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Council approves master service and business associate agreements with UCS/Valens to audit five high health‑insurance claims
Summary
Council approved agreements with UCS Holdings Inc., doing business as Valens, to audit five high health claims for a $3,750 fee. The vendor retains 40% of any recovered savings; council said the audit may produce refunds and provide data for future benefit negotiations.
Emmaus Borough Council approved on May 19 a master service agreement and a business associate agreement with UCS Holdings Inc. doing business as Valens to audit five historically high health‑insurance claims.
Budget and finance committee members said the five claims total roughly $360,000 in billed amounts. The audit fee is $3,750; the vendor will retain 40% of any recovered savings and the borough would retain the remainder. "For them to audit the 5 high claims, whether they find anything or not, is $3,750," a council member explained. The company’s historical recovery on miscoding was summarized during the meeting as an illustrative estimate, not a guarantee.
Council members emphasized the audit does not change employee benefits or insurance arrangements and would not affect ongoing insurance coverage. The audit is intended to verify billing codes and charges on the identified high claims and, if errors are found and refunded by insurers, to return funds to the borough net of the vendor’s contingent fee.
Budget and finance members said the audit could also inform upcoming broker negotiations and that the borough is simultaneously evaluating proposals from several brokers. The agreements were approved after council members reviewed the documents and made the approvals contingent on the usual staff review process.
Staff said the audit timeline typically takes several weeks (the vendor estimated a 10–12 week review), and council will receive results and any recovered amounts when the vendor completes its work and insurers issue refunds, if any.
