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2023-05-05 Disability Board PacketEDMONDS LEOFF 1 DISABILITY BOARD MEETING NOTICE AND AGENDA REGULAR MEETING Friday, May 5, 2023 Fourtner Room City Hall 11:00 am • CALL TO ORDER • APPROVAL OF MEETING MINUTES a. From the 2/24/2023 Meeting b. From the 5/31/2022 Meeting • DISCUSS AND APPROVE CLAIMS SUMMARY REPORT c. For the period 01/01/2023 — 03/31/2023 d. Review/Discuss LEOFF 1 member's request for LTC services e. Review/Revise Board Policies i. 004-06 Hearing Aids (last reviewed 2/24/23) ii. 011-16 Medical Services & Equipment (last reviewed and revised 10/20/2016) • OTHER 0 2023 WSLEA Benefits Comparison o Next Board Meeting date (July 2023) Page 1 EDMONDS' LEOFF 1 DISABILITY BOARD Meeting Minutes Regular Meeting 05/31 /2022 MEMBERS PRESENT: Ken Jones, Board Chair Gary McComas, Board Member Susan Paine, Council Member Laura Johnson Council Member Jim Distelhorst, Citizen -at -Large STAFF PRESENT: Sharon Cates, Attorney Emily Wagener, Sr. Human Resources Analyst Carly Derrick, Human Resources Analyst MEMBERS OF THE PUBLIC PRESENT: None CALL TO ORDER: Chair Jones called the meeting to order at 10:30 AM DISCUSS AND APPROVE CLAIMS SUMMARY REPORT 01/01/2022 — 03/31/2022 Chair Jones introduced the claims summary report for the period of January 2022 to March 2022. He mentioned the budget shows a zero dollar balance so everything used is going to be a deficit. Ms. Derrick explained that finance didn't separate out the expenses as they usually do, but an administrative budget amendment just needs to be done by Finance. Council member Johnson suggested moving the approval to the next regularly scheduled meeting. Chair Jones agreed. Ms. Wagener explained that waiting doesn't hold up any reimbursements. Summary of Current Costs 01/01/2022 - 03/31 /2022 SERVICE Number of Claims Total Paid for Service Dental Expenses 7 $ 2,465.30 Eyeglasses 2 $ 374.98 Long Term Care 7 $ 27,063.00 Medical Services 8 $ 2,731.07 Medicare Premium 17 $ 29,155.00 Prescription 18 $ 5,279.99 Grand Total 59 $ 67,069.34 Edmonds LEOFF 1 Disability Board — 05/31/2022 BUSINESS Review/discuss LEOFF 1 member's increase in LTC services (+$271.89/month effective 9/1/2022) Chair Jones introduced the next item for discussion, the increase in long term care services by $271.89 per month. Council Member Paine noted it looked reasonable. Board Member McComas made a motion to approve long term care increase for LEOFF 1 member. Citizen -at -Large Distelhorst seconded the motion. The motion carried. Review/Revise Board Policies 001-06 Payment of Annual Deductibles (last reviewed and revised 1/29/13) 003-02 Purchase of Eye Glasses (last reviewed and revised 02/03/16) 005-06 Medicare Premium Reimbursements (last reviewed and revised 04/19/17) Council member Paine requested some verbiage changes on the annual deductibles policy to provide further clarification. Attorney Cates will make changes to the policies as requested. Board member McComas proposed raising the amounts for eyeglasses from $150.00 to $250.00 per year and from $300 to $500 every two years. Ms. Wagener mentioned there is an updated policy from 2018 that shows $225 annually. Council member Johnson said she preferred a $450 every two years policy because $225 won't cover lenses. The board agreed and talked about raising the amount to $500 every two years. The eye exam would be covered in full, in addition to the $500 hardware maximum. Chair Jones made a motion to increase the eyeglass reimbursement maximum to $500 every two years effective January 1, 2022. Council member Johnson seconded that motion. Motion carried. The Board decided to leave the current policy for Medicare Premiums intact. Board member Jones made a motion to keep the Medicare premium policy the same. Council member Paine seconded the motion. Motion carried. OTHER OPMA Changes The Board discussed the possibility of returning to in -person meetings. Chair Jones suggested not having another meeting until after July when there is more clarification on the requirements of in -person meetings due to COVID. Board member adjourned the meeting at 11:15 AM. Page 2 of 2 CITY OF EDMONDS DISABILITY BOARD O EDAir) CLAIMS SUMMARY 01 /01 /2023 to 03/31 /2023 CLAIM NO. SERVICE RCW/PAST PRACTICE COST 1 Medicare Premium 005-06 $ 1,782.00 2 Prescription 010-15 $ 64.04 Medical Services RCW $ 195.00 Eyeglasses 003-02 $ 300.00 3 Prescription 010-15 $ 31.00 Medical Services RCW $ 66.25 Long Term Care 008-11 $ 3,292.89 4 Medicare Premium 005-06 $ 1,978.80 Long Term Care 008-11 $ 6,000.00 5 Prescription 010-15 $ 41.00 Medicare Premium 005-06 $ 1,978.80 Long Term Care 008-11 $ 3,292.89 6 Prescription 010-15 $ 129.29 Medical Services RCW $ 25.91 Medicare Premium 005-06 $ 1,978.80 7 Medicare Premium 005-06 $ 1,978.80 8 Prescription 010-15 $ 87.38 Medicare Premium 005-06 $ 1,978.80 9 Prescription 010-15 $ 2.23 Medicare Premium 005-06 $ 1,765.20 Dental Expenses 002-05 $ 197.00 10 Prescription 010-15 $ 448.36 Medical Services RCW $ 1,302.25 Medicare Premium 005-06 $ 1,597.20 Dental Expenses 002-05 $ 700.00 11 Prescription 010-15 $ 620.65 12 Prescription 010-15 $ 250.02 13 Prescription 010-15 $ 384.96 Medical Services RCW $ 203.50 Medicare Premium 005-06 $ 2,041.20 Dental Expenses 002-05 $ 700.00 14 Prescription 010-15 $ 476.45 Medicare Premium 005-06 $ 2,041.20 Dental Expenses 002-05 $ 224.20 Deductibles 001-06 $ 300.00 15 Prescription 010-15 $ 327.17 Medical Services RCW $ 161.88 Medicare Premium 005-06 $ 2,041.20 Dental Expenses 002-05 $ 89.00 Deductibles 001-06 $ 9.98 16 Medicare Premium 005-06 $ 62.40 17 Medicare Premium 005-06 $ 62.40 Long Term Care 008-11 $ 6,600.00 18 Medicare Premium 008-11 $ 62.40 Prescription 010-15 $ 41.00 Long Term Care 008-11 $ 3,292.00 19 Long Term Care 008-11 $ 7,101.36 26 , Total Approved Claims Total Reimbursed $ 58,306.86 Disability Board 2023 Q1 City of Edmonds - Human Resources Department Page 1 Current and Historial Claim Count & Costs Summary of Current Costs 01 /01 /2023 - 03/31/2023 SERVICE Number of Claims Total Paid for Service Deductibles 2 $ 309.98 Dental Expenses 5 $ 1,910.20 Eyeglasses 1 $ 300.00 Long Term Care 6 $ 29,579.14 Medical Services 6 $ 1,954.79 Medicare Premium 14 $ 21,349.20 Prescription 13 $ 2,903.55 Grand Total 47 $ 58,306.86 Summary of Historical Costs 01 /01 /2022 - 03/31/2022 SERVICE Number of Claims Total Paid for Service Dental Expenses 7 $ 2,465.30 Eyeglasses 2 $ 374.98 Long Term Care 7 $ 27,063.00 Medical Services 8 $ 2,731.07 Medicare Premium 17 $ 29,155.00 Prescription 18 $ 5,279.99 Grand Total 59 $ 67,069.34 Disability Board 2023 Q1 [05/05/2023] City of Edmonds - Human Resources Department Page 1 CURRENT SUMMARY OF COST BY BARS NUMBER 01/01/2023 - 03/31/2023 LEOFF 1 Fund BARS NUMBER ANNUAL APPROPRIATION YTD EXPENDITURE BALANCE % USED 009.000.39.517.20.23.00 $64,000.00 $24,422.25 $39,577.75 38.16% Reimbursement Benefits 009.000.39.517.20.23.10 $142,650.00 $32,318.80 $110,331.20 22.66% Premium Benefits 009.000.39.517.20.29.00 $152,990.00 $29,579.14 $123,410.86 19.33% In Home/Assisted Living 009.000.39.517.20.41 - 49 $7,500.00 $0.00 $7,500.00 0.00% Proff. Svcs, Travel, Misc. Expenses TOTAL: $367,140.00 $86,320.19 $280,819.81 23.51 % Fireman's Pension Fund BARS NUMBER ANNUAL APPROPRIATION YTD EXPENDITURE BALANCE % USED 001.000.39.517.20.23.20 $10,000.00 $1,964.43 $8,035.57 19.64% Reimbursement Benefits 001.000.39.517.20.23.10 $14,560.00 $5,386.48 $9,173.52 37.00% Premium Benefits 001.000.39.517.20.29.00 $165,023.00 $22,293.57 $142,729.43 13.51 % Pension and Disability Payments 001.000.39.517.20.41.00 $1,200.00 $0.00 $1,200.00 0.00% Professional Svcs. TOTAL: $190,783.00 $29, 644.48 $161,138.52 15.54% Disability Board 2023 Q1 [05/05/2023] City of Edmonds - Human Resources Department Page 2 HISTORICAL SUMMARY OF COST BY BARS NUMBER 01/01/2022 - 03/31/2022 LEOFF 1 Fund BARS NUMBER ANNUAL APPROPRIATION YTD EXPENDITURE BALANCE % USED 009.000.39.517.20.23.00 $64,000.00 $35,794.98 $28,205.02 55.93% Reimbursement Benefits 009.000.39.517.20.23.10 $142,650.00 $23,928.33 $118,721.67 16.77% Premium Benefits 009.000.39.517.20.29.00 $252,990.00 $21,363.00 $231,627.00 8.44% In Home/Assisted Living 009.000.39.517.20.41 - 49 $7,500.00 $7,000.00 $500.00 93.33% Proff. Svcs, Travel, Misc. Expenses TOTAL: $467,140.00 $88,086.31 $379,053.69 18.86% Fireman's Pension Fund BARS NUMBER ANNUAL APPROPRIATION YTD EXPENDITURE BALANCE % USED 001.39.517.20.23.20 $10,000.00 $1,599.10 $8,400.90 15.99% Reimbursement Benefits 001.000.39.517.20.23.10 $14,560.00 $3,779.19 $10,780.81 25.96% Premium Benefits 001.000.39.517.20.29.00 $70,944.00 $11,824.74 $59,119.26 16.67% Pension and Disability Payments 001.000.39.517.20.41.00 $1,200.00 $0.00 $1,200.00 0.00% Professional Svcs. TOTAL: $96,704.00 $17,203.03 $79,500.97 17,79a�a Disability Board 2023 Q1 [05/05/2023] City of Edmonds - Human Resources Department Page 3 expstat.rpt 05/04/2023 1:45PM Periods: 0 through 3 009 LEOFF-MEDICAL INS. RESERVE 39 NON -DEPARTMENTAL EXPENSES Account Number 009.39.517 EMPLOYEE BENEFIT PROGRAMS 009.39.517.20 "` Title Not Found — 009.000.39.517.20.23.00 REIMBURSEMENT BENEFITS 009.000.39.517.20.23.10 PREMIUM BENEFITS 009.000.39.517.20.29.00 IN -HOME LTC CLAIMS 009.000.39.517.20.41.00 PROFESSIONAL SERVICES 009.000.39.517.20.43.00 TRAVEL 009.000.39.517.20.49.00 MISCELLANEOUS Total LEOFF-MEDICAL INS. RESERVE Grand Total Expenditure Status Report City of Edmonds 1/1/2023 through 3/31/2023 Page: 1 Adjusted Year-to-date Year-to-date Prct Appropriation Expenditures Expenditures Encumbrances Balance Used 64,000.00 24,422.25 24,422.25 0.00 39,577.75 38.16 142,650.00 32,318.80 32,318.80 0.00 110,331.20 22.66 152,990.00 29,579.14 29,579.14 0.00 123,410.86 19.33 7,000.00 0.00 0.00 0.00 7,000.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 500.00 0.00 0.00 0.00 500.00 0.00 367,140.00 86,320.19 86,320.19 0.00 280,819.81 23.51 367,140.00 86,320.19 86,320.19 0.00 280,819.81 23.51 Page: 1 expstat.rpt 05/04/2023 1:47PM Periods: 0 through 3 001 GENERAL FUND 39 NON -DEPARTMENTAL EXPENSES Account Number 001.39.517 EMPLOYEE BENEFIT PROGRAMS 001.39.517.20 *** Title Not Found *** 001.000.39.517.20.23.00 PENSION & OTHER BENEFITS 001.000.39.517.20.23.10 PREMIUM BENEFITS 001.000.39.517.20.23.20 REIMBURSEMENT BENEFITS 001.000.39.517.20.29.00 PENSION AND DISABILITY PAYMENTS 001.000.39.517.20.41.00 PROFESSIONAL SERVICES Total *** Title Not Found *** 001.39.517.78 *** Title Not Found *** 001.000.39.517.78.11.00 SALARIES 001.000.39.517.78.23.00 BENEFITS - UNEMPLOYMENT Total *** Title Not Found *** 001.39.517.90 *** Title Not Found *** 001.000.39.517.90.23.00 PENSION EXPENSE 001.000.39.517.90.49.00 MISCELLANEOUS -SMART COMMUTER GRANT Total *** Title Not Found *** Total GENERAL FUND Grand Total Expenditure Status Report City of Edmonds 1/1/2023 through 3/31/2023 Page: 1 Adjusted Year-to-date Year-to-date Prct Appropriation Expenditures Expenditures Encumbrances Balance Used 25,000.00 0.00 0.00 0.00 25,000.00 0.00 14,560.00 5,386.48 5,386.48 0.00 9,173.52 37.00 10,000.00 1,964.43 1,964.43 0.00 8,035.57 19.64 165,023.00 22,293.57 22,293.57 0.00 142,729.43 13.51 1,200.00 0.00 0.00 0.00 1,200.00 0.00 215,783.00 29,644.48 29,644.48 0.00 186,138.52 13.74 101,750.00 0.00 0.00 0.00 101,750.00 0.00 25,000.00 0.00 0.00 0.00 25,000.00 0.00 126,750.00 0.00 0.00 0.00 126,750.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 342,533.00 29,644.48 29,644.48 0.00 312,888.52 8.65 342,533.00 29,644.48 29,644.48 0.00 312,888.52 8.65 Page: 1 From: "Rady To: subja F l£IXT1 Date: MorKiW, Mania 27, 20D 1:4108 W Begin forwarded message: From: Subject: LEOFF 1 Date: March 27, 2023 at 12:32:06 PM PDT To: "Derrick, Carly"<carly.derrick([Dedmondswa.c�ov> Hello Carly, Visited yesterday during which time he asked that I send you a note with the various c olces of residences. He thought outline form would work. ! Cogir of Edmonds a. Price is agreeable $150 / day or approximately $4560 / month. They have a point system in place for additional care which may not need. b. Studio apartment with meals is available or respite lodging c. Preferred by family because of location d. Staff there is ready to help B Fairwinds-Brighton Court in Edmonds a. Similar in price as Cogir b. Currently in COVD lockdown c. Strong 2nd choice III Chateau in Lynnwood a. Similar price but not convenient location IV Genet Adult Family Home a. $6000 / month b. Heard small children in background each time she called c. Physical Therapy? Treadmill in garage .& I have other items in place or being worked on. Dr. Callaway agreed to write a letter giving an order for extra day(s) for Ken's care before transfer to care facility. Also, Swer ish/Stevens case worker Katie has been in touch to ask if she can help in this process. Carly, hopefully I've supplied the required information needed for the LEOFF 1 board to consider. Please call or email me with further questions. Sincerel 1A li City of Edmonds Disability Board POLICY AND PROCEDURE Effective: Approved by the Board at the May 3, 2006 meeting Revised: Approved by the Board at the January 24, 2007, January 21, 2010, July 2015, March 3, 2015 and April 20, 2018, July 19, 2018, and February 24, 2023 meeting(s) SUBJECT: HEARING AIDS, #04-06 A benefit is provided by the City of Edmonds Disability Board for both hearing tests (once every three years) and hearing aids as follows: • Preapproval from the Board is required for the intial purchase of any hearing aids or the replacement of hearing aids. HR may approve hearing aid purchase reimbursement up to the maximum allowed by this policy for any replacement hearing aids. • The reimbursement cost for the purchase of hearing aids will be a maximum of $4,600 every 36 months. Reimbursement requests must be accompanied by supporting documentation from a licensed physician or hearing specialist. • HR staff has the authority to process Board pre -approved hearing aid purchase requests for reimbursement with the appropriate supporting documentation from a licensed physician and/or hearing specialist up to the approved maximum amount of $4,600 every 36 months. • Replacement of hearing aids will only be covered after 36 months and if the current hearing aid cannot be reasonably repaired, presuming the hearing aid is not covered by warrantee or insurance. The Disability Board will consider replacement of hearing aids after 36 months if a different model or style of hearing aid is needed due to a significant hearing change or if a new hearing aid significantly accommodates the members hearing loss. In most cases, HR may approve replacement hearing aid purchase reimbursement requests up to the limits set by this policy. • The cost of batteries is covered under this policy. NOTE: Any special needs above and beyond the dollar amount set in this policy are subject to appeal by the LEOFF 1 member to the City of Edmonds Disability Board with appropriate medically necessary documentation. This policy will be reviewed by the Disability Board on an annual basis. City of Edmonds — Disability Board 5/2/2023 From: Sharon Cates To: Derrick, Carlv Subject: RE: Disability Board Date: Wednesday, May 3, 2023 11:35:56 AM Attachments: imaae001.ong Hearing Aids, #04-06.pdf RCW 41.26.150 Sickness or disabilitv benefits --Medical services.Ddf Hi Carly, I've looked into the question of the legality of the Disability Board requiring LEOFF I members to obtain a hearing evaluation from a hearing specialist before the Board will cover the cost of hearing aids, given the new FDA regulations relating to over -the-counter (OTC) hearing aids. The short answer is that, yes, it is legal for the Board to require a medical exam before purchasing any type of hearing aid. The new FDA regulations were implemented to improve access to hearing aid technology for Americans, since OTC hearing aids are significantly less expensive than traditional hearing aids. Here is a link to the Federal Register that helps explain the intent of the regulations: https://www.federalregister.gov/documents/2022/08/17/2022-17230/medical-devices-ear-nose- and-throat-devices-establishing-over-the-counter-hearing-aids. The main reason for these regulations is to help ensure the safety and effectiveness of OTC hearing aids so that individuals may be more likely to buy them and improve their quality of life. These regulations do not impact the Disability Board's ability to require a medical evaluation before covering the cost of their purchase because the provisions of Chapter 41.26 RCW govern the Board's actions. As you know, that statute requires the board to pay for medically necessary health care, and any member who refuses to obtain a required examination from a licensed physician forfeits all right to benefits under the statute for the period of the refusal (see highlighted copy of RCW 41.26.150, attached). So, while the FDA regulations don't require a medical exam, they also don't prohibit entities like Disability Boards from requiring a medical exam before covering the cost of the purchase of medical services or equipment. In researching this topic, I found that the use of OTC hearing aids is controversial, with some in the medical community supporting their use since many who could benefit might go without because of the cost of traditional hearing aids, and others concerned that, without the guidance of a medical professional, OTC hearing aids could damage individuals' ears or not work well enough and result in them giving up on hearing aids altogether. In addition, hearing loss can be a symptom of an underlying health issue, so consulting with at least a primary care physician is helpful in determining the best hearing aid route for that person. In summary, there is no legal roadblock to the Board continuing to require a medical exam in this situation. The current wording of the second bullet point of Policy #04-06 seems to be appropriate for both traditional and OTC hearing aids because it requires "supporting documentation from a licensed physician or hearing specialist," which means that a member could consult their primary care physician only and if the physician thinks that an OTC hearing aid is appropriate, the policy will cover the cost of that purchase. Also, because the policy covers the cost of hearing tests, a member could also go that route and obtain the necessary supporting documentation from a hearing specialist instead. Please let me know if this doesn't fully answer your questions. Best regards, Sharon Sharon Cates 600 Stewart Street, Suite 400 Seattle, WA 98101 Phone: 206-273-7440 E-mail: Sharon(@lighthouselawgroup.com THIS MESSAGE IS PRIVATE AND PRIVILEGED. IF YOU ARE NOT THE PERSON MEANT TO RECEIVE THIS MESSAGE, PLEASE DELETE IT AND PLEASE DO NOT COPY OR SEND IT TO ANYONE ELSE. From: "Derrick, Carly" <Carly.Derrick@edmondswa.gov> Date: Tuesday, May 2, 2023 at 2:21 PM To: Sharon Cates <sharon@lighthouselawgroup.com> Subject: Disability Board Hi Sharon, The Board decided to change the hearing aid policy to outline the following: 1. Reimbursement for hearing aids is a maximum of $4,600 every 36 months. The Board would like to keep the second bullet point of requiring an evaluation from a hearing specialist, but they wanted to know if that was "legal" to require that in light of the new ruling that hearing aids can be purchased over the counter and an evaluation is not required by the FDA. Thank you, Carly Derrick, SHRM-CP Human Resources Analyst City of Edmonds Office Hours: Monday: 8:00 am - 4:30 pm (remot%ffsite) Tuesdays & Fridays: 8:30 am — 5:00 pm (remote from 8:30-9:30 am, onsite 9:30 am — 5:00 pm) (425) 672-5751 (Direct) (425) 275-4806 {HR Fax} 11-16 City of Edmonds Disability Board Effective: Reviewed and approved by the Board at the October 20, 2016 meeting SUBJECT: REIMBURSEMENT OF MEDICAL SERVICE EXPENSES AND/OR MEDICAL EQUIPMENT COSTS*, #11-16 The City of Edmonds' Disability Board designates the medical services available to members of the LEOFF 1 (persons who establish members in the retirement system on or before September 30, 1977) to include the following medical services in addition to those noted in RCW 41.26.030 (22). GENERAL RULE. The Disability Board will authorize payment of reasonable expenses for necessary medical services and supplies incurred by a LEOFF 1 member, as long as the expenses were not the result of dissipation or abuse. Decisions will be made on a case -by -case basis, although the Board will adopt general policies addressing certain frequently recurring medical claims. Any LEOFF 1 member who is unsure whether particular medical services or supplies are covered by the LEOFF 1 program is encouraged to petition to the Board before the costs are incurred. EMPLOYER'S INSURANCE PLAN. As the City provides an insurance plan to LEOFF 1 members with a coverage benefit under the group hospitalization and medical aid insurance plan, a LEOFF 1 member seeking medical services or supplies must attempt to do so in a manner that allows for coverage under the insurance plan. If the Board determines that the LEOFF 1 member could have obtained reasonable equivalent services or supplies through the insurance plan and that the LEOFF 1 member failed to do so without good reason, reimbursement will not be authorized. OTHER SOURCES OF COMPENSATION. The amount that the Disability Board awards for medical services/and or medical equipment will be reduced by any amount that the member receives, or is eligible to receive, from workers' compensation, social security, insurance provided by other employers, or other pension plans, Medicare, or other similar sources. "For the purpose of this policy, eligible means that a member could be reimbursed by the employer for premiums or could submit a member paid premium to the Disability Board for approval of payment." Therefore, a member who is eligible for compensation from one of these other sources, but who does not apply for its benefits, will have his/her medical benefits under LEOFF 1 reduced by the amount that would have been paid by the other source. There will be no such reduction, however, if the member presents a claim to the other source and that other source provides justification for refusal of payment. City of Edmonds - Disability Board 7/18/2017 It is the policy of the Disability Board to purchase supplies, materials, equipment and services at the most reasonable price as soon as reasonably possible. This procedure is designed to assure the establishment of a competitive price, selection of the lowest qualified/responsible bidder, while meeting the LEOFF 1 Retiree's needs and expectations • Pre -authorization from the Board prior to the acquisition of the goods and/or services is required for items with an expense of $500.00 or more in addition to documentation of medical necessity from the LEOFF 1's medical provider. • No price quotes are required for purchases under $500.00, but requests for reimbursement in the amount of $500.00 or less must still be accompanied by documentation of medical necessity from the LEOFF 1's medical provider if not covered by Medicare and/or the City's medical insurance and/or any other medical insurance the LEOFF 1 retiree may have coverage through. • In cases where the cost of acquisition of the goods and services exceeds $500.00, three (3) quotes are required on all purchases of $500.00 or more. The number of vendors contacted may be reduced if the item being sought is only available from one or two vendors. The LEOFF 1 Disability Board will reimburse the lowest qualified bid unless there is proof of extenuating circumstances (documented by the LEOFF 1 Retiree's medical provider) as to the medical necessity of the non -lowest priced, qualified bid. • Replacement costs for medical equipment will only be covered if any current medical equipment being used cannot be reasonably repaired and must be supported by documentation from the medical provider of medical necessity. NOTE: Any special needs above and beyond the dollar amount set in this policy are subject to appeal by the LEOFF 1 member to the City of Edmonds Disability Board with appropriate medically necessary documentation. This policy will be reviewed by the Disability Board on an annual basis. *Includes visual aids and/or adaptive devices, but excludes hearing aids NOTE: Any special needs above and beyond the dollar amount set in this policy are subject to appeal by the LEOFF 1 member to the City of Edmonds Disability Board with appropriate medically necessary documentation. This policy will be reviewed by the Disability Board on an annual basis. 2023 WSLEA COMPARISON OF BENEFITS* Acupuncture Jurisdiction Policy Summary Aberdeen Physician prescribed, certified acupuncturist. Bellingham Physician prescribed. 25 visits/yr also see Massage therapy Bothell Physician prescribed, certified acupuncturist. Treatment plan over 2 visits. Submit claims w/in 6 months Bremerton Physician prescribed. Clallam Co Physician prescribed as medically necessary. Cowlitz Co Tx beyond insurance requires tx plan in a month w/updates every 12 mos. Douglas Co Physician prescribed, certified provider. Treatment plan over 2 visits. Everett Case by Case benefit. Submit directly to Board secretary's office. Kennewick Pre -approval required over 12 visits/year. King Co Physician prescribed, certified acupuncturist. Pre -approval over 2 visits. Mason Co No policy Pacific Co Physician prescribed, licensed acupuncturist. 12 visits/year. Pierce Co 12 visits/year. Puyallup 12 visits/year. Redmond Case by case — if medically necessary. Renton Covered in plan 25/yr Massage/Acupuncture; to exceed needs pre -approval Richland Fire Administered by physician or licensed acupuncturist under guidance of physician. Richland Police Administered by physician/licensed acupuncturist. 12 visits/year; pre -approval for additional. Dr letter required. Seattle Fire One treatment day/$135; Rx from Doctor. State licensed. Seattle Police Licensed practitioner for Acupuncture and Massage Therapy. As prescribed by medical doctor. Skagit Co Physician prescribed, certified acupuncturist. Pre -approval over 3 visits. 12 visits/6-mos. Skamania Co 12 visits in 6 months. Snohomish Co Physician prescribed as medical necessity. Pre -approval over 4 visits. Spokane Co $750 per year/lifetime/one condition/$3000 for tx. Includes Naturopathy, acupuncture, massage, chiro and other holistic or alternative. Tacoma 12 visits/year through Regence BlueShield. Vancouver Administered by or under direction of a physician. Pre -approval required. Walla Walla Physician prescribed, provided by certified acupuncturist. Treatment plan over 2 visits. Whatcom Co Services provided by certified acupuncturist. Whitman Co Services provided by certified acupuncturist. Treatment plan 6 months or 10 visit. Yakima Co Services by certified acupuncturist. 12 visits/year. Bariatric Surgery Jurisdiction Policy Summary Benton Co Have covered for medical necessity. Bothell Board will consider programs that are Dr prescribed. Everett Diet Education 100% allowable charge. Non -surgical tx only. Grays Harbor Co Have covered for medical necessity. Kirkland Would consider if medically necessary. Pasco Not covered Snohomish Co Have covered for medical necessity. Spokane Have covered for medical necessity. 1 WSLEA Comparison of Benefits, Revised February 5, 2023 Bariatric Surgery (Cont.) Jurisdiction Policy Summary Thurston Co Have covered for medical necessity. Yakima Co Have covered for medical necessity. Board Administration Jurisdiction Policy Summary Aberdeen HR Director Bellevue Sr HR Analyst Bellingham Finance Clerk (meetings); HR Benefits Rep (pensions/bills); HR Director (policy changes) Benton Co Commissioner's Executive Secretary Bothell Sr HR Analyst Bremerton Clerk (meetings/policies), HR (bills/pension) Chelan Co HR Clallam Co HR Edmonds HR Director Everett Deputy City Clerk — Finance Franklin Co HR Island Co Commissioner's staff Jefferson Co Commissioner's staff Kennewick Police Department Administrative Assistant Kent Benefits Manager Kirkland HR Analyst Klickitat Co Commissioner's Office Clerk of the Board/Deputy Clerk Claims Lewis Co Commissioner's Office Administrative Assistant Marysville HR Director Mason Co Commissioner's Office/Human Resources Mercer Island Human Resources Okanogan Co Commissioner's staff Olympia Office Specialist III and Personnel Analyst1 Pacific Co Accounts Payable - Chief Deputy Auditor Pasco HR Director Pend Oreille Co Commissioner's staff Pierce Co Risk Management Richland Accounting Specialist - Finance SeaTac Fire Department Administrative Assistant Skagit Co HR Director Skamania Co No LEOFF I pensioners Snohomish Co Human Resources Generalist Spokane Assistant Retirement Director (pensions/Medicare); HR Benefits Specialist (medical) Spokane Co Commissioner's Office Administrative Assistant Thurston Co Human Resources Vancouver Human Resources Walla Walla Co Commissioner's Office Administrative Assistant Whatcom Co Executive's Office Whitman Co Commissioner's Office Clerk of the Board Yakima Co HR Sr Program Rep 2 WSLEA Comparison of Benefits, Revised February 5, 2023 Cataract Up -grade Jurisdiction Policy Summary Bellevue Have covered - case by case. Chelan Co Have covered - case by case. Everett Allowed up to $550 instead of payment for eyeglasses. Island Co Would consider case by case. Kirkland Would consider case by case. Klickitat Co Would consider medical necessity. Marysville Monofocal lens approved; no specialty multifocal approval Olympia Would consider medical necessity. Pacific Co Not covered Pierce Co Have denied as not medically necessary. Puyallup Consider case by case. Redmond $1500 lifetime limit for Toric or Multifocal lenses during cataract surgery Richland Have covered. Seattle Police Consider it medically necessary for the member's vision. Snohomish Co Have covered for medical necessity, case by case. Spokane Would consider medical necessity. Tacoma Denied the extra charges. Thurston Co Would consider medical necessity. Vancouver Have denied as not medically necessary. Whatcom Co Monofocal only. Yakima Co Have covered for medical necessity. Chemical Dependence Jurisdiction Policy Summary Aberdeen Repeat patients reimbursed 1 year after completion w/evidence of continued recovery. Bellingham Fire Provided through medical plan for alcohol and drug tx. Bellingham Police Medical plan coverage Bothell $2,000/year for 3 consecutive years. Written confirmation program completion. Bremerton Per statute Chelan Co Medical plan covers, non -covered costs up to $5,000 over 2-year period, conditions apply. Clallam Co Pre -approval required. One-time $6,000 maximum Cowlitz Co If exceeding insurance coverages, Licensed psychiatrist, et all (see plan), Dr ordered with Tx plan. State licensed facility. Notify pension w/I 10 days of admission. Repeat tx: Pay for tx/reimbursed after one year of completion. Everett 100% allowable charges both inpatient and outpatient. Franklin Co Pre -approval required. Part of regular coverage. Grays Harbor Co Prescribed by licensed physician. Jefferson Co $2,000/year for 3-consecutive years. Kennewick Inpatient treatment facilities, one-time only. Pre -approval required. King Co Maximum $6,000. Pre -approval and written confirmation of program completion. Kirkland Physician prescribed State -approved program. Pre -approval required. Kittitas Co Licensed agency: Dr ordered, written plan w/in 5 days of admission. Complete tx, if tx discontinued member cost prorated. Lewis Co Not to exceed by 10% average cost for such care in Lewis Co area. Marysville Covered through city plan/expenses not covered can be submitted to board. Okanogan Co Pre -approval required. 3 WSLEA Comparison of Benefits, Revised February 5, 2023 Chemical Dependence (Cont.) Jurisdiction Policy Summary Pacific Co Not to exceed by 10% the average cost for such case in the Pacific Co area. Pasco State approved tx only Pend Orielle Licensed facility approved by board Dr. Max $5,000 during consecutive years — Dr recommended. Written tx plan, within 5 days of admission. Remains in facility thru final or prorated. Pierce Co Only if administered by state -approved treatment program. Puyallup $12,000 every 2 calendar years. Redmond Case by case. Renton Board discretion, pre -approval needed. Richland Fire Complete use disorder program by City of Richland first before an out of network plan submission to Board for authorization. Richland Police Complete use disorder program by City of Richland first before an out of network plan submission to Board for authorization. Seattle Fire State licensed facility. Primary Dr letter/determine Tx. In/outpatient. Reimbursement lifetime max $18,000. Seattle Police 100% billed charges in/outpatient. Up to lifetime max $30,000. State licensed facility Skagit Co $9,600 maximum. Pre -approval required. Repeat treatment considered after 1year Skamania Co Pre -approval required. Prescribed by physician, psychiatrist, or psychologist. Snohomish Co Licensed treatment facility referred by doctor, one treatment per lifetime. Spokane Co Outpatient/residential including diagnostics, counseling. Not exceeding $7,000/2 years or total $14,000/lifetime. Tacoma Provided by Regence Blue Shield. Vancouver Pre -approved only in case of medical necessity. Walla Walla $6,000 maximum. Pre -approval required. Repeat treatment considered after 1year. Wenatchee Pre -approval by Board physician required. Maximum $5,000/2 consecutive years. Whatcom Co $6,000 maximum. Pre -approval required. Repeat treatment considered after 1year. Whitman Co $6,000 maximum. Pre -approval required. Repeat treatment considered after 1year. Yakima Co Preferred & Participating Providers. 100% of Allowed amount. Yakima Drug/Alcohol inpatient and outpatient/100% to max $5,000 every two consecutive yrs/lifetime max $10,000. Yakima Fire $5,000 maximum in a two -consecutive -calendar -years, $10,000 lifetime maximum. Chemical Dependence Jurisdiction Policy Summary Aberdeen Evaluation/treatment plan required every 6 months. Auburn Same as medical benefit if performed by licensed chiropractor. Bellingham Medicare covers spinal manipulations. Anything not covered, send documentation to Board for reimbursement. Bellingham Fire Submit itemized bill and EOB for reasonable charges to pension board. Bothell Covered by insurance plan. If visits exceed entitlement, can submit to Board for consideration. Bremerton Covered by insurance; if +visits then board discretion. Chelan Co Insurance max applies. Any exceeding evaluation required to establish necessity Clallam Co Covered when provider licensed chiropractor. Clark Co More than 20 visits per year must be pre -approved. Cowlitz Co Tx beyond insurance requires tx plan in a month w/updates every 12 mos. Douglas Co 20 visits per calendar year. Everett 100% of allowable charges; x-rays: once every 12/mos. 100% allowable charges. Franklin Co Pre -approval required over 20 visits per calendar year. 4 WSLEA Comparison of Benefits, Revised February 5, 2023 Chemical Dependence (Cont.) Jurisdiction Policy Summary Grant Co Insurance policy criteria, 20 visits/year submit report from chiro to exceed/pr Grays Harbor Co Evaluation/treatment plan required for services exceeding insurance coverage. Jefferson Co Prior approval required after 2 treatments exceeding insurance coverage. Kennewick Pre -approval required for over 12 visits per calendar year. Board eval for addt'I. King Co Treatment plan required for more than 2 visits and every 6-continuous months. Kirkland Prior approval after insurance limitations exhausted. Kitsap Co Same as other necessary medical claims. Kittitas Co 15 visits year, exceed 15 visits requires board medical to determine necessity. Klickitat Co 12 visits/year Max $45 per visit. Pre -approval req'd after 12/year. Lacey 20 visits annually. To exceed/board Dr to determine necessity. Lewis Co Pre -approval required after 35 visits/calendar year. Lynnwood Pre -approval required before exceeding defined insurance benefit Marysville Covered with city plan, 25 visits per year Mason Co No policy Mercer Island Pre -approval required over 20 visits per calendar year. Olympia Pre -approval required over 20 visits per calendar year. Pacific Co Pre -approval required. No more than 35 visits per calendar year. Pierce Co As governed by statute. Puyallup 25 visits/calendar year. Redmond Covered same as active employes — 22 visits annually; Board covers remaining. Renton Pre -approval required over 20 visits per year. Richland Covered as any other medical. Seattle Fire Licensed Chiro. $80 per session/26 sessions per year/1 tx day. X-rays covered up to two sets per year. Seattle Police Maximum $60/visit up to 24 visits/year without prior Board approval. Skagit Co Pre -approval required after 3 visits/six mos for same condition. Skamania Co 12 visits/year unless prescribed by chiropractor or physician. Pre -approval before exceeding Snohomish Co 20 visits annually. Treatment plan required after 4 visits for same injury. Spokane Co $750 per year/lifetime/one condition/$3000 for tx. Includes Naturopathy, acupuncture, massage, chiro and other holistic or alternative choice. Tacoma Written report required after 20 visits. Tumwater Reasonable expenses by licensed medical provider. Vancouver First call $129; subsequent calls $40; x-rays $100. Kaiser members shall access services through Kaiser. Walla Walla Treatment plan required after 10 visits for same condition. Whatcom Co Treatment plan required after 3 visits for same condition. Whitman Co Treatment plan required after 3 visits for same condition. 6-month progress reports. Yakima No specific policy Yakima Co 12/year. Pre -approval required before exceeding defined benefit. Chiropractic Jurisdiction Policy Summary Asotin Rx should be monthly; Rx must be quarterly March, June, September, and December. Benton Co Submit with required documentation; Bothell Submit within six months of billing date Bremerton Accept faxed, copied, or e-mailed claims Chelan Co Accept US Mail or email within 6 months 5 WSLEA Comparison of Benefits, Revised February 5, 2023 Chiropractic (Cont) Jurisdiction Policy Summary Clark Co Submission to one year of date of service Clallam Co Submission to a year of date of service Douglas Co Accept within 6 months of date of service Everett Accept faxed, copies or e-mailed claims Franklin Co Accept faxed, copied, or e-mailed claims Grays Harbor Submission to 6 months from date of service or processed by insurance. Kennewick Submission within six months of date of service/insurance processing. Island Co Accept faxed, copied, or e-mailed claims Kirkland Submission within 6 months of service Kittitas Co Submission w/I 180 days of receipt of original bill. Klickitat Co Submission up to one year from date of service. Longview Submission within six months following original billing. Lynnwood Submission within one year: Fire: Medicare & Sup Police: Medicare & Sup HMA and Dental to board Marysville Submission within 6 months of dates of service. Mercer Island Accept faxed, copied, or e-mailed claims Olympia Active or covered thru spouse/premium reimbursement $50/month. Not active/no other plan: $600/year. Retired: 2 cleanings/year. Provision: $2000/annually premiums/fillings/crowns. Over 2k Tx plan preapproval required. Dentures: Preapproval/two quotes 100%. Pasco Two-year term; Nominations and ballots to all members Pend Orielle Submission w/in 6 months Richland Fire Submission w/in 90 days of date of expense. SeaTac Fire Submission within 90 days of receipt of bill. Skamania Co Accept faxed, copied, or e-mailed claims Spokane Accept faxed, copied, or e-mailed claims Spokane Co Submission w/in 12 months after receipt of insurance EOB Tacoma Submission by one year from date of service Tumwater Submission by one year date of service Whitman Co Accept faxed, copied, or emailed claims Yakima One year from dates of service. Walla Walla Submission within a year of dates of service Claim Filina Limits Jurisdiction Policy Summary Aberdeen 6 months of receipt of original bill Asotin Co Rx at least quarterly, March, June, Sept, December Bellingham 12 months of date of service Bellevue 1 year from date of service Bothell 6 months of billing date Bremerton 1 year from date of service Chelan Co 1 year from date of service Clallam Co 1 year of date of service Clark Co 1 year of date of service Cowlitz Co Within 6 months from original billing. Douglas Co Within 6 months from the date incurred Edmonds 12 months from date of service Everett 1 year of date of service 6 WSLEA Comparison of Benefits, Revised February 5, 2023 Claim Filing Limits (Cont.) Jurisdiction Policy Summary Grays Harbor Co 6 months of date of service or from date of denial by insurance carrier Jefferson Co 6 months of receipt of original billing Kennewick 6 months of date of service or date processed by insurance carrier King Co 6 months of receipt of original billing Kirkland 6 months of receipt of original billing Kittitas Co 180 days of receipt Klickitat Co 1 year of service date Lewis Co Submission w/in 12 mos of date of service. Lynnwood No later than one year. Marysville 6 months of receipt of original billing Mercer Island 120 days Okanogan Co 1 year of date of service Olympia 1 year of date of service Pacific Co 1 year of date member becomes aware, or should have become aware Pierce Co 1 year of service date Puyallup 1 year of service date or knowledge of the claim Redmond 6 months of service date Renton 1 year of service date Richland Police Submission first to any medical/dental coverages then by 6 months date of expense. Skagit Co 6 months of receipt of original billing Skamania Co 6 months after receipt of insurance EOB; medication 1 year from date of service Snohomish Co 1 year of service date Spokane Co 6 months of date of service Tacoma 1 year of service date Thurston Co 1 year of service date Vancouver 1 year of service date Walla Walla 6 months of receipt of original billing Whatcom Co 1 year of date of service Whitman Co Rx submission by 12months from purchase; Other claims 90 days of treatment date. Yakima Co 1 year of service date Claim Funding Jurisdiction Policy Summary Bellevue Separate fund for LEOFF I expenses. Benton Co Claims paid from general fund and administered by Commissioner's office. Bremerton Claims paid from general fund and administered by Board Secretary (City Clerk). Chelan Co Claims paid from general fund and administered by Commissioner's office/HR. Clallam Co Budgets for medical claims in Human Resources budget. Clark Co Have separate fund for LEOFF I expenses. Douglas Co Employing agencies pay claims, Board has budget exams ordered by Board. Everett Has separate fund for LEOFF I expenses. Jefferson Co No separate budget, paid from general fund, administered by Auditor's Office. Mercer Island Submission within 120 days of dates of service Olympia Funded through general fund and processed by Human Resources. Pierce Co Budget through Sheriffs department/through Risk Management for long term care Redmond Set aside budget for claims. Richland General fund transfers into pension fund based on actuary recommendation. Skagit Co No separate budget, paid from general fund, administered by Human Resources. 7 WSLEA Comparison of Benefits, Revised February 5, 2023 Claim Funding (Cont.) Jurisdiction Policy Summary Skamania Co Submission in timely fashion, no 6+ month claims. Medication submission w/in a year from date. Snohomish Co Claims paid from benefit fund out of the LEOFF sub -fund. Spokane Co Budgets fund in the Sheriff's office budget, individual districts administer fund. Vancouver Has separate budgeted funds for LEOFF 1 expenses. Walla Walla Co Budget for claims as part of Sheriff's office budget, claims paid from Sheriffs Office. Yakima Co Budgets in a separate fund with general fund providing revenue. Yakima Fire Have separate fund for LEOFF I expenses. Yakima Police Funded through general fund and processed by City Clerk's office. Claim Processinq Jurisdiction Policy Summary Adams Co Submitted to board within 6 months. Bellevue Adams Co Auditor and Accounts Payable. Bellingham All claims must be approved by the Board prior to payment. Bellingham Fire All claims must be approved by the Board prior to payment, prescription copays reimbursed twice yearly, medical paid monthly following Board approval. Benton Co Submit within rolling 12 mos. from date of service w/60-day grace period. Bothell Board secretary provides vouchers to Auditors Office for payment. Confidential information retained in Board files. Claims processed monthly following Board approval. Bremerton Staff has $1,000 authorization limit for processing general medical claims, Claims paid weekly. Chelan Co HR Clark Co All claims must be approved by the Board prior to payment. Clallam Co Claims processed monthly following Board approval. Douglas Co All claims must be approved by the Board prior to payment. Edmonds Claims must be submitted with 6 months. Claims paid monthly. Everett Claims paid as received, items requiring further Board review are paid quarterly. Franklin Co Secretary processed per Board policies. Grant Co Process claims as received. Grays Harbor Co Claims processed monthly following Board approval. Island Co Accountant in Sheriffs Department. Jefferson Co All claims must be approved by the Board prior to payment, paid bi-monthly. Kennewick Auditor's Office Accountant. King Co Claims paid monthly. Kirkland Board Clerk. Kittitas Co HR Staff Assistant to Board, claims processed bi-monthly. Klickitat Co Auditor's Office for County, Local Police & Fire Department's handle their own. Lacey Sheriffs Department after Board approval. Claim Processing Jurisdiction Policy Summary Longview Claims paid as received. Marysville Claims processed monthly following Board approval. Mason Co Claims paid monthly after Board approval. Mercer Island Human Resources. Mountlake Terrace Secretary has $450 authorization limit for processing general medical claims, checks cut weekly. 8 WSLEA Comparison of Benefits, Revised February 5, 2023 Claim Processin_g Jurisdiction Policy Summary Okanogan Co Claims paid monthly. Olympia Claims processed monthly. Pacific Co Office Specialist III in Human Resources Pasco Checks cut weekly. Board Secretary may process claims up to $450. Pierce Co Board Clerk, claims paid monthly following Board approval. Puyallup Risk Mgmt sends authorization to pay to Accts Pay in Sheriffs Dept or another agency. Renton HR Staff Assistant to Board. Richland Secretary has $500 authorization limit for processing general medical claims, claims processed twice per month. SeaTac Secretary processes per Board policies. Skagit Co Board secretary processed bills up to $500 without Board pre -approval. Skamania Co Secretary follows Board guidelines, claims processed as received. Snohomish Co Civil Deputy, Sheriffs Office. Spokane All claims must be approved by the Board prior to payment, claims paid monthly. Spokane Co Staff process per Board guidelines; process warrants twice a month. Tacoma Individual cities and fire districts. Thurston All claims must be approved by the Board prior to payment; Claims processed monthly. Vancouver Secretary processes per Board policies. Walla Walla Co HR Staff Assistant to Board/3rd Party Administrator processes and pays claims within 2-3 weeks of receipt. Whitman Co Warrants processed twice a month. Yakima Secretary processes per Board policies, claims paid weekly. Yakima Co Pension Records Clerk. Cosmetic Surgery Jurisdiction Policy Summary Bothell Only as result of accidental injury or disease necessary to correct function. Clallam Co Not medically necessary except post trauma reconstructive. Everett No specific policy but would likely approve if medically necessary. Jefferson Co Not considered a medical necessity. Kent Not considered a medical necessity. King Co Not considered a medical necessity. Kirkland Only as result of accidental injury or disease necessary to correct function. Lacey Services for beautification purposes not considered. Pacific Co Do not provide. Richland Only as result of accidental injury or disease necessary to correct function. Seattle Fire Only if medically necessary. Seattle Police Reconstruction to correct as a result of injury only. Pre auth required w/Dr letter Snohomish Co Reconstruction to correct/repair as result of injury. Yakima Co Not covered unless result of duty related injury. Dental Jurisdiction Policy Summary Auburn Check-up, cleaning, x-rays semi-annually. All other services require pre -approval. Orthodontic if determined medically necessary. Bellevue $1,200/year. Bellingham Fire As covered by statute. No insurance. 9 WSLEA Comparison of Benefits, Revised February 5, 2023 Dental (Cont) Jurisdiction Policy Summary Bellingham Police Accidental injury see policy/submit to board. Max $3,000 preventative/cleanings/maintenance/yearly. Shall have at least one cleaning/yr. Failure may impact other dental authorizations. No whitening. Case by case for implants/surgery. Benton Co Accidental injury see policy/submit to board. Max $3,000 preventative/cleanings/maintenance/yearly. Shall have at least one cleaning/yr. Failure may impact other dental authorizations. No whitening. Case by case for implants/surgery. Bothell Allowance of $1,000 in conjunction w/vision per year Bremerton 2 exams, cleaning & x-ray up to $500/year; treatment of periodontitis allowed first occurrence only. Routine & periodontal $2,500/yr. Chelan Co Accidental injury Clallam Co Accidental injury to teeth only. Clark Co Checkup, x-rays, cleaning, fluoride treatment one per year. $1,500 every 2 years for routine/periodontal, root canal, dentures, etc. Columbia Co Employer shall provide benefits similar to those for active employees. Cowlitz Co Employer provides dental insurance. Douglas Co Per RCW except "Well care" as defined by member plan. Cosmetic dental/case by case, medically necessary. Pre -approval unless emergency. Edmonds Accident Win 90 days of accident Everett $700 per year services or premium. Use it or lose it. Franklin Co $2,000 per calendar year (1-year roll-over of unused balance up to $4,000). Grant Co Accidental injury to teeth. Dentures up to $350 per plate, once every seven years. Grays Harbor Co $750/12-mo period; $1,200 one set dentures or bridge. No orthodontia unless for medical necessity. Island Co 1 exam/year; 2 cleanings/year; $1,000/year routine dental; dentures, implants, bridgework 50% to $3,000/year; no teeth whitening; no cosmetic. Jefferson Co No policy. No dental insurance. Kennewick Up to $500 per calendar year for check-ups, cleaning or denture reline. Kent As governed by statute. King Co $1,500/year. $1000 lifetime orthodontia. City covers insurance. Kirkland Maximum $3,000/year. Cosmetic dental only as medically necessary. Kitsap Co One annual routine/cleaning x-rays. All other dental preapproval required. Dental Injury start within 90 days of accident/completed within 2 years. Kittitas Co Max $1,000/year. Wellness/x-rays/cleaning prescriptions by dentist. Klickitat Co $500/year preventive and x-rays Lacey Accidental injury to teeth. Orthodontics for medical necessity, pre -approval rqd. Lewis Co Do not provide dental care. Longview Only accidental injury to teeth. Mason Co 100% billed charges routine max $2,500. One mandatory cleaning/Yr. Can carry funds to max $5,000. Marysville $2000/year includes 2 cleanings/1 set of X-rays. Further expenses require prior approval. Mercer Island $1,500 maximum per year for premiums/deductibles for members on city plan. If not on city plan/case by case basis. Okanogan Co Accidental injury to teeth received while on -duty. Olympia As governed by statute. 10 WSLEA Comparison of Benefits, Revised February 5, 2023 Dental (Cont) Jurisdiction Policy Summary Pacific Co $600/year preventive/restorative. Dentures 50% lowest of 2 quotes. Prior approval. Reimburse premium for retiree coverage through current employer up to $48/month. Pasco $300/year. Dentures if medical necessity and pre -approved. Pierce Co Procedures medically necessary to prevent physical problems, prior approval required. No orthodontia. Pullman $2,000 per year. Cosmetic not approved. Puyallup No dental insurance. Redmond $2,000/year. Renton Accidental injury to teeth and claims documented medically necessary. Richland Police Covered under city plan w/ limits for Type of care. Two cleanings per yr. Richland Fire $1,200/year preventive/restorative. $1,500/dentures one set bridges/denture/implant, one lifetime payment. Orthodontics if medically necessary. SeaTac Fire $2,000/year exam, fillings, crowns, repair dentures; $1,500 one set/bridges/full or partial dental. Orthodontic not approved unless medical tx, no cosmetic dental. Seattle Fire $2,000 annual applied towards premiums/dentures/cleanings/x-rays etc. by licensed dentist. Seattle Police $3,000 per year/Premera plan. Oral surgery/implants if medically necessary w/prior authorization and limits. No premium reimbursement. Skagit Co $750 annually for out-of-pocket dental expenses. Skamania Co Accidental injury to teeth only. Orthodontics for medical necessity pre -approved. Snohomish Co 100% routine dental care. No cosmetic procedures. Board will pay insurance excess up to $2,000. Spokane Police 1 exam/year, 2 cleanings/year, routine dental, and peri if medically necessary. No cosmetic or whitening. $25 max fluoride tx/year. Spokane City Fire $1500/year through Washington Dental Service. Spokane Co Coverage through plan, claims to TPA w/I 24 months Stevens Co $2,000 year premiums allowed. No dental insurance/two cleanings/yr. with one of those cleanings and one checkup being mandatory. Fluoride $25/year. No ortho, whitening, cosmetic. Submission w/in one year. Tacoma $750/12 months for preventive & restorative. $1,200 for dentures. Thurston Co $2,000/calendar year for non -cosmetic dental care w/Regence; Willamette not to exceed max allowance. Tumwater As governed by statute Vancouver Reasonable expenses for medically necessary dental/ortho tx directly related to medical condition. Wahkiakum Co Accidental injury to teeth. May approve one-time purchase of dentures. Reline of dentures not covered. Medically necessary claims considered. Walla Walla As governed by statute Wenatchee As governed by statute. Orthodontics for medical necessity only, pre -approved. Whatcom Co $300/year for preventive. Whitman Co $3,000 per calendar year. Yakima Co As governed by statute. Yakima As governed by statute. Group dental plan provided - members pay premiums. Yakima Fire $1500/year excludes cosmetic 11 WSLEA Comparison of Benefits, Revised February 5, 2023 Jurisdiction Disclosure to Employer Benton Co Policy Summary Bremerton Insurance carriers have been willing to provide information. Kitsap Co Insurance carriers have been willing to provide information. Pierce Co Authorizations requested as needed only. Seattle Fire Insurance carrier considers Board additional insurance provider, no release required. Spokane Co Members sign authorization each year giving Board permission to discuss their PHI with family members or providers to resolve billing and/or coverage issues. Whitman Co Members work directly with insurance carriers. Yakima Routinely send out authorization forms. Yakima Co Claim form includes authorization for disclosure necessary to process claim. Elections Jurisdiction Policy Summary Aberdeen Nominations and ballots by July 1 annually. Bellevue Nominations and ballots sent to all members. Benton Co 2-year term/expire Dec 31. Bremerton Absentee ballots sent to all members — no election if only one member nominated. Chelan Co Secret ballot. Two-year term. Held in November. Clallam Co Nominations and ballots to members. Two-year term. Clark Co Two-year term; Police: odd year Fire: even year; nominations & ballots to members Cowlitz Co Nominations and ballots to affected members. Police: odd years Fire: even years Everett Nominations and ballots sent to all members. Grays Harbor Co Nominations and ballots sent to all members. 2 yr term; by Jan 15th yearly Kennewick Two yr term, elections in even years/January. Nominations & Ballots to members. Kent Nominations and ballots sent to all members; December election. Kitsap Co Nominations and ballots to all members via mail by January 2; Two-year term. Klickitat Nominations and ballots to all members via mail by December; Two-year term. Lacey Two-year term, nominations, and ballots to all members Lewis Co Two-year term/even years in January Nominations and ballots to members. Lynnwood Two-year terms; Fire Rep: December/even years; Police Rep: December/odd years via mail nominations and ballots. Marysville Nominations and ballots/2-year term beginning January 1. Mercer Island Two-year term. Police: even year. Fire: odd years. Nominations/Ballots mailed. Pend Orielle Secret ballots to all. 1st week/December every other year/two-year term. Pierce Co If only one person nominated there is no election. Pullman January yearly/1 yr. Nominations and ballots to members. Renton Two-year terms/staggered. Nominations & ballots November annually. Richland Police Nominations and ballots sent to all members. SeaTac Fire Two-year term. Nominations and Ballots to all members via US Mail. LEOFF1/December odd years; LEOFF2/even years Seattle Police Nomination and ballots to all members. Skamania Co Nominations and ballots to members via USPS. Two-year term/alternating. Snohomish Co Two-year term, even years; Nomination and Ballots mailed to all members Spokane City Fire Nominations and ballots to members in December yearly Spokane Co Fire: Secret ballot/all fire members/January every other yr. Police: Secret ballot/all police members/January opposite year of Fire election. Two-year term. Tacoma Nominations sent to all LEOFF I members. No balloting if only one nominee. Tumwater Nominations and ballots in US Mail to all members 12 WSLEA Comparison of Benefits, Revised February 5, 2023 Elections Jurisdiction Policy Summary Vancouver Nominations and ballots sent to all members. Police: 3 yr term/staggered. Fire: 2 yr term/staggered. Whatcom Co Nomination and ballots to respective membership: 2 Yr Term/one LE one FF Whitman Co Two-year term; Police/odd years. Fire/even years; Nominations & ballots to affected groups members. Yakima Three-year term: Nominations and ballots sent to all members. Yakima Fire Two-year term. Nominations and ballots sent to all members. Yakima Co Nominations and ballots sent to all members. Walla Walla Two-year term. Police Odd years. Fire: Even years; Nominations and ballots to members. Equipment Jurisdiction Policy Summary Aberdeen Pre -approval required. Must be medically necessary. Bellingham Coverage through Regence. Orthotics covered by Regence. No payment for ice bags, heating pads, thermometers, vaporizers, etc. Bellingham Fire If not covered w/insurance, submit to board. Bothell No equipment or supplies which have a non -medical use or function. Bremerton Must be prescribed by medical doctor. Prior authorization needed for reimbursement. Chelan Co Must be prescribed by medical doctor, anything over $250 needs prior approval, unless emergency. <$250 reimbursed. Clallam Co Durable medical equipment/orthotics prescribed by physician for patient's use only. Board may require quotes prior to purchase. Clark Co Medical necessary rental of durable medical equipment, unless purchase more cost effective. Cowlitz Co Dr. Prescribed, must submit through any insurance coverage first then pension. Douglas Co Durable medical equipment prescribed by physician as medically necessary. Preapproval required to purchase Edmonds >$500 Pre -Authorization from board required. Reasonable replacement costs. Physician prescribed as medically necessary Everett 100% of allowable charge. Kennewick Pre -approval required. King Co Pre -approval required; physician prescribed as medically necessary. Kirkland Pre -approval required for non -emergency equipment costing over $100. Kittitas Co Prothesis case by case basis likely covered/Dr documentation. Klickitat Co Pre -approval required; Physician prescribed as medically necessary. Lacey Preauthorization prior for $500+ and 3 quotes. <$500 no quote necessary. Lewis Co Pre -approval. Medically necessary. Mason Co Pre -approval required; physician prescribed as medically necessary. Pacific Co Pre -approval required; Physician prescribed as medically necessary. Pasco Pre -approval required for non -emergency equipment costing over $100. Pend Orielle If cost +$500/prior approval unless emergency. Pierce Co Braces, splints, orthopedic appliances/orthotics, prosthesis for functional reasons. Puyallup Medically necessary durable medical equipment defined by medical plan. All other considered case by case. Richland Physician's verification of medical necessity. Richland Fire Provide the board with letter from Dr outlining services needed. Seattle Fire Pension will reimburse after Medicare. Pre-auth on most. Primary doctor letter or Rx required depending on dollar amount. Under $250 with Dr RX 13 WSLEA Comparison of Benefits, Revised February 5, 2023 Equipment (Cont.) Jurisdiction Policy Summa►y Seattle Police Physician's letter/prescription required for medical necessity. Utilize preferred provider (they can also ship) is preferred. Skagit Co Pre -approval required; Physician prescribed as medically necessary. Skamania Co Prescribed by physician as medically necessary. Preauthorization required. Snohomish Co Per RCW 41.26. Tacoma Amount not covered by Medicare/Regence BlueShield must be pre -approved. Vancouver Pre -approval required; physician prescribed as medically necessary. Walla Walla Pre -approval required; physician prescribed as medically necessary. Wenatchee Physician prescribed medically necessary. Pre -approval required over $250. Whatcom Co Pre -approval required; physician prescribed as medically necessary. Yakima Co Prescribed by physician as medically necessary. Federal Income Tax Jurisdiction Policy Summary Bellevue Prior act paid through ap, 1099 end of year, no tax withheld. Bothell Prior act paid through ap, 1099 end of year, no tax withheld. Everett Prior act paid through ap, 1099 end of year, tax withheld upon request. Richland Prior act paid through payroll, fit withheld. Spokane Co No FIT withheld. Tacoma Prior act paid through payroll, 1099R at end of year, tax withheld upon request. Handicap Jurisdiction Policy Summary Douglas Co Paid for motorized scooter & lift for vehicle, as well as lift installation. Edmonds Paid for "turnaround" apparatus for members vehicle. Everett Have paid for stair lift; case -by -base no formal policy. Prosthetics 100% allowable charges. Pierce Co Paid wheelchair ramp, railing and other modifications to make home accessible. Richland Have paid for wheelchair ramps and home modifications. Spokane Paid for lifts and ramp. Tacoma Does not pay - considered convenience rather than medically necessary. Thurston Co Paid for wheelchair ramps walk-in shower, bathroom modifications, shower chair and toilet seat riser. Vancouver Have paid for installation of grab bars, raised toilet seat, lift chair. Yakima Have paid shower remodeling; lift recliner. Yakima Co Partial Approval to reimburse a Lift Chair (2016 — minus heat/vibration features). Denied reimbursement of wheelchair ramp as not medically necessary. Hearing Aids Jurisdiction Policy Summary Adams Co Covered. Asotin Co Pre -approval required. $3,000 max/every 3 yrs. Must provide 3 bids w/warranty. Costco ok, City card available. Auburn Amount determined by Board designated provider 1/five years. Necessary repairs are covered. Batteries not covered. Bellingham Audiogram/3 years. $2,000/aid/36 months. Repairs and batteries covered. 14 WSLEA Comparison of Benefits, Revised February 5, 2023 Bellingham Fire Covered w/insurance every 3/yrs Max $2,000 per aid. Repairs replacement due to normal wear is covered. Batteries including rechargeable w/station. Accessories not medically necessary and cleaning not covered. Bellevue Pre -approval required. Exam by MD/DO or Audiologist. Max $6,000. Replacement/3yr. $50 for batteries. Benton Co Pre -approval required. Dr or Audiologist required. Board will reimburse for one or both h/a every 5 years, submit to board within one year of billing date. Bothell Exam by Dr or hearing special ist/audiogram and report. $3,000 per ear/36 months. Replacement 1x/36 months w/documentation. Repair -documentation why. Except regular maintenance and batteries. Bremerton $1,800 per ear every five years; repair reimbursement up to $600 accumulative. Chelan Co Aids/Exam up to $6,000 every 3 yrs. Clallam Co Exam covered. $1,600/aid/36-months for basic amplifier hearing aid. $2,600/aid/5-years for digitally programmable analog; $2,800/aid/5-years for programmable digital; batteries and necessary repair/replacement. Clark Co Pre -approval required. Two estimates required. Charges limited to that necessary to achieve functional corrections. Replacement: pre -approved on case by cast, limit to reasonably necessary costs. Cowlitz Co Evaluation w/otolaryngologist then audiologist to include a 2 yr warrant and audiogram/aid recommendation. 1 pair every 5 years. Repair/Maint: exceed 2 yr warranty at reasonable cost. Repair/Replace: claim form/information 1x every 5 yr Douglas Co 5-year replacement. Two estimates required. - $1,200/per aid. Maintenance/batteries/loss not covered. Edmonds 1 hearing test/3 years. Costco current rates or pre -approval if no Costco/will cover Annual membership if member is not. Repairs/replacement 36 months. Batteries covered. Everett $4,300/ 24 mos; by licensed Audiologist. All claims to HMA. Franklin Co Audiogram covered. Prior approval required. Active members only, unless hearing deficiency was reason for retirement and was duty -incurred. Battery replacement excluded. 6-year replacement. Grant Co Case by case pre -approval by board, medical necessity. Two bids by two vendors. Max $1750 ea/$3500 year on 5-year basis. Maintenance/repair case by case Grays Harbor Co $2,500/aid/5 years. Reasonable cost of batteries and repairs covered. Island Co Would be considered case -by -case. Jefferson Co $3,000/aid/5 years. Pre -approval required. Kennewick Pre -approval required. Exam by board designated provider. Every 5 years. Necessary repairs, no routine maintenance, or batteries. Kent $2,000/aid plus 50% of balance to $3,000/aid/3 years. Necessary repairs, routine maintenance and batteries covered. King Co $2,500/aid/5 years. 2-year warranty required. Regular maintenance and batteries. Kirkland $2,500 per aid/36-months by qualified medical provider or audiologist. 2-year warranty required. Reasonable battery cost. Replacement allowed but not more than every 3 years. Kitsap Co $5,000/aid/5 years, warranty and batteries not covered. Kittitas Co $6,500/3 years. Batteries and repairs covered. Klickitat Co Exam by Dr/hearing specialist; Audiogram, report. Max $4,400/pair/48 months. Replacement if line duty or accident. Maintenance/batteries allowed. Lacey Exam by Md or ENT. Dr statement. Aid's must be issued by licensed fitting dispenser or licensed audiologist. Submit to insurance first. Case by case basis. 15 WSLEA Comparison of Benefits, Revised February 5, 2023 Hearing Aids (Cont.) Jurisdiction Policy Summa►y Lewis Co Pre -approval required. Medical necessity, two bids. Repair statement why/repair vs replacement, Replacement on case -by -case basis Longview Prior approval. Audiology report, device recommendation w/cost estimate. Replacement requires new support. Lynnwood $2,600/ear/5 yrs; $100 allowed towards handheld remote control. Damage due to negligence and batteries are covered. Marysville Pre -approval required for first time. $1,600/aid/36-months. Mason Co $3,000/3 yrs, includes 2-yr warranty, maintenance, batteries, and reasonable repairs. Exam covered if not covered by medical insurance. Effective 9-1-15, reimburse minimum Costco membership fee when hearing aids are purchased at Costco, if not already a member. Mercer Island Pre -approval required. Okanogan Co Pre -approval required. $1,000/aid/5-years. 2-yr warranty required. Maintenance and batteries not covered. Olympia Pre -approval required. Charges necessary to achieve functional correction. 3-yr warranty required. Necessary repair and batteries allowed. Pacific Co Charges necessary to achieve functional correction. $2,500/aid/ 60-months. Pasco $1,500/aid/36-months. Batteries not covered. Pend Orielle Preauthorization. Medical necessity by licensed audiologist. Pierce Co $1,875/aid/5 years. Batteries and reasonable repairs covered. Pullman Two options/without prior approval evaluation by Audiologist $6,000 pair/4 years. Audiologist evaluates/audiogram and recommendations estimates for two aids/fittings/adjustments and costs of aids including 2 yr warranty. Lost/broken or damage no replacement if negligent or abuse. Puyallup Pre -approval required. Reasonable charges based on current rate charged by Costco/3-yrs/2-yr warranty required. Batteries & maintenance covered only when included in purchase price. Redmond Pre -approval required. $2,500/aid/4-years. 2-year warranty required. Cost of maintenance and batteries eligible. Renton $2,500/aid/36-months digital analog; $2,800/aid/5 years digitally amplified; Batteries covered; Repairs need board approval Richland Fire $2,500 per aid. Batteries at member's expense. Replacement considered after 5 years on case by case/information by Audiologist. Richland Police $1,800/aid. Every 5/yrs Licensed Audiologist. Replacement batteries not covered. Repairs/per Audiologist. SeaTac Fire Pre -approval required. Seattle Fire Medically necessary, $3800/ear/36 months cost include warranty & batteries Seattle Police 100% hearing tests. Digital $3,500/aid/5 years. Prescribed and dispensed through licensed Audiologist. Repair, reprogramming, maintenance, and batteries covered. Skagit Co $2,600/aid/36-months. Regular maintenance and batteries covered. Skamania Co Costs of Wa St L&I standards aids every 5 years. Damage/Responsibility of member. Snohomish Co $5,000/pair. Batteries $40/year. Spokane Police $4,000/5 years. Batteries covered. Repair/replacement case by case. Spokane Co $4,000/set, claim accompanied by documentation of Licensed Otolaryngologist of medical requirement of disorder. Batteries/$75/year. Repair/ Case by case. Spokane City Fire Digital aids through TPA; Cleanings/Repair paid in full/5 years; batteries covered Spokane Co $2,000/aid/3-years. Batteries $75/12-months. Repair considered. Tacoma Pre -approval required. Digital $1,295/aid/5 years. $250/aid for repairs. Tumwater Otorhinolaryngologist or Md. Reasonable expenses. 16 WSLEA Comparison of Benefits, Revised February 5, 2023 Hearing Aids (Cont.) Jurisdiction Policy Summa►y Vancouver Pre -approval required. Charges necessary to achieve functional correction. 3-year warranty required. Batteries not covered. Walla Walla Pre -approval required. $1,500/aid/36-months analog; $2,500/aid/60-months digital. $25 deductible for regular maintenance and batteries. Wenatchee Prior approval required. $2900/aid/36-months. Regular maintenance/repair and batteries eligible for reimbursement. Replacement of lost aids not covered. Whatcom Co $3,000/aid/5-years. 2-year warranty required. Regular maintenance and batteries covered. Whitman Co $1,600/aid/5-years. Repairs considered. Maintenance/batteries not covered. Yakima $1,800 ea aid. With preapproval and 30-day trial period. Repairs & batteries 100%. Pre -approval required if cost $500 to repair. Yakima Co $2,000/aid/5 years. Repair/loss only in line of duty. Cleaning/service/batteries excluded. Yakima Fire Pre -approval required. $1,800/aid/5 years. Batteries and repairs 100% reasonable cost. 30-day trial period required. Reasonable costs for repairs and batteries. HIPPA Jurisdiction Policy Summary Bellevue Members assigned random number; discussions refer only to number. 3rd-party administrator process claims. Documents kept in Disability Board files. Benton Co Send a form to Auditors office for payments and keep all claims and receipts in Pension Files for HIPAA purposes. Bremerton Employer provided with a form authorizing payment. Clallam Co Summary of medical claims (not including provider) sent to the jurisdictions for payment. All back-up paperwork stays in Pension office. Everett Documentation kept in Pension Board files. Grant Co Employer provided with form authorizing payment. Documentation kept in pension board files. Island Co Provide an authorization to pay. Original documentation is kept in Pension files. Kent Only Pension Office see documents. All others see only voucher numbers, payee, and amount. Board documents redacted of members identity. Marysville Documents maintained in Board files. Payment requisition sent to accounting stating that documentation is on file in the Pension office. Mercer Island Send a form to AP for payment and keep all claims in Pension files. Pend Oreille Co Have a HIPAA policy listing who in the auditor's office will be handling these documents and where they are stored. Pierce Co Documentation remains in Board files. Authorization to pay provider sent to employer for payment. SeaTac Fire Requisition includes statement that documentation is kept in disability board files. Seattle Police Documents kept in Police Pension Office. All others see only voucher numbers, payee, and amount. Minutes show Board action only, specifics considered in executive session. Skamania Co Send form to AP for payment and keep all receipts in Pension files. Spokane The Boards, entire Retirement Department, and Risk Management staff are HIPAA and EPHI compliant. Whitman Co Employer provided with a form authorizing payment. Documentation kept in Board files. Yakima Co Board Secretary sees details. All others see only voucher numbers, payee, and amount. Records kept locked in Human Resources. 17 WSLEA Comparison of Benefits, Revised February 5, 2023 Hot Tubs Jurisdiction Policy Summary Everett Request denied. Grays Harbor Co Request denied as spa could be used by others. Kent Approved purchase in 2001 ($4,460.75). Kirkland No requests but have paid for physical therapy that included therapeutic hot tub. Seattle Police Have approved bathtub attachments that would serve as a therapeutic hot tub. and subscriptions to health type clubs that offer hot tub/pool. Snohomish Co Request denied. Tacoma Request denied. Yakima Co Request denied as hot tub could be used for and by others for non -necessary medical reasons and treatments could be provided in a clinical setting. Immunizations Jurisdiction Policy Summary Bellingham Fire Flu, Tetanus. Pneumonia by Regence. Shingles vaccine covered by Board. Bellevue Covered by insurance plan. Bellingham Police Covered in insurance plan; overseas travel access through county health department/submit itemized bill to pension office Bellingham Fire Covered in insurance plan; overseas travel access through county health department/submit itemized bill to pension office. Bothell Insurance prior to any reimbursement Bremerton Covered if prescribed by medical doctor for specific medical condition. Chelan Co Covered by medical plan. Clallam Co Vaccinations covered. Clark Co Flu and pneumonia vaccinations covered. Everett Flu/pneumonia/shingles vaccinations covered. Grant Co Shingles, Pneumococcal, Prevnar 13 Grays Harbor Co Covered if prescribed by medical doctor. Kennewick Flu/pneumonia vaccinations covered. Kent Flu/pneumonia/shingles vaccinations covered. Kirkland Up to the amount the city pays for flu shots. Kitsap Co Flu/pneumonia/shingles vaccinations covered. Lacey No policy. Lewis Co Have paid shingles vaccinations. Longview Flu/pneumonia/shingles vaccinations covered. Lynnwood Flu 1/year. All other vaccinations must be Physician prescribed. Marysville If Physician prescribed would likely approve. Mason Co None. Mercer Island Covered if physician verified necessity. Okanogan Co Flu vaccinations covered. Olympia Flu 1/year. All others must be physician prescribed. No travel. Pacific Co Covered if recommended and administered by physician. Pierce Co Flu/pneumonia/shingles vaccinations covered. Puyallup Vaccinations covered. Redmond Covered same as active employees. Renton Flu, Shingles, and pneumonia. Richland Police Annual flu, H1N1, HepB including boosters; One time shingles/pneumonia or by doctor prescription. Richland Fire Annual flu, H1N1, HepB including boosters; One time shingles/pneumonia or by doctor prescription. Seattle Fire Covered w/Premera.or submit to Premera. No travel immunizations. 18 WSLEA Comparison of Benefits, Revised February 5, 2023 Immunizations Jurisdiction Policy Summary Seattle Police Flu/pneumonia/shingles vaccinations covered. Skagit Co Shingles vaccine covered. Skamania Co As prescribed by physician. Snohomish Co Have paid shingles vaccinations. Spokane Vaccinations covered. Spokane Co Pneumonia vaccine covered. Tacoma Pneumonia/shingles vaccine covered through Regence BlueShield, travel vaccines not covered, other vaccines such as hepatitis covered if exposed. Thurston Co Flu/pneumonia/Hepatitis vaccinations covered. Vancouver Flu/pneumonia vaccinations covered. Inoculations suggested/required to travel outside US and/or other inoculations related to specific medical conditions or exposures. Walla Walla Every 2 years: TB, Hepatitis B; other as needed Whatcom Co None Whitman Co Flu vaccines are covered. Yakima Flu/pneumonia/shingles vaccinations covered. Yakima Fire Shingles 100% 60 plus years of age. Yakima Co Flu/shingles vaccines are covered. Insurance Jurisdiction Policy Summary Bellevue Self -insured through Premera - no spouse/dependent coverage for retirees. Bellingham Pay medical premiums. Do not reimburse premiums for outside employment. Bothell Pay medical premium. Bremerton City provides insurance. Chelan Co County provides health insurance. Spouse coverage available at member's cost. Clallam Co Cities provide medical insurance. Clark Co Health/dental insurance for spouses/dependents may be purchased. Douglas Co Member pays dependent portion of premium. Edmonds Annual deductible for medically necessary services Everett Self -insured. No spouse/dependent coverage available. Franklin Co County pay health insurance composite rate and $1,250 deductible. Grays Harbor Co Each entity has insurance policies - none cover spouse/dependent. Island Co Insured through WA Counties Insurance Fund - 1 spouse purchased coverage. Jefferson Co Provide health insurance. Dependent premium paid by member. Kent Cover premium for active members. Self -insured - spouse (to 65)/dependent (to 25) at own expense. Kirkland Provide health insurance. Dependent premium paid by member. Kitsap Co Medical insurance for members. Kittitas Co Retirees covered by same carrier as active until Medicare. Klickitat Co Employee only portion of medical & dental for active; full medical premium for retirees. Lewis Co Not self -insured - 4 different plans - spouse/dependent coverage at own expense. Lynnwood Fire: Medicare & Supp, HMA with Rx & Vision included, Delta Dental supplemental Police: Medicare & Supp, Regence w/ Rx & Vision incl, Dental handled by board. Marysville Members covered with city plan Mercer Island LEOFF Trust plan. 19 WSLEA Comparison of Benefits, Revised February 5, 2023 Insurance (Cont) Jurisdiction Policy Summary Olympia Fire: Contact labor first, NWFFT, Davis Vision, Epic Hearing. Police: Med/advantage/Kaiser, VSP/vision Pacific Co County provides health insurance. Cities are responsible for their members. Pasco Do not reimburse premiums. Self -insured - no spouse/dependent coverage available. Pierce Co Pay employee contribution to insurance, co -pay, deductible, or co-insurance. Self - insured (TPA-Regence) - spouse (to 65)/dependent (to 25) at own expense. Puyallup Cover insurance premium until Medicare. Self -insured. Member may purchase spouse/dependent coverage via city's plan at retirement only. Redmond Self -insured - no spouse/dependent coverage available. Renton Self -insured - no spouse/dependent coverage available. Richland Police Medical/Dental premiums paid by the Board. Richland Fire Medical/dental premiums will be paid for board approved plans. Seattle Police Reimbursement for premiums by employers/spouse employer for primary coverage. Skagit Co Self -insured - spouse/dependent at own expense. Skamania Co County insurance - spouse/dependent at own expense (widow may continue). Snohomish Co Spouse -dependent at member's expenses, deducted from retirement check. Spokane Pay premium for active employees; reimburse retired members for Medicare Parts A and B. Self -insured through Premera - no spouse/dependent coverage. Bargaining unit employees covered through LEOFF Welfare and Trust. Tacoma Self -insured. Coverage may be purchased for spouse (to 65)/children (to 23). Thurston Co Employer pays insurance premium. Vancouver Spouse/dependents coverage available for purchase (offered COBRA if member dies). Walla Walla No coverage allowed for spouses. Wenatchee AWC insurance carrier. No spouse coverage available. Whitman Co Do not provide insurance. Yakima 100% of medical premiums. No reimbursement for outside employer premiums. May purchase spouse coverage (until 65) at time of retirement only. Yakima Co May purchase spouse/dependent medical -dental insurance July 4 1. 18 Increase Jurisdiction Policy Summary Bellevue Seattle CPI-W from BLS. July COLA given regardless of when retiree passed away. Everett Seattle CPI-U from BLS. July COLO given regardless of when retiree passes away. Kent CPI Jan 1-Dec 31 previous year with 2% Minimum Richland Seattle CPI-U from BLS. July COLA given regardless of when retiree passed away. Seattle Fire July COLA given as due regardless of when retiree passed away. Spokane July COLA given as due regardless of when retiree passed away. Spokane City Fire July COLA given as due Tacoma Seattle CPI-U from BLS for July COLA. Vancouver Use same as DRS April 1st COLA. Yakima CPI from L&I Legal Counsel Jurisdiction Policy Summary Bellevue City Attorney 20 WSLEA Comparison of Benefits, Revised February 5, 2023 Legal Counsel (Cont.) Jurisdiction Policy Summary Bremerton City Attorney Everett Pension Board Attorney Grays Harbor Co Deputy Prosecuting Attorney Kennewick City Attorney Kent City Attorney Kirkland City Attorney Klickitat Co Prosecuting Attorney Marysville City Attorney Olympia City Attorney Pierce Co Deputy Prosecuting Attorney Puyallup City Attorney Richland City Attorney SeaTac Fire City attorney Skamania Co County Prosecuting Attorney Snohomish Co Deputy Prosecuting Attorney Spokane Co Prosecuting Attorney Tacoma City Attorney Thurston Co Deputy Prosecuting Attorney Vancouver Assistant City Attorney Whatcom Co Prosecuting Attorney Yakima Co Appointed Attorney Long Term Care Jurisdiction Policy Summary Aberdeen No insurance. Home health physician prescribed, licensed/state certified provider. Caregiver residing in member's home or family member not eligible. Not to exceed average daily cost of nursing home care. Hospice in DSHS certified/Medicare- approved program. Adult family home, assisted living facility, boarding home or nursing home at minimum required service. Max daily rate/Genworth determined. Adams Co Carry insurance for members aged 65 and over. Auburn Pre -approval required. Not to exceed nursing care under the City's existing LTC insurance. Non -medical charges not covered. Bellingham Semi -private room and board and medical care in nursing home, assisted living or In - home case -by -case. Bellingham Fire Reimburse cost for geographic region using median rate/LTC. Nursing home — semiprivate using median rate. Assisted Living/stay at home care on case -by -case basis; Assisted living/Facility- case by case after assessment. Studio/1 bedroom Bellevue Medical necessity required. Assisted living - one bedroom. Nursing home - semi- private room. Upgrades and excess charges only if medically necessary. Max determined w/Genworth cost or 120% for area member resides. In home care/assisted living preferable to nursing home care. In home care capped at Nursing Home rate. See room limitations. Bothell UNUM for LTC coverage. Will not include non -medical charges. Nursing Home - average daily amount for semi -private room, Assisted Living - average for studio room; In -Home Care average daily amount of local nursing facility for semiprivate room (custodial or housekeeping services included). Bremerton Nursing home (semiprivate) or home health care based on Genworth rates. Assisted living for medical necessity. Hospice covered with insurance, Dr review. Chelan Co Reimbursement for out of pocket limited to $7859.81 month semi -private room in nursing home. In home/Asst Liv $4000 monthly. Licensed in WA State 21 WSLEA Comparison of Benefits, Revised February 5, 2023 Lonp Term Care Jurisdiction Policy Summary Clallam Co No insurance. Medical necessity. Assisted living (studio). Nursing home (semiprivate room). Upgrades and excess charges only if medically necessary. 120% of latest Genworth costs for area member resides. In home care/assisted living preferable to nursing home care. Hospice care covered with Dr review. Clark Co Pre -approval exceeding 45 days. Not to exceed average care in Clark Co by 10%. Semiannual evaluation by Dr. Cowlitz Co Skilled nursing: Dr ordered w/tx plan updates every 6 months, services w/licensed agency, max cost not exceed avg daily of nursing home through USHHS. Hospice: admission to licensed facility or program w written plan by Dr. Facilities: Dr ordered. Licensed facility, submit to insurance/TPA, prior approval, case by case basis. Douglas Co Pre -approval required. Max $ based on average local facilities for semiprivate room. In home and assisted living limit same max as nursing. Licensed agency. Everett Skilled nursing: case by case basis, board review/pre-auth; Rehab 36 visits/year 100# allowable/Board review for additional. Franklin Co Average rate for Franklin County. Non -medical not covered. Grays Harbor Co Prior approval required. Adult daycare/Nursing home care when cost not exceed 10% average cost in Grant Co. Licensed facility. Written care plan. In home/Asst living or liv/group home medically necessary by licensed agency, itemized billing; supplies services medically necessary, physician re-eval/6 mos if board requests. Island Co Carry John Hancock for most, one is covered through UNUM. Jefferson Co Average cost of semi -private room in defined geographic area. Kennewick Pre -approval required. Reasonable expenses authorized/determined medically necessary, prescribed by Dr not to exceed median daily or monthly rate for semi private room based on Genworth COC. Custodial care/Asst Liv-case by case basis. Hospice: reasonable expenses licensed certified program. Kent Pre -approval required, Semi -Private Room $354 • Private Room $414; Respite/Daycare: 14 days/yr max. King Co Home Health Care /Hospice Care physician prescribed, licensed/state certified provider. Not to exceed average cost of nursing home care in County where provided. Long -Term Care in state licensed facility. Kirkland Capped amount based on Genworth in home care, nursing, adult family home. Costs reviewed annually Kitsap Co Capped amount 120% based on MetLife/Genworth. In home care, adult daycare, assisted living, memory care, nursing home semiprivate room and hospice. Klickitat Co By order of physician. Nursing Home max $220/day. Home care pre -approval required/max $130/day. No housekeeping. Non -medical charges not covered. Hospice admission to DSHS certified/Medicare approved program Lacey Provide long term care coverage. Lewis Co Pre -approval required. Home health, Hospice, Skilled Nursing, Rehab less costly than inpatient confinement, plan review periodically. Tx plan by Dr; Longview Preauthorization required. Medical necessity. Licensed agency/facility. Max monthly based on average of three local facilities; 24 hr. care, semi private room. Lynnwood Medical necessity. Board approval required. Average of three facilities in South Snohomish/North King Counties. Semiprivate. Custodial/non-medical charges not covered. Marysville Medically necessary (including assisted living facility and in -home care). Mercer Island No insurance. Pre -approval required. Average of 3 facilities in geographic area for semi -private room. No payment for non -medical services. 22 WSLEA Comparison of Benefits, Revised February 5, 2023 Long Term Care (Cont) Jurisdiction Policy Summary Olympia Pre -Authorization required. Physicians report/medical necessity. In home preferred to Nursing home. Board review costs periodically/costs up to amount of Panorama Rehab/Convalescent Center in Lacey. Semiprivate room/24 hrs. No custodial care. . Pacific Co Prior approval required. $2,000/mo assisted living/in-home; $3,883.20/mo nursing home. Pasco Medical necessity. Custodial/housekeeping not covered. Assisted living/skilled nursing, average in geographic area. Provider must be bonded/licensed. Pend Orielle Pre -Authorization by board mandatory. Physician Ordered. Max monthly per day for 24 hr care in facility or home care $170 per day. No custodial care. Pierce Co No insurance, some agencies under Board use UNUM. Pre -approval requested. In - home up to allowed nursing home care. Nursing home average rate for semiprivate. Non -medical charges excluded. Do not pay deposit. Pullman No custodial care. Home healthcare/Dr prescribed max daily not exceed average daily nursing home care; Nursing Home/Hospital Extended and other facilities/Dr. ordered, State licensed, if 6+ months updated tx plan. Case by case basis. Hospice/Dr ordered. Care is part of written plan for continuous care. Puyallup Individual policies. All other insurance primary to Board. Medical necessity, preapproval required. Approval based on latest annual MetLife Market survey of Nursing Home, Assisted Living, Adult Day Svcs & Home Care Costs. Only services provided by bonded & licenses providers considered. No custodial services. Redmond Nursing/Home care COC Genworth; Private room Nursing Home; State Licensed. Home care/no family/RN or otherwise defined by Genworth Renton Pre -approval required. In-Home/Hospice/Skilled Nursing state licensed facility. Richland Fire Adult day-care, home healthcare, rehab, assisted living and nursing home facilities: Use Cost of Care/authorized payment. Case by case. Richland Police Adult day-care, home healthcare, rehab, assisted living and nursing home facilities: Use Cost of Care/authorized payment. Case by case. Seattle Fire Medically necessary. Pre Auth required. Assessment. Facilities 24/7 care. No care by immediate family members is reimbursable. Seattle Police Medical necessity required. May limit to Seattle area average daily rate for nursing home. Skagit Co No insurance. Physician prescribed; provider licensed. DSHS certified/Medicare approved facility. Pre -approval required. Home Health provided by Dept of Health licensed agency. Skamania Co Nursing home - average of 3 facilities in Columbia Gorge geographic area for semi- private; Assisted Living - average of 3 facilities in Columbia Gorge geographic area for studio apartment. Custodial/housekeeping and non -medical charges not covered. Physician ordered. Medically necessary. Snohomish Co Pre -approval required. Spokane Police Washington State Medicaid daily rate allowed for nursing home/adult family homes/assisted living and/or home health. Custodial/housekeeping not covered. Have covered one deposit. 23 WSLEA Comparison of Benefits, Revised February 5, 2023 Lonp Term Care (Cont) Jurisdiction Policy Summary Spokane Co Homecare/Hospice/prescribed by physician, written plan, provided by professional licensed agency or professional. Max cost not to exceed daily nursing home care in county by Genworth COC/Studio or semi -private room. No Custodial care. Adult home/nursing, Board preapproval required, placement by physician, Licensed facility, Genworth COC /semiprivate/studio. No custodial care. Spokane City Fire Pre -approval. Nursing/Home care through TPA, no custodial care. Medical necessity. Doctor ordered. Home health 150% of Genworth COC. Asst Living/Studio. Nursing Home, Preapproval or w/in 72 hrs. of emergency; Hospice care. Tacoma Pre -approval required for home care, assisted living and skilled nursing care. Not to exceed average rate for semi -private room based on Genworh Survey. Non -medical charges excluded. Do not cover deposits/move-in fees. Thurston Co No policy. Have covered adult day-care, in -home care, and respite care. Vancouver No insurance. Pre -approval required, if possible. Medical necessity. Not to exceed average semi -private room for nursing home in Washington State. Miscellaneous expenses not covered. Home Health care/Assisted Living by licensed -bonded providers only. Wahkiakum Co Carry Transamerica Life Insurance. Walla Walla Pre -approval required. Home/Health Care physician prescribed, provider registered nurse or Board -approved nursing assistance. Not to exceed that of nursing home. Hospice Care for DSHS-certified/Medicare-approved program. Wenatchee Average of 3 nursing facilities in Greater Wenatchee area for semi -private room. $4,000/month in -home care provided by bonded/licensed provider. Whatcom Co Pre -authorization required. Physician prescribed, licensed professional, home care/long term care/nursing/hospice. Review after 6 months. All case -by -case basis. Whitman Co Reasonable expenses incurred in facility with 100 miles of member's residence. Non -medical charges not covered. Custodial care considered case -by -case. Home Health Care not to exceed allowed rate for Skilled nursing home. Yakima No insurance. 100% of average basic rate for room and meals, which may include misc. housekeeping services of nursing homes or assisted living facility, in regional area services provided plus 100% of reasonable charges for medically necessary services. Home health limited to amount allowed for nursing home. Yakima Co Medically necessary. Prior approval required. Nursing Home $220/day; In -home Skilled Nursing $130/day; Assisted Living $3,000/month. Yakima Fire Nursing home/Assisted Living. 100% reasonable charges. Medical Report/request for Long Term Care is required. Jurisdiction Policy Summary Aberdeen Physician prescribed, Bellingham Physician prescribed. Massage Therapy provider licensed massage therapist. 25 visits/yr also see Acupuncture therapy Bellingham Fire On Medicare/Limited to tx by physical therapist as part of tx plan. 12 visits/yr. Referral required by doctor. Bothell Insurance submission then any self -pay can be submitted. Bremerton Must be prescribed annually by medical doctor. Chelan Co Covered by insurance if prescribed by doctor. 24 WSLEA Comparison of Benefits, Revised February 5, 2023 Massage Therapy (Cont.) Jurisdiction Policy Summary Clallam Co Physical/massage therapy physician prescribed, performed by licensed therapist. Treatment plan after 45 days. Clark Co May be covered under physical therapy benefit. Pre -approval over 45 days. Cowlitz Co Tx beyond insurance requires tx plan in a month w/updates every 12 mos. Douglas Co Physician prescribed/licensed massage therapist. 6 sessions or 1 month. Everett Case by case, pre -approval by board w/physician's statement required. King Co Physician prescribed, licensed massage therapist. Treatment plan after 2 visits. Klickitat Co Prior authorization required. Physician prescribed, licensed therapist. Lacey 6 sessions or 1 month. Dr ordered. 6+ preapproval by board required. Lewis 35 visits/year Tx prescribed. Mason Co None Pacific Co Not covered Pend Orielle Licensed Massage Therapist, Dr or Chiro ordered. Short tx: 6 sessions or 6 months/first. Updated Rx if exceeding limit. Long tx/chronic. 1 yr tx. Dr ordered. Board review by board dr. Puyallup Physician prescribed/medically necessary. Redmond Case by case — if medically necessary. Renton Covered in plan 25/yr Massage/Acupuncture; to exceed needs preapproval Richland Police $25/visit, maximum 2 visits/month unless ordered by physician. Pre -approval required for more than two per month. Seattle Fire State Licensed. 26/year @ $70 per tx/1x day. Seattle Police 100% of billed charges with physician's prescription. Skamania Co Prescribed by physician provided by licenses massage therapist. Evaluation and treatment plan required beyond 2 visits. Snohomish Co Physician prescribed as medically necessary. Pre -approval over 4 visits. Spokane Co $750 per year/lifetime/one condition/$3000 for tx. Includes Naturopathy, acupuncture, massage, chiro and other holistic or alternative choice. Tacoma Covered by Regence BlueShield. Physician prescribed for medically necessary rehabilitation following injury/illness. Tumwater Dr letter required. Licensed Massage Therapist. No more than six sessions or one month. Limits can be exceeded with Dr Reports/board approval. Vancouver Not covered Walla Walla Physician prescribed, certified massage therapist. Treatment plan over 2 visits. Whatcom Co Services must be provided by licensed massage therapist. Pre -approval of treatment plan for continuous care. Yakima Co Case by case basis with medical documentation. Meal Supplements Jurisdiction Policy Summary Aberdeen Does not cover weight loss products. Bellingham Not covered Benton Co Not covered Kent Not covered Pasco Not covered Port Angeles Not covered Richland Has reimbursed Glucerna but not Medi fast Snohomish Co Has reimbursed Glucerna for diabetic members, but not Medi fast. Spokane Not covered Vancouver Not covered Yakima $1,500 lifetime maximum for weight loss programs. 25 WSLEA Comparison of Benefits, Revised February 5, 2023 Medic Alert Jurisdiction Policy Summary Clark Co have covered Kent have covered Richland Fire 50% monthly fee, must be pre -approved Spokane have paid ($35-40/month) Vancouver Have covered Medicare Jurisdiction Policy Summary Aberdeen Part B premiums reimbursed; enrollment required. Premiums for Medicare supplicant insurance reimbursed. Do not pay Part D premiums. Auburn Part B premiums reimbursed. Do no pay Part D premiums. Bellevue Base Medicare premium reimbursed. No penalty for failure to sign up is reimbursed. Bellingham Bellingham Fire Benton Co Bothell Bremerton Chelan Co Clallam Co Clark Co Cowlitz Co Douglas Co Edmonds Everett Franklin Co Grays Harbor Co Island Co Jefferson Co Kennewick Kent King Co Kirkland Kitsap Co Kittitas Co Klickitat Co Lacey Longview Lynnwood Marysville Part B & D premiums reimbursed each December. Part B & D premiums reimbursed. Part B premiums reimbursed. Medicare required/if fail to obtain any service will be reduced by amount member entitled to. Part B premiums reimbursed. Do not pay Part D premiums. Mandatory enrollment Part B premiums reimbursed. Enrollment required. Part B premiums reimbursed. Enrollment required. Part B premiums reimbursed. Part B premiums. Enrollment required Part B premiums reimbursed. Part A/B premiums reimbursed. No Part D premiums. Part B premiums reimbursed. Do not pay Part D premiums. Enrollment required. Part B premiums reimbursed. Pay Medicare supplement. Part B premiums reimbursed. Enrollment required. Part B premiums reimbursed (pay full premium) Part B premiums reimbursed. Part B premiums and supplemental reimbursed. Enrollment required. Premiums reimbursed; enrollment required. Part B premiums reimbursed. Part B premiums reimbursed; enrollment required. Do not pay Part D premiums. Part B premiums reimbursed. Part B premiums reimbursed. No. Member responsible to enroll to avoid reduction in benefits. Part B premiums reimbursed. Part B premiums reimbursed. Part D if member required to pay premium Part B premiums reimbursed. Mandatory enrollment. Part B premiums reimbursed; Medicare is required. Mason Co Part B premiums reimbursed. Mercer Island Part B premiums reimbursed. Okanogan Co Part B premiums reimbursed. Olympia Part B premiums reimbursed; enrollment required. Medical plan pays prime on providers that opt -out of Medicare. Pacific Co Part B premiums reimbursed; enrollment required. Pasco Do no pay Medicare Part B or Part D premiums. Pend Oreille Co Part B premiums reimbursed; Quarterly. Enrollment required. 26 WSLEA Comparison of Benefits, Revised February 5, 2023 Medicare (Cont.) Jurisdiction Policy Summary Pierce Co Part B premiums reimbursed by all jurisdictions except Sheriff's Department. Members strongly urged to enroll. If member does not enroll benefits reduced by amount Medicare could have paid. Pullman Part B premiums reimbursed. Puyallup Part B premiums reimbursed. Redmond Part B premiums reimbursed. Enrollment required. No part D. Renton Part B premiums reimbursed. Quarterly reimbursements. Richland Police Part B premiums reimbursed. Richland Fire Part B premiums reimbursed w/verification. No IRMA reimbursement. SeaTac Part B premiums reimbursed. SeaTac Fire Part B premiums reimbursed Seattle Fire Part B premiums reimbursed. Part A reimbursed if members do not qualify. Seattle Police Part A/B premiums reimbursed. Mandatory enrollment. Skamania Co Part B premiums reimbursed. If member chooses to utilize provider that opted out of Medicare, member pays the portion that Medicare would have paid. Snohomish Co Part B premiums reimbursed. Medicare required. Spokane Part B premiums reimbursed (plus late enrollment penalty, but not additional based on income); part A reimbursed if member has no SS benefits. Enrollment required. Part D covered through medical plan. If member chooses to utilize provider opted out of Medicare, member pays portion Medicare would have paid. Spokane Co Part B premiums reimbursed. Enrollment required. Spokane City Fire Part B premiums reimbursed Tacoma Part B premiums reimbursed (except penalty for late enrollment); enrollment required. Thurston Co Part B premiums reimbursed; enrollment required. Part A reimbursed if ineligible. Tumwater Medicare required. Part B reimbursed Vancouver Part B premiums reimbursed; enrollment required. Part A not reimbursed. Walla Walla Part B premiums reimbursed for actual rate paid Walla Walla Co Part B premiums reimbursed. Wenatchee Part B premiums reimbursed; enrollment required. Do not pay Part D premiums. Whatcom Co Part B premiums reimbursed. Whitman Co Part B premiums reimbursed; enrollment required. Yakima Part B premiums reimbursed.; Supplemental premium $250 month/members not covered by city plan. Yakima Co Part B premiums reimbursed, no reimbursement for penalty for late enrollment. Reimbursement in March Mental Health Jurisdiction Policy Summary Aberdeen Services provided by licensed psychiatrist/psychologist/certified clinical social worker. Requires treatment plan beyond insurance coverage. Bellingham Covered through the Regence medical plan. Bellingham Fire Covered through medical plan, counseling and psychiatric. Bothell Prior written physician recommendation, provider licensed psychiatrist/certified clinical social worker. Treatment plan/6-mo progress reports required. Bremerton Must be prescribed by medical doctor. Chelan Co Upon 6t" visit for same/similar condition possible board request for records. Medically necessary paid. Clallam Co Psych iatrist/psychologist licensed under the provisions of RCW 18.83 covered. Clark Co Pre -approval required. Treatment must be required by a physician. 27 WSLEA Comparison of Benefits, Revised February 5, 2023 Mental Health (Cont.) Jurisdiction Policy Summary Cowlitz Co If exceeding insurance coverages, Licensed psychiatrist, et all (see plan), Dr ordered, Tx plan every 10 sessions, see plan for requirements Everett 100% allowable charges. Franklin Co Prior approval required. Grant Co Licensed psychologist/psychiatrist, 6 visits/year without board approval. 7+ physician report, pre -approval by board. Grays Harbor Co Under direction of licensed psych iatrist/psychologist. 6 visits/year without Board review. Treatments for sexual dysfunction excluded. Jefferson Co Treatment plan required every 6 months Kennewick Must see board approved physician for evaluation and treatment plan. 3-month progress reports required. King Co Providers licensed/certified. Treatment plan required after 2 visits and every 610 sessions. 50-minute unit by psychiatrist - $150; psychologist/advanced registered nurse practitioner - $125; clinical social worker or mental health counselor - $110. Kirkland Provided by State licensed psychologist/psychiatrist, unless referred to State certified counselor by physician or Employee Assistance counselor. Kittitas Co 10 visits or $600 within 12 months. To exceed needs board approval. Lacey Case -by -case. Lewis Co 35 visits/year. Claim must include physician's statement of necessity. Lynnwood Pre -approval before exceeding defined benefit through insurance. Marysville Utilize member insurance first; non covered expenses may be submitted for reimbursement Mercer Island Pre -approval after 2 visits. Olympia Licensed psychologist/psychiatrist/counselor, up to 20 visits/ preapproval for additional. Pacific Co 35 visits/year. Pasco State -licensed psychologist/psychiatrist, unless referred to state -certified counselor by physician or EPA. Pend Orielle 5 visits for same/similar condition. Only necessary services. Puyallup 100% for treatment rendered by a physician. Renton Covered insurance plan 20 visits/yr Excess needs board approval. Richland Police Licensed therapist/psychologist or psychiatrist. Richland Fire Licensed Psychologist/psychiatrist on case -by -case basis. Seattle Fire State licensed. Letter from Doctor. 26 visits/year; exceeding visits need pre auth. Inpatient facility. Seattle Police State licensed psychologist; Limit of $3600 year/24 visits year. Excess approved by Board Secretary. Counseling state licensed qualified professional $110 visit or $2,640 year Skagit Co Pre -approval required over 3 visits. 50-minute unit maximum rates: Psychiatrist $110; Psychologist $90; Clinical Social Worker $80. 52 visits/year. Skamania Co Licensed psych iatrist/psychologist/certified clinical social worker. Written Tx plan. Pre - authorization by Board. Spokane Co Insurance primary, excess must be preauthorized by board. Limit $600 per year. Tacoma Coverage provided through Regence BlueShield. Marital/family counseling not covered. 28 WSLEA Comparison of Benefits, Revised February 5, 2023 Vancouver Physician prescribed; Pre -approval required. Walla Walla $2,200 for outpatient care/12-month period. Marriage and family counseling not covered. Treatment plan required. Wenatchee Upon 6t" visit, medical report required. Whatcom Co Treatment plan required after 2 visits. 50-minute unit rate: psychiatrist $150; psychologist/advanced registered nurse practitioner $125; clinical social worker $110; certified mental health counselor $100. Whitman Co Treatment plan required after 2 visits. 50-minute unit rate: psychiatrist $135; psychologist/advanced registered nurse practitioner $110; clinical social worker $90; certified mental health counselor $90. Yakima Co State licensed psychologist/psychiatrist, unless referred to State certified counselor by physician or Employee Assistance counselor. Yakima Paid at 100% $9,000 max inpatient, $3,000 max outpatient, $12,000 max/year in/outpatient. Lifetime Max $24,000. Yakima Fire Pre -approval required after 2 visits. $9,000 inpatient per year. $3,000 outpatient per year. Up to $24,000/lifetime. Miscellaneous Medical Jurisdiction Policy Summary Aberdeen Surgical procedures and devices for birth control are not considered medically necessary. Fitness program at members own expense. Organ transplants need pre - approval. Bellingham Fire Funeral benefit $500 paid to estate if hired prior to March 1, 1970. Bellingham Police Death benefit $1,000 to pre-LEOFF, w/5 years' service assume qualifying beneficiary. Not applicable if hired after March 1, 1970, Benton Co Have paid dental claims from Mexico Bothell Experimental, research, drugs procedures/biofeedback are case by case. Clallam Co Have paid claims from Canada Douglas Co Pain Therapy covered when physician prescribed, by licensed practitioner. Everett Swim fees if Everett Parks/submit to board office. Genetic testing, obstetrics, blood transfusions, ambulance, contraception 100% allowable charges. Franklin Co Members required to use insurance contracted provided. Prior authorization required for experimental treatments and preventative medicine. Grant Co $750/year exam/filling, root canal/crown/bridge/dentures. Max $1200 full or partial denture every 5 yrs. Ortho only if medically necessary. Grays Harbor Co Non -emergency air ambulance service excluded. Vitamins not prescribed by a physician excluded. Kennewick Board must be advised 1 month prior to surgical procedure (except in emergency). Physical therapy/12 visits yr through licensed RPT. Kent Medical necessity required. King Co Charges must be reasonable and considered usual and customary. Kirkland Routine physical exam will be covered. Subrogation recovery rights. Kitsap Co Claims must utilize any available insurance/Medicare etc; claim submission up to 1 year. Svc's beyond primary insurance require prior authorization. Klickitat Co Charges reasonable and considered usual and customary unless a provision in these Rules provides for reimbursement for a lesser amount. Lacey Pain therapy tx when given by licensed practitioner; board discretion. Podiatry reasonable expenses, Dr prescribed, case by case. Orthotics 2 pair/one year. Residence access ramps preapproval required, reasonable expenses, primary and secondary ramps, future maintenance, or repair/members responsibility. Three bids. Lynnwood Claims not covered by insurance require pre -approval. 29 WSLEA Comparison of Benefits, Revised February 5, 2023 Miscellaneous Medical (Cont.) Jurisdiction Policy Summary Mercer Island Only medical services deemed reasonable and necessary shall be paid. Mountlake Terrace Cover out of country claims. Okanogan Co Missed appointments not covered. Physical therapy over 45 days must be preapproved. Olympia Medical Recommendation/Colonoscopy. Bone Density - age 70/$350 every two years. Pasco Reasonable cost of necessary medical care or services. Pend Orielle No mileage/food or lodging except as pre -authorized by board. Pierce Co Insurance covers Mexico, foreign travel. Naturopathy policy allows $2,500/yr inclusive of any amounts paid by insurance. Renton Have paid claims from Mexico. Richland Police Naturopathic not covered. Physical Therapy/city plan then Dr letter w/plan submitted to board. Richland Fire Meal expenses/business travel for board business only; Physical Therapy/Insurance benefit, if +insurance must be pre -approved by Board. Death benefit $1,000 per RCW. Seattle Fire Naturopath State licensed. Letter from Primary. See lab restrictions. $150 per visit/1 x day; Organ transplants. Letter required. Reasonable expenses/reasonable donor expenses, federal licensed facility. Orthotics $450 one time/year; Seattle Police Dental coverage and limitations through Delta Dental plan, all members premiums paid through office. No cosmetic. Skagit Co If physician outside group plan requires referral from group plan physician. Skamania Co Pre -authorization for any necessary medical expense not covered by insurance. Snohomish Co Out of country claims must be pre -approved. Spokane City Fire Travel for tx must be pre -approved. Member only. If problem, can be corrected locally/no coverage. Spokane Co Physical therapy: above insurance requires prior approval. $750 per year/lifetime/one condition/$3000 for tx. Includes Naturopathy, acupuncture, massage, chiro and other holistic or alternative choice. Tacoma Naturopathic visits covered by Regence BlueShield, supplies/special diets/herbs/nutritional supplements/vitamins not covered. Emergency medical care only out of country. Denied spinal decompression therapy. Thurston Co Denied administrative fees. Tumwater Pain therapy. Licensed facility. Vancouver Use of non -Kaiser facilities by Kaiser members requires pre -approval. Have paid Administrative Fee for LTC. Have covered dental & glasses from Mexico. Whatcom Co Naturopathic $2,500/Year Yakima Co Insurance covers out of country claims. On -Line Policies Jurisdiction Policy Summary Bellevue www.bellevuewa.gov (Boards and Comm issions/LEOFF 1 Disability Board/Policies and Procedures Bothell www.ci.bothell.wa.us Bremerton www.bremertonwa.gov Clallam Co www.clallam.net (Co Laws & Policies/Co Administrative Policies/Section 200: Personnel/295: Disability Board Grays Harbor Co www.co.grays-harbor.wa.us (departments, disability board) 30 WSLEA Comparison of Benefits, Revised February 5, 2023 On -Line Policies (Cont.) Jurisdiction Policy Summary Kennewick www.ci.kennewick.wa.us (City Managers Web Page in Navigation Pane- Disability Board Olympia http://olympiawa.gov/city-government/advisory-committees/leoff-disabilityboard.aspx Renton www.rentonwa.gov (City Departments and Services/Human Resources/LEOFF Policies and Procedures Tacoma POLICE (cityoftacoma.org) Tumwater Podiatry/reasonable expenses; Orthotics not to exceed two pair in one year Vancouver http://www.citVofvancouver.us/hr/page/leoff-1-police-and-fire-pension-boards Whatcom Co www.whatcomcounty.us/2445/Leoff-1-Disability-Board Jurisdiction Bellingham Fire Bellingham Bothell Bremerton Clallam Co Clark Co Douglas Co Edmonds Everett Franklin Co Grays Harbor Co Kirkland Kitsap Kittitas Co Lacey Lynnwood Marysville Mercer Island Mountlake Terrace Olympia Pacific Co Pasco Pierce Co Puyallup Richland Police Richland Fire Seattle Fire Seattle Police Skamania Co Snohomish Co Spokane Spokane Co Tacoma Thurston Co Vancouver Physicals Policy Summary Retired annual well physical and labs covered by Insurance. Covered by plan. $300/year. Allowed annually. Cover costs not covered by other insurance. Once every two years for members over 40. More frequent require pre -approval. Once annually. $300 annually Once annually. Pay co -pay. Allowed as preventative. $350/24 months, except annual pap spear or prostate examination. $350 per year. Cover co -pays. Yes $350/year Any additional procedures prescribed by Dr shall also be paid. Not covered. $350/year. Covered $350/year. Not covered. Not covered. Covered Covered $400/year. $400/year. Charges exceeding to be brought before the Board for consideration Reimbursable and encouraged $500/year. Annual physical exam covered. $250/year. Covered $200/year. Billed to insurance plan first. 1 /year 1 /year 1 /year 31 WSLEA Comparison of Benefits, Revised February 5, 2023 Physicals (Cont.) Jurisdiction Policy Summary Walla Walla 2 years age 36-50 to include medical history/exam, complete blood count, urinalysis, chemistry profile, PSA, mammography, pap smear (yearly), hemoccult, complete cholesterol profile. Every 4 years beginning at age 36: chest x-ray, exercise treadmill test, spirometry, audiogram. Every 5 years beginning at age 50: flexible sigmoidoscopy. Wenatchee Covered Whitman Co $350/year for routine physical exams and immunizations. Yakima Co Covered annually. Request members use preferred network when possible. Preferred Provider Jurisdiction Policy Summary Bellevue Use of network providers not required, but benefits reduced for non -preferred providers. Bellingham Should use network providers and/or pharmacies. For non -network provider, the Board may decline all or a portion of the charges. Benton Co Primary care physician must be network provider, may refer to non -network providers. Bremerton Do not require use of preferred providers - Medicare doctors required. Chelan Co Members required to use in network provider when possible. If out of network reimbursed to member for difference of in network provider, not full amount. Clallam Co Do not require use of preferred providers. Clark Co Do not require use of preferred providers. Everett Do not require use of preferred providers. Grant Co Do not require use of preferred providers. Grays Harbor Co Encourage use of preferred providers, may consider by pre -approval. Kennewick Do not require use of preferred providers. King Co Do not require use of preferred providers. Klickitat Co Do not require use of preferred providers. Lynnwood Do not require use of preferred providers. Marysville Do not require preferred providers, reduced benefits for non -participating providers. Pasco Do not require use of preferred providers. Pierce Co Do not require, but request use of preferred providers. Puyallup Do not require use of preferred providers. Redmond Do not require use of preferred providers. Renton Do not require, but request use of preferred providers. Richland Police In network encouraged. Richland Fire Encouraged to utilize preferred and Medicare. If not, may not be 100% covered. Seattle Police Encourage member utilize participating providers. Skamania Co Do not require preferred providers but reduce benefit for non -participating providers. Snohomish Co Do not require use of preferred providers; member must obtain services through prepaid health plan. Spokane Co Do not require use of preferred providers. Tacoma Require use of Regence BlueShield preferred providers except for long term care. Vancouver Do not require use of preferred providers. Wenatchee Do not require use of preferred providers. Whitman Co Do not require, but request use of preferred providers. Yakima Co Members encouraged to use preferred provider 32 WSLEA Comparison of Benefits, Revised February 5, 2023 Prescriptions Jurisdiction Policy Summary Aberdeen Medically necessary erectile dysfunction 4 doses/month. Pre -authorization required. Asotin Co Max $100/month; should submit monthly -must submit quarterly March, June, September, and December. Auburn Erectile dysfunction paid as any other prescribed medication. Bellingham Through medical plan. Member has Medicare -with copay process with HRA card at pharmacy. Mail order- 90-day supply. OTC by physician Rx, Rx needs annual renewal. E/D covered with Rx. Bellingham Fire Covered through insurance. Copays to pension w/proof/documentation. OTC w/rx submit to pension for reimbursement. E/D covered w/Rx from Dr. Bellevue Prescriptions exceeding medical plan reviewed case -by -case. Benton Co Insurance first. OTC by order of note or Rx by Dr. Bothell OTC covered with physician's prescription. Bremerton Covered in medical plan. Erectile dysfunction 6/month. Chelan Co Co -pay covered. Erectile dysfunction paid as any other prescribed medication. OTC available without note or prescription is not covered. Clallam Co E/D Rx limited 6/month. Clark Co Physician prescribed for medical necessity. Douglas Co OTC medications available without a prescription are not covered. E/D same as any other Rx. Edmonds Co -pays covered by board. Any E/D cap $250/yr with physician's prescription Everett 100% to Treatment/diagnosis illness/injury. Erectile dysfunction 6/month. Franklin Co OTC and vitamins covered with physician's prescription. Grant Co Rx by licensed Dr. Grays Harbor Co OTC covered with Dr. prescriptions. Sexual dysfunction 8/month or 96/yr Kennewick E/D 8 pills/month medical necessity documentation required King Co Sexual dysfunctions are determined to be reimbursable. Kirkland Physical prescribed for medical necessity Kitsap OTC and E/D (limit 6 doses/month) with physician's prescription. Any Rx to be reduced by insurance first. Klickitat Co Must use Mail order as part of plan when available. OTC covered with physician's prescription. Lewis Co OTC covered with physician's prescription. Generics encouraged. E/D $500 12 months/case by case showing medical necessity. Longview Two-year term Ballots and Nominations in February every other year Mason Co Erectile dysfunction 6/month; OTC covered with physician's prescription. Mountlake Terrace OTC covered with physician's prescription. Olympia OTC covered with physician's prescription. Pacific Co Physician prescribed for organic diagnosis, up to 6 tablets per month. Pasco Only when prescribed by a physician. Pend Orielle Unless approved by board/Rx to be purchased from local Pend Orielle County area. Pierce Co OTC covered with physician's prescriptions. Up to 8 doses/month for Erectile dysfunction (other drugs for same purpose). Puyallup 100% when physician prescribed/medically necessary. Richland Police If Rx requires pre auth by FDA, member required to follow City's benefit provider; E/D as prescribed by Dr. Richland Fire If Rx requires pre auth by FDA, member required to follow City's benefit provider; E/D as prescribed by Dr. Seattle Fire Covered with Premera at pharm/mail order. Copay's reimbursable when medically necessary for specific conditions. 33 WSLEA Comparison of Benefits, Revised February 5, 2023 Prescriptions (Cont.) Jurisdiction Policy Summary Seattle Police E/D limit/12/month or 36/month using mail order/3-month supply Skagit Co Erectile dysfunction not considered medically necessary. Skamania Co OTC covered with physician's prescription. Snohomish Co E/D 6 doses/month if shown medically necessary. Spokane Co Only drugs and medicines that require a physician's prescriptions. Tacoma Members shall use Regence BlueShield participating pharmacy. OTC covered by Regence BlueShield with RX. Thurston Co OTC covered with physician's prescription. Vancouver Erective dysfunction paid as any other prescribed medication. Walla Walla OTC covered with a physician's prescription. Erectile dysfunction 13/quarter. Wenatchee OTC covered with a physician's prescription. Whatcom Co Erectile dysfunction when prescribed to treat organic diagnosis. 75% of charge. Whitman Co Erectile dysfunction not considered medically necessary. Yakima Co Erectile dysfunction paid as any other prescribed medication. Smokina Cessation Jurisdiction Policy Summary Aberdeen Covered under Regence Plan Bellingham Fire Covered through insurance. Bothell Insurance coverage, any out of pocket on case by case/1x only following successful completion and 1/yr maintenance. Cowlitz Co Exceeding insurance to specified amount, 1x only following completion for one year. Everett part of regular coverage. Grays Harbor Co Hypnotherapy to stop smoking excluded. Jefferson Co $300 one -time -only for patches. King Co $250 once -only following successful completion and 1-yr maintenance of goals. Kirkland Covered as Physician prescribed. Pre -approval required. Pullman 80% of remaining balance not paid by insurance. One lifetime benefit. Puyallup Paid 100%. Richland Police Smoking cessation, pre -approval required. Seattle Fire Letter from Primary. $1000 limit/exceeding limit must have prior authorization. Seattle Police Smoking cessation treated as other illness/injury. Skagit Co $300 once -only following completion and 1-year maintenance of program goals. Snohomish Co Prescriptions limited to 90-days per lifetime Spokane Co Pre -approved by board/lifetime max $500. Walla Walla $250 once -only following completion and 1-year maintenance of program goals. Whatcom Co $250 once -only following completion and 1-year maintenance of program goals. Whitman Co $250 once -only following completion and 1-year maintenance of program goals. Yakima $50 lifetime maximum for Nicorette Travel Jurisdiction Policy Summary Bellingham Travel costs not covered. Bellevue Travel costs not covered. Bremerton Have allowed mileage for doctor's appointments and to pick up prescriptions. Chelan Co No personal mileage, food, or lodging. Clallam Co Transportation to medical facility if service not available locally. Have paid cabulance from nursing home to doctor visit. Clark Co Have paid medical transportation to healthcare providers. 34 WSLEA Comparison of Benefits, Revised February 5, 2023 Travel (Cont) Jurisdiction Policy Summary Douglas Co Travel for medical pre authorization required, max/per diem rates for lodging, meals and incidentals and IRS mileage rate using private vehicle. Everett Have paid - case -by -case. Franklin Co Would consider if no other options in local area or upon physician's necessity. Grays Harbor Co Case -by -case; generally, not approved. Island Co Would have to be necessary medical expense. Kennewick With physician referral case -by -case. Kitsap Co For out -of -area treatment for member only. Prior approval would be required. Klickitat Co Only when member required to submit to an evaluation requested by the Board. Lacey Case -by -case. Mercer Island No Pasco No Pierce Co Must be proven medically necessary unless doctor visit requested by Board. Puyallup Has paid airfare for member out of country to allow treatment in the states. Richland Police Current city travel policy. Preauthorization required for board or medical tx. Seattle Fire Cabulance to treatment. Travel for out -of -area treatment not covered. Seattle Police No Snohomish Co No Spokane Have paid travel and meals — case -by -case. Tacoma No covered. Thurston Co Have covered personal assistance including transportation to medical appointments. Vancouver Have paid transportation from massage. to nursing facility and doctor's appointments from nursing facility. Walla Walla Would cover travel only if Board directed a member to an out -of -area physician. Walla Walla Co If no other options or upon physician's recommendation. Wenatchee Pre -authorization required. Yakima Have paid cabulance/medical taxi; have paid mileage for home health care provider to transport member to doctors; case -by -case basis if same services not available in Yakima. Yakima Co Only reimbursed if Board issued for IME purposes. Vision Jurisdiction Policy Summary Aberdeen $325/lenses and frames/24-months. $200/contact lens/24-months. Asotin Pre -approval required. $200 max/2 yrs. Glasses may be purchased at Costco, city card if needed. Auburn $270/year for frames and lenses; exam covered by medical. $1,000 per eye for Radial Keratotomy or laser eye surgery in lieu of glasses in 2 calendar years. Bellevue 2 sets of lenses plus $200 for frames/24-months. $400 for laser/refractive eye surgery instead of hardware. If vision conditions uncorrectable by any other means and member precluded from performing duties of his/her position greater amount may be considered case -by -case. Bellingham Fire Routine exam/hardware covered under city Vision Plan. Laser max amount to cost of contact lenses. One-time payment only. Bellingham Police Routine exam/hardware covered under city Vision Plan. Laser max amount to cost $190 total. One-time payment only. Bellevue 2 sets of lenses plus $200 for frames/24-months. $400 for laser/refractive eye surgery instead of hardware. Benton Co Allowance of $1,000 in conjunction w/dental per year 35 WSLEA Comparison of Benefits, Revised February 5, 2023 Vision (Cont.) Jurisdiction Policy Summary Bothell Lenses $200/12-months. Frames $120/24-months. Tinting, coloring, photo sun, other options or a spare pair not covered. Bremerton 100% exams; $190/year for eyewear - laser surgery $760 in lieu of 4 yrs eyewear benefit. Chelan Co Exams covered; corrective lenses covered to $400/24 months. No Rx sunglasses. Laser surgery to $4,000, no other vision benefits for 5 years. Clallam Co Annual exam. $500/2 years lenses/contacts/glasses. Refractive/laser surgery medically necessary. Treatment for glaucoma, cataracts, macular degeneration, tear ducts, etc. are covered. Clark Co 1 exam yr, 1 frame/2yr, 1/lens/yr. Frames/lenses/contacts $350 per event. Otherwise, case by case w/review by board. Cowlitz Co Reasonable cost of necessary eye exam, glasses, and contacts, one pair glasses/year of contacts, 1x/year; Single pair glasses/frames/lenses every 12 most. Single, bifocal, trifocal. Second pair for specific applications only approved if by Ophthalmologist or licensed optometrist. Reimb limited to one every 24 months. Contact lens, years' worth every 12 mos. Replacement: one per year. No additional or spare reimbursement. Lasik, laser, cataract if medically necessary. Douglas Co 1 exam/24 months. $300/24 months for lenses -frames or contacts. Laser surgery $500/eye. Edmonds Annual benefit of $150 (for a total up to $300 every two years (24/mos) glasses or contacts or eye medical services. Everett 1 exam plus $550/year for glasses/contacts. Yearly allowance may be applied to laser eye surgery instead of purchase of glasses. Franklin Co $300 for lenses/contacts/frames/prescribed eye treatments per two years. Grant Co Eyeglasses/contacts prescribed by optometrist/ophthalmologist. 1 yr/12 months $500 frames/lenses/contacts/tinting/bifocal/trifocal every 2 years. Grays Harbor Co Pre -approval required. 1 exam/12-months. $500 for frames, lenses, contacts, tinting, bifocals, etc. per 2 years. Island Co 1 exam/12-months. One pair of glasses obtained for the first time. Replacement lenses for prescriptions change. Jefferson Co 1 exam/year; 100% lenses; $100 frames/24-months; $200/contact lenses/12months. No reimbursement for options not determined medical necessity. Kennewick Exam/glasses or contact lenses once/12 months. $100/year frames. $200/year contact lenses. Tinting, coloring, photo -gray, photo -sun, etc., excluded unless medically necessary. Progressive lenses not covered. Replacement only if damaged in line of duty. Laser eye surgery case -by -case. Kent Exam coverage by Ophthalmologist or optometrist, after all insurance has been utilized. Contacts max $100/yr. Frames $100/24 mos; Lenses $150/12 mos; Laser/RK $250 per eye then cease hardware for two years. King Co $350/single set of frames/lenses/12 months. $200/pair of contact lenses/12months. Corneal laser surgery, laser treatment for refractive conditions, and lens implants (multifocal lens excluded) eligible only for medical conditions. Kirkland Rx by Optometrist or ophthalmologist limit to $350 frames/lenses and up to $200 for second pair frames/lenses. Kitsap Co Frames/2 years up to $200. Lenses/annually not including extra options. Contacts in lieu of glasses; retinal scan $50/yr. Laser in lieu of glasses/contacts suspend hardware benefits for 4 years. 36 WSLEA Comparison of Benefits, Revised February 5, 2023 Vision (Cont.) Jurisdiction Policy Summary Kittitas Co By Rx/licensed ophthalmologist/optometrist. Eyewear $500 excluding eye exam. Klickitat Co Annual Exam 100%; frames $120/year; Lenses 100%/year; Contacts considered as lenses; Replacement for damage during duty limit 1/year. No over -sizing, tinting, coloring etc. options. Lacey Exam 100%, Lens 100% including tint, coating), Frames 100% w/in two-year period. Second pair 25% of total cost, can be contacts/glasses. Contacts $130/two years. Lewis Co 1 exam/year; 1 frames/2 years. Complete cost not to exceed $550. Lenses may be tinted if prescribed by doctor as medical necessity. Longview Lenses/Frames $100 limit/yr or $200/2 years or Contacts; Lasik $3500 Lynnwood 1 exam/year. Frames one/2 years. Lenses 1 pair/year. $400/year maximum Marysville 1 exam/year. $240/year for eyeglasses/contact lenses. No tinting, coloring, photo - sun, or other options unless medical necessity. Mason Co Lenses -annually; Frames -. every 2 years. Limit $500 every 2 years when purchasing 2 pairs of glasses at tone time. Laser surgery allowed at 50%. Mercer Island Untreated/un-tinted lenses (either eyeglass or contact lenses) 2 pairs/24 months. $260/2 years for contact lenses. Member pays $20% co -pay for lenses. Frames $100/pair. 1 pair frames/24-months. Okanogan Co 100% of examination; lenses/frames $150; contact lenses $100. 1 exam and 1 pair of glasses or contacts/1 2-months. Olympia 1 exam/year. $300 annually. Police coverage-VSP. Fire coverage -Humana. First to insurance, then seek reimbursement. Pacific Co 1 exam/12 months. $300/12 months for lenses, frames and/or contact lenses. Replace due to breakage in the line of duty. Refractive Keratotomy Surgery for myopia/astigmatism not considered necessary medical. Corneal Laser Surgery require pre -approval. Pasco Annual exams and $375/yr for corrective lenses or contact lenses. Tinting/progressive lenses if prescribed. Sunglasses only for specific condition. Replacement only in line of duty. Pend Orielle Total cost for corrective lenses/excluding exam $300 max/1 every two years. Pierce Co $250 one paid of lenses/frames or contacts per year. Replacement when damaged in line of duty. Pullman Annual eye exam covered. $600 glasses/frames/lenses and or contacts. Puyallup 1 per year; exam/refraction/glaucoma testing/OptoMap $100/single $125/bifocal $160/trifocal $210 progressive $300/polycarb $75/high index $300/protective coating $40/transitions $120/anti-reflective $140/frames $250/corrective surgery $500 per eye. Redmond 1 exam/year. $400/year for lenses and frames or contact lenses. Replacement on case by case. Toric or Multifocal cataract $1500 lifetime. Renton $450/2 years for lenses and frames or contact lenses, including tinting and Refractive/Laser Eye Surgery. 1 exam/year. Richland Police Annual exam and one pair lens, include anti-scratch/glare) tint, transition max $150/frames year. Sunglasses/1x year only Dr prescribed for medical condition. Contact Lenses/$200/year. 37 WSLEA Comparison of Benefits, Revised February 5, 2023 Vision (Cont.) Jurisdiction Policy Summary Richland Fire Insurance first if applicable; exam and one pair lens, include anti-scratch/glare) tint, transition max $150/frames year. Sunglasses only Dr prescribed for medical condition. Contact Lenses/$200/year. Broken frames/lenses no replacement. Seattle Fire Exam and tx, Rx by Dr. Frames/lenses/sunglasses 24/mos. Lens enhancements are allowed w/i limits. One pair single vision $550; bifocal $580; trifocal $645. Change in Rx/12 mos single $310; bifocal $335 Trifocal $405. Lasik/Licensed Ophthalmologist. FDA approved. Performed/USA. One time $1400/eye. Seattle Police Annual exam. $800/year for hardware (frames/lenses) w/prescription change. Laser eye surgery/keratotomy and blepharoplasty (eyelid) surgery if medical necessity. Refractive Keratotomy Surgery to #1400/eye/lifetime by licensed ophthalmologist. Corneal Laser Surgery prescribed for medical condition. SeaTac Fire Glasses/frames $400 every two years or sooner if correction is required. Special Rx due to circumstance on case -by -case basis. Skagit Co 1 pair eyeglass or contact lenses/12 months. $250/pair lens; $100/frames; $200/pair contact lens. No over -sizing, tinting, coloring, photosun, or other options, special requests, unless medically necessary. Pre -approval required for laser corneal surgery. Skamania Co 1 exam/year; $250 for 1 set of frames/2 years; $300 for 1 pair lenses/year; laser eye surgery required preapproval. Contacts/$300. Replacement: breakage/loss on duty. Laser surgery preapproval $1,000/eye w/no hardware/2 years. Snohomish Co 1 exam/year. $200/frames and $300/lenses every 2 years. Spokane Police 1 exam/year; hardware $500/2 years, Lasik $2600 per lifetime. Spokane City Fire Lasik through TPA/lenses for glasses allowed w/i 6 months after Lasik. Spokane Co $150/2 years unless medical necessity requires change sooner. Laser: Medical necessity are only options for adequate vision or safety of employee. Tacoma Active plan through City (line of duty damage covered by Board). Retired members - $300/calendar year for eyewear (glasses or contacts) through Regence BlueShield. Current eyewear allowance for Radial Keratotomy or laser eye surgery, in lieu of hardware in same year. Tumwater One exam/2 yrs. Lens covered 100%/2yrs; Frames $100/second pair glasses or contacts 25% total cost. Contacts $130/2 years Vancouver 1 exam and 1 pair of glasses or contact lenses/1 2-months, except replacement if broken in line of duty, or as needed for specific medical condition. Exam $80; $250/year hardware (lens, frames, coatings, contacts, etc.) plus $20 for UV protection. Charges for sunglasses, photo gray or contact lenses in excess of allowance, only pre -approved medical necessity. 1-year hardware allowance may offset the cost of laser surgery unless vision cannot be corrected by glasses and/or contacts. Wahkiakum Co Vision premiums paid on a composite basis. Expenses not paid by insurance covered, excluding hardware. Walla Walla $240/pair lenses/ 1 2-months. $100/frames/24-months. $240/pair contact lens/12- months. Over-sizing/tinting/coloring/photosun or spare pair not allowed. Refractive Keratotomy Surgery to correct myopia and/or astigmatism not covered. Pre - approval required for prescribed laser corneal surgery. Wenatchee Annual eye exam. $500 for corrective lenses every 2-years. Refractive keratotomy surgery or laser surgery not considered medical necessity. Whatcom Co $800/frames and lenses/12 months 38 WSLEA Comparison of Benefits, Revised February 5, 2023 Vision (Cont.) Jurisdiction Policy Summary Whitman Co $75/year exam; frames/lenses/contacts $500 per two years. No laser vision correction Yakima Co Annual exam. Frames $200/year. No maximum on lenses. Disposable contact lens $200/year. Tinting, special coatings, rolled and/or polished edges, oversized lenses or prescription sunglasses not covered. Yakima Eye exam 100%; $500 max every two years lenses/frames/contacts; The $500 can be applied toward cost of corrective vision surgery. Yakima Fire Annual exam. $275/2 years for lenses and/or frames and/or contact lenses. $275 lens allowance can be applied toward cost of corrective vision surgery. W-2 for DisabilitV Jurisdiction Policy Summary Bellevue 2 pay codes (non -duty disability taxable and duty disability non-taxable). Everett duty & non -duty disability same pay code. W-2 adjusted to reflect actual taxable amount. Marysville no active members. Richland 2 pay codes (non -duty disability taxable and duty disability non-taxable). Walla Walla 2 pay codes (non -duty disability taxable and duty disability non-taxable). Whitman Co no active members. Weight Loss Jurisdiction Policy Summary Aberdeen Physical fitness no covered. Auburn $500/one-time-only, for prescribed weight loss program for at least 60 pounds. Bellingham Weight loss has been approved for medical necessity case -by -case. Physical fitness not covered. Bothell Weight loss programs, physical fitness/health spas, considered when prescribed. No requests for surgery. Bremerton Not covered. Clallam Co Physical fitness not covered. Weight Loss program if prescribed. No requests for surgery. Cowlitz Co Case by case, Dr. Monitored. Everett Swim Fees of Everett Parks, submit to Pension Board. Franklin Co Considered if prescribed by physician and approved by Board Physician. Prior approval required. Grays Harbor Co Weight loss programs/physical fitness/health spas must be medically necessary. Pre -approved one lap -band surgery. Jefferson Co If medically necessary if reasonable equivalent benefits could not be obtained for less. Kennewick Necessary medical costs. No food supplements, membership in weight loss programs, physical fitness clubs or health spas. Will cover counseling by licenses psychologist/psychiatrist or dietician/nutritionist. King Co May approve weight loss program prescribed/monitored by physician one-time only, exclusive of food supplements/replacements. Kirkland Not covered unless medical necessity and equivalent treatment could not be obtained for less. No gym or spa memberships. Lewis Co Covered for medical necessity and equivalent treatment could not be obtained for less. Lynnwood Not covered. 39 WSLEA Comparison of Benefits, Revised February 5, 2023 Weight Loss (Cont.) Jurisdiction Policy Summary Marysville Weight -loss programs/physical fitness/health spas not covered unless medical necessity and equivalent treatment not available for less. Olympia Access through insurance and no reimbursement Pacific Co Weight loss programs/physical fitness/health spas not covered unless medically necessary. Pasco Weight -loss programs/physical fitness/health spas not covered unless medical necessity and equivalent treatment not available for less. Richland Weight loss program prescribed one -time -only. Board will pay 50%, exclusive of food. If applicant demonstrates goal completion and maintenance for 2 years, Board may provide further compensation. Richland Fire Complete city's health care before any plan submission to Board. Dr prescribed/1x per person/case by case. 50% excludes food/other parts as determined prior to start. After two years/w goals/maintenance the board may provide up to full amount. Seattle Fire Medical necessity/BMI <30 limited $1,000. Food/supplements not covered. Prior authorization required. Doctor letter required. Seattle Police 100% excluding supplements/nutritional products. Upon physician's prescription do pay 100% for physical fitness facilities for members with chronic wasting diseases. Skagit Co Prescribed/monitored by physician, one -time -only (excludes food supplements). Pre -approval required. Physical fitness programs no covered. No requests for surgery. Skamania Co 50% one-time only, exclusive of food and other parts of the program. After 2 years may pay up to full amount upon maintenance of goals. Exercise/fitness programs not covered. Snohomish Co Health club memberships case -by -case in lieu of physical therapy for medically necessary rehabilitation following surgery. Spokane Police Case -by -case for medical necessity. Spokane Co $500/year for prescribed dietary counseling, up to $1,500 for one condition. Thurston Co Would require pre -approval for any procedures. Have approved one surgery. Walla Walla Physical fitness program not covered. Pre -approval for weight loss program prescribed/monitored by physician, one -time -only, excludes food supplements/replacements. No requests for surgery. Wenatchee One-time only when medical necessity, physician prescribed/monitored, when proven cost savings long term. Whatcom Co One -time -only when physician prescribed/monitored, excludes food supplements/replacements. Yakima Physician prescribed/monitored, one -time -only, excludes food supplements. Preapproval required. No requests for surgery. Yakima Co Have covered surgeries deemed medically necessary. *This is a general comparison list only and should not be used to confirm, verify or determine any benefit(s) from your Pension Board. Please contact your Pension Board directly for any of your needs. Rev: January 2023 40 WSLEA Comparison of Benefits, Revised February 5, 2023