HomeMy WebLinkAboutMemorandum - Office of the City AttorneyCITY OF MIAMI
OFFICE OF THE CITY ATTORNEY
MEMORANDUM
TO: The Honorable Mayor and Members of the City Commission
FROM: Julie O. Bru, City Attorneys
DATE: May 25, 2011
RE: Proposed Resolution for City Commission Meeting — June 9, 2011
Resolution authorizing the City Attorney to seek all relief against
responsible parties relating to the failure to pay amounts due under the
medical stop loss insurance policies issued to the City of Miami.
File No. 11-00479
The Department of Risk Management sought to limit the City of Miami's expense
incurred on behalf of individual beneficiaries under the City of Miami's health insurance plan. In
furtherance of that goal, the City of Miami has contracted with numerous parties since 2005 to
obtain insurance coverage for individual health insurance claims in excess of certain substantial
amounts. In addition to contracting with these so called "stop loss" insurance carriers, the City of
Miami also contracted with various parties to ensure that all information required by the "stop
loss" carriers was timely transmitted from the City's health insurance claims administrator to the
"stop loss" carriers.
"Stop loss" carriers that entered into contracts with the City of Miami have failed to pay
claims due under the policies. Defenses raised by the "stop loss" carriers have included the
failure to timely submit information. Despite demands the "stop loss" carriers refuse to comply
with the terms of the "stop loss" policies.
The Office of the City Attorney is evaluating the policies and related information. If the
evaluation proceeds along its current tract, more than $1 million may be due to the City.
Accordingly, this Office recommends approval of a Resolution to authorize the Office of the City
Attorney to pursue through all legal means including, but not limited to, lawsuits in Miami -Dade
County Circuit Court, all relief possible against all responsible parties including, but notlimited
to, the City of Miami's medical "stop loss" insurance carriers and medical "stop loss" insurance
liaisons relating to the failure to pay amounts due under the medical "stop loss" insurance
policies issued to the City.
cc: Tony E. Crapp, Jr., City Manager
Elvi Gallastegui, Agenda Coordinator
Attachment(s)
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