10/24/2017 Resolutions 2017-303RESOLUTION 2017-303
WHEREAS, the City Of Grand Island (City) has an administrative
services agreement with Blue Cross and Blue Shield of Nebraska (BCBSNE) for payment
of employee health care expenses and provision of stop loss insurance (the "Plan"); and
WHEREAS, BCBSNE subrogates health care claims paid on behalf of the
City; and
WHEREAS, at the time of the conversation with an injured city
employee's attorney, a BCBSNE employee failed to recognize that a claim in the amount
of $113,214.87 had been processed by BCBSNE on July 18, 2017. Had the claim been
identified, the Plan's total lien amount at the time of the conversation would have been
$141,754.89; and
WHERAS, pursuant to the made whole doctrine in Blue Cross and Blue
Shield ofNebraska, Inc. v. Dailey, 268 Neb. 733 (2004), an insurer cannot recover under
subrogation unless the insured has been made whole; and
WHEREAS, due to the application of Dailey to the Plan, the most that the
Plan would have recovered, without pursuing litigation, is 50% of its lien amount at the
time of settlement (i.e., $70,877.45); and
WHEREAS, because of its error, BCBSNE offered to compensate the Plan
in an amount equal to $46,687.00 (i.e., $70,877.451ess the $24,190.53 already recovered
by the Plan) in full and final resolution of this issue.
NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND
COLTNCIL OF THE CITY OF GRAND ISLAND, NEBRASKA, that BCBSNE's offer to
compensate the City Plan in the amount of $46,687.00 is approved and the Mayor is
hereby authorized to execute the agreement by and between the City of Grand Island and
Blue Cross and Blue Shield of Nebraska.
Adopted by the City Council of the City of Grand Island, Nebraska, on October 24, 2017.
Attest:
O.u.. t.�Q1�,
RaNae Edwards, City Clerk
Je em L. s, Mayor
Approved as to Form tt
October 23, 2017 Ci ttorney