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County has $367,000 claim against former health insurer

Washington County is currently in arbitration with its former health insurance administrator and policy holder, with the county claiming it is owed more than $360,000.
The dispute is over how much coverage the county had under its policy, said County Attorney John Rambo.
Corporate Systems was the health insurance administrator when the county was self-insured.
The county was under the impression it had a “stop loss” program, which is coverage purchased by the county to limit its exposure under self-insurance — basically to limit the amount of money it can pay out at a certain level.
The county had gone over its decided limit on the stop loss program, and so expected to not have to pay under its selected policy.
“The county thought it had purchased a policy that provided more coverage than what the policy we actually ended up getting,” Rambo said.
The county claims Corporate Systems purchased the wrong policy, one with out a stop loss limit, despite the fact the county wanted and thought it had a policy with the program, Rambo said.
“Corporate Systems said actually, they did purchase the right policy,” Rambo said.
But the actual insurance policyholder is not acknowledging that the county had a stop loss
The dispute is over how much coverage the county actually had.
If there was a stop loss program in the policy, the county would be owed $367,000, he said.
Right now, the county is in arbitration with Corporate Systems, and is also making an appeal to the policyholder asking it to reconsider the county’s claims.
A lawsuit “could happen,” Rambo said. “It would probably include everybody just to clarify the responsibility between parties.”