City council takes formal action on employee’s health plan challenge

    At its third special meeting on the topic last month, Imperial city council members formally denied an appeal to a decision on the city’s employee health plan coverage.
    At the Aug. 25 meeting, the council voted 4-0 on the denial, which for the first time, named the Leibhart family as the party making the appeal.
    In the motion, the council outlined their reasoning for voting to turn down the appeal by the Leibharts regarding medical claims related to injuries sustained by Brock Leibhart, a plan beneficiary.
    Brock Leibhart’s father, Dan, is employed by the city of Imperial in its public works department.
    The motion stated, “There is insufficient evidence to overturn the initial Adverse Benefit Determination made by Lucent Health, the third party administrator for the city’s health plan.”
    The motion also cites the “illegal acts” exclusion in the benefit plan which “precludes payment for medical expenses incurred by the Leibhart family.”
    In July, the city hired attorney David Dudley as legal counsel for the issue. He was directed to transmit last week’s council action to the Leibharts’ attorney.
    The medical claim challenge has been a topic at the council’s special meetings in August, all of which were in closed session.
    Leyland said last week’s meeting and formal vote on denying the claim was necessary since the council as the health plan administrator had to take action within a specific time period after the Leibharts, through their attorney, gave notice they were appealing.
    As third party administrator, Lucent Health makes the initial decisions on payment or denial of all claims submitted on the city’s plan.