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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 Page 1 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 Page 2 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 Page 3 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 Page 4 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 Page 5 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 Page 6 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 Page 7 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 Page 8