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.

ERISA vs PHSA health plan compliance is one of the most common, and most misunderstood, regulatory challenges facing employer-sponsored health plans. This guide breaks down the key differences in coverage, fiduciary duties, and compliance obligations for private employers and public entities.

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.

Major networks are finally shifting on data sharing. The excuses are gone. It is the employer’s fiduciary responsibility to demand access. If a carrier or vendor refuses, and the pattern continues, you must replace them because their obstruction causes you to breach your fiduciary obligations.

At ClaimInformatics, we help plan sponsors identify hidden fiduciary risks. Before your renewal, we are offering a complimentary ASO Agreement and SPD Analysis, valued at $5,000, to the first 15 self-funded entities who schedule a call this month.

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

When claim administrators audit their own networks, conflicts arise. Independent payment integrity ensures ERISA and CAA compliance, protecting plan sponsors, members, and fiduciary accountability.

As renewal season approaches, fiduciaries should carefully review contract terms and challenge “mandatory” payment integrity programs that shift costs back onto plans. If you’re being asked to pay to fix what you’ve already paid for, the time to push back is NOW!

Today, self-funded health plans are entering that same era of scrutiny. Just as 401(k) plan sponsors had to adapt to fiduciary standards, employers offering self-funded healthcare must now comply with ERISA and new mandates under the Consolidated Appropriations Act (CAA 2021). Those who fail to evolve risk legal action, regulatory enforcement, and financial harm to both the plan and its participants.

At ClaimInformatics, ClaimIntelligence™ delivers payment integrity across Pre-Pay and Post-Pay, with PAIR™ for historical lookback and Ongoing Monitoring of new claims, while FOCUS™ provides the fiduciary oversight layer, including CLEAR™ contract review, to help plan fiduciaries safeguard participant assets, enforce SPD protections, and achieve ERISA and CAA compliance.

Without transparency and access to THEIR data, plan sponsors risk breaching fiduciary duty under ERISA and the CAA. The 2025 Pulse of the Purchaser Survey confirms what many of us already know: affordability threats are not easing. For the fifth straight year, employers rank drug prices, hospital costs, and high-cost claims as the top drivers of unsustainable healthcare spending For self-funded plans, these challenges bring heightened fiduciary obligations. According to the