A suit was filed on Thursday in the Northern District of Georgia by plaintiff Trustmark Health Benefits, Inc. against the Walton County Board of Commissioners (BOC), MSI Benefits Group, and Matthew S. Bidwell. The complaint alleges that the BOC breached an administrative services agreement between them and the plaintiff which was signed in July of 2021.
Trustmark is a company that “contracts with public and private health plan administrators to provide third party claims review services.”
When the BOC chose to opt out of a group health program that was available to all Georgia counties, they turned to the plaintiff and solicited a “proposal for administration of health claims and stop-loss insurance coverage in connection with [BOC’s] self-funded health and welfare benefit plan.”
After the plaintiff provided proposals for 12 and 24 months, defendant BOC entered into a 36-month agreement with discounted rates and an annual wellness credit of $50,000.00. Trustmark then worked with the defendant’s broker to “implement the relationship and commenced providing claims administration services to the Plan.”
After the agreement was provided to BOC’s broker, BOC opted to change brokers, which resulted in revisions being made to the administrative services agreement, including adjusting the agreement to be 24 months rather than 36. The plaintiff explains that they ensured the agreement reflected this timeline change and forwarded the draft to the BOC and their broker. However, the broker sent the agreement back with an adjusted timeline again, changing it back to 36 months.
The plaintiff claims they then forwarded the final draft of the agreement to BOC’s new broker, MSI, clarifying, “Are you OK getting this signed?” in reference to the adjusted timeline. The signed agreement, reflecting the 36-month term, was returned to the plaintiff five days later with signatures from both the BOC and MSI.
When the opportunity to reenter the state of Georgia’s group health program became available, the BOC had their lawyers contact defendant Bidwell at MSI to inform him of their belief that the agreement they had with the plaintiff was “void and unenforceable,” thus allowing them to terminate it prior to the end of the agreed upon 36-month term. Shortly thereafter, MSI informed the plaintiff of the BOC’s termination of the administrative services agreement.
The complaint cites breach of contract, equitable estoppel, fraudulent misrepresentation, fraud in the inducement, negligent misrepresentation, and negligence. The plaintiff is seeking for the court to find and hold the administrative services agreement, and in the event the defendant continues to breach the agreement, they seek compensatory and consequential damages. The plaintiff also seeks favorable judgment on each count, punitive damages, litigation fees, and any other relief deemed equitable by the court.
The plaintiff is represented by Wilson Elser Moskowitz Edelman & Dicker, LLP.
