Insurer Meritain Health challenges Augusta's bid award to Blue Cross Blue Shield of Georgia

One of the five providers to bid to administer Augusta’s new self-funded health insurance pool is protesting the Au­gusta Commission’s Oct. 16 decision to award the bid to Blue Cross Blue Shield of Georgia.


The legal challenge by Aetna subsidiary Meritain Health Inc. alleges the city procurement office used miscalculated cost data in recommending Blue Cross Blue Shield to the commission. It also alleges the office made a last-minute change to the request for proposals to which only Blue Cross Blue Shield, as the city’s current health-insurance provider, had the data to evaluate and make an appropriate response.

Meritain attorney William Keogh said the company’s bid was as much as $900,000 less than that of Blue Cross Blue Shield to run the program of insuring about 2,270 city employees and their dependents, according to protest documents attached to Monday’s administrative services committee agenda.

In a response, city attorney Kenneth Bray said Blue Cross Blue Shield’s possession of recent claims information, which Meritain sought to address the cost of a stop-loss underwriting policy to cover large unforeseen claims, was “an unavoidable result” of them being the city’s current provider. He said any errors were the fault of Blue Cross Blue Shield.

Meritain was ranked highest in the first two phases of evaluation by a committee, but the city’s decision at that point to require a “no laser” policy at both initiation and renewal of the stop-loss policy – an arrangement that prevents stop-loss providers from excluding large claims – gave Blue Cross Blue Shield a definitive advantage, according to the bid protest.

The administrative services committee will determine whether to uphold city Administrator Fred Russell’s decision to deny the protest at its Monday meeting, set to start at 1:05 p.m. The full commission has a called legal meeting at 12 p.m. before the administrative services, engineering, public services and public safety committee meetings.

In other committee business, commissioners will be asked to:

• Renew an agreement with Au­tomatic Data Proces­sing to handle employee automated benefits and time and labor management services, at a total projected cost of $519,300

• Discuss the lease of the former Augusta Youth Develop­ment Center for a new sheriff’s substation, at the request of Commissioner Matt Aitken

• Discuss implementation of a storm water fee, at the request of Commissioner Alvin Mason

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Committee agendas


Sat, 01/20/2018 - 21:01

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