Coffee County Mayor Gary Cordell says the $600K in medical benefits paid out to allegedly ineligible county employees did not to come out of the county’s pockets but instead was paid by the insurance company.
In the original story, published by the Manchester Times and Tullahoma News, it was reported that during the Budget and Finance committee, “the Sequoyah Group told the committee an unnamed department or departments head had enrolled 11 ineligible employees in the health insurance plan. Two in particular total to over $600,000 in claims,” the story reads.
The matter came before the committee in asking for clarification on the request for proposal process for employee insurance.
“The article reads as if the county spent an extra $600K in money, which was misleading,” Cordell’s statement said. “It is very important that tax payers and citizens of Coffee County understand that this amount reflects claim dollars that the state medical pool paid out on behalf of the claimants and not the county.”
Cordell said in the letter submitted via county HR Director Heather Shelton, the $600,000 was actually noted and discussed by Sequoyah Group with the county after the claims information was received from the state.
“In reviewing the claims information at that time and looking at some of the large claimant’s information, it was determined that two (2) of the largest claimants may have not been eligible to be on the plan, as they were on extended medical leave, not qualifying for FMLA benefits,” the statement read. “By removing these high claimants from the claims information this improves the medical loss ratio, claims to premiums which impacts the marketability of the county directly with the insurance carriers. The previous article stated there were eleven (11) ineligible employees which is not accurate. There were close to eleven (11) claimants in the last twelve (12) months data that was shown.”
“(These individuals) should not even been on the county plan,” Greer was quoted as saying in the story. “They are not eligible for coverage. Those claims were paid and should not have been.”
Cordell also wanted clarified that his quote, “Don’t mention the department. You got the press here” was to protect the possibility that a claimant’s information might be released to the public. This conversation occurred during an open meeting, and all the material covered is public record.
Cordell did offer an explanation into the insurance process and noted therein that premiums in the county’s insurance pool are set by the state regardless of claims.
“This can greatly benefit a county that may not have good claims experience; however, depending on how the claims experience is there may be the opportunity to go direct to the insurance carriers and have a savings or more control over the benefits offered. When participating in the pool, the county cannot decide the plans, coverage, benefits or rates,” the statement said.