Claims Have Doubled But Blue Cross Is Free

“We do not pay Blue Cross to administer our plan at all.”

(WARNING: Excessive head scratching leads to baldness. Reader beware).

Hoodwinked School District Believes They Get Free TPA Claim Administration

The Edinburg Independent School District awarded their self-funded group medical plan to Blue Cross in 2018. Plan spend has since increased from $20,000,000 to +$40,000,000 in five years.

But, they believe, Blue Cross is costing them nothing. (Read on, it gets better)

The believe their BCBS admin fee is a negative $70.82. In other words they believe Blue Cross is paying Edinburg Independent School District for the privilege of providing free administration.

That’s got to look good on a Request for Proposals spreadsheet.

“This charade is the equivalent to a car dealer giving a trade-in value off an inflated, arbitrary number, while selling the new car above factory invoice. The customer thinks it is a good deal. The car dealer ends up with a free used car and earns a profit off the new car.” Hoodwinking – A Popular & Proven Sales Strategy


THE TRUTH (as we see it) About the Blues PPO Discounts

Cool Hand Luke Starring Tommy Taylor

Edinburg ISD Seeks Insurance Consultant

Edinburg ISD Issues Gag Order During RFP Process

Edinburg ISD Ranks Ten Insurance Consultants

Insurance Consultants Make Pitch To ECISD

ECISD & DHR Establish On-site Health Care Clinic

School District Learns PPO Allowed = 338% of Medicare

Claim Audit Exposes Managed Care Reimbursement Levels

Where Did Our $19,000,000 Go?

Joe Wilson’s Frontier DPC Presentation To 7,200 Member School District