A court-unsealed expert report in Comau v. BCBSM exposed $8.1M unreconciled and $7.3M overpayments. What it reveals about every self-funded plan’s blind spot.

The next “401(k) fee crisis” will not be about retirement plans. It is happening in healthcare. Courts are applying the fiduciary standards from 401(k) fee litigation to self-funded health plans, where hidden costs are buried in ASO, PBM, and Stop-Loss contracts. Learn where these fees hide and how to protect your plan.

Aetna has issued a 60-day notice asking plan sponsors to authorize it to control litigation decisions for their plan. Self-funded plan sponsors should review and opt out by the July 30, 2026 deadline.

A landmark Blue Health Intelligence analysis quantifies AI-driven upcoding in employer plans. For self-funded fiduciaries, it is a direct hit to plan assets and a fiduciary wake-up call.

CAA 2026, the DOL's enforcement overhaul, and Schlichter's expanding litigation campaign have shifted the ground beneath every self-funded health plan fiduciary. Here is what to do now.

Most plan sponsors ask how much they will save. Their ERISA counsel should be asking whether the vendor's percentage-of-savings compensation creates a prohibited transaction under Section 406. Here is the legal argument, the Post-Pay contingency gap, and why a fixed per-claim fee model is structurally immune.

Your TPA's contractual 'guarantees' of payment accuracy may be worth far less than the paper they're printed on. The Sixth Circuit's Tiara Yachts ruling, combined with EBSA's $1.4B in FY 2025 recoveries, tells a clear story: fiduciary duty cannot be satisfied by self-reported metrics from the same vendor processing your claims.

99% accuracy claimed. 1.4% errors admitted. Millions missing. UnitedHealthcare recovered $922M for self-funded clients in 2022, and kept up to 35% of those dollars. The Aetna/Optum 'dummy code' settlement. Cross-plan offsetting. Spread pricing. Here's what carrier self-reporting actually looks like.

The era of passive plan oversight is over. Schlichter's 4-suit December 2025 dump, the Supreme Court's Cunningham decision, the Sixth Circuit's Tiara Yachts ruling, and the CAA 2026 PBM reforms together create a perfect storm of fiduciary risk. Here's what every self-funded plan fiduciary must know.

Every year, self-funded health plan fiduciaries are handed a legal contradiction. ERISA holds them personally liable for billions in plan assets. Yet the TPAs who actually pay those claims routinely deny access to the data required to validate that spending. A fiduciary cannot prudently oversee what it cannot see.

The January 2026 issue of The Self-Insurer makes one thing clear: 'fiduciary' is no longer a formality buried in plan documents — it's a market force reshaping vendor relationships, compressing margins, and raising expectations for transparency and performance.

On December 23, 2025, Schlichter Bogard LLC — the firm that extracted billions from 401(k) plan fiduciaries — filed four simultaneous ERISA class actions targeting major employers and their benefits consultants. The 401(k) playbook is now targeting healthcare benefits.