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
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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
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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
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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
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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
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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
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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
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