Texas Healthcare Insurance Administrator Not Subject to Statutory Penalties for Alleged Delayed Claims Payments
Summary: The plaintiff healthcare insurance administrator acts in various roles including administering some plans that expressly assume the risk of medical costs and establish their own benefit plans, including employer self-funded plans, state government plans, and claims arising under the BlueCard program allowing out-of-state patients to obtain care in Texas. Plaintiff also services benefit plans for federal employees in Texas under the Federal Employee Health Benefits Program (“FEHBP”).