Girard files suit over its health plan
Says companies, individuals have mismanaged it
GIRARD — City officials have filed a civil lawsuit alleging mishandling of employee health plans by the companies and individuals responsible for managing the city’s self-funded health plan.
The suit was filed Tuesday in Trumbull County Common Pleas Court against WJL Administrative Services LLC, Deborah A. Lovell, Health Plan Administrators LLC, and Pamela S. Priddy as defendants.
In the lawsuit, city officials allege the defendants failed to correctly process medical claims.
The lawsuit states that the city contracted with the third-party administrators to manage its health plan and claims the companies did not follow an agreement to pay insurance claims after the contract ended.
According to the lawsuit, that alleged failure left the city with more than $200,000 in unpaid medical bills.
The lawsuit includes allegations of breach of contract, negligent misrepresentation and civil theft. The city is asking for monetary damages to cover the losses and a court order to fix the issues.
Officials said the health plan is used by municipal employees and their dependents and some employees had to pay for medical costs out of their own pockets because of the errors.
Mayor Mark Zuppo said the city is taking legal action to protect the financial security of its workers. He said the city remains steadfast in safeguarding the interests of its employees and the integrity of the health plan. Zuppo said the city is taking appropriate legal measures to protect the health and financial security of the city and its employees.
The suit states a main concern is “a run out agreement” between the city and WJL and HPA to ensure that insurance claims incurred during a policy period are still processed after the insurance contract ends.
According to the suit, WJL and HPA did not process claims in a timely manner and misled those at the city to believe they were processed, leaving the city to cover unprocessed claims with balances over $200,000. Individual employees also were faced with out-of-pocket expenses.


