GILMER–Upshur County Commissioners Court on Wednesday of last week chose a new third-party administrator for the county’s health insurance plan and rejected retaining the current one, effective Oct. 1.

The court accepted a recommendation by its newly-hired consultant, Tyler-based Employee Benefits Consulting, to name Assured Benefits Administrators of Dallas, thus rejecting competing proposals from the current administrator, Tyler-based HealthFirst, and Boon-Chapman, which has an office in Austin.

In making her recommendation, Rachel Means of EBC told the court that while she had no issue with HealthFirst, the county had a “certain level of distrust” of that firm which involved “a lot of fees.” She recommended the court either stay with HealthFirst and pay a little more or choose ABA, but said officials should choose ABA if they were serious about saving money and getting the best plan.

Means also said her firm had a “very good relationship” with the Dallas organization.

The third-party administrator monitors and pays medical bills for the self-insured county’s officials and employees. The county in turn reimburses the administrator.

Means also said that while workers have a lower deductible at Tyler medical facilities than at Longview’s, only 23 percent of current claims go through the Tyler network. She said the $1,000 deductible in Longview should be “flip-flopped” since Longview is closer to Gilmer than Tyler, and that she wanted to lower the deductible “the closer the care is.”

She also said workers are not required to go to a certain doctor and that “y’all can go to any pharmacy you want.”

Means told the court her job was focusing on claims, that her firm had put the “stop-loss” total out for bids, and that it was making sure third parties do not “take advantage of you.”
She also said EBC had already saved the county benefit plan about $16,000, more than the county had paid EBC so far.

The court also last week approved possibly re-establishing the position of information technology coordinator. Commissioners also took no action on a proposal to admit certain roads to the county road system for maintenance after a two-year waiting period instead of the recently-approved four years.