of the Costco Hearing Aid Center regarding Mr. Wolters' examination. Board members reviewed Mr. Wolters' claim. Chair Kelly noted that the LEOFF Board approved payment in the amount of $1,658.00 for hearing aids for Mr. Wolters on April 7, 1997. Chair Kelly also noted that the LEOFF Board Policy and Procedure Manual provides that the LEOFF Board will consider payments for hearing aids every five years. Motion by Chair Pro Tem Larson, second by Member Barber to deny Mr. Wolters' request for hearing aids. MOTION CARRIED UNANIMOUSLY. 5-0. 2. Coy Franklin Grail a. Regence Explanation of Benefits Statement No. 0119310561300 processed on July 31, 2001 for services received on July 2, 2001 in the amount of $70.94. Motion by Member Vandver, second by Member Brothers to approve Mr. Grall's claim in the amount of $70.94. MOTION CARRIED UNANIMOUSLY. 5-0. LEOFF Board Minutes September 4, 2001 Page 5 City of Auburn Law Enforcement Officers and Firsfighters Disability Board Tuesday, September 4, 2001 - 10:00 AM - Conference Room I 3. Don Casselman a. Regence Explanation of Benefits Statement No. 0119431829100 processed on July 25, 2001 for services received on July 12, 2001 in the amount of $138.00. Members reviewed Mr. Casselman's claim and noted that the Regence Explanation of Benefits Statement indicate the services were for routine, preventative or elective care. Motion by Member Brothers, second by Member Vandver to deny Mr. Casselman's claim. MOTION CARRIED UNANIMOUSLY. 5-0. 4. Gerry E. Fuller a. Regence Explanation of Benefits Statement No. 0120620645000 processed on August 6, 2001 for services received on July 6, 2001 in the amount of $53.36. Mr. Fuller's claims was presented as part of an agenda modification. Motion by Member Brothers, second by Chair Pro Tem Larson to approve Mr. Fuller's claim in the amount of $53.36 according to the Explanation of Benefits Statement. MOTION CARRIED UNANIMOUSLY. 5-0. D. Correspondence No correspondence was received. E. Discussion 1. Hearing Aid Policy Chair Kelly recalled the Board's discussion of the hearing aid policy several months ago. He noted that the Board adopted the current hearing aid policy on September 3, 1996, designating Costco as the Board's hearing aid provider as of January 1997. No maximum amount was included as part of the policy adoption. The minutes are available for review. LEOFF Board Minutes September 4, 2001 Page 6 City of Auburn Law Enforcement Officers and Firefighters Disability Board Tuesday, September 4, 2001 - 10:00 AM - Conference Room I 2. LEOFF Board Policies and Procedures Chair Kelly requested the secretary include review of the Policies and Procedures on the October and November agendas, and that Board members prepare to review the Policies and Procedures by December 2001. V. ADJOURNMENT There being no further business to come before the LEOFF Board, the meeting adjourned at 10:35 AM. APPROVED THIS/5/..~ DAY OF OCTOBER, 2001. Jir~ Kelly, Chai;' (~ Danielle Daskam, Secretary LEOFF Board Minutes September 4, 2001 Page 7