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.

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.

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.

$1.4 billion recovered. 878 investigations closed. And that was just the warm-up. On January 15, 2026, the DOL announced a wholesale shift of enforcement resources directly toward self-funded health plans, TPAs, and the fiduciaries who oversee them.

The voluntary benefits lawsuits weren't about accident insurance. They were about the process. The same procedural prudence framework is now being applied to healthcare benefits.

A nonprofit prevailed against the DOL in one of the first health plan excessive-fee cases. Here's exactly how they did it, and why it matters for every self-funded plan fiduciary in 2026.

Benefit consultants and brokers face fiduciary liability after Schlichter names Gallagher, Mercer, Lockton, and WTW in ERISA suits. The 401(k) playbook has come to healthcare consulting.

Between 2010 and 2024, the number of registered broker-dealers dropped by 30%. The same regulatory pattern is now coming for benefits brokers, and the early-adopter advantage is real.

On December 23, 2025, Schlichter Bogard LLC filed lawsuits against major employers and their consultants, alleging workers paid premiums up to 600% above market rates for voluntary benefits.

ERISA class-action litigation is accelerating, putting retirement plan sponsors and fiduciaries under unprecedented pressure. Explore how recent court decisions, rising settlements, and proposed legislative reforms impact retirement plans, and what fiduciaries can do now to protect participants, reduce risk, and build a defensible governance framework.

Courts are applying the same fiduciary standards used in 401(k) fee litigation to health plans.

Fiduciaries need the people, process, and technology to ensure plan oversight. After nearly a decade of litigation, Aetna Life Insurance Company and OptumHealth Care Solutions have agreed to pay $8.4 million to settle allegations that they concealed administrative fees inside claims using so-called “dummy codes.” 🚩 Allegations Plaintiff Sandra Peters argued that Aetna and Optum: Directed providers to submit claims with “Administrative Add-On Services.” Masked Optum’s adminis

2020 was a landmark year in healthcare – and not just because of Covid-19. Over the last 18 months, multiple government agencies have sought to hold large insurers accountable in court for alleged wrongdoing. On March 26th, 2020, the Department of Justice sued Anthem in the Southern District of New York, alleging that Anthem up-coded diagnoses submitted to the government to increase their reimbursement rate for Medicare Part C plans. The lawsuit alleges that, in addition to h

Georgia's insurance commissioner has fined Blue Cross Blue Shield $5 million for violations of state laws and agency rules and regulations, the commissioner's office said March 29. Below is the statement of the Insurance and Safety Fire Commissioner, John F. King - “As Georgia’s Insurance Commissioner, my number one priority is protecting Georgia consumers,” said Commissioner King. “To that end, after numerous complaints made to our office regarding the operations of Blue Cro

A Miami physician’s six-year, $38 million health care fraud scheme paid for luxury cars and beachfront condominiums, prosecutors say. But 63-year-old Armando Valdes won’t be doing any driving where he’ll be living next—and the accommodations are sure to be a step down. That’s because on Tuesday, a judge sentenced him to five years in federal prison after a guilty plea earlier this year. According to the U.S. Department of Justice, Valdes owned and operated Miami-based Gasiel