HomeMy WebLinkAbout12-03-2001 City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, December 3, 2001 - 10:00 AM - Conference Room 1
MINUTES
I. CALL TO ORDER
Chair Kelly called the meeting to order at 10:05 AM in Room 1 located in Auburn
City Hall, 25 West Main Street, Auburn, WA, 98001. Members present included
Chair Jim Kelly, Chair Pro Tem Bud Larson, Member Stacey Brothers, and
Member Russ Vandver. Member Jeanne Barber arrived at 10:07 AM. Also
present were Human Resources Director Brenda Heineman and Board
Secretary Danielle Daskam.
II. APPROVAL OF MINUTES
A. Minutes of the November 5, 2001 LEOFF Board Meeting
Motion by Chair Pro Tem Larson, second by Member Brothers to approve
the November 5, 2001 minutes as distributed.
MOTION CARRIED UNANIMOUSLY. 4-0.
B. Minutes of the November 19, 2001 special LEOFF Board Meeting
Motion by Chair Pro Tem Larson, second by Member Vandver to approve
the November 19, 2001 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. Ronald L. Cude
a. Request for reimbursement of medical services received on
March 9, 2001 in the amount of $202.47.
b. Request for reimbursement of medical services received in
March, April and May 2001 in the amount of $354.79.
LEOFF Board Minutes
December 3, 2001
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, December 3, 2001 - 10:00 AM - Conference Room I
On October I and November 5, 2001, the Board tabled Mr.
Cude's claim in the amount of $202.47 pending the receipt
of Regence Explanation of Benefits Statement, and tabled
the claim in the amount of $354.79 pending the receipt of
Medicare Explanation of Benefits Statement. To date, no
new information has been received.
Motion by Chair Pro Tem Larson, second by Member
Brothers to table Mr. Cude's claim until the next meeting.
MOTION CARRIED UNANIMOUSLY. 5-0.
2. Stan Laatsch
Request for reimbursement of lense expenses incurred on June 2,
2001 in the amount of $93.00.
On October I and November 5, 2001, the LEOFF Board tabled Mr.
Laatsch's claim pending the receipt of a LEOFF Corrective Eye
Exam and Lenses Worksheet. On November 5, 2001, Mr. Laatsch
submitted a Corrective Lenses Worksheet.
Board members reviewed the Corrective Lenses Worksheet
submitted by Mr. Laatsch.
Motion by Chair Pro Tem Larson, second by Member Vandver to
approve reimbursement of vision expenses in the total amount of
$78.00, which includes $68.00 towards lenses and $10.00 for the
exam co-pay.
MOTION CARRIED UNANIMOUSLY. 5-0.
3. Patricia Djarf
a. Request for reimbursement of lense expenses in the amount
of $10.00.
On November 5, 2001, the LEOFF Board tabled Ms. Djarf's claim
pending the receipt of the date of service for her claim. No new
information was received.
LEOFF Board Minutes
December 3, 2001
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, December 3, 2001 - 10:00 AM - Conference Room 1
Motion by Member Vandver, second by Chair Pro Tem Larson to
table Ms. Djarfs claim for an additional month.
MOTION CARRIED UNANIMOUSLY. 5-0.
IV. NEW BUSINESS
A. Disability Leave/Retirement Applications
There was no new application for disability leave/retirement.
B. Appeals
No request for reconsideration was filed.
C. Medical Claims
1. Bill Petersen
a. Regence Explanation of Benefits Claim No. 0124110541800
processed on September 12, 2001 for services received on
August 1, 2001 in the amount of $222.00.
Board members reviewed Mr. Petersen's claim. Chair Kelly
noted that according to the Explanation of Benefits
Statement, the medical services received were found to be
routine, preventative or elective care not covered by
Regence.
Motion by Chair Pro Tem Larson, second by Member
Brothers to table the claim pending the receipt of additional
information regarding the medical necessity of the medical
services.
MOTION CARRIED UNANIMOUSLY. 5-0.
LEOFF Board Minutes
December 3, 2001
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, December 3, 2001 - 10:00 AM - Conference Room I
2. Bruce Caldwell
Board members reviewed Mr. Caldwell's claims.
a. Regence Explanation of Benefits Claim No. 0130332127300
processed on November 7, 2001 for services received on
October 29, 2001 in the amount of $29.00.
Motion by Chair Pro Tem Larson, second by Member Barber
to approve Mr. Caldwell's claim in the amount of $29.00.
MOTION CARRIED UNANIMOUSLY. 5-0.
b. Regence Explanation of Benefits Claim No. 0129732071400
processed on November 7, 2001 for services received on
October 22, 2001 in the amount of $150.00.
Motion by Chair Pro Tem Larson, second by Member Barber
to approve Mr. Caldwell's claim in the amount of $150.00.
MOTION CARRIED UNANIMOUSLY. 5-0.
c. Regence Explanation of Benefits Claim No. 0129032081900
processed on October 31, 2001 for services received on
October 11 and 12, 2001 in the amount of $444.00.
Motion by Chair Pro Tem Larson, second by Member
Brothers to approve $150.00 of Mr. Caldwell's claim and
table the remaining $294.00 pending the receipt of additional
information regarding his claim.
MOTION CARRIED UNANIMOUSLY. 5-0.
d. Regence Explanation of Benefits Claim No. 0130231969000
processed on November 14, 2001 for services received on
October 25, 2001 in the amount of $150.00.
Motion by Member Vandver, second by Chair Pro Tem
Larson to approve Mr. Caldwell's claim in the amount of
$150.00.
LEOFF Board Minutes
December 3, 2001
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, December 3, 2001 - 10:00 AM - Conference Room I
MOTION CARRIED UNANIMOUSLY. 5-0.
3. William Pitzl
a. Request for reimbursement of lense and frames expenses in
the amount of $291.85.
The Board members reviewed Mr. Pitzl's claim for
reimbursement of vision expenses. Chair Kelly noted that
insurance paid $45 towards flames and $60 towards lenses.
The eye examination was paid in full by Regence.
Motion by Chair Pro Tem Larson, second by Member
Brothers to approve payment in the amount of $70.00 as
reimbursement for vision expenses.
MOTION CARRIED UNANIMOUSLY. 5-0.
4. Victor ShivelV
a. Request for reimbursement of lense and frames expenses in
the amount of $93.00.
Board members reviewed Mr. Shively's claim for vision
expenses. Chair Kelly noted that Mr. Shively's payment
receipt itemized a $10.00 copay for the eye exam, but the
worksheet did not include the itemization. According to the
worksheet, insurance paid $97.81 towards frames and
$132.50 toward lenses.
Motion by Chair Pro Tem Larson, second by Member
Brothers to approve reimbursement of the $10.00 eye exam
co-pay and deny the remaining $83.00 lenses expense as
the insurance benefit for frames and lenses exceeded the
maximum benefit allowance.
MOTION CARRIED UNANIMOUSLY. 5-0.
LEOFF Board Minutes
December 3, 2001
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, December 3, 2001 - 10:00 AM - Conference Room I
5. Alan Kosko
a. Request for pre-approval of oral surgery expenses in the
amount of $9,825.00.
Board members reviewed Mr. Kosko's handwritten letter
dated November 21, 2001 and a letter from Dr. Woo's office
dated August 7, 2001, requesting pre-approval of oral
surgery expenses in the amount of $9,825.00.
Member Vandver provided some background on Mr. Kosko's
condition. According to the letter from Dr. Woo's office, oral
surgery is required to prevent other conditions. However,
the procedure is not a covered expense by Regence
Medical and is not covered by Mr. Kosko's personal dental
insurance. Therefore, Board approval is requested for the
oral surgery.
Chair Kelly referred to Policy 8.08(D) and Policy 8.03(B).
Board members questioned whether any portion of the
expenses outlined by Dr. Woo's office would be covered by
Mr. Kosko's dental insurance. Chair Kelly summarized that
there appears to be a Board consensus that the oral surgery
is a medical necessity; however, there appears to be
insufficient information for the Board to determine the
amount eligible for reimbursement as some costs may be
eligible under Mr. Kosko's dental plan.
Motion by Chair Pro-Tem Larson, second by Member
Brothers to table Mr. Kosko's request pending the receipt of
additional information regarding potential insurance
coverages.
MOTION CARRIED UNANIMOUSLY. 5-0.
6. Helen Bowden
Ms. Bowden's claim was added as an agenda modification.
Chair Kelly explained that the claim for reimbursement of
LEOFF Board Minutes
December 3, 2001
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, December 3, 2001 - 10:00 AM - Conference Room 1
pharmacy expenses comes before the Board because some
of the pharmacy receipts have been altered.
Motion by Chair Pro Tem Larson and second by Member
Brothers to approve $14.00 of the pharmacy expenses and
deny $11.00 due to the altered receipts.
MOTION CARRIED UNANIMOUSLY. 4-0. (Member Barber
left the meeting prior to the Board's action on this claim.)
D. Correspondence
No correspondence was received.
F. Discussion
1. LEOFF Board Policies and Procedures
Board members reviewed the recommended amendments to the
policies and procedures from the November 19, 2001 special
LEOFF Board meeting.
Member Brothers expressed opposition to the proposed
amendment to include a laser eye surgery benefit.
Members discussed the amount recommended for reimbursement
for laser eye surgery. Chair Kelly noted that the Board intends to
reimburse a portion of the cost of the surgery. The amount
recommended for reimbursement is $700 per eye.
Board members also reviewed a survey of four providers for the
cost of lenses and frames. Chair Kelly proposed amending Section
9.02 to clarify coverages for lenses and frames expenses and to
provide a reimbursement rate over and above the amount paid by
insurance.
Board members discussed designating Costco Vision Center as
the LEOFF Board's vision care provider for lenses and frames. It
was consensus of the Board to recommend a policy that would
provide for reimbursement of lenses and frames expenses in an
amount equivalent to the high-end Costco cost and after any
insurance reimbursement. The reimbursement amounts, based on
LEOFF Board Minutes
December 3, 2001
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City of Auburn Law Enforcement Officers and Firefighters Disability Board
Monday, December 3, 2001 - 10:00 AM - Conference Room I
Costco expenses, would be outlined in the policy and reviewed
every other year.
Chair Kelly and Secretary Daskam are to develop policy language
for vision care services for the Board's consideration at the next
regular meeting.
V. ADJOURNMENT
There being no further business to come before the LEOFF Board, the meeting
adjourned at 11:26 AM.
APPROVED THE 7TM DAY OF JANUARY, 2002.
Chair Board Secretary
LEOFF Board Minutes
December 3, 2001
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