Case 1:22-cv-02514-AT Document 1 Filed 06/23/22 Page 1 of 20
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`UNITED STATES DISTRICT COURT
`NORTHERN DISTRICT OF GEORGIA
`ATLANTA DIVISION
`
`
`TRUSTMARK HEALTH
`BENEFITS, INC.,
`
`
`Plaintiff,
`
`
`vs.
`
`
`
`Civil Action File No.:
`
`
`WALTON COUNTY BOARD OF
`COMMISSIONERS, MSI
`BENEFITS GROUP and
`MATTHEW S. BIDWELL,
`
`
`Defendants.
`
`
`
`
`
`
`COMPLAINT
`
`
`
`Plaintiff Trustmark Health Benefits, Inc. (“Trustmark”), by its undersigned
`
`counsel, complains of Defendants Walton County Board of Commissioners
`
`(“BOC”), MSI Benefits Group (“MSI”) and Matthew S. Bidwell (“Bidwell”)
`
`(collectively “Defendants”) as follows:
`
`The Parties
`
`1.
`
`Trustmark is a company, incorporated under the laws of Delaware with a
`
`principal place of business in Lake Forest, Illinois. Trustmark contracts with public
`
`and private health plan administrators to provide third party claims review services.
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`272313435v.1
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`1
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`
`
`UNITED STATES DISTRICT COURT
`NORTHERN DISTRICT OF GEORGIA
`ATLANTA DIVISION
`
`
`TRUSTMARK HEALTH
`BENEFITS, INC.,
`
`
`Plaintiff,
`
`
`vs.
`
`
`
`Civil Action File No.:
`
`
`WALTON COUNTY BOARD OF
`COMMISSIONERS, MSI
`BENEFITS GROUP and
`MATTHEW S. BIDWELL,
`
`
`Defendants.
`
`
`
`
`
`
`COMPLAINT
`
`
`
`Plaintiff Trustmark Health Benefits, Inc. (“Trustmark”), by its undersigned
`
`counsel, complains of Defendants Walton County Board of Commissioners
`
`(“BOC”), MSI Benefits Group (“MSI”) and Matthew S. Bidwell (“Bidwell”)
`
`(collectively “Defendants”) as follows:
`
`The Parties
`
`1.
`
`Trustmark is a company, incorporated under the laws of Delaware with a
`
`principal place of business in Lake Forest, Illinois. Trustmark contracts with public
`
`and private health plan administrators to provide third party claims review services.
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`Case 1:22-cv-02514-AT Document 1 Filed 06/23/22 Page 2 of 20
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`2.
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`BOC is the governing body of Walton County, Georgia, and a citizen of
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`Georgia. BOC is the plan sponsor of a self-funded health and welfare benefit plan
`
`for eligible employees of Walton County and their dependents.
`
`3.
`
`MSI is an employee benefit consulting and brokerage firm organized under
`
`the law of the State of Georgia with its principal place of business in Kennesaw,
`
`Cobb County, Georgia.
`
`4.
`
`
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`Bidwell is a licensed insurance broker, affiliated with MSI, with extensive
`
`experience in employee welfare benefit programs, specifically, health benefit
`
`programs, for Georgia’s municipalities and counties. Bidwell is a citizen of Georgia.
`
`Jurisdiction and Venue
`
`5.
`
`This Court has original jurisdiction over this lawsuit pursuant to 28 U.S.C.
`
`§1332(a)(1) in that there is diversity between the parties and the amount in
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`controversy exceeds $75,000.00.
`
`
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`
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`6.
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`Venue is proper in this district pursuant to 28 U.S.C. §1391(a)(2) since a
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`substantial part of the events or omissions giving rise to this claim occurred within
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`the Northern District of Georgia.
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`Nature of Action
`
`7.
`
`Trustmark seeks damages for BOC’s breach of the Administrative Services
`
`Agreement (“ASA”) entered into between Trustmark and BOC effective July 1,
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`2021, and fraudulent misrepresentations regarding same, and as a result of MSI’s
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`and Bidwell’s respective fraudulent and negligent actions and omissions in
`
`brokering the ASA. A true and correct copy of the ASA is attached hereto as Exhibit
`
`A (“Ex. A”) and fully incorporated by reference herein.
`
`Statement of Facts
`
`8.
`
`After BOC decided to opt out of the group health program available to all
`
`Georgia counties, the ACCG group health program, BOC’s then broker Insurance
`
`Office of America (“IOA”) solicited Trustmark’s proposal for administration of
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`health claims and stop-loss insurance coverage in connection with BOC’s self-
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`Case 1:22-cv-02514-AT Document 1 Filed 06/23/22 Page 4 of 20
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`funded health and welfare benefit plan (“Plan”), with 562 participating employees
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`and their respective dependents, starting July 1, 2021.
`
`9.
`
`Trustmark provided proposals for 12 and 24 months of services. BOC
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`subsequently appointed IOA as its broker of record and elected to enter into a 36
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`months/3 year agreement at discounted rates with an annual wellness credit in the
`
`amount of $50,000.00.
`
`10.
`
`Relying on BOC’s representations, Trustmark worked with IOA to implement
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`the relationship and commenced providing claims administration services to the Plan
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`on July 1, 2021.
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`11.
`
`On July 28, 2021, Trustmark provided IOA with the ASA, memorializing the
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`terms of the relationship between Trustmark and BOC for a period of three (3) years,
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`stating “[p]lease have the County sign and return a copy to us. Our Regional
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`President will sign and we’ll return a fully executed copy to you.”
`
`
`
`
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`
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`12.
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`In September 2021, due to service and implementation issues, BOC changed
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`its broker of record from IOA to MSI, its previous broker since at least 2016. The
`
`meeting minutes reflect the following:
`
`Discussion and possible action regarding Healthcare Broker - Insurance
`Office of America Human Resources Director Melissia Rusk addressed
`the Board with concerns and problems the County is experiencing with
`Insurance Office of America and requested that the services of
`Insurance Office of America be terminated immediately and that the
`Board return to a contract with MSI Benefits, the former broker. She
`stated that employees and covered dependents have experienced a total
`of 623 medical and pharmacy denials since July1st. She also cited
`numerous examples of unacceptable customer service and support.
`Motion: Chairman Thompson made a motion to notify and terminate
`the services of Insurance Office of America effective today if possible
`and give HR Director Melissia Rusk the authority to specify the specific
`date. Commissioner Adams seconded the motion. All Commissioners
`including Chairman Thompson voted in favor.
`
`13.
`
`The change in BOC’s broker of record from IOA to MSI resulted in several
`
`revisions to the ASA, including reducing the term from 3 years to 2 years. Trustmark
`
`adjusted the ASA to reflect the desired changes and sent a final draft to Bidwell at
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`MSI on November 3, 2021, relying on his expertise in putting the ASA into effect.
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`The same day, BOC through its broker Bidwell at MSI, returned a signed copy of
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`the prior ASA draft provided in July, reflecting a 3 year term, to Trustmark.
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`
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`14.
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`On November 4, 2021, Trustmark sent the final ASA draft, which included
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`changes to the COBRA administration, to Bidwell at MSI, pointing out that the draft
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`now also reflected the three (3) year term and the COBRA administration changes,
`
`asking “[A]re you OK getting this signed? Or prefer we try to use the original
`
`signature you sent yesterday and handle the Cobra termination by a letter??”
`
`15.
`
`On November 9, 2021, Bidwell sent the signed ASA to Trustmark, bearing
`
`BOC’s Human Resources Director Melissia Rusk’s signature. Relying on the
`
`validity of Ms. Rusk’s signature, Trustmark’s Regional President Kimberly A. Fiori
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`countersigned the same day. See Ex. A.
`
`16.
`
`In reliance on MSI, Bidwell and BOC’s representations, Trustmark continued
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`to provide claims administration services to the Plan.
`
`17.
`
`In or around April 2022, BOC learned that the usual two year waiting period
`
`until permitted reentry into the ACCG group health program had been reduced to
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`one (1) year and received a proposal to rejoin. In an effort to do so and rid itself of
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`the contractual relationship with Trustmark, BOC involved its attorneys at Atkinson
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`Ferguson, LLC, who subsequently contacted Matt Bidwell at MSI, informing him
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`that in their opinion the ASA is void and unenforceable and asking him to let
`
`Trustmark know.
`
`18.
`
`Bidwell at MSI, as agent of BOC, informed Trustmark on April 27, 2022:
`
` […]
`
`The County Attorney at Walton has reviewed the contract in place for
`the administrative services with Trustmark. Please see his remarks
`below.
`The County is wishing for an amicable settlement on this issue. I think
`the County would like to be offered a contract to accept that would
`reflect the year arrangement in which they had coverage with
`Trustmark. Please let me know what Trustmark can do. Please feel
`free to correspond with the County Attorney, directly, if you feel that
`would be best. His information is below,
`Thank you.
`
`A true and correct copy of Bidwell’s April 27, 2022 email to Trustmark is attached
`
`hereto as Exhibit B.
`
`19.
`
`On May 6, 2022, MSI employee Zori Worrall, as BOC’s agent, informed
`
`Trustmark of BOC’s termination of its relationship with Trustmark as of July 1,
`
`2022. Her email states:
`
`[…]
`Walton County decided to change back to Anthem BCSB [sic] and
`wishes to cancel their coverage and services with Trustmark effective
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`Case 1:22-cv-02514-AT Document 1 Filed 06/23/22 Page 8 of 20
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`7-1-2022. The group is requesting Trustmark to administer runout
`medical claims.
`The FSA and DCA plans are also terminating with 60 days runout
`period. Please provided the carryover balances on September 1st, 2022.
`(I am so sorry to be the bearer of bad news.)
`
`A true and correct copy of Ms. Worrall’s email is attached hereto as Exhibit C.
`
`20.
`
`Attached to Ms. Worrall’s email on Walton County’s letterhead and signed
`
`by Chairman David Thompson was a cancellation notice dated “May 2022”, stating
`
`that “Walton County BOC wishes to cancel all services with Trustmark effective
`
`July 1, 2022. Please administer runout medical claims. […] We appreciate the
`
`service over the past year but have decided that a change is needed at this time.” A
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`true and correct copy of Chairman Thompson’s letter is attached hereto as Exhibit
`
`D.
`
`COUNT I AGAINST BOC
`
`BREACH OF CONTRACT
`
`21.
`
`Trustmark restates, realleges and incorporates its allegations set out in
`
`paragraphs 1 through 19 above as if fully set forth herein.
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`22.
`
`For due consideration, Trustmark and BOC entered into a valid and binding
`
`contract effective July 1, 2022, the ASA, according to the terms of which Trustmark
`
`rendered claims services to BOC’s health and welfare benefit plan for its eligible
`
`employees and their dependents and BOC paid Trustmark a monthly administrative
`
`fee. See Ex. A.
`
`23.
`
`The ASA is governed in accordance with the laws of the state of Illinois,
`
`without regard to conflict of law provisions. See Ex. A, p. 5.
`
`24.
`
`BOC’s Human Resources Director Melissia Rusk signed the ASA verifying
`
`that she was authorized to do so:
`
`Ex. A, p. 14.
`
`25.
`
`Pursuant to the terms of the ASA, and in reliance on IOA’s, MSI’s and BOC’s
`
`representations that Ms. Rusk was duly authorized to sign the ASA and bind BOC,
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`
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`Case 1:22-cv-02514-AT Document 1 Filed 06/23/22 Page 10 of 20
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`Trustmark provided and is still providing claims services to the Plan, administering
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`health benefit claims for BOC’s employees and their dependents, including for
`
`Chairman Thompson and the members of its board.
`
`26.
`
`During the negotiation of the terms of the ASA, BOC specifically requested a
`
`three (3) year term for the ASA and subsequently signed the ASA, providing as
`
`follows:
`
`6.01 Term. This Agreement and referenced Addenda shall be in effect
`for a period of three (3) years from the Effective Date (the “Initial
`Term”) and shall renew automatically thereafter for the successive one
`(1) year periods of time (each such period, a “Renewal Term” and
`collectively with the Initial Term, the “Term”), unless otherwise
`terminated or renegotiated in accordance with this Agreement. […]
`
`Ex. A, p. 3.
`
`
`27.
`
`The ASA provides as follows pertaining to a termination of the agreement:
`
`6.03 Termination. This Agreement may be terminated effective as of
`the time specified below:
`A. By either party, with or without cause, by giving written notice to
`the other party at least ninety (90) days prior to the last day of the
`applicable Initial Term or Renewal Term, effective at the end of the
`applicable Initial Term or Renewal Term; […]
`
`
`Ex. A, p. 3.
`
`
`
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`In direct breach of the ASA’s termination provision and the inherent covenant
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`28.
`
`of good faith and fair dealing, BOC sent a notice of cancellation of the ASA on May
`
`3, 2022, less than 60 days before the end of the first year of service.
`
`29.
`
`Trustmark remains willing and able to provide claim services to the Plan for
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`the entire term of the ASA.
`
`30.
`
`As a direct result of BOC’s breach of the ASA’s term and termination
`
`provisions and the covenant of good faith and fair dealing, Trustmark has been
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`damaged in the amount of $705,923.00.
`
`COUNT II AGAINST BOC
`PLEADING IN THE ALTERNATIVE
`
`EQUITABLE ESTOPPEL
`
`
`
`31.
`
`Trustmark restates, realleges and incorporates its allegations set out in
`
`paragraphs 1 through 27 as if fully set forth herein.
`
`32.
`
`
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`BOC, through IOA, solicited proposals for claims services and stop loss
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`coverage from Trustmark for its Plan effective July 1, 2021, accepted Trustmark’s
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`proposal and subsequently had its Human Resources Director Melissia Rusk sign
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`the ASA for a three (3) year term at discounted rate, knowing full well that Ms. Rusk
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`was not authorized to sign the ASA and could not validly bind BOC.
`
`33.
`
`
`
`Trustmark, in executing the ASA and providing claims administration
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`services to BOC, relied on the representations of BOC and IOA as well as MSI, that
`
`Ms. Rusk was duly authorized to sign the ASA and bind BOC for a three year term.
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`34.
`
`BOC, in concealing the lack of authorization of Ms. Rusk to sign the ASA and
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`bind BOC, expected Trustmark to provide claims administration services to BOC,
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`and do so at a discounted rate with an annual wellness credit given the three year
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`term of the agreement.
`
`35.
`
`Allowing BOC to terminate the ASA in breach of its provisions, claiming it
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`is unenforceable, prejudices Trustmark, causing damages in the amount of $705,923.
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`COUNT III AGAINST BOC
`PLEADING IN THE ALTERNATIVE
`
`FRAUDULENT MISREPRESENTATION, FRAUD IN THE INDUCEMENT
`
`36.
`
`Trustmark restates, realleges and incorporates its allegations set out in
`
`paragraphs 1 through 27 as if fully set forth herein.
`
`37.
`
`
`
`BOC, through IOA, solicited proposals for claims services and stop loss
`
`coverage from Trustmark for its Plan effective July 1, 2021, accepted Trustmark’s
`
`proposal and subsequently had its Human Resources Director Melissia Rusk sign
`
`the ASA for a three (3) year term at a discounted rate, knowing full well that Ms.
`
`Rusk was not authorized to sign the ASA and could not validly bind BOC.
`
`38.
`
`
`
`Trustmark, in executing the ASA and providing claims administration
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`services to BOC, relied on the representations of BOC and MSI, that Ms. Rusk was
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`duly authorized to sign the ASA and bind BOC for a three (3) year term.
`
`39.
`
`BOC, in concealing the lack of authorization of Ms. Rusk to sign the ASA and
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`bind BOC, intended to induce Trustmark to enter into a relationship it would be able
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`to terminate at will without repercussion with Trustmark providing claims
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`administration services to BOC, and do so at a discounted rate with an annual
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`wellness credit given the pretended three year term of the agreement.
`
`40.
`
`As a result of its reliance on Ms. Rusk’s pretended authorization to bind BOC,
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`Trustmark is damaged in the amount of $705,923.00.
`
` COUNT IV AGAINST BOC, MSI and BIDWELL
`PLEADING IN THE ALTERNATIVE
`
`NEGLIGENT MISREPRESENTATION
`
`41.
`
`Trustmark restates, realleges and incorporates its allegations set out in
`
`paragraphs 1 through 27 as if fully set forth herein.
`
`42.
`
`
`
`BOC, through IOA, solicited proposals for claims services and stop loss
`
`coverage from Trustmark for its Plan effective July 1, 2021, accepted Trustmark’s
`
`proposal and subsequently had its Human Resources Director Melissia Rusk sign
`
`the ASA for a three (3) year term at discounted rate with reckless disregard to
`
`ensuring that Ms. Rusk was properly authorized to sign the ASA and validly bind
`
`BOC.
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`
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`43.
`
`
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`Trustmark, in executing the ASA and providing claims administration
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`services to BOC, relied on the representations of BOC, MSI and Bidwell, that Ms.
`
`Rusk was duly authorized to sign the ASA and bind BOC for a three year term.
`
`44.
`
`BOC, while recklessly failing to ensure that Ms. Rusk was properly authorized
`
`to sign the ASA and bind BOC, intended to induce Trustmark to enter into a
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`relationship and provide claims administration services to BOC, and do so at a
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`discounted rate with an annual wellness credit given the three (3) year term of the
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`agreement.
`
`45.
`
`MSI, while recklessly failing to ensure that BOC entered into a binding
`
`agreement, intended to induce Trustmark to enter into a relationship and provide
`
`claims administration services to BOC in an effort to obtain commission payments.
`
`46.
`
`Bidwell, while recklessly failing to ensure that BOC entered into a binding
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`agreement, intended to induce Trustmark to enter into a relationship and provide
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`claims administration services to BOC in an effort to obtain commission payments.
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`47.
`
`BOC, MSI and Bidwell, given its and his lengthy relationship with BOC, had
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`superior knowledge of the procedures regarding the signing of binding contracts for
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`Georgia counties, and thus, owed a duty to Trustmark to communicate accurate
`
`information, including the lack of authorization on the part of Ms. Rusk to bind BOC.
`
`48.
`
`As a result of its reliance on Ms. Rusk’s pretended authorization to bind BOC,
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`Trustmark is damaged in the amount of $705,923.00.
`
`COUNT V AGAINST MSI and BIDWELL
`PLEADING IN THE ALTERNATIVE
`
`NEGLIGENCE
`
`49.
`
`Trustmark restates, realleges and incorporates its allegations set out in
`
`paragraphs 1 through 27 as if fully set forth herein.
`
`50.
`
`
`
`BOC, through IOA, solicited proposals for claims services and stop loss
`
`coverage from Trustmark for its Plan effective July 1, 2021, accepted Trustmark’s
`
`proposal and subsequently had its Human Resources Director Melissia Rusk sign
`
`the ASA for a three (3) year term at discounted rate with reckless disregard to
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`ensuring that Ms. Rusk was properly authorized to sign the ASA and validly bind
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`BOC.
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`51.
`
`
`
`Trustmark, in executing the ASA and providing claims administration
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`services to BOC, relied on the representations of MSI, that it had obtained a binding
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`signature for a three (3) year term from BOC when it provided Trustmark with the
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`ASA signed by Ms. Rusk.
`
`52.
`
`Trustmark, in executing the ASA and providing claims administration
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`services to BOC, relied on the representations of Bidwell, that he had obtained a
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`binding signature for a three (3) year term from BOC when he provided Trustmark
`
`with the ASA signed by Ms. Rusk.
`
`53.
`
`MSI, while recklessly failing to ensure that BOC entered into a binding
`
`agreement, intended to induce Trustmark to enter into a relationship and provide
`
`claims administration services to BOC in an effort to obtain commission payments.
`
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`54.
`
`Bidwell, while recklessly failing to ensure that BOC entered into a binding
`
`agreement, intended to induce Trustmark to enter into a relationship and provide
`
`claims administration services to BOC in an effort to obtain commission payments.
`
`55.
`
`MSI, given its lengthy relationship with BOC, had superior knowledge of the
`
`procedures regarding the signing of binding contracts for Georgia counties, and thus,
`
`owed a duty to Trustmark to communicate accurate information, including the lack
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`of authorization on the part of Ms. Rusk to bind BOC.
`
`56.
`
`Bidwell, given his lengthy relationship with BOC, had superior knowledge of
`
`the procedures regarding the signing of binding contracts for Georgia counties, and
`
`thus, owed a duty to Trustmark to communicate accurate information, including the
`
`lack of authorization on the part of Ms. Rusk to bind BOC.
`
`57.
`
`MSI breached its duty of care in failing to ensure that a binding agreement
`
`between BOC and Trustmark was achieved while being fully aware that Trustmark
`
`relied upon the terms of the ASA.
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`58.
`
`Bidwell breached his duty of care in failing to ensure that a binding agreement
`
`between BOC and Trustmark was achieved while being fully aware that Trustmark
`
`relied upon the terms of the ASA.
`
`59.
`
`As a result of its reliance on MSI’s and Bidwell’s actions, omissions and
`
`representations, Trustmark is damaged in the amount of $705,923.00.
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`PRAYER FOR RELIEF
`
`WHEREFORE, Plaintiff Trustmark Health Benefits, Inc. requests judgment
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`against Defendants as follows:
`
`(1) Find and hold the Administrative Services Agreement valid and
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`enforceable, requiring Defendant Walton County Board of Commissioners
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`to honor its terms and duration;
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`(2) In the alternative, find and hold that Defendant Walton County Board of
`
`Commissioners breached the terms of the Administrative Services
`
`Agreement and awarding Trustmark compensatory and consequential
`
`damages;
`
`(3) In the alternative, find and hold that Defendant Walton County Board of
`
`Commissioners are equitably estopped from taking advantage of Ms.
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`Rusk’s lack of authorization to enter into a binding agreement, requiring
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`Defendant Walton County Board of Commissioners to honor its terms and
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`duration;
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`(4) Find and hold that Defendants Walton County Board of Commissioners,
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`MSI Benefits Group and Matthew S. Bidwell fraudulently and/or
`
`negligently misrepresented material facts and/or, as to MSI Benefits Group
`
`and Matthew S. Bidwell, breached their respective duty of care towards
`
`Trustmark, awarding Trustmark compensatory and consequential
`
`damages;
`
`(5) Awarding Trustmark punitive damages;
`
`(6) Awarding Trustmark attorneys’ fees for having to commence this action
`
`as well as the costs of this action;
`
`(7) Awarding such other and further relief as may be just and equitable.
`
`Respectfully submitted this 23rd day of June, 2022.
`
`
`
`
`3348 Peachtree Road, NE
`Suite 1400
`Atlanta, GA 30326
`470-419-6650 (telephone)
`470-419-6651 (facsimile)
`eleanor.jolley@wilsonelser.com
`
`WILSON ELSER MOSKOWITZ
`EDELMAN & DICKER, LLP
`
`/s/ Eleanor G. Jolley
`Eleanor G. Jolley
`GA Bar No. 602577
`
`Counsel for Plaintiff
`
`
`
`272313435v.1
`
`20
`
`
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