Council authorizes switch of health‑plan third‑party administrator to Allied Benefits

Selma — The City Council approved Aug. 19 a staff recommendation to change the city’s health‑plan third‑party administrator from the incumbent to Allied Benefits.

Staff and the health‑insurance committee said the proposed change is administrative (the medical, dental and vision benefit designs are unchanged) but would address ongoing operational issues with the incumbent TPA, including claims processing problems and inadequate system support for the city’s payroll practice of employees prepaying a month of coverage. The committee reported Allied’s bid was roughly $2,000 higher than the current TPA but offered stronger vendor performance, Blue Shield/Blue Cross relationships and integrated telehealth access via an Allied app.

HR/benefits staff told the council the current TPA had been placed on notice by a major insurer for service issues and was limited in writing new business, prompting the committee to pursue a change to avoid future disruptions. The committee also expects Allied to provide enhanced claims review services and negotiation support for high‑cost claims.

Council action and next steps - Council authorized the city manager to execute a contract with Allied Benefits for TPA services and directed staff to proceed with open‑enrollment preparations under the city’s benefits calendar. - Staff will notify the incumbent TPA and proceed with implementation activities necessary for effective coverage continuity. Benefits changes (plan design, premiums) were not decided at this meeting and will be discussed separately during the committee’s fall meetings.

Why it matters The TPA handles claims adjudication for the city’s self‑insured arrangements; vendor performance affects claim payment accuracy, administrative burden and potentially the city’s long‑term costs. Council and staff framed the change as a risk‑management move to secure reliable plan administration and support.