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County health plan administrator says TPA change is clearing claims backlog; RFP for 2027 administration planned
Summary
William Rustenberg said returning claim administration to Sentivo has triggered payment of previously delayed claims (1,441 claims totaling $546,438 processed since April 1) and that a request for proposals for plan administration will be issued for the 2027 plan year.
William "Bill" Rustenberg told the court the San Patricio County employee health plan experienced delayed payments after administrative changes last October, but the county moved administrative claim functions back to Sentivo (the longstanding third‑party administrator) and is now processing previously unpaid claims. "Since April 1 through last week, Sentivo has processed 1,441 claims for a total payout of $546,438," Rustenberg said, and he forecast that remaining unpaid claims would be resolved "in the next two or three weeks," subject to normal documentation processes.
Rustenberg emphasized the plan's solvency and said prescription drug spend is down due to enforcement and competitive sourcing. He also said the county would issue a request for proposals this week for plan administration services for the 2027 plan year and that routine member concerns (for example, primary‑care physicians temporarily not accepting patients) should be routed through HR so the plan can help resolve access issues.
