Modesto’s unpaid medical claims top $8.3 million. City has a plan to pay them.
City officials will ask the
The plan is based on the premise that the health care providers will be willing to accept less than full payments for their outstanding claims. "We are going with the assumption that we will be successful with this approach," Deputy City Manager Caluha Barnes said in an interview.
Barnes said that confidence is based on several factors, including that providers could be eager to settle for less than the full amount to resolve claims that are many months old, and in some cases more than a year old, and that the city will hire an experienced claims administrator to negotiate and settle the claims.
City officials are proposing Modesto hire
Barnes stressed that
She said S&S has full access to Modesto's unpaid claims, a track record in negotiating and settling claims, and an incentive to succeed. S&S only gets paid when it settles a claim, with the company receiving 20 percent of the amount it saves Modesto.
For instance, if S&S settled a
The city switched to a new health insurance provider effective
The premiums for the new insurance are about 50 percent higher than Riverstone's, though that is the total increase in premiums and individual city employees who cover their dependents are facing significantly higher increases.
For instance, an employee with dependents who had been paying about
Employees have asked for more relief for the rest of 2019. Barnes said Modesto continues to discuss this with its labor groups but did not provide specifics.
The
The estimated
City officials may need to ask the council for more money at a later date. A city report calls the
But Barnes said Modesto has what is called stop loss insurance in which the insurer picks up the amount of individual claims that exceed
She said she will report to the
Barnes said city officials are recommending the council move forward to resolve these claims in order to put this behind the city and its employees. The city continues to look at its legal options against Riverstone and
The
The judge wrote that the
But Modesto was scrambling well before the
Modesto was facing steep increases from its then insurance provider when it choose Foy and Riverstone to provide health insurance for three years starting
But that has raised questions over whether the deal was too good to be true.
Modesto spokesman
The council meets at
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