Adams County officials question practice of prepaying MedAir membership premiums

Adams County supervisors on Monday questioned a practice in which the county pays an emergency membership vendor up front and then recoups the cost from employees through payroll deductions.

County staff told the board that State Audit advised the practice appears to amount to advancing money to employees for work they have not yet performed and therefore is not legally permissible. "State audit has said that you cannot pay people in advance for work they hadn't done," a county staff member said during the discussion.

The matter concerned a county cafeteria-plan option provided by a membership vendor identified in the meeting as part of the Air Medicare network / MedAir EVAC program. Under the current setup, the county receives an invoice after enrollment and pays the vendor for the year; participating employees then remit the membership cost back to the county in payroll deductions spread over the year. MedAir's local membership sales manager, who identified herself only as Sherry, told the board the arrangement predated her tenure and that the company had informed employees it would allow payment over 24 pay periods. Sherry said this year's invoice is $3,500 and that MedAir could work with the county "to offer some other option for the county to pay to where they're not paying it upfront."

County officials expressed two related concerns: (1) if an employee leaves before the payroll deductions recoup the full premium, the county may have to collect the balance from the former employee; and (2) paying the vendor up front exposes the county to vendor insolvency or other vendor-side risk. "If they were to go bankrupt or something along those lines...that would be a question," one supervisor said.

The board did not take a formal vote on the matter. Supervisors directed staff to work with the vendor and the county's insurance/finance staff — and to consult State Audit guidance — to develop a legally permissible alternative for handling enrollments and payments, including options that would avoid county prepayment.

Clarifying details the board discussed included: the company had told employees enrolled this year they would be on a 24-payroll-deduction schedule; the lowest one-year membership package cited in the meeting was $70 per year (about $5.83 per pay period if spread over 24 pays); and this year's vendor invoice presented to the county was $3,500. County staff said they had asked the vendor to change the setup so the county would instead "pass through" the premium like other cafeteria plans, rather than advance payment to the vendor.

The discussion was framed as a legal and administrative concern rather than a policy endorsement; staff said they would return with a proposal that meets State Audit requirements before the next enrollment period.