Liberty County Insurance Audit Finds Six Potentially Ineligible Members

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Commissioners heard a report from the County Treasurer, Kim Harris, who also oversees the human resources department, which details the results of a dependency eligibility audit with the county's self-financing insurance.

On April 10, 2018, the court authorized PlanSource to conduct the audit to verify that each member of the plan was eligible for coverage.

The consequences for ineligible persons were termination of the plan and the possibility of recovering any expense on their behalf.

"I think the audit went well and made it possible to achieve what we are trying to do," Harris said.

As county insurance is self-financing, Harris and the commissioners wanted to avoid any type of fraud or misuse of funds.

"Every dollar donated comes directly from the county fund and is administered by Blue Cross Blue Shield," said the treasurer.

"They extract money from our bank account to pay these claims. No one wants to be ineligible because it is important to keep every penny in this account, "she said.

Harris was concerned about the PlanSource report and asked to extend the deadline.

"I think there was some confusion among some groups of employees about what they needed to get back to PlanSource. Some of them thought they submitted everything to comply with the audit but did not do so, "she said.

Harris said the deadline was set for the middle of the holiday season, December 18, and some may have missed the deadline inadvertently.

She noted that PlanSource had sent 200 letters to employees whose plan had dependents.

Of these 200 employees, 22 employees did not answer at all.

She discovered that some of the people involved were employees who were abandoning the blanket anyway.

"These really do not need an answer," she said.

29 others did not have enough documentation, according to PlanSource.

Further examination showed that some of them had excluded the delivery of a copy of the back of the driver's license.

"That does not seem to me relevant and I think it would be a pettiness to remove somebody from the cover because he's submitted everything except the back of the driver's license," Harris told the commissioners.

Six members, approximately 3% of those with dependents, were found to be ineligible.

"There are employees who acknowledge having dependents who are ineligible for our plan and have chosen to terminate their coverage (by themselves)," Harris said.

Harris said that she had just received the report the day before.

"Now that we have the list of people who have not responded or partially complied with the audit, we can contact these people and say," Here is the situation. That's what you have to do, it's your last chance, and if you do not comply with it by the date chosen by the court, your coverage will be terminated, "she said.

Harris has asked the Commissioners for a 30-day extension starting January 8th.

Commissioner Leon Wilson asked Harris to forward the names of the non-compliant list or missing documents to their supervisors so that they could follow up with their employees to ensure that the paperwork was completed. completed on time, and Harris agreed.

In addition to terminating the coverage of those who are not eligible for coverage, the commissioners also wanted to deal with the reimbursement of expenses on behalf of those who were not supposed to be covered.

Harris did not recommend it, but asked the court to attack it because they had requested verification.

In an application by Commissioner Bruce Karbowski, the court excluded the refund until the end of the 30-day extension.

Harris said she could change her mind when she claims damages from those who took the county's funds as ineligible members.

"It depends on what I find in the final analysis on each of these," she said.

"I did not do a full review of the situation of the six non-eligible dependents," she said.

"I need time to consider what the situation was and why they were on our plan and ineligible to start."

Harris said that this could be something as simple as not submitting any information or incorrect information, but that she would spend the next few days investigating the circumstances.

The requirements for insurance and the addition of dependents include a spousal affidavit and a marriage certificate for the spouse, and even a birth certificate for the claim of children enrolled in the plan. She said that they were trying to do due diligence to make sure that only those who are supposed to be covered by insurance are genuine participants.

"This is a grace period, but at the end of this period, we may have to ask them to pay back their claims," ​​she said. It would be a legal matter referred to Matthew Poston, County Attorney.

In other lawsuits, the commissioners claimed $ 1,434.60 to the city of Plum Grove to get a refund of money in accordance with an interlocal agreement, up to $ 1,444.60. 39 that Commissioner James Reaves be present at the meeting. Commissioner Greg Arthur was also absent from the meeting.

The court also approved a preliminary platform for Encino Estates, Section 2. The plans had already been submitted to LJA Engineering. Jay Wilkerson of Encino Estates said that they had already sold Section 1 with 392 lots and that Section 2 had sold 100 additional lots discussed with two builders willing to continue construction.

dtaylor@hcnonline.com