BREAKING: Firm that bungled school employee health claims sued
Burlington Education Association Sues Firm that Bungled Educator Health Claims
The state’s largest union says Future Planning Associates committed consumer fraud and breach of contract
MONTPELIER—The firm responsible for causing thousands of Vermont educators’ medical bills to be unpaid was fraudulent when it pitched its services to the state’s school districts, according to a lawsuit filed today by the state’s largest union.
In its filing on behalf of the Burlington Education Association and others in Vermont Superior Court, Vermont-NEA accused Williston-based Future Planning Associates of consumer fraud and breach of contract. The suit seeks unspecified damages.
The failure of Future Planning to properly process claims and reimbursements has wreaked havoc on thousands of educators, some of whom avoided medical procedures, left prescriptions unfilled, and were refused care because of unpaid bills. Some were also threatened with collection agencies because of the unpaid bills.
“Unfortunately, the expertise touted by Future Planning Associates didn’t exist,” said Don Tinney, a long-time high school English teacher who serves as the president of Vermont-NEA. “Their incompetence has had real consequences on the women and men who teach Vermont’s children. By filing this lawsuit on behalf of our local associations, we are making it clear that Future Planning caused great harm to our members.”
Vermont school districts relied on Future Planning’s assertions that it was experienced and had the capacity to manage claims for high-deductible health plans, the type of plans all Vermont educators switched to on Jan. 1, according to the lawsuit.
“In the fall of 2017, in reasonable reliance on FPA’s advertising, self-promotion, express promises and fraudulent misrepresentations, approximately 80 percent of Vermont public schools were persuaded to contract with FPA – allegedly the premier firm providing [third party administrator] services in northern New England -- to administer the high deductible [Blue Cross/Blue Shield] health plans covering their employees,” the suit said.
It was clear that Future Planning was not up to the task, according to the filing. “The crisis generated by FPA’s business mismanagement, by its deliberate minimization of the problems that it had caused, and by its abrupt termination of contracts with public-school clients was unprecedented,” the suit said. “The magnitude and scope of the problems were, and remain, staggering.”
After a little over two months, Future Planning abruptly notified districts that they were terminating their contracts withdrawing from their contracts in May. The suit said that when they did so, they failed to accurately and completely disclose the magnitude of the problem with unprocessed or incorrectly processed payments, claims, and reimbursements.
The mess Future Planning left was so massive, the suit says, that the company contracted by most districts to replace them has needed months just to review and clean up botched claims, reimbursements, and payments.
The new company “soon discovered that the true scope and complexity of the problems caused…were much worse than what [Future Planning] had represented and much worse than anyone had initially believed,” the suit said.
In total, Future Planning left more than $1.1 million of claims, payments, and reimbursements unprocessed or processed incorrectly, the suit said. More than 24,000 school employees’ health reimbursement arrangements were managed by Future Planning.
Although Future Planning’s contracts were between them and school districts, school employees are third-party beneficiaries, meaning Future Planning is responsible for the harm caused to educators, the suit said.
The union is seeking a jury trial.
Editor’s Note: You can read the suit here.
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