“Clerical error” by insurance carrier drops county retirees off plan accidentally

Thursday, September 8, 2022
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A clerical error on the part of the county’s insurance provider left retirees without coverage for a short time, causing alarm for a group of five retirees who are currently suing the county for trying to end their coverage.

There is currently a courtordered Temporary Restraining Order (TRO) in place preventing the county from proceeding with what was its’ planned termination of the retiree program on Aug. 31.

When the TRO was issued, the county notified its carrier — EBMS — and instructed it to continue the coverage for the retirees.

EBMS received notification of that from the county on Aug. 23. EBMS representative Tyrell Mailloux sent the following notification to Stillwater County Nancy Rohde, who forwarded it to the retirees’ attorney Melinda Driscoll.

“A clerical error was made, and members of the retiree Plan were terminated. They were reinstated on the plan as of September 6, 2022 via EDI file sent to Magellan on September 5th, retroactive to September 1, 2022 with no break in coverage,” wrote Mailloux.

The issue surfaced last Friday when retiree Carol Rice called the local pharmacy to set up her weekly shot, which requires preauthorization. Shortly after that initial conversation, the pharmacy called Rice back with alarming news.

“They said ‘your coverage has been terminated’,” Rice told the News this week.

Rice contacted Driscoll and the wheels began turning to find out what had happened. Rice called EMBS herself to find out what steps needed to be taken to resolve the issue and by the end of the day last Friday, nothing had been resolved. On Tuesday afternoon, Rice was finally able to get the preauthorization she needed for her shot.

Rice said that regardless of who made the error, it should not have happened — especially considering the overall circumstances.

“A professional doesn’t allow that to happen,” said Rice.