Cross-plan offsetting costs self-funded plans millions in hidden fees. Learn how bulk recovery practices create fiduciary risks and what sponsors can do.

For many plan sponsors, the word “audit” suggests penalties or after-the-fact corrections. In reality, independent claims reviews are about prevention, transparency, and protecting plan assets — not punishment. 

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.

Benefits committees are becoming essential to ERISA compliance for self-funded health plans. Learn why structured oversight of vendors, fees, claims accuracy, and data transparency is a fiduciary imperative—and how benefits committees strengthen governance, reduce risk, and protect plan participants.

The next “401(k) fee crisis” won’t be about retirement plans — it’s happening in healthcare. Self-funded plan sponsors face a wave of hidden costs buried in ASO, PBM, and stop-loss contracts. What appears to be routine administration often masks charges that drain plan assets and compromise compliance.

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.

The carrier controls claim audits. Claim reviews are fiduciary responsibilities under ERISA. Understand why reviews are crucial for safeguarding plan assets. Audits offer a snapshot of a carrier’s operations. Reviews are your fiduciary duty under ERISA. Fiduciaries must understand the difference to protect plan assets.

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 unfolds, fiduciaries face a critical opportunity to align contracts with their ERISA duty: act solely in the interest of participants and prudently manage plan assets

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!

Excited to see Employee Benefit News  highlighting Stephen Carrabba , ClaimInformatics, Inc. , and Jamie Greenleaf, AIF, CBFA, C(k)P,...

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).

Florida Women's Care, one of the largest women’s health providers in the state, revealed troubling allegations of systematic overbilling and upcoding designed to pad private equity profits. These practices come at a steep cost to patients and health plans.

Fiduciaries need the people, process, and technology to ensure plan oversight. After nearly a decade of litigation , Aetna Life Insurance...

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