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County health fund strained after TPA chargebacks; officials consider benefit changes for FY27
Summary
Union County said a prior TPA underreported claims leading to about $5 million in chargebacks; rising specialty‑drug costs (notably GLP‑1 drugs) and increasing utilization forced a drawdown of the health fund and will prompt consideration of plan‑design changes and a fund replenishment plan for FY27.
County staff told commissioners that a prior third‑party administrator underreported paid and pending claims, producing roughly $5 million in chargebacks that reduced the county’s health fund. Staff said the county is self‑insured and bore the cost when denied claims processed during the TPA run‑out converted to paid claims.
Officia…
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