IMPORTANT ANNOUNCEMENT ABOUT THE
MSES CONSULTANTS, INC. EMPLOYEE HEALTH PLAN
On December 12, 2024, a settlement was reached by the United States Department of Labor (“DOL”) with Lawrence Rine and the MSES Consultants, Inc. Employee Health Plan (the “Plan”). As part of the settlement, Examination Resources, LLC was appointed as the independent fiduciary (“Fiduciary”) by the United States District Court for the Northern District of West Virginia (the “Court”) to resolve unpaid claims in accordance with the Consent Judgement and Order in the case (available for download HERE and below) and ERISA.
What does it mean for beneficiaries of the Plan and medical providers of services to the Plan?
The Fiduciary was appointed by the Court to resolve legitimate claims presented to the Plan during the tenure of Lawrence Rine of MSES Consultants, Inc., which covers the from July 1, 2016, and October 31, 2016 (“Rine Tenure”). The claims presented during the Rine Tenure are referred to throughout this website as the “Unpaid Claims.” The Fiduciary will use all reasonable efforts to identify all Unpaid Claims and subject to a potential adjustment based upon the amount of funds available for payment.
How is the Fiduciary identifying unpaid claims of beneficiaries and medical providers of services?
The Fiduciary is collecting information about unpaid claims from the former administrator. In addition, the Fiduciary will send a proof of claim document (“POC”) to beneficiaries and medical providers who received or provided services under the Plan where it appears that a legitimate claim was presented to the Plan during the Rine Tenure but the records are insufficient. The POC is available for download at this LINK and at the link at the bottom of the page.
What should I do?
The Fiduciary has created frequently asked questions for former beneficiaries and medical providers who provided medical services at the links below. The questions and answers cover the Fiduciary’s process for identifying and verifying unpaid claims and instructions on how to complete a proof of claim. All documents referenced above, including the beneficiary and medical provider proofs of claim, are available for download through the links at the bottom of this page.
Frequently Asked Questions for Beneficiaries
RESPONSE: The Fiduciary was appointed by the Court to resolve legitimate claims presented to the Plan during the tenure of Lawrence Rine as Secretary of MSES Consultants, Inc., which covers the from January 1, 2016, and October 31, 2016 (“Rine Tenure”). The claims presented during the Rine Tenure are referred to throughout this website as the “Unpaid Claims”.
RESPONSE: Yes, the Fiduciary will use all reasonable efforts to identify all Unpaid Claims and subject to a potential adjustment based upon the amount of funds available for payment.
RESPONSE: In most cases, the Fiduciary will contact you. The Fiduciary intends to work with the previous Plan manager and administrator to identify claims and the associated providers. The Fiduciary will outreach to all providers identified in the records whose claims were adjudicated or presented for adjudication within the time described in FAQ 1.
RESPONSE: You should file a proof of claim if you receive a Proof of Claim form from the Fiduciary. Instructions for filing the Proof of Claim will be sent along with the Proof of Claim form.
RESPONSE: Yes, if you paid an Unpaid Claim and were not previously reimbursed.
NOTE: Any payments for Unpaid Claims will be net of associated cost share, if any.
RESPONSE: The Fiduciary intends to make payments on or before September 17, 2025, from the total amount of funds available to the Fiduciary for the purpose of paying Unpaid Claims.
RESPONSE: Yes, the Fiduciary intends to update the website it established for this matter when there are material developments or changes to any important information such as deadlines.
RESPONSE: You may email garlandscott@examresources.net with any questions.
Frequently Asked Questions for Medical Providers
RESPONSE: The Fiduciary was appointed by the Court to resolve legitimate claims presented to the Plan during the tenure of Lawrence Rine as Secretary of MSES Consultants, Inc., which covers the from January 1, 2016, and October 31, 2016 (“Rine Tenure”). The claims presented during the Rine Tenure are referred to throughout this website as the “Unpaid Claims”.
RESPONSE: Yes, the Fiduciary will use all reasonable efforts to identify all Unpaid Claims and subject to a potential adjustment based upon the amount of funds available for payment.
RESPONSE: In most cases, the Fiduciary will contact you. The Fiduciary intends to work with the previous Plan manager and administrator to identify claims and the associated providers. The Fiduciary will reach out to all providers identified in the records whose claims were adjudicated or presented for adjudication within the time period described in FAQ 1.
RESPONSE: You should file a proof of claim if you receive a Proof of Claim form from the Fiduciary. Instructions for filing the Proof of Claim will be sent along with the Proof of Claim form.
RESPONSE: No. As part of payment of the unpaid claim, the Fiduciary will require the provider to execute a general release, which can be reviewed at this LINK.
NOTE: The Proof of Claim must be postmarked or sent by secure electronic means no later than MARCH 31, 2025. Submission instructions are available at this LINK.
RESPONSE: The Fiduciary intends to make payments on or before September 17, 2025, from the total amount of funds available to the Fiduciary for the purpose of paying Unpaid Claims.
RESPONSE: Yes, the Fiduciary intends to update the website it established for this matter when there are material developments or changes to any important information such as deadlines.
RESPONSE: You may email garlandscott@examresources.net with any questions.
Proof Of Claim Submission
In the submission form below, please provide the submitter’s name and email address, the name of the employer health plan, any additional information or message, then attach a copy of the completed Proof Of Claim form and click SEND to submit. You will receive a confirmation email.