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County hears from TAC HEBP on Blue Cross HRA errors, $177,814 in unprocessed claims; wellness use low
Summary
Texas Association of Counties HEBP told Cooke County commissioners that a Blue Cross administrative error left roughly $177,814.53 in HRA claims unprocessed for a span of months; consultants recommended vendor options and urged higher wellness engagement.
Cooke County Commissioners Court heard a presentation from the Texas Association of Counties Health and Employee Benefits Pool (TAC HEBP) about the county’s employee medical plan on March 18.
Jonathan Collinder, employee benefits consultant with TAC HEBP, told the court that Blue Cross and Blue Shield failed to process some Health Reimbursement Arrangement (HRA) claims for a span from July 2024 through February 2025. TAC HEBP estimates the amount of affected claims at $177,814.53. Collinder said Blue Cross agreed not to hold Cooke County responsible for reimbursing those HRA claims and that TAC HEBP will continue working with county staff to resolve outstanding issues.
Collinder reported the county’s most recent 12-month loss ratio at 112.41 percent — meaning premiums collected were exceeded by claims paid — and noted the three-year average remains higher. He said the county is trending toward improved loss ratios compared with the previous year and that TAC HEBP’s board will release renewal details in mid-May.
Collinder also presented options to move Cooke County’s HRA administration away from Blue Cross; TAC HEBP offered to cover first-year administration fees for a new HRA vendor if the county chooses to switch.
Michelle Gifford, TAC HEBP wellness consultant, reviewed wellness and utilization data. She confirmed musculoskeletal (MSK) conditions and pharmacy costs for anti-diabetic drugs are major drivers of plan costs. Preventive-exam participation among subscribers fell from 91 last plan year to 79 year-to-date; dental screenings rose slightly. Gifford encouraged stronger promotion of available no-cost programs through the pool — including MSK services, Livongo and Omada — and suggested county-specific incentives to increase preventive exams and program use.
No formal action was taken. Commissioners asked staff to continue working with TAC HEBP on renewals and on resolving the Blue Cross HRA processing issue.
