2024-10-16 Disability Board PacketEDMONDS LEOFF 1 DISABILITY
MEETING NOTICE AND AGENDA
REGULAR MEETING
Wednesday, October 16, 2024
Fourtner Room City Hall
11:00 am
• CALL TO ORDER
• APPROVAL OF MEETING MINUTES
a. Minutes from the regular, 7/22/2024 meeting will be available at a future
meeting.
• DISCUSS AND APPROVE CLAIMS SUMMARY REPORT
b. For the period 07/01/2024 — 09/30/2024
BUSINESS
c. LEOFF 1 Member Request for Reimbursement (misc expenses)
d. LEOFF 1 Member Request for Reimbursement (medical bed)
e. LEOFF 1 Member Request for Reimbursement (dental expenses)
• OTHER
o Notice of increase in Medicare Supplement premium.
o Next Board Meeting date (January 2025)
Page 1
Current and Historial Claim Count & Costs
Summary of Current
Costs
07/01/2024 - 09/30/2024
SERVICE
Number of Reimbursements
Total Paid for Service
Deductible
1
136.61
Dental Expenses
0
-
Eyeglasses
1
240.00
Hearing Aids
1
749.99
Long Term Care
5
28,087.78
Medical Services
1
(106.91)
Prescription
4
335.60
Grand Total
13
$ 29,443.07
Summary of Historical
Costs
07/01 /2023 - 09/30/2023
SERVICE
Number of Reimbursements
Total Paid for Service
Deductible
0
-
Dental Expenses
2
519.66
Eyeglasses
0
-
Hearing Aid
1
60.00
Long Term Care
13
71,968.44
Medical Services
5
477.72
Prescription
7
793.28
Grand Total
28
$ 73,819.10
Disability Board 2024 Q3 [10/16/2024] City of Edmonds - Human Resources Department Page 1
CURRENT SUMMARY OF
COST BY BARS NUMBER 01/01/2024 - 09/30/2024
LEOFF 1 Fund
BARS NUMBER
ANNUAL APPROPRIATION
YTD EXPENDITURE
BALANCE
% USED
009.000.39.517.20.23.00
64,000.00
43,160.87
20,839.13
67.44%
Reimbursement Benefits
009.000.39.517.20.23.10
142,650.00
86,990.80
55,659.20
60.98%
Premium Benefits
009.000.39.517.20.29.00
152,990.00
95,158.07
57,831.93
62.20%
In Home/Assisted Living
009.000.39.517.20.41 - 49
7,500.00
7,400.00
100.00
98.67%
Proff. Svcs, Travel, Misc.
Expenses
TOTAL:
$367,140.00
$232,709.74
$134,430.26
63.38%
Fireman's Pension Fund
BARS NUMBER
ANNUAL APPROPRIATION
YTD EXPENDITURE
BALANCE
%USED
001.000.39.517.20.23.00
6,000.00
-
6,000.00
0.00%
Pension & Other Benefits
001.000.39.517.20.23.10
16,000.00
4,273.90
11,726.10
26.71%
Premium Benefits
001.000.39.517.20.23.20
6,000.00
3,230.20
2,769.80
53.84%
Reimbursement Benefits
001.000.39.517.20.29.00
141,668.00
30,483.79
111,184.21
21.52%
Pension and Disability
Payments
001.000.39.517.20.41.00
1,200.00
(714.18)
1,914.18
-59.52%
Professional Svcs.
TOTAL:
$170,868.00
$37,273.71
$133,594.29 21.81%
Disability Board 2024 Q3 [10/16/2024] City of Edmonds - Human Resources Department Page 2
HISTORICAL SUMMARY
OF COST BY BARS
NUMBER 01 /01 /2023 - 09/30/2023
LEOFF 1 Fund
BARS NUMBER
ANNUAL APPROPRIATION
YTD EXPENDITURE
BALANCE
% USED
009.000.39.517.20.23.00
64,000.00
32,682.14
31,317.86
51.07%
Reimbursement Benefits
009.000.39.517.20.23.10
142,650.00
67,280.34
75,369.66
47.16%
Premium Benefits
009.000.39.517.20.29.00
152,990.00
136,516.06
16,473.94
89.23%
In Home/Assisted Living
009.000.39.517.20.41 -49
7,500.00
19,000.00
(11,500.00)
253.33%
Proff. Svcs, Travel, Misc.
Expenses
TOTAL:
$367,140.00
$255,478.54
$111,661.46
69.59%
Fireman's Pension Fund
BARS NUMBER
ANNUAL APPROPRIATION
YTD EXPENDITURE
BALANCE
% USED
001.000.39.517.20.23.00
25,000.00
4,385.22
20,614.78
17.54%
Pension & Other Benefits
001.000.39.517.20.23.10
14,560.00
10,772.96
3,787.04
73.99%
Premium Benefits
001.000.39.517.20.23.20
10,000.00
2,850.00
7,150.00
28.50%
Reimbursement Benefits
001.000.39.517.20.29.00
165,023.00
59,726.64
105,296.36
36.19%
Pension and Disability
Payments
001.000.39.517.20.41.00
1,200.00
12,500.00
(11,300.00)
1041.67%
Professional Svcs.
TOTAL:
$215,783.00
$90,234.82
$125,548.18 41.82%
Disability Board 2024 Q3 [10/16/2024] City of Edmonds - Human Resources Department Page 3
September 25, 2024
Dear Leoff 1 Board,
The receipts sent in for —are for the following:
• Ramp: lumber, screws, paint from Home Depot to build a ramp (our son built it) scM
can walk in and out of our home safely. Currently_uses canes and a walker, but Eis
transitloning to a wheelchair to get to the car.■does not safely navigate stairs because of
lack of strength. (AMBULATING)
• Electrical Wiring: -has a lift chairas well as blood pressure needs, so we wired an
outlet under the house to the middle of the floor wherelWhalr sits. Our son did the labor,
but material costs are included in the receipts. (AMBULATING AND HEALTH CARE)
• Baby Monitor:=wanders and is a fall risk. This is a safety need. The baby monitor is so
I can monitor movements when 1 am not in the room wimp (SAFETY)
• Hospital Bed Rental: Mneeds a hospital bed with rails to sleep in for comfort and
safety. This is also where Ecan sit and be raised high enough so I can changeMostomy.
(AMBULATORY)
• Hoses and Shower Chair for the shower are necessary to safely take a shower. The hose
for the toilet Is necessary for jWstomy bag care. (GROOMING)
_needs assistance with dressing, showering, transferring, the toilet , feeding, grooming and
getting in and out of the house. All of the above items assist with the five Activities of Daily Living
(ADLs). The ADLs are: Grooming, toileting, ambulating, feeding, and dressing. Memory care, or
compensation for dementia, counts as a separate but important part of the ADLs (SAFETY). The
equipment is necessary for me, _ to safely care for=2417.
Sincerely,
LEOFF 1 Requested MISC Reimbursement, total Requested $859.64
Wal Mart - Baby Monitor, with tax $119.35
W a I m a r t :;:.
509-765-8979 M r:ROBERT
1005 N STRAT ORD RD
MOSES LAK WA 98837
STII 02007 Op# 0001 H T#i 25 IR#
6M�Lp429 628(rly9TC# 6248 03 2758 � N5
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
DISH CODE # 100027564923
BABY MONITOR 073507805070 110.00DX
PRODUCT SERIAL r� 071909170000
Home Depot - Ramp Supplies, with tax $455.88
FHow doers
'All" get more done_
?80 W CENTRAL DRIVE MOSES LAKE, WA 988
509-765-912B
;966 00002 21911 06/23/24 07:56 111
A:,E CASHIER PETRYSHA
814795001957 2X4-16 GDF <A>
2X4-16FT PREMIUM FIR
2@11.52 23.04
604603002296 2X4-8 SELECT <A>
2X4-8FT PT OUTDOOR WOOD
4@7.68 30.72
091162009628 CLAMP 24IN <A> 19.9'i
BESSF,Y BAR CLAMP 24X2-1/2 IN, 600 LB
SUBTOTAL 73.73
SALES TAX 6.27
TOTAL S80.00
How doers
get more done_
'BJ W CENTRAL DRIVE MCSES LAKE, WA 98837
sna-7C,5-9128
966 00062 85092
ALE SELF CHECKOUT
FHow doers
'412- get more done_
980 W CENTRAL DRIVE MOSES LAKE, WA 98837
509-765-9128
11 8966 00002 18812
06/22/24 02:42 pM SALE CASHIER MILES
32474669518 PPP&FSLTGRYG <A> 37.98
PREM PLUS PRCH 6 FLR SLATE GRAY -GAL
J02-169-000 GL RecycS <A,U> 0.95
PAINTCARE FEE
38309410577 2-7/8"SCREW <A> 26.97
HEADLOK 2-7/8" FLATHEAD 50PK
37083014129 TB3 WD GLU 4 <A> 4.98
TITEBOND III WOOD GLUE 40Z
'64666619937 BRWN DCKSCRW <A> 11.97
DECKMATE COMP, BROWN, 2-1/2 IN, 1 LB
20066322519 ROANTISKD <A> 15.48
R-0 ANTI-SKID ADDITIVE 8OZ
77089601305 6PCTRAYKIT <A> 12.98
BETTER 9 IN TRAY SET - 6 PIECE
SUBTOTAL 111.31
SALES TAX 9.46
TOTAL $120.77
06/22/24 08:37 PM
043374431551 WTHR STRIP <A>
MD 1/4"X1"X10' RUBBER WS-5 YR
2@5.93 11.86
043374020069 A/C W/S <A>
MD 1-1/4"X1-1/4"X42" AC WS-GRY
4@2.93 11.72
074985001543 GREAT STUFF <A> 4.38
GREAT STUFF GAPS & CRACKS 120Z
857442000736 23/32 PLY SB <A>
23/32 4X8 RADIATA PINE PLYWOOD
2@55.88 111.76
604603002791 2X6X12 PT GC <A> 16.98
2X6-12FT PT GC CONSTRUCTION SELECT
604603002364 2X6-16 PT/OW <A>
2X6-16FT PT OUTDOOR WOOD
3@23.78 71.34
604603002487 2X4X8 PT GC <A> 7.08
2X4-8FT PT GC CONSTRUCTION SELECT
SUBTOTAL 235.12
SALES TAX 19.99
TOTAL $255.11
Amazon - Electrical Wiring, with tax $208.06
Order Placed: June 7, 2024
Amazon.com order number: 114-9060896-1565839
Order Total: $127.22
Shipped on June 7, 2024
/
Items Ordered
1 of: Hubbell Wiring Systems RF515BN rradeSELECT Aluminumm Floor Box for Structural Wood Floor, 1SA, 12SV, Chestnut Bron556.30 L
Paint
Sob br: Amazor.com SaVKK, Inc
Suopbd Cv. OUW
Corddbn: Nei.
Order Placed: June 7, 2024
Amazon.com order number: 114-0427612-6621818
Order Total: $146.97
Shipped on June 7, 2024
Price
Items Ordered
1 of: Residential Floor Box Cover, Flange & Hinged Door Cover Assembly, for Use with Bryant RF500, Aluminum, Brown Pa1�37.02
Sold oy: AMMO-.MM 5e r(K M
Suppead W. Orer
Ll—
ccndrux New
1 of: RACO 62390K Floor Kit with Recessed Duplex 15A TR Dunce and Adjustable Steel Box, I -Gang, Black
549 73
Solo ter: Anuzon.com Sar c . Inc
S.+o, by CtMr
V
Condton N—
I of: Southwire Romex Brand Simpull Solid Indoor 1212 WIG NMB Cable 50ft coil - SWR 28828222
548.70
50lo w: Amazon.Com SYKei. :nC
Suppler ty Othv
Condton New
Amazon - Shower Supplies, with tax $76.35
Order Placed: 1„ne r, 1014
Amazon.com order number: 114-2180612 533865H
Order Total: $50.89
Shipped on June 8, 2024
Items Ordered Prlc
1 of: Essential Medical Supply Height Adjustable Shower and Bath Bench with Padded Arms and Textured Shower Chair Seat 546.90
SoldoV Arnaroo.com Services, Inc
SuppW by: Otter
FSA or NSA 449M
Corgton: New
Order Placed: June 8, 2024
Amazon.com order number: 114-9905364-6735411
Order Total: S25.46
Shipped on June 9, 2024
Items Ordered- - Price
1 of: BOPai ORB Suction Shower Head Holder, Relocatable Handheld Showerhead Holder, Chrome $13.49
Soo nV 6oparmar-us 4416er Profit)
Suppled 7v tiuP&,-MaI-US (Sete Pro%)
Conaton New
Shipped on June 9, 2024
Items Ordered '-p\i4p-
1 ot:,5170wer )lose, 118 Inches Shower Hose Extra Long, Premium 304 Stainless Steel Shower Head Hose, Plexwble Hand Held
Shower Hose &renston, Universal Shower Hose Replacement G112 Threaded Insert and Nut
SoldDv- orquW11041e10roree)
SAxw bv: ouquen)i (weer oro9w)
Condwr,: New
Invoice Statement
Date Sent: 07/30/2024
BALANCE DUE:
$276 68
orco
M Engfooyx Oenn<t Cmnpany
I -Pay Online pay.norco-inc.com
rr Account #: KNNP3
(Reconvnended)Invoice #: 41208064
Where applicable, insurance has
been filed and paid. .�, Detach payment coupon and submit with a
��►Pay by Mail �
Primary: SELF PAY check or credit card information. —_
I —
■ Phone: (208) 577-5280
■ • • Office Hours: M-F 8:00am - 6:00pm MT
i�
Visit pay.norco-inc.com to make a payment today. You can also set up Autopay, enroll in eDelivery Only, check balances
and update insurance information.
ot; PATIENT ADJUSTED BALANCE-'
1 =_ _RESP. •
UE
PATIENT NAME:
ME
07/22/2024 141208064 �001-000 - E0265 - RENTAL FULL ELECTRIC BED $217.00 $0.00 I $0.00 $276.68
- K0001 - RENTAL STANDARD WIC 18 INCH
TOTAL
CREDITS AND PREVIOUS BALANCE
TOTAL DUE
IMPORTANT MESSAGES
$0.00
$276.68
• Questions on deductible, co-insurance, max out of pocket? Please watch the video Norco created on the following URL:
norco-inc.com/insurancebasics
• If you have new insurance, please contact us.
• Payments made within 10 days prior to this statement may not be reflected in the account balance.
• Contact US: Phone: (208) 577-5280 • Website: pay.norco-inc.com • Email: Estatements@norco-inc.com
Kjersten Heron, DMD
To Whom It May Concern:
-requires cleanings and exams 3 times a year due tcobattle with the bone loss
around. teeth. Prior to coming to see us, had lost 13 teeth despite an excellent home care routine.
■hopes not to lose any more teeth in the future and is requesting financial assistance with the cost of
this treatment which is estimated to be $724.51. Please consider these costs to help this deserving
retired first responder keep the remaining teeth Was left.
Feel free to contact us with any questions or additional information that you might need.
Sincerely,
Kjersten Heron, DMD
To date, member has been reimbursed $700.00 (policy max)
Pending reimbursement is $111.71
Division Street Dental
rem,y„�,E.,.,omm„ud,o....��.M.
Dr. Kjenbn A. Xeron, D.D.9.