The 1944 Public Health Service Act covers publicly sponsored health plans by public entities and the federal government. ERISA vs PHSA Health Plan Compliance ERISA vs PHSA health plan compliance  is one of the most common—and most misunderstood—regulatory challenges facing today’s employer-sponsored health plans. Whether you manage benefits for a private employer with a large workforce or a public entity such as a university serving thousands of students and staff, federal re

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 & 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, our FOCUS™ platform (Fiduciary Oversight, Compliance, and Utilization Safeguard)—powered by PAIR™ technology, Ongoing Monitoring, Pre-Pay Payment integrity and Recovery Services, and advanced analytics helps plan fiduciaries safeguard participant assets, enforce SPD protections, and achieve compliance with ERISA and the Consolidated Appropriations Act (CAA).

Without transparency and access to THEIR data, plan sponsors risk breaching fiduciary duty under ERISA and the CAA. The 2025 Pulse of the...